ABSTRACT
PURPOSE: To describe a case of bilateral corneal ulcers caused by Pseudomonas in a disposable soft contact lens wearer. This case study discusses the role of patient examination, contact lens care instruction, and adequate patient supervision in reducing the risk of serious potential complications. METHODS AND RESULTS: A 17 year old student who had been using disposable soft contact lenses on an extended wear basis for 6 months presented complaining of pain in the left eye. When he was examined, a corneal ulcer with surrounding infiltrate was observed in the superior middle periphery of the left eye. Samples were collected for culture, and treatment with fortified cefalotin and gentamicin was started. After 8 hours the patient returned, now complaining of pain in the right eye. Examination of the right eye revealed a diffused keratitis with a mucopurulent discharge. A culture was taken, and the same treatment was instituted. The laboratory tests revealed Pseudomonas in both eyes. The bilateral corneal ulcers responded to therapy after 1 week of treatment. CONCLUSIONS: We discuss the factors involved in the occurrence of infectious keratitis in contact lens wearers, and stress that even disposable contact lens wear can be associated with serious complications. This case also highlights extended wear as one of the main risk factors for complications in disposable soft contact lens wear.
Subject(s)
Contact Lenses, Hydrophilic/adverse effects , Cornea/microbiology , Corneal Ulcer/microbiology , Disposable Equipment/microbiology , Eye Infections, Bacterial , Pseudomonas Infections , Pseudomonas aeruginosa/isolation & purification , Adolescent , Cephalosporins/therapeutic use , Cephalothin/therapeutic use , Contact Lenses, Hydrophilic/microbiology , Cornea/pathology , Corneal Ulcer/diagnosis , Corneal Ulcer/drug therapy , Drug Therapy, Combination/therapeutic use , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/etiology , Follow-Up Studies , Gentamicins/therapeutic use , Humans , Male , Ophthalmic Solutions/therapeutic use , Patient Education as Topic , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Pseudomonas Infections/etiologyABSTRACT
PURPOSE: The objective of this study was to analyze prospectively the continuous use of disposable contact lenses. METHODS: We conducted a clinical study of extended wear of disposable contact lenses for a period of 7 days and 6 nights by 25 patients during a 90-day period. Factors such as visual acuity, keratometry, complications, and contamination were analyzed. RESULTS: Visual acuity and keratometry measurements did not present significant alterations during the study. Complications related to the use of disposable contact lenses were not observed. Analysis of cultures did not present any significant microbiological alterations due to contact lens use. All of the patients were satisfied with the wear schedule and considered the Acuvue lenses comfortable. CONCLUSIONS: Our results may be useful in increasing the level of acceptance of extended wear of disposable contact lenses in Brazil.
Subject(s)
Contact Lenses/statistics & numerical data , Disposable Equipment/statistics & numerical data , Adult , Brazil , Contact Lenses/adverse effects , Cornea/pathology , Equipment Contamination , Female , Humans , Male , Patient Satisfaction , Prospective Studies , Visual AcuityABSTRACT
We prospectively analyzed bacterial contamination in 15 soft contact lens wearing subjects. Contact lenses, cases, tips of saline solution bottles, and conjunctiva were cultured. Cultures were positive for 13 subjects (86.6%). Contamination was present in 13 contact lens cases (86.6%), 12 contact lenses (80.0%), nine saline solution bottles (60.0%), and in the conjunctiva of three patients (20.0%). Gram-negative bacteria (Pseudomonas aeruginosa and Proteus mirabilis) were the most frequently isolated organisms. Staphylococcus aureus was the only gram-positive organism isolated. We discuss the possible sources of contamination, and emphasize the importance of contact lens care instruction.
