Corneal ulcers associated with daily-wear and extended-wear contact lenses

Over a 21-month period, we treated corneal ulcers in 11 patients using daily-wear contact lenses and 29 patients using extended-wear contact lenses. Since more patients use daily-wear than extended-wear lenses, this suggests that patients using extended-wear lenses are at greater risk for the development of corneal ulcers. Positive bacterial cultures were obtained from the corneal scrapings of nine of 11 patients using daily-wear lenses and 20 of 29 patients using extended-wear lenses. In the daily-wear group, all 11 patients failed to exercise satisfactory care in using and disinfecting their contact lenses: three did not wash their hands before manipulating the contact lenses, eight wore them overnight, two did not use any disinfecting system, and four had contaminated contact lens cases, solutions, or drops. In the extended-wear group, 17 patients failed to exercise satisfactory care in using and disinfecting their contact lenses: 12 had contaminated contact lens care systems, two did not use any disinfection system, five reported not washing their hands before contact lens manipulation, and two disinfected their contact lenses at intervals of more than a month. We were unable to identify any defect in the way 12 patients took care of their extended-wear lenses, suggesting that there may be a problem with these contact lenses even when care is satisfactory.