Considerations in Contact Lens Use Under Adverse Conditions Proceedings of a Symposium (1991) / Chapter Skim
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Adverse Reactions Associated With Contact Lens Use
Adverse Reactions Associated With Contact Lens Use
Pages 58-67
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This usually takes the form of microbial keratitis (Figure 2~. Although extended-wear contact lenses are singled out in Figure 2, the rationale shown here applies equally to daily-wear lenses.
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About 13 percent of the commercial lens care products were also contaminated, and 12 out of 12 homemade saline solutions were culture positive, including 2 with acanthamoeba. This contamination was seen with all lens types, with all wearing patterns, and in patients who followed recommended procedures.
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Thomas John)
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However, the scar in his corneal stroma extends into the visual access, and he is miserable under brightly lit conditions. Unfortunately, despite widespread publicity concerning contact lens infections, there are still severe cases.
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62 OLIVER SCHEIN FIGURE 4 Peripheral staphylococcal comeal ulcer associated with cosmetic soft contact lens wear. FIGURE 5 Six months after treatment for contact-lens-associated infection with paracentral scar.
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Chart 1 presents the microbiology of cases of lens-associated microbial keratitis that we reviewed over a 4-year period at the Massachusetts Eye and Ear Infirmary. During this time contact-lens-related ulcers accounted for about 30 to 40 percent of all cases of corneal ulceration.
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Considering only the lenses used for cosmetic purposes, they are mostly gramnegative, and almost all of them are pseudomonas. DIAGNOSIS AND THERAPY Diagnosis is based on clinical presentation wherein all infiltrates underlying an epithelial ulceration are presumed microbial.
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I sense, however, that what is really important not just from the military perspective but from the civilian perspective as well is some concept of the rate at which such infections occur, the relative risk by various lens types, and the hygiene strategies that may impinge on the infection rates. This information, unfortunately, is very difficult to come by.
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Pnce, Gerald Bentley, and Patnck Leas 1987 An Operational Evaluation of Extended-Wear Soft Contact Lenses in an Armored Division. United States Army Aeromedical Research Laboratory Technical Report No.
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Seddon, K.R. Kenyon, and the Microbial Keraiitis Study Group 1989 The relative risk of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses: a case-control study.
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