Contact lens keratitis is an inflammation of the cornea, the transparent outer layer of the eye, associated with contact lens use. This condition is serious because it can develop quickly and harm vision if not addressed promptly. It arises when the cornea becomes inflamed from either infectious or non-infectious causes related to lens wear, making immediate medical attention necessary to prevent lasting damage.
Recognizing the Symptoms
The initial signs of keratitis can appear suddenly. A primary indicator is eye pain, ranging from mild irritation to severe discomfort, accompanied by significant eye redness. Vision may become blurred, and individuals often experience heightened sensitivity to light, a condition known as photophobia.
Many people also report the feeling that something is lodged in the eye. This sensation can be coupled with excessive tearing or an unusual discharge. These symptoms signal that the cornea is in distress and require immediate evaluation by an eye care professional.
Causes and Risk Factors
Contact lens keratitis is frequently caused by microscopic organisms that invade the cornea. Bacteria are a common culprit, particularly Pseudomonas aeruginosa, which thrives in damp environments and can contaminate lenses and their storage cases.
Fungi and amoebas are other sources of infection for contact lens wearers. The microscopic amoeba Acanthamoeba is a pathogen found in various water sources, including tap water, swimming pools, and hot tubs. Exposing contact lenses to any type of water increases the risk of developing Acanthamoeba keratitis, a severe and painful infection that is difficult to treat.
Certain behaviors elevate the risk of developing keratitis. These include:
- Sleeping in contact lenses, even those approved for extended wear.
- Handling lenses without thoroughly washing hands, which can transfer germs to the eye.
- Failing to clean the storage case or reusing old solution.
- Wearing lenses beyond their recommended replacement schedule.
Medical Diagnosis and Treatment
A diagnosis of keratitis is made by an ophthalmologist or optometrist. The process includes a patient history and an external eye examination using a slit lamp, a specialized microscope. This provides a magnified view of the cornea, allowing the doctor to assess the inflammation and look for an ulcer or foreign body.
The doctor may apply a fluorescein dye to the eye’s surface, which highlights any corneal damage under the slit lamp. If an infection is suspected, a small tissue sample may be scraped from the cornea. This sample is sent to a lab for a culture to identify the specific organism causing the infection.
Treatment for contact lens keratitis depends on its cause. Infections require intensive courses of prescription eye drops, such as antibacterial, antifungal, or anti-amoebic formulas. These often need to be administered frequently, sometimes hourly, even through the night. For non-infectious cases, artificial tears or anti-inflammatory drops might be sufficient, while severe infections may also require oral medications.
Prevention and Safe Lens Wear
Preventing keratitis centers on hygiene and safe wear protocols. Always wash your hands with soap and water and dry them completely before touching your contact lenses. You should also follow the lens care instructions provided by your eye doctor and the manufacturer.
Proper care of your lens case is also required. Discard the old solution from the case every time you disinfect your lenses and never “top off” the existing liquid. The contact lens case should be replaced at least every three to six months to avoid a buildup of contaminants.
Avoid any contact between your lenses and water. This means you should not wear them while swimming, in a hot tub, or in the shower. If you experience symptoms like redness, pain, or blurred vision, remove your lenses immediately and contact your eye doctor. Do not resume wearing lenses until you are advised it is safe.