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Contact Lens-Related Infectious Keratitis: Review of 29 Cases

DOI: 10.4236/oalib.1103815, PP. 1-9

Subject Areas: Ophthalmology

Keywords: Contact Lens, Infectious Keratitis, Hypopyon, Stromal Infiltrates

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Aim: To describe the epidemiological, clinical, microbiological and therapeutic features of corneal abscesses related to Contact Lens (CL) wear. Patients and Methods: Retrospective review of 29 patients (29 eyes) with infectious keratitis associated with contact lens wearing was conducted at Ophthalmology Department Fattouma Bourguiba University Hospital of Monastir, Tunisia between January 2006 and June 2016. All patients underwent detailed ophthalmological examination. Slit lamp examination and corneal culture were performed on all patients. The Contact Lens and Contact Lens cases were also analyzed if available. The mean follow-up period was 88 days (range: 30-360 days). Results: The mean age of our patients was 27 year old. Twenty-three patients (97.3%) were females and 6 patients (20.7%) were males. Twenty-seven patients (93.1%) were soft contact lens users. The mean initial Visual Acuity (VA) was 20/1000. Stromal infiltrates were associated with ulcers in all cases, and were located in central cornea in 21 cases (72.4%). Hypopyon was noted in 10 cases (34.5%). Microbial cultures were positive in 18 patients (72.4%). Pseudomonas aeruginosa was isolated in 41.4% of cases. Amoebic cysts were found in 5 cases (17.3%). Fusarium was isolated in one eye (3.5%). Antimicrobial treatment was based on the suspected or isolated causative agent. Final VA was 20/125. Conclusion: Corneal abscesses are a rare but serious complication of CL wear. Educating CL users, early diagnosis and appropriate management are important elements so as to reduce ocular morbidity.

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Khochtali, S. , Daldoul, N. , Zina, S. , Ksiaa, I. , Zaouali, S. , Jelliti, B. and Khairallah, M. (2017). Contact Lens-Related Infectious Keratitis: Review of 29 Cases. Open Access Library Journal, 4, e3815. doi:


[1]  Hoddenbach, J.G., Boekhoorn, S.S., Wubbels, R., Vreugdenhil, W., Van Rooij, J. and Geerards, A.J.M. (2014) Clinical Presentation and Morbidity of Contact Lens-Associated Microbial Keratitis: A Retrospective Study. Graefe’s Archive for Clinical and Experimental Ophthalmology, 252, 299-306.
[2]  Verhelst, D., Koppen, C., Van Looveren, J., Meheus, A. and Tassignon, M.-J. (2006) the Belgian Keratitis Study Group. Contact Lens-Related Corneal Ulcersrequiring Hospitalization: A 7-Year Retrospective Study in Belgium. Acta Ophthalmologica Scandinavica, 84, 522-526.
[3]  Benhmidoune, L., Bensemlali, A., Bouazza, M., Karami, R., El Mansouri, H., ElBelhadji, M., et al. (2013) Contact Lens Related Corneal Ulcers: Clinical, Microbiological and Therapeutic Features. Journal Francais D’Ophtalmologie, 36, 594-599.
[4]  Goh, P.P., Shamala, R., Chandamalar, S. and Tai, X.Y. (2010) National Eye Database Study Group. Contact Lens-Related Corneal Ulcer: A Two-Year Review. Medical Journal of Malaysia, 65, 120-123.
[5]  Keay, L., Edwards, K. and Stapleton, F. (2009) Signs, Symptoms, and Comorbidities Incontact Lens-Related Microbial Keratitis. Optometry and Vision Science, 86, 803-809.
[6]  Wagner, H., Richdale, K., Mitchell, G.L., Lam, D.Y., Jansen, M.E., Kinoshita, B.T., et al. (2014) Age, Behavior, Environment, and Health Factors in the Soft Contact Lens Risk Survey. Optometry and Vision Science, 91, 252-261.
[7]  Cheng, K.H., Leung, S.L., Hoekman, H.W., Beekhuis, W.H., Mulder, P.G., Geerards, A.J., et al. (1999) Incidence of Contact-Lens-Associated Microbial Keratitis and Itsrelated Morbidity. Lancet, 354, 181-185.
[8]  Stapleton, F., Keay, L., Edwards, K., Naduvilath, T., Dart, J.K.G., Brian, G., et al. (2008) The Incidence of Contact Lens-Related Microbial Keratitis in Australia. Ophthalmology, 115, 1655-1662.
[9]  Dart, J.K.G., Radford, C.F., Minassian, D., Verma, S. and Stapleton, F. (2008) Risk Factors Formicrobial Keratitis with Contemporary Contact Lenses: A Case- Controlstudy. Ophthalmology, 115, 1647-54, 1654.e1-3.
[10]  Keay, L., Edwards, K., Naduvilath, T., Taylor, H.R., Snibson, G.R., Forde, K., et al. (2006) Microbial Keratitis. Ophthalmology, 113, 109-116.
[11]  Yeung, K.K., Forister, J.F.Y., Forister, E.F., Chung, M.Y., Han, S. and Weissman, B.A. (2010) Compliance with Soft Contact Lens Replacement Schedules and Associatedcontact Lens-Related Ocular Complications: The UCLA Contact Lens Study. Optometry, 81, 598-607.
[12]  Morgan, P.B., Efron, N., Toshida, H. and Nichols, J.J. (2011) An International Analysis of Contact Lens Compliance. Contact Lens Anterior Eye, 34, 223-228.
[13]  Bourcier, T., Thomas, F., Borderie, V., Chaumeil, C. and Laroche, L. (2003) Bacterial Keratitis: Predisposing Factors, Clinical and Microbiological Review of 300 Cases. British Journal of Ophthalmology, 87, 834-838.
[14]  Garg, P. (2010) Diagnosis of Microbial Keratitis. British Journal of Ophthalmology, 94, 961-962.
[15]  Alexandrakis, G., Alfonso, E.C. and Miller, D. (2000) Shifting Trends in Bacterial Keratitisin South Florida and Emerging Resistance to Fluoroquinolones. Ophthalmology, 107, 1497-1502.
[16]  Nilsson, S.E. and Montan, P.G. (1994) The Hospitalized Cases of Contact Lens Inducedkeratitis in Sweden and Their Relation to Lens Type and Wear Schedule: Results of a Three-Year Retrospective Study. The CLAO Journal, 20, 97-101.
[17]  Szczotka-Flynn, L.B., Pearlman, E. and Ghannoum, M. (2010) Microbial Contamination of Contact Lenses, Lens Care Solutions, and Their Accessories: A Literature Review. Eye Contact Lens, 36, 116-129.
[18]  Ancele, E., Lequeux, L., Fournié, P., Chapotot, E., Douat, J. and Arné, J.-L. (2009) Severe Bacterial Keratitis. A Clinical, Epidemiologic, and Microbiologic Study. Journal Francais D’Ophtalmologie, 32, 558-565.
[19]  Perol, J., Gaujoux, T., Laroche, L. and Borderie, V.M. (2009) Infectious Keratitis in Contact Lens Wearers: Analysis of Risk Factor, Etiologic Agents and Evolution after Treatment. Journal Francais D’Ophtalmologie, 32, 1S159.


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