Patterns of lens care practices and lens product contamination in contact lens associated microbial keratitis

A prospective study of 24 contact lens patients with culture- or histopathology-proven microbial keratitis was performed between July and December 1987 to determine associated lens care practices and patterns of lens care product contamination. A questionnaire was used to document methods of lens care. Bacterial cultures were performed on all available contact lenses, lens cases, and solutions (including saline, disinfectant, daily cleaner and wetting agents), in addition to standard smears and cultures of the corneal ulcer. Failure to follow standard recommendations regarding contact lens care was widespread (21 of 24, 88%). In the majority of patients (20 of 24, 83%) bacterial contamination of the contact lens, case, and/or solutions was present. Almost two-thirds (15 of 24, 62%) of patients used solutions that were more than 3 months old. Cosmetic extended wear lens patients were most likely (7 of 8, 88%) to use solutions that were more than 3 months old and very likely (6 of 8, 85%) to have contaminated solutions. Efforts to improve lens care and decrease lens product contamination are necessary to prevent contact lens associated corneal ulcers.