Update in management of microbial keratitis associated with contact lenses

The rising prevalence of contact lens wear is associated with increased contact lens-related complications, with one of the most serious being contact lens (CL)-associated microbial keratitis (MK). We describe updated prevention and management strategies of this sight-threatening condition.

Poor contact lens hygiene and practices remain the most common predisposing factors for CL-associated MK. Management currently relies largely on antimicrobial therapy guided by culture data; however, increasing antimicrobial resistance is a worldwide concern. Recent studies show early promise for novel broad-spectrum therapies including cross-linking and rose Bengal-photodynamic therapy, povidone iodine, and antimicrobial peptides.

There has been increased investigation in past years into broad-spectrum nonselective treatments for MK. While these investigations show early promise, prevention of CL-associated MK through education on hygiene practices remains an important healthcare intervention.