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The
most commonly found contact lens induced infections are infectious bacterial
keratitis and ulcers that are related to P. aeruginosa. P. aeruginosa keratitis
can lead to corneal perforation and ultimate loss of vision. Sterile keratitis
is mote common with disposable extended wear lenses, where as infectious
keratitis is more common with re-usable extended wear contact
lenses.

The
primary source of bacterial infections is poor contact lens cleansing regiments
and poor hygiene of the patient. Patients who have existing blepharitis or dry
eyes are more prone to infections, further complicating the situation.
Disposable and frequent replacement contact lenses were developed to combat
these problems. Other types of contact lens induced infections include sterile
corneal infiltrates, acanthamoebic keratitis, and fungal keratitis.

Sterile corneal infiltrates occur in patients who are sensitive to the preservatives
used on contact lens solutions. Symptoms include burning, itching, pain and
discharge. Patients should be treated with topical antibiotics and perhaps
topical steroids.

Acanathamoebic
keratitis is found primarily in those patients who wear soft daily lenses and
make their own saline solution. It is also common in people who swim with
lenses in. This is because acanthamoeb is a pathogenic protozoan found in
contaminated water, soil, dust, or may be airborne. Initially the corneal
epithelium is effected. Later the corneal tissue and even the sclera are
effected. Treatment can be lengthy and involves a combination of a topical
antimoebic, and topical steroids. Prevention including avoiding non-sterile
solution and tap water is every patient’s best choice.

Fungal
keratitis occurs most often with high water content hydrogel lenses in humid
climates. It appears as a superficial gray feathery infiltrate. It is
associated with satellite lesions and inflammation. Again prevention with
proper lens care is the best medicine.

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