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Orthokeratology associated microbial keratitis
R Shehadeh-Masha'our1, F Segev, I S Barequet
1Bnai Zion Medical Center, Faculty of Medicine Technion, Haifa, Israel.
European Journal of Ophthalmology
|January 6, 2009
Summary
Overnight orthokeratology can lead to microbial keratitis, a serious eye infection. Prompt treatment is crucial, but corneal scarring can impair vision long-term.
Area of Science:
- Ophthalmology
- Microbiology
- Corneal Disease
Background:
- Overnight orthokeratology (ortho-k) is a vision correction method using rigid gas permeable lenses worn during sleep.
- Microbial keratitis is a significant risk associated with contact lens wear, including ortho-k.
Observation:
- This study reports on four cases of microbial keratitis in patients undergoing overnight orthokeratology.
- Patients presented with central or paracentral corneal ulcers and varying visual acuity, from 20/30 to hand motion.
Findings:
- Pseudomonas aeruginosa was identified in all cases, cultured from corneal scrapings or lens storage solutions.
- All infections resolved with intensive topical antimicrobial therapy.
- Despite successful treatment, all patients developed corneal scarring, impacting final best-corrected visual acuity (ranging from 20/25 to 20/200).
Implications:
- Infectious keratitis is a sight-threatening complication of overnight orthokeratology.
- Ophthalmologists and eye care practitioners must recognize this risk and counsel patients on rigorous lens hygiene.
- Early detection and prompt medical intervention are essential to manage ortho-k-associated microbial keratitis and minimize visual sequelae.
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