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Several risk factors increase risk of severe keratitis due to contact lens use
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SAN FRANCISCO — Patients who do not comply with their prescribed contact lens program, as well as environmental and patient-specific risk factors, contribute to an increased risk of developing severe microbial keratitis.
 Eduardo C. Alfonso |
Also significant are the type of lens used and the duration of use, according to Eduardo C. Alfonso, MD. The risk of severe infection is greatest among hydrogel lenses, followed by silicone hydrogel lenses and gas permeable hard contact lenses, he said at the American Society of Cataract and Refractive Surgery meeting here.
"The risk of a severe ulcer is greater when lenses are used for a longer period of time, 1 to 4 weeks, than in a daily disposable," Dr. Alfonso said during the Richard L. Lindstrom, MD, Lecture.
Studies have shown that between 40% and 70% of patients are noncompliant with the prescribed usage regimen, but other factors, such as smoking, male sex and low socioeconomic status, are also influential.
Microbial pathogens can come from environmental sources, such as poorly cleaned contact lens cases, but also from bacterial infections in other parts of the body. Treatment is optimized with fluoroquinolones, although steroids should be avoided because they may increase the growth of certain microbes such as Fusarium, which has been widely implicated in severe corneal keratitis, Dr. Alfonso said.