Contact Lens Induced Infections

The primary source of bacterial infections is poor contact lens cleansing regiments & poor hygiene of the patient. Patients who have existing blepharitis or dry eyes are more liable to infections, further complicating the situation. Disposable & frequent replacement contact lenses were developed to combat these problems. Other types of contact lens induced infections include sterile corneal infiltrates, acanthamoebic keratitis, & fungal keratitis.

The most commonly found contact lens induced infections are infectious bacterial keratitis & ulcers that are related to P. aeruginosa. P. aeruginosa keratitis can lead to corneal perforation & ultimate loss of vision. Sterile keratitis is mote common with disposable extended wear lenses, where as infectious keratitis is more common with re-usable extended wear contact lenses.

Sterile corneal infiltrates occur in patients who are sensitive to the preservatives used on contact lens solutions. Symptoms include burning, itching, pain & discharge. Patients should be treated with topical antibiotics & perhaps topical steroids.

Acanathamoebic keratitis is found primarily in those patients who wear soft daily lenses & make their own saline solution. It is also common in people who swim with lenses in. This is because acanthamoeb is a pathogenic protozoan found in contaminated water, soil, dust, or may be airborne. Initially the corneal epithelium is effected. Later the corneal tissue & even the sclera are effected. Treatment can be lengthy & involves a combination of a topical antimoebic, & topical steroids. Prevention including avoiding non-sterile solution & tap water is every patient’s best choice.

Fungal keratitis occurs most often with high water content hydrogel lenses in humid climates. It appears as a superficial gray feathery infiltrate. It is associated with satellite lesions & inflammation. Again prevention with proper lens care is the best medicine.