The most common contact lens-related eye infections are corneal infections (keratitis), an infection of the transparent dome in front of the eye covering the pupil and iris. They’re also called corneal ulcers.
Contact lens-related infections of the eye can be extremely uncomfortable and, depending on the cause and severity of the infection, can lead to vision loss and possibly even blindness if left untreated. The most common eye infection related to contact lens usage is keratitis, a corneal infection that can range from mild to severe and has multiple causes. Serious eye infections can cause corneal scarring, which can ultimately require a corneal transplant to restore vision.
Causes of Contact Lens-related Eye Infections
Most contact lens-related eye infections can be avoided by practicing good habits and proper hygiene in regards to handling your lenses. Here are some common causes of contact lens-related eye infections:
- Sleeping in contact lenses
- Wearing contact lenses for extended periods of time
- Environmental irritants
- Reduction of tear exchange while wearing contact lenses (especially soft lenses in which metabolic by-products and tear film debris is increased)
- Improper maintenance of contact lenses or lens case
- Reuse and/or topping off of contact solution
Being aware of and practicing proper contact lens usage, care, and maintenance is the easiest way to reduce the risk of infection from contact lenses.
Symptoms of a Contact Lens-related Eye Infection
- Blurry vision
- Redness, pain, or swelling of the eye
- Eye tearing or discharge
- Increased sensitivity to light
- Burning or itching of the eye
- Sensation of foreign object in the eye
If you experience any of these symptoms of an eye infection, you should contact your ophthalmologist as quickly as possible. Treating an eye infection in a timely manner will not only help you feel better, but could actually save your sight. You should also wear eyeglasses rather than your contact lenses until your eye condition has been properly diagnosed, as not to aggravate your symptoms.
Diagnosing a Contact Lens-Related Eye Infection
Diagnosing a contact lens-related eye infection will require a thorough eye exam by your ophthalmologist. You should never try to self-diagnose any eye condition, as this can cause harm to your eyesight and delay needed treatment. Be sure to take your lens case with you to your eye appointment since it may be helpful in determining the cause of your eye problem.
Types of Microbial, or Germ-related, Keratitis
Many contact lens-related infections occur when germs invade the eye, resulting in microbial keratitis. Types of microbial, or germ-related, keratitis are:
- Bacterial keratitis: Bacterial infection of the cornea with Pseudomonas Aeruginosa or Staphylococcus Aureus
- Fungal keratitis: Fungal infection of the cornea with Candida, Fusarium, or Aspergillus
- Viral/herpes keratitis: Viral infection of the cornea due to the herpes virus
- Acanthamoeba/parasitic keratitis: Parasitic infection of the cornea with Acanthamoeba
Bacterial keratitis is a corneal eye infection which is often caused by the bacteria Pseudomonas Aeruginosa (especially in contact lens wearers) or Staphylococcus Aureus. Bacterial keratitis is typically a result of improper contact lens care or an eye injury and often develops suddenly.
Bacterial keratitis can be caused by:
- Extended use of contact lenses
- Topical steroid use
- Eye injury or trauma
- Contaminated contact lens solution
- Corneal disease
When contact lenses are not stored or cleaned correctly, bacteria can spread from the patient’s skin or from the unsterile solution in which the contact lenses are soaked.
Immediate treatment of bacterial keratitis is key in order to prevent vision damage. Your ophthalmologist may prescribe a regiment of antibiotic eye drops, as well as a topical steroid. When diagnosed and treated early, most patients fully recover from bacterial keratitis with no permanent vision loss. Left untreated, or in severe cases, the center of the cornea can be affected, which can result in decreased vision or even blindness.
Fungal keratitis is a corneal infection caused by the eye’s exposure to a fungus, such as Candida, Aspergillus, or Fusarium. Fusaria are commonly found in water, soil, or plants. Fungal keratitis can result from an eye injury involving plant material, such as thorns, stickers, or branches.
Contact lens wearers are at higher risk for fungal keratitis if using tap water to clean or store lenses (which should not be done). Also, simply having this organic matter on your hands and subsequently inserting your contact lenses can result in a serious eye infection.
Treatment of fungal keratitis usually includes oral medication and antifungal eye drops. As with bacterial keratitis, fungal keratitis should be treated quickly to avoid eye and vision damage.
Viral or herpes keratitis is a corneal infection caused by the herpes simplex virus (HSV). HSV Type I is typically the cause of viral keratitis since it is the virus which can affect the face by bringing on cold sores and fever blisters. HSV can be transmitted to the eye by touching an infected area and then inserting contact lenses or touching the eye. When HSV enters the eye, it often infects the cornea, as well as the eyelids and conjunctiva.
Treatment for viral keratitis may include topical medication and oral antiviral medicine. Because HSV remains dormant in the body once you contract it, you should not use steroid eye drops because they can actually multiply the virus. Treatment should be immediate to avoid permanent eye damage.
Acanthamoeba keratitis (AK) is a rare and serious corneal infection caused by a microscopic ameba (one-celled organism). Acanthamoeba parasites are present in bodies of water, such as oceans or lakes, and in the air and soil. Swimming pools, hot tubs, and even tap water can be the source of the Acanthamoeba, and 85% of those infected by the parasites in the U.S. are contact lens wearers.
Activities which increase the risk of Acanthamoeba keratitis include:
- Using tap water or homemade solution to disinfect or clean contact lenses
- Improper handling and storing of contact lenses
- Contact with contaminated water source
- Showering, swimming, or hot tubbing while wearing contact lenses
Your ophthalmologist can determine if your eye infection is caused by a parasite by taking a gentle scraping of the eye or detecting it visually by means of confocal microscopy (a method of using light/lasers which produces extremely high quality imaging).
If diagnosed early and treated with prescription medication, patients with AK can fully recover with no residual vision damage.
Tips for Preventing Contact Lens -Related Eye Infections
- Maintain good eye health by scheduling an annual ophthalmic exam
- Only use prescription contact lenses (never insert fake lenses, such as colored Halloween contacts)
- Carefully follow the instructions given by your eye doctor and the manufacturer guidelines on wearing, cleaning, and replacing contact lenses
- Always wash hands with soap and warm water, if possible, before handling your contacts
- Do not wear contact lenses during water-related activities (such as showering or swimming)
- Thoroughly clean your contact lenses every time you remove them
- Use only contact lens solution to disinfect your lenses (not saline or rewetting drops)
- Never use tap water to clean or store lenses
- Do not reuse or top off old contact solution when storing your contacts (use fresh only)
- Use a proper storage case for your contact lenses
- Clean storage case thoroughly and allow to air dry after each use
- Replace storage case every 3 months or sooner
- Do not wear contact lenses while sleeping, unless specifically prescribed for such use
- Remove contact lenses if your eyes are irritated, red, or sore
- Always carry eyeglasses with you in case your contact lenses become bothersome
- Use daily disposable contacts only once
Keratitis, when superficial – on the outermost corneal layer, usually leaves no scar on the cornea and has no lasting effect on the patient’s vision. If deeper corneal layers become affected, scarring can occur which may require surgery to correct, or may affect vision permanently. Always contact your ophthalmologist if you experience symptoms of an eye infection.
At Fort Worth Eye Associates, we are committed to providing the highest quality individualized care to every patient. If you have questions regarding your contact lenses or think that you may have an eye infection, please call our Fort Worth office at 817-732-5593.