This article is more than 5 years old. Information may no longer be current.
Workshop participants take steps to address MK
Click Here to Manage Email Alerts
One of the great features of Healio.com is the ability to access so much contemporary information across so many medical disciplines. Among the topics I “link” with is that of infectious disease. My interest – and fascination – lies in the similarities between eye care and systemic infectious disease. We both encounter an evolving cast of characters (microbes) that present diagnostic and therapeutic challenges.
This past week, my Infectious Disease News feeds on Healio.com/Infectious-Disease highlighted proceedings from IDWeek 2014, an annual gathering of the world’s experts in infectious disease. While there was the much anticipated coverage of media-saturated topics such as Ebola and enterovirus D86, the heart and soul of the meeting centered on resistant microbial disease. Topics such as recurrent methicillin-resistant Staphylococcus aureus skin infections, Clostridium difficile management, multidrug-resistant bacteria epidemiology (yes, there are regional differences) and environmental considerations in infectious disease prevention served as a sobering reminder of the gravity of infection while providing a glimmer of hope going forward.
Perhaps, however, most unsettling was the issue of microbial resistance to last-resort antibiotics. The topic leaves one with a sense that we better had figure this out – and we had better do it now.
In some respects, microbial resistance reminds me of our battle with microbial keratitis (MK) in contact lens wear. While the past 3 decades have taught us overnight wear is the primary risk factor in MK, they have also reminded us this is not always the case (think Acanthamoeba). So, we have pushed forward with our efforts to make contact lenses – overnight and daily wear – safer for our patients.
Michael D.
DePaolis
We have introduced disposability, optimized oxygen transmission, improved disinfection regimens and hammered our patients about compliance. While I truly believe contact lens wear is safer today, we really have not moved the needle with respect to MK. Sadly, the numbers are not much different than those reported 20 years ago. Ugh.
Perhaps the reason we continue seeing MK in contact lens practice is because we have been operating in a bit of a vacuum. We still assess lens care products’ efficacy against the same line-up – organisms and actual strains – as we did decades ago, without consideration of “newer” bugs such as Acanthamoeba. Furthermore, testing techniques are somewhat variable and not reflective of the “soiled” world within which we (and our bugs) live.
Simply put, we have underestimated our microbial foes. Unfortunately, as our infectious disease brethren will attest, microbes are formidable foes. They are savvy, adaptive to changing environments and very opportunistic … all in the name of survival.
Fortunately, this is all about to change. Recently, the U.S. Food and Drug Administration Center for Devices and Radiological Health, in concert with the American Academy of Optometry, American Optometric Association, American Academy of Ophthalmology and Contact Lens Association of Ophthalmologists, convened a special session to address contact lens safety. The goal is a better understanding of organisms causing MK and to devise product testing more targeted at their eradication.
Please take a few minutes and read part 1 of our coverage of this landmark event in this month’s Primary Care Optometry News (“Experts agree on need to standardize testing for contact lens products,”). I am sure you will agree the implications go well beyond contact lens practice … providing us a better understanding of infectious disease and how it relates to improved patient care.