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Fungus scare puts emphasis on hazards of contact lenses

May 14, 2006 | Washington Post

The recent withdrawal from the market of a popular contact lens solution under investigation in an outbreak of a rare eye infection has left many contact lens users confused and concerned. Eye doctors report a surge in calls from users of Bausch & Lomb’s ReNu with MoistureLoc MultiPurpose Solution, which the company has asked retailers to stop selling.

Last month, the Food and Drug Administration recommended that those who use the product immediately stop and throw away any remaining supplies.

“We’ve gotten a lot of calls from people” worried about fusarium keratitis, a fungal eye infection that can cause corneal scarring and permanent blindness, said Roy Rubinfeld, a spokesman for the American Academy of Ophthalmology and an ophthalmologist at Washington Eye Physicians & Surgeons in Chevy Chase, Md. “Fortunately, we haven’t seen any” cases.

“People are calling my office off the hook saying, ‘My eyes itch. Is that the fungus?” According to the Centers for Disease Control and Prevention, 176 cases of fusarium keratitis are suspected or confirmed in 27 states. The infection is linked to fusarium, a fungus found in plants, tap water and soil. Risk factors include trauma (usually involving plant material), immunodeficiency, chronic ocular surface diseases and, on rare occasions, contact lens use, according to the FDA.

The FDA says that in a population of 10,000 people, four to 21 cases of severe eye infection called microbial keratitis, which includes fusarium will occur annually. Fusarium infection is so rare that many eye doctors say they’ve never seen a case. Symptoms include redness, blurry vision, discharge, swelling, tearing, pain and increased sensitivity to light. Eye itchiness, Rubinfeld said, is more likely caused by spring allergies and is not a cause for alarm.

He advises contact wearers who experience eye irritation to switch to glasses. If symptoms persist beyond a few hours, experts recommend seeing a doctor or going to the emergency room if symptoms are severe.

A fusarium keratitis infection can be confirmed through a culture taken at a doctor’s office. Treatment usually begins with medications; if that’s not effective, surgery including a cornea transplant may be necessary.

Experts said the outbreak should remind contact lens users about 30 million of them in the United States that contacts carry risks.

“I think this is a real wake-up call for both patients and the medical community,” said Arthur Epstein, chair of the American Optometric Association’s contact lens and cornea section.

Bausch & Lomb pulled ReNu with MoistureLoc from U.S. stores April 13; other ReNu products are still available. Of the 30 cases the CDC and the FDA had fully investigated late last month, 28 involved contact lens wearers. Of these, 26 “reported using a Bausch & Lomb ReNu brand contact lens solution or a generic brand manufactured by the same company” the previous month, according to an FDA statement.

Five patients reported using other contact lens solutions, including solutions made by Alcon and Advanced Medical Optics Inc. Nine reported wearing their contacts overnight. Eight people needed cornea transplants as a result of the infection.

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