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Alternaria and paecilomyces keratitis associated with soft contact lens wear

Elvin H Yildiz1, Haresh Ailani, Kristin M Hammersmith

  • 1Cornea Service, Wills Eye Institute, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.

Cornea
|March 26, 2010
PubMed
Abstract

Insights

Soft contact lens (SCL) wearers developed fungal keratitis from unusual organisms like Alternaria and Paecilomyces. This study highlights the increased risk of atypical fungal infections in SCL users, emphasizing the need for awareness.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Fungal keratitis is a serious eye infection that can lead to vision loss.
  • Soft contact lens (SCL) wear is a known risk factor for microbial keratitis.
  • Unusual fungal organisms are increasingly implicated in SCL-related infections.

Observation:

  • A series of five patients with SCL-related fungal keratitis caused by Alternaria and Paecilomyces were diagnosed in 2008.
  • These cases represented a significant increase compared to previous years, where these organisms were rarely isolated.
  • All patients used specific brands of SCLs and multipurpose contact lens solutions.

Findings:

  • Alternaria was isolated in two cases, and Paecilomyces in three cases of SCL-related fungal keratitis.
  • Treatment involved voriconazole or natamycin, with most patients responding well.
  • Complications included corneal perforation in one patient and a requirement for penetrating keratoplasty in another.

Implications:

  • This case series raises awareness of fungal keratitis caused by less common organisms in SCL wearers.
  • It underscores the importance of considering atypical pathogens in the diagnosis and management of contact lens-related microbial keratitis.
  • Further research into the specific risk factors and preventative measures for SCL-associated fungal keratitis is warranted.

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