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Chronic Conjunctivitis From a Retained Contact Lens.

Jawad I Arshad1, Asma Saud, Darrell E White

  • 1Department of Ophthalmology and Visual Sciences (J.I.A., A.S., and R.R.S.), Case Western Reserve University and University Hospitals Eye Institute, Cleveland, OH; Skyvision Centers (D.E.W.), Westlake, OH; and Division of Cornea and Refractive Surgery (N.A.A.), Shiley Eye Institute, University of California San Diego, San Diego, CA.

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|February 7, 2019
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Summary
This summary is machine-generated.

A retained soft contact lens can cause chronic bacterial conjunctivitis. Early diagnosis and removal of the lens, along with targeted antibiotics, are crucial for successful treatment, even with Gram-negative bacteria.

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Area of Science:

  • Ophthalmology
  • Microbiology

Background:

  • Unilateral chronic bacterial conjunctivitis can be recalcitrant to treatment.
  • Retained soft contact lenses are a rare but significant cause of persistent ocular infections.

Observation:

  • Three cases of unilateral recalcitrant chronic bacterial conjunctivitis associated with retained soft contact lenses were identified.
  • Gram-negative bacteria (Pseudomonas aeruginosa, Achromobacter xylosoxidans) and Gram-positive bacteria (Staphylococcus epidermidis) were isolated from the retained lenses.

Findings:

  • Successful treatment involved surgical removal of the retained contact lens and administration of targeted antibiotic eyedrop therapy.
  • Two of the three cases involved Gram-negative bacterial infections, a finding not previously emphasized in literature.

Implications:

  • Clinicians should suspect a retained contact lens in patients with chronic conjunctivitis, especially those with a history of contact lens wear.
  • Thorough ocular examination, including eyelid eversion, is essential for diagnosis.
  • Broad-spectrum antibiotic coverage is recommended due to the potential for Gram-negative pathogens.