Inadequate contact lens hygiene increased risk for acute conjunctivitis

NEW YORK — Failure to properly clean and store contact lenses significantly increased risk for acute conjunctivitis, according to a presenter at the 2014 Infectious Diseases in Children Symposium.

There have been three outbreaks of Acanthamoeba keratitis and Fusarium keratitis in the United States since 2006. Each of these outbreaks were related to contact lens use, highlighting the importance of contact lens hygiene and the need for reinforcement of infection prevention among contact lens users.

“Contact lenses are a key risk factor for serious infection,” Penny A. Asbell, MD, of Icahn School of Medicine at Mount Sinai in New York, said during her presentation.

Penny A. Asbell

Pediatricians should instruct patients who use contact lenses not to keep lenses in while sleeping and never use water on lenses, Asbell said, echoing the CDC’s recommendations for contact lens users.

Additionally, the CDC recommends using only fresh contact lens disinfecting solution. Contact lens users should never mix fresh solution with old or used solution. According to Asbell, old contact lens solution can serve as a breeding ground for infection.

However, children with impaired vision are not the only contact lens users due to the growing popularity of cosmetic contact lenses among teenagers and young adults, Asbell noted.

While the FDA has classified all contact lenses as medical devices and restricted their distribution to licensed eye care practitioners, non-prescription contact lenses can still be purchased on the Internet, in convenience stores and at flea markets.

Since many of these cosmetic contact lenses are neither prescribed nor regulated, these products are often associated with increased risks of corneal abrasions and ulcers which are more vulnerable to bacteria.

“The CDC recently published a Morbidity and Mortality Weekly Report on keratitis which found that 25% of serious infections were in patients under 20 years old — many of them are going to be the teenagers in your office,” Asbell said. “They could be getting over-the-counter cosmetic lenses for Halloween or some other function and not even seeing a practitioner for contact lenses.”

According to the CDC, cosmetic users should follow the same recommendations as corrective users; any contact lens use requires a prescription. If a contact lenses user presents with red eye, they should be referred to an ophthalmologist. However, if a pediatrician finds they need to treat a patient with acute conjunctivitis, Asbell recommended using antibiotics.

“Although acute conjunctivitis is self-limiting, treating with antibiotics can decrease length of symptoms and signs in about 2 to 5 days as opposed to 2 weeks,” Asbell said. “You can limit the spread of disease to family members or school mates, reduce the small risk for vision loss, eliminate uncomfortable infection with discharge, and speed the return to school, which allows the parent to return to work.”

For more information:

Asbell PA. “Differentiating the various causes of pediatric conjunctivitis.” Presented at: IDC NY 2014; November 22-23, 2014; New York.

Visit http://www.cdc.gov/contactlenses/ for more information on healthy contact lens use.

Disclosure: Asbell reports financial ties with Alcon, Candeo, J&J Nicox, Paragon, Senju, R-tech and Valeant.