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Contact lens-associated microbial keratitis
Abstract:
During a 14-year period, 42 cases of microbial keratitis were associated with contact lens (CL) wear. Pseudomonas aeruginosa was isolated in 40% of the cases and Staphylococcus in 31%; Streptococcus pneumoniae, alpha-hemolytic Streptococcus, and Serratia marcescens were the next most commonly isolated pathogens. There was a single fungal corneal ulcer. Bandage CL use was associated with a high prevalence of infection with quasi-commensal organisms and with polymicrobial keratitis, a pattern of disease quite distinct from that induced by other types of CLs. Marked visual loss frequently occurred. There was a disturbing increase in the number of infections associated with extended-wear CLs (worn for either aphakia or myopia) over the last 18 months of the study.
Insights
Contact lens wear is linked to microbial keratitis, with Pseudomonas and Staphylococcus as common causes. Extended wear and bandage contact lens use show distinct infection patterns and risks of vision loss.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Microbial keratitis is a significant cause of vision impairment.
- Contact lens wear is a known risk factor for microbial keratitis.
Purpose of the Study:
- To analyze the trends and causative agents of microbial keratitis associated with contact lens wear over a 14-year period.
- To identify specific risk factors, including bandage and extended-wear contact lenses.
Main Methods:
- Retrospective analysis of 42 microbial keratitis cases linked to contact lens wear.
- Identification of microbial pathogens through laboratory isolation.
Main Results:
- Pseudomonas aeruginosa (40%) and Staphylococcus (31%) were the most frequent pathogens.
- Bandage contact lens use was associated with quasi-commensal organisms and polymicrobial infections.
- A notable increase in infections linked to extended-wear contact lenses was observed.
Conclusions:
- Contact lens-related microbial keratitis presents diverse etiological patterns based on lens type.
- Extended-wear and bandage contact lenses pose unique risks, potentially leading to severe visual outcomes.
- Surveillance and awareness are crucial for preventing contact lens-associated microbial keratitis.