scholarly journals Contact Lens-Associated Infectious Keratitis: Update on Diagnosis and Therapy

2021 ◽  
Author(s):  
Jimena Alamillo-Velazquez ◽  
Raul E. Ruiz-Lozano ◽  
Julio C. Hernandez-Camarena ◽  
Alejandro Rodriguez-Garcia

The focus of this chapter is to review the most recent advances in the diagnosis and treatment of contact-lens-related infectious keratitis, the most sight-threatening complication of contact lens wear. In the last decades, contact lenses technology has confronted several challenges, including the need for safer and more comfortable polymer materials. The development of high coefficient oxygen permeability (Dkt) and low-water content disposable contact lens translated into a significant improvement in ocular discomfort related to dry eye and allergic reactions, decreasing biofilm build-up on the external surface of the lens. Additionally, the emergence and boom-effect of corneal refractive surgery have also driven the development of better contact lens manufacturing. Despite these substantial technological advances, contact lens users continue to be at risk for developing corneal infections. We describe recent epidemiologic data, and advances in understanding the complex pathogenesis of the disease, including the clinical characteristics of the infectious process produced by bacteria, fungi, and protozoans. Finally, the recent development of diagnostic techniques and therapeutic regimens are discussed.

2018 ◽  
Vol 2 (2) ◽  
pp. e14-e21
Author(s):  
Melissa Barnett ◽  
Jonathon Ross ◽  
Blythe Durbin-Johnson

Abstract Objectives: The purpose of this study was to evaluate the performance (i.e. vision, comfort and fit) of spherical and front-surface toric scleral lenses in subjects with regular, healthy corneas. Methods: Scleral lenses were fitin the eyes (n = 16) of healthy subjects (n = 9) with regular corneas, absent of pathology, and studied using an observational, multi-visit design. Lens fit was objectively evaluatedby an experienced practitioner.Following 1 month of successful lens wear, participants completedsubjective satisfaction surveys regarding the scleral lens wearing experience. Results:  According to participant surveys, scleral lenses were subjectively preferred over soft toric or gas permeable contact lenses in 88% of eyes, including in all eyes fit with a front-surface toric scleral lens (n = 3). Seventy-five percent (75%) of eyes achieved visual acuity of 0.1 logMAR or better, while all eyes with prior spectacle wear achieved visual acuity with a scleral lens within 1 Snellen line of spectacle correction. Seventy-five percent (75%) of eyes achieved good subjective comfort with a scleral lens. No participants reported poor subjective vision and/or comfort. Conclusions:  Our findings suggest that subjects preferred the performance of a scleral lens (spherical or front-surface toric) compared to a soft toric or gas permeable contact lens. Moreover, scleral lenses may provide a viable, alternative contact lens modality option for patients considering discontinuation of traditional soft toric and/or rigid contact lens wear; so long as the factors associated with hypoxia remain minimized. Key Words:  scleral lens; scleral contact lens; front-surface toric scleral lens; lens performance; normal eyes; healthy eyes


2018 ◽  
Vol 41 ◽  
pp. S41
Author(s):  
Samuele Tosatti ◽  
Olof Sterner ◽  
Rudolf Aeschlimann ◽  
Stefan Zuercher ◽  
Charles Scales ◽  
...  

2020 ◽  
Vol 5 (1) ◽  
pp. e000476
Author(s):  
Anna Stellwagen ◽  
Cheryl MacGregor ◽  
Roger Kung ◽  
Aristides Konstantopoulos ◽  
Parwez Hossain

