Ulcerative Keratitis Associated with Contact Lens Wear

Alfonso, Eduardo C.; Mandelbaum, Sid; Fox, Martin J.; Forster, Richard K.

doi:10.1016/0002-9394(86)90641-0

Cited by 210 publications

(58 citation statements)

References 17 publications

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“…Six isolates (3, 4, 5, 9, 18, and 21) showed similar patterns of relative adherence to polystyrene and tefilcon lenses, although attachment numbers were higher on polystyrene. Four isolates (1,10,15, and 22) also demonstrated similar adherence patterns on the hydrogel and polystyrene, but these isolates showed similar attachment numbers to both substrata. Isolate 3 showed strong adherence to all three substrates and was used to characterize adherence to hydrophilic lenses.…”

Section: Methodsmentioning

confidence: 91%

“…Adherence also was influenced by hydrophobicity and chemical composition of the substratum, as well as pH and electrolyte concentration. An extracellular polymeric adhesive appeared to be involved in the firm attachment of cells to soft contact lenses.Recently, an apparently increased incidence of Pseudomonas keratitis has been associated with hydrophilic contact lens wear (1,6,12,16,18,19,25). Mayo et al (15) determined that nonmucoid strains of Pseudomonas aeruginosa isolated from corneal ulcers and home-prepared saline of a patient generally were the same strain.…”

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confidence: 99%

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The Adherence of Pseudomonas aeruginosa to Hydrophilic Contact Lenses and Other Substrata

Miller¹,

Wilson²,

Ahearn³

1987

Cornea

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Nonmucoid Pseudomonas aeruginosa isolated from corneal ulcers and contact lens cases and solutions were examined for their ability to adhere to polystyrene, glass, and hydrophilic contact lenses of varying water content and polymer composition. Adherence to the various substrates was strain specific. Adherence also was influenced by hydrophobicity and chemical composition of the substratum, as well as pH and electrolyte concentration. An extracellular polymeric adhesive appeared to be involved in the firm attachment of cells to soft contact lenses.Recently, an apparently increased incidence of Pseudomonas keratitis has been associated with hydrophilic contact lens wear (1,6,12,16,18,19,25). Mayo et al. (15) determined that nonmucoid strains of Pseudomonas aeruginosa isolated from corneal ulcers and home-prepared saline of a patient generally were the same strain. Other investigations have also concluded that lens solutions were probable vectors for eye-associated infections (24,26). Lenses that have been soaked in contaminated solutions may harbor adhered bacteria. Because most contact lenses result in changes in the cornea that could predispose to infection, bacteria harbored on the lens present a risk (2, 24).Few workers have examined the adherence of pseudomonads to hydrophilic contact lens polymers. Pringle and Fletcher (21) reported that a freshwater isolate of P. fluorescens demonstrated decreased adherence with increased water content of a hydrogel polymer used for contact lenses. Dart and Badenoch (4) demonstrated that P. aeruginosa adhering to hard contact lenses showed higher attachment numbers in comparison to soft, more hydrophilic lens material. These and other studies (9,11,13) have demonstrated a relationship between the hydrophobicity of a surface and microbial adherence.A number of workers have examined the adherence of Pseudomonas species to substrata, such as polystyