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Understanding Contact Lens Complications: Infection
Introduction
An infection of the eye related to contact lens wear is rare; however, if it occurs, it must be treated as a vision-threatening emergency.
Most contact lens solutions are composed of chemicals with preservatives that break down over time once they are exposed to air, such as being squirted into the well of a contact lens case. This is to decrease the incidence of solution-related sensitivities and allergic reactions. When we think about this, it is sensible that an effective lens cleaner and/or disinfectant might not be the most comfortable thing to put right into the eye.
Unfortunately, non-compliance with lens care instructions is usually a factor in contact lens-related infections. Many patients do not clean and air-dry their contact lens case every day, but instead “top off” the leftover solution in the lens wells in the evening, in a misguided effort to keep costs down. What this does is make it possible for bacteria to grow, because the active ingredients are not concentrated enough to work properly.
Patients are always told to empty and rinse their lens cases and rinse them with hot water, leaving them open to air dry during the day. (Bacteria don’t like well-lit and dry spaces, preferring dark, moist ones.) Then, at the end of their wear period, they are told to refill the lens wells with fresh solution and place their lenses in it. These instructions, if followed, make it difficult for bacteria or viruses to get a hold on a lens.
Symptoms of an infection include discharge, redness, burning, swelling and pain. The eye may feel hot and be sensitive to light.
Most infections are not serious, but some of them can be quite serious. Humans carry around in the normal flora and fauna of their eyes bacteria such as staph or pseudomonas; if there is an opportunity, they are already there and will take advantage of it.
Treatment
If you think you have an infection, see your eye care practitioner right away! Do not wait to see if it gets better or worse, but call immediately. Some infections can be very serious and are considered to be vision-threatening events requiring urgent- or emergency-level care.
Treatment for most infections is in the form of topical (eye drops) or ointments. In severe cases, oral antibiotics may be required to reach the required dose level. Eyecare practitioners may also prescribe anti-inflammatory medications to relieve the symptoms and improve comfort. Even in the case of viral infections, which don’t respond to antibiotics, they may be prescribed anyway to prevent a secondary infection while the defenses of the eye are already compromised.
Patching the eye may make the patient somewhat more comfortable, although no patch should ever be applied to an eye without first treating it with antibiotics. The patch should be removed regularly and re-treated at scheduled intervals.
Along with treatment for the eye infection, efforts should be made to prevent spread of the infectious agent. Wash your hands frequently and keep them away from your eyes. Household devices that are touched frequently, like computer keyboards, the telephone keypad and remote control units or game controllers should be sanitized with alcohol swipes. And don’t forget the light switches!
All contact lenses that have been used by the infected patient must be disposed of, along with all opened cleaning and disinfecting solutions. The contact lens case, especially, should follow the solutions into the trash can.
All contact lens care must be suspended until the infection is completely cleared and all symptoms have disappeared. Once contact lens wear is approved again by your optometrist, only brand new lenses that are still in their original packaging should be used.
Use all medications exactly as directed and use them for the complete course of treatment to avoid establishing a resistant strain of the infecting agent.