ObjectiveMicrobial keratitis is a sight-threatening complication of contact lens wear, which affects thousands of patients and causes a significant burden on healthcare services. This study aims to identify compliance with contact lens care recommendations and identify personal hygiene risk factors in patients who develop contact lens-related microbial keratitis.Methods and analysisA case–control study was conducted at the University Hospital Southampton Eye Casualty from October to December 2015. Two participant groups were recruited: cases were contact lens wearers presenting with microbial keratitis and controls were contact lens wearers without infection. Participants underwent face-to-face interviews to identify lens wear practices, including lens type, hours of wear, personal hygiene and sleeping and showering in lenses. Univariate and multivariate regression models were used to compare groups.Results37 cases and 41 controls were identified. Showering in contact lenses was identified as the greatest risk factor (OR, 3.1; 95% CI, 1.2 to 8.5; p=0.03), with showering daily in lenses compared with never, increasing the risk of microbial keratitis by over seven times (OR, 7.1; 95% CI, 2.1 to 24.6; p=0.002). Other risks included sleeping in lenses (OR, 3.1; 95% CI, 1.1 to 8.6; p=0.026), and being aged 25–39 (OR, 6.38; 95% CI, 1.56 to 26.10; p=0.010) and 40–54 (OR, 4.00; 95% CI 0.96 to 16.61; p=0.056).ConclusionThe greatest personal hygiene risk factor for contact lens-related microbial keratitis was showering while wearing lenses, with an OR of 3.1, which increased to 7.1 if patients showered daily in lenses. The OR for sleeping in lenses was 3.1, and the most at-risk age group was 25–54.


2008 ◽  
Vol 34 (2) ◽  
pp. 122-123 ◽  
Author(s):  
Vishal Jhanji ◽  
Namrata Sharma ◽  
Tushar Agarwal ◽  
Jeewan S. Titiyal

2011 ◽  
Vol 52 (5) ◽  
pp. 2175 ◽  
Author(s):  
Qi Chen ◽  
Jianhua Wang ◽  
Meixiao Shen ◽  
Lele Cui ◽  
Chunyan Cai ◽  
...  

2019 ◽  
Author(s):  
Motohiro Itoi ◽  
Koji Kitazawa ◽  
Hisayo Higashihara ◽  
Chie Sotozono

AbstractPurposeTo evaluate the impact of removal of rigid gas-permeable (RGP) contact lenses on the anterior and posterior cornea surfaces of eyes with keratoconus.MethodsEight eyes of 8 patients with keratoconus (KC) (age 34.3 ± 15.3 years; range 19–60 years) were enrolled. Anterior segment optical coherence tomography (AS-OCT) was performed at 1, 5, 10, 20, and 60 minutes after the patients removed their RGP contact lenses. Measurements included anterior and posterior best-fit sphere (BFS); elevation values and corneal surface areas; corneal thickness at the thinnest point; and the anterior-posterior ratio of the corneal surface (As/Ps) between 1 minute and 60 minutes after RGP contact lens removal.ResultsAnterior and posterior elevation values and corneal surface areas showed significant increases, whereas anterior and posterior BFS and central corneal thickness decreased significantly (P < 0.01) between 1 minute and 60 minutes after RGP contact lens removal. No statistically significant differences were found in the As/Ps ratio during the first hour after suspending RGP contact lens wear.ConclusionsWe found that the patients with keratoconus experienced significant changes in both the anterior and posterior corneal shape for 60 minutes after removal of RGP contact lenses.


2013 ◽  
Vol 1 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Farihah Tariq ◽  
Peter Koay

Contact lenses are lenses placed on the surface of the cornea to correct refractive errors such as myopia (short-sightedness), hyper­metropia (far-sightedness) and astigmatism. Lens-related complications are becoming a greater health concern as increasing number of individuals are using them as an alternative to spectacles. Contact lenses alter the natural ocular environment and reduce the efficacy of the innate defences. Although many complications are minor, microbial keratitis is potentially blinding and suspected cases should be rapidly diagnosed and referred to an ophthalmologist for treatment. Several risk factors have been identified with extended wear, poor hand hygiene, inadequate lens and lens-case care being the most significant. Promotion of good contact lens hygiene and practices are essential to reduce the adverse effects of contact lens wear.


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