Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water

Arance-Gil, Ángeles; Gutiérrez-Ortega, Ángel Ramón; Villa-Collar, César; Nieto-Bona, Amelia; Lopes-Ferreira, Daniela; González-Meijóme, José Manuel

doi:10.1016/j.clae.2013.11.008

Cited by 46 publications

(24 citation statements)

References 32 publications

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“…It has been shown that swimming with lenses can increase the bacterial bioburden on lenses 22 and can expose the ocular surface to Acanthamoeba . Swimming has been identified as a likely factor for AK in GP wearers 23 , orthokeratology wearers 24 , frequent replacement SCL wearers 23 and daily disposable lens wearers. 25 Avoiding contact lens wear while swimming is the safest practice; however, if one chooses to swim while wearing reusable contact lenses, a pair of tight fitting goggles should be worn, thorough disinfection should occur in the evening 22 , and patients should be educated to be alert for signs and symptoms of infection after swimming.…”

Section: Discussionmentioning

confidence: 99%

Water Exposure is a Common Risk Behavior Among Soft and Gas-Permeable Contact Lens Wearers

Zimmerman

Richdale

Mitchell

et al. 2017

Cornea

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Purpose To understand soft contact lens (SCL) and gas permeable lens (GP) wearers’ behaviors and knowledge regarding exposure of lenses to water. Methods The Contact Lens Risk Survey (CLRS) and health behavior questions were completed online by a convenience sample of 1,056 SCL and 85 GP wearers age 20–76 years. Participants were asked about exposing their lenses to water and their understanding of risks associated with these behaviors. Chi-square analyses examined relationships between patient behaviors and perceptions. Results GP wearers were more likely than SCL wearers to ever rinse or store lenses in water (rinsing: 91% GP, 31% SCL, p<0.001; storing: 33% GP, 15% SCL p<0.001). Among SCL wearers, males were more likely to store (24% vs 13%, p=0.003) or rinse (41% vs 29%, p=0.012) their lenses in water. Showering while wearing lenses was more common in SCL wearers (86%) than GP wearers (67%) (p<0.0001). Swimming while wearing lenses was reported by 62% of SCL wearers and 48% of GP wearers (p=0.027). Wearers who rinsed (SCL; p<0.0001, GP; p=0.11) or stored lenses in water (SCL; p<0.0001, GP p=0.007) reported this behavior had little or no effect on their infection risk, compared with those that did not. Both SCL (p<0.0001) and GP wearers (p<0.0001) perceived that distilled water was safer than tap water for storing or rinsing lenses. Conclusion Despite previously published evidence of Acanthamoeba keratitis’ association with water exposure, most SCL, and nearly all GP wearers regularly expose their lenses to water, with many unaware of the risk.

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Section: Discussionmentioning

confidence: 99%

Water Exposure is a Common Risk Behavior Among Soft and Gas-Permeable Contact Lens Wearers

Zimmerman

Richdale

Mitchell

et al. 2017

Cornea

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“…In 2008, the American Academy of Ophthalmology issued an official statement on the safety of orthokeratology, recommending a wide margin of safety for patients undergoing this therapy due to case reports of vision-threatening complications, such as infectious keratitis and milder complications of corneal erosions and iritis. 29 Since then, case reports and series have been published that noted a high incidence of Pseudomonas and Acanthamoeba species [30][31][32][33][34][35][36][37][38] and other gram-negative organisms including Serratia 39 from corneal isolates of infectious keratitis cases associated with orthokeratology use.…”

Section: Safety Concernsmentioning

confidence: 99%

Update on Orthokeratology in Managing Progressive Myopia in Children: Efficacy, Mechanisms, and Concerns

Li¹,

Friedman²,

Medow³

et al. 2017

J Pediatr Ophthalmol Strabismus

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Myopia is an important public health issue, and high myopia may lead to severe complications if left untreated. Orthokeratology lenses, worn overnight to reshape the cornea, are one of many recent modalities used to slow down the progression of myopia in children. This treatment has been proven successful, as evidenced by decreased spherical refractive error and axial length relative to the control at interval follow-up ranging from 6 months to 5 years. In this systematic review, the authors collected published controlled studies that analyzed the efficacy of orthokeratology lens wear and calculated longitudinal relative changes in axial length, revealing a weighted average of -45.1% change in axial length at the 2-year follow-up. The exact mechanism by which orthokeratology lenses reduce myopia progression is unknown, but research shows that the corneal reshaping decreases peripheral hyperopic defocus and therefore increases peripheral myopic defocus to likely reduce stimuli for axial elongation and subsequent development of myopia. Use of orthokeratology lenses is generally safe, but cases of associated infectious keratitis may have a higher incidence of virulent organisms such as Pseudomonas, Acanthamoeba, and antibacterial-resistant strains of Staphylococcus, partially due to the required overnight use of these lenses. Orthokeratology is regarded as one of the most effective non-pharmacologic measures to slow progression of myopia in children and, with regular follow-up to ensure safety, continues to be one of the most effective treatments for myopia management around the world. [J Pediatr Ophthalmol Strabismus. 2017;54(3):142-148.].

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“…Contact lens use in these environments has been acknowledged as a potential risk factor for developing ocular infection (Radford et al 2002;Choo et al 2005;Arance-Gil et al 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Negative bacterial and fungal cultures that do not improve with medical treatment should be further and immediately investigated. Confocal microscopy is useful to confirm the diagnosis of AK, considering that Acanthamoeba cultures usually show negative results (Choo et al 2005;Vaddavalli et al 2011;Arance-Gil et al 2014).…”

Section: Discussionmentioning

confidence: 99%

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Virulent T4 Acanthamoeba causing keratitis in a patient after swimming while wearing contact lenses in Southern Brazil

Fabres

Maschio

Santos

et al. 2018

Acta Parasitologica

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Several strains of free-living amoebae belonging to the genus Acanthamoeba can cause a painful sight-threatening disease of the cornea known as Acanthamoeba keratitis (AK). The numbers of AK cases keep rising worldwide mainly due to an increase in contact lens wearers and lack of hygiene in the maintenance of contact lenses and their cases. We report a case of AK in a healthy young woman admitted to the Hospital de Clinicas in Porto Alegre, southern Brazil. Corneal scrapings were examined for the presence of Acanthamoeba strains. The initial isolate was characterized by morphological and genotypic properties. The isolate belonged to group III according to Pussard and Pons' cyst morphology. Analysis of its 18S rDNA sequence identified the isolate as genotype T4. The T4 genotype is the most commonly reported among keratitis isolates and the most common in environmental samples.

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Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water

Cited by 46 publications

References 32 publications

Water Exposure is a Common Risk Behavior Among Soft and Gas-Permeable Contact Lens Wearers

Water Exposure is a Common Risk Behavior Among Soft and Gas-Permeable Contact Lens Wearers

Update on Orthokeratology in Managing Progressive Myopia in Children: Efficacy, Mechanisms, and Concerns

Virulent T4 Acanthamoeba causing keratitis in a patient after swimming while wearing contact lenses in Southern Brazil

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