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Contact lens related infections

  • 7 min read

Contact lens-related microbial keratitis is one of the most serious complications of contact lens wear. According to various studies, the incidence of microbial keratitis varies but is typically reported to be between 1 in 500 to 1 in 10,000 contact lens wearers per year. The incidence rate is higher for those who wear their contact lenses overnight.

The type of contact lens worn can influence the risk of developing an infection. Extended wear of contact lenses, particularly overnight wear, has been shown to significantly increase the risk of microbial keratitis. This is true for both soft and rigid lenses, but the risk is generally higher with soft lenses.

Regarding specific brands, it’s important to note that infections are typically more related to contact lens hygiene practices, the type of lens (soft, rigid, extended wear), and the lens care solution used rather than the specific brand of contact lens. That said, there have been instances where a particular type of contact lens or lens care solution has been associated with an increased risk of infection.

For example, in the mid-2000s, there were outbreaks of Fusarium and Acanthamoeba keratitis that were associated with specific contact lens solutions, leading to those products being recalled. However, these are more exceptions than the rule.

It’s also worth noting that many different companies produce contact lenses and lens care solutions, and the products can vary significantly in terms of material, design, and other factors. Therefore, it’s difficult to make broad generalizations about the risk associated with a particular brand.

Maintaining good lens hygiene, including proper cleaning and disinfection, not sleeping in lenses unless they are designed for overnight wear, and replacing lenses as recommended, are the best ways to reduce the risk of contact lens-related infections.

Evolution of contacts and related infections.

  1. Late 1980s to Early 1990s: The use of contact lenses was becoming increasingly popular. The first extended-wear soft contact lenses were introduced, and with them, an increase in microbial keratitis was noted. Researchers began to study the correlation, with various publications outlining the increased risk of infection associated with overnight wear.
  2. Mid to Late 1990s: Studies further explored the risk factors for contact lens-related microbial keratitis. Poor hygiene, overuse of lenses, and overnight wear were all identified as significant risk factors. Publications also began to note the importance of patient education in reducing these risks.
  3. Early 2000s: In this era, the role of biofilms in contact lens-related infections was explored. Biofilms are colonies of bacteria that adhere to the lens surface and are resistant to disinfection. This understanding led to improvements in lens care solutions and practices.
  4. Mid to Late 2000s: There were outbreaks of Fusarium and Acanthamoeba keratitis associated with specific lens care solutions, which led to product recalls and increased scrutiny of solution efficacy. Research publications also began to explore the role of lens material and design in infection risk.
  5. 2010s: The rise of daily disposable contact lenses led to a decrease in the rate of microbial keratitis, as noted in several studies. However, non-compliance with lens care and replacement schedules remained an issue. Research also explored the role of the lens microbiome, the collection of normal bacteria that live on the lens and eye, in infection risk.
  6. Late 2010s to 2020: Increased understanding of the role of the eye’s microbiome in health and disease, as well as further improvements in lens materials and designs. New technologies for diagnosing and treating contact lens-related infections were also explored.
Contact lens Induced Corneal Infection Ulce

What are the predisposing risk factors?

There are several factors that can predispose an individual to contact lens-related infections, such as microbial keratitis:

  1. Poor Lens Hygiene: This is one of the main risk factors. It includes not washing hands before handling lenses, not cleaning and disinfecting lenses properly, and not replacing the lens case regularly.
  2. Overnight Wear: Sleeping in contact lenses significantly increases the risk of infection, even if the lenses are approved for overnight wear.
  3. Overuse of Lenses: Not replacing lenses as recommended by the manufacturer or eye care professional can increase the risk of infection.
  4. Use of Tap Water with Lenses: Tap water can contain microorganisms, including Acanthamoeba, that can cause serious eye infections. Using tap water to rinse lenses or a lens case increases the risk.
  5. Poor General Health or Immune System Function: Individuals with compromised immune systems may be more susceptible to infections.
  6. Environmental Factors: Exposure to certain environments, such as swimming or using hot tubs while wearing lenses, can increase the risk of infection.
  7. Young Age: Some studies have found that younger people (teens and young adults) may be more at risk, possibly due to poorer compliance with lens care guidelines.
  8. Contact Lens Type: As mentioned before, the type of contact lens can also influence the risk. Extended wear lenses, and soft lenses in particular, have been associated with a higher risk of microbial keratitis.

Remember, these risk factors do not guarantee that an infection will occur, but they do increase the likelihood. The best way to minimize the risk of contact lens-related infections is to follow proper lens care practices and guidelines provided by eye care professionals.

Is the number of years a person wears contact lens related to more side effects?

The length of time a person has been wearing contact lenses isn’t necessarily associated with an increased risk of side effects or complications on its own. However, long-term misuse or poor hygiene practices can increase the likelihood of problems over time.

For example, consistently not cleaning lenses properly, not replacing them as recommended, or sleeping in lenses not designed for overnight wear can all contribute to an increased risk of issues such as infections, corneal ulcers, and other eye health problems. These behaviors over many years could lead to more complications than if a person was consistently following good lens hygiene practices.

There is also some evidence to suggest that long-term contact lens wear can cause changes to the eye, such as the formation of new blood vessels in the cornea (corneal neovascularization). This is often a response to a lack of oxygen reaching the cornea, which can occur with certain types of lenses or with overuse of lenses. This condition can potentially lead to complications, including a higher risk of infection.

Overall, it’s important for contact lens wearers to follow their eye care professional’s instructions for lens care and to have regular eye check-ups to monitor their eye health. Regular eye exams can help detect any potential issues early, before they become more serious.

Is it OK for lovers to share contact lenses?

No, it is not safe or hygienic to share contact lenses with anyone, including lovers. Sharing contact lenses can transmit microorganisms, leading to serious eye infections. Each contact lens is fitted to the specific shape and size of an individual’s eye, and wearing someone else’s lenses could cause discomfort or even damage to the eye.Here are a few reasons why sharing contact lenses should be avoided:

  1. Risk of Infection: Eyes have their unique sets of bacteria. Sharing lenses can transfer bacteria or other microorganisms, increasing the risk of eye infections, including serious ones such as microbial keratitis.
  2. Different Prescription: Even if the two individuals have similar vision problems, their exact prescriptions are likely to differ. Wearing the wrong prescription can cause eye strain, headaches, and blurred vision.
  3. Different Sizes and Shapes: Contact lenses are often tailored to the individual eye’s shape and size. A lens that fits one person well might not fit another person, leading to discomfort and potential eye damage.
  4. Allergic Reactions: Some people might be allergic to the type of contact lens or the cleaning solution another person uses. This can lead to allergic reactions, causing redness, itching, and swelling.

The best practice is to never share contact lenses with anyone and to follow proper lens care guidelines to maintain eye health.

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