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Eye infections in state lead to investigation

May 19, 2006 | Two Missouri cases of an aggressive fungal eye infection associated with the use of contact lenses are under investigation.

The Centers for Disease Control and Prevention has released information indicating 122 confirmed cases of Fusarium keratitis, 15 possible cases and 60 cases that are still under investigation, including the two from Missouri. The eye infection is now in 33 states and may be affecting more than 200 people, according to the Centers for Disease Control and Prevention. Additional data released by the center has also confirmed that five types of contact lens solution were used by people suffering from Fusarium keratitis.

“There are a lot of confused contact lens wearers out there, and we are aggressively reaching out to them,” Cory Ridenhour, executive director of the Missouri Optometric Association, said. “While we realize the importance of due diligence throughout this investigation process, we are hoping for a swift, definitive conclusion from federal health officials to ease patient concerns and minimize further risk.”

In efforts to minimize further risk, Bausch & Lomb asked retailers to remove its ReNu with MoistureLoc brand contact lens solution in Missouri, as well as the rest of the country. However, 28 patients who have contracted the infection have told investigators they used ReNu MultiPlus or an unspecified ReNu solution.

Dr. David Falkenhain, O.D., of Falkenhain Eye Group in Rolla, said the Bausch & Lomb contact solution isn’t the only one that may be linked to the eye infection, but it is the one the most Fusarium keratitis cases have been associated with.

“We still don’t know what brought on the Fusarium keratitis cases, but Bausch & Lomb did take their MoistureLoc brand off the market since that was the one that seemed to have the most Fusarium keratitis cases associated with it.”

Health authorities in Europe, Singapore, Hong Kong and Malaysia are investigating similar cases. Investigators in Singapore have also found a strong association between the eye infections and the use of Bausch & Lomb solutions.

Fusarium keratitis is similar to Pink Eye infections, according to Falkenhain.

“It’s actually a form of Pink Eye,” he said. “It’s painful, so you’ll know there’s something wrong if you have it.”

Falkenhain said Fusarium keratitis is treatable if it’s diagnosed, but could cause serious problems if it goes untreated.

“If it goes untreated it could cause some serious eye problems, but otherwise there are topical eye drops to control it,” he said.

Falkenhain, along with other optometry doctors in Missouri, want to remind people that only slightly more than 200 cases of the eye infection have been reported compared to the more than 30 million Americans who wear contact lenses.

“There was actually only a very small number of cases,” Falkenhain said.

Even still, Missouri optomtery doctors are educating patients about the difference among contact lens care solutions. Most solutions are approved for use without rubbing when disinfected, according to the Missouri Optometric Association. However, optometrists are recommending that all patients rub and then rinse their lenses according to package instructions for additional safety. Regardless of which cleaning or disinfecting solution consumers use, contact lens wearers should take extra precautions with lens hygiene habits to help lower their chances of infection.

To guard against infection, Falkenhain recommends contact wearers always wash their hands before handling contact lenses. Replacing contact cases every six months is also important. Although many of the newer contracts are OK to sleep in, Falkenhain recommends people don’t sleep in their contacts.

“Washing your hands, replacing the contact case and not sleeping in your contacts are all important,” he said. “The main thing is to be clean about it. If you do notice any problems, get your contacts out and get to an eye doctor.”

Although Falkenhain hasn’t seen any cases of Fusarium keratitis in his practice, he said he’ll be watching for it just in case.

“I’ve been watching for it, but luckily I haven’t seen any cases,” he said. “And I’ve also pulled the MoistureLoc off my shelves, so that’s about all I can do.”

Reducing your risk of infection:
  • Always wash your hands before handling contact lenses.
  • Carefully and regularly clean contact lenses as directed by your optometrist. If recommended, rub the contact lenses with fingers and rinse thoroughly before soaking lenses overnight in sufficient multi-purpose solution to completely cover the lens.
  • Store lenses in the proper lens storage case and replace the case every three months. Clean the case after each use, and keep it open and dry between cleanings.
  • Use only products recommended by your optometrist to clean and disinfect your lenses. Saline solution and rewetting drops are not designed to disinfect lenses.
  • Only fresh solution should be used to clean and store contact lenses. Never re-use old recommendations, even if the lenses are not used daily.
  • Replace your lenses on schedule as directed by your optometrist.
When wearing or cleaning contacts:
  • Never put contact lenses in the mouth or moisten them with saliva, which is full of bacteria and a potential source of infection.
  • Don’t use tap water or homemade saline solutions. Improper use of solutions has been linked to a potentially blinding condition among soft lens wearers.
  • Never use contacts that have not been prescribed by an eye doctor. Contact lens wear is not an option for everyone; consult with an optometrist to see if contact lenses are an appropriate choice for vision correction.
Doctors remind patients to be aware of the signs of infection and urge anyone who experiences the following symptoms to contact their optometrist immediately:
  • Red and irritated eyes lasting for an unusually long period of time after lens removal
  • Pain in and around the eyes, especially if it progressively worsens
  • Increased sensitivity to light
  • Sudden blurred or fuzzy vision
  • Excessive eye tearing of discharge

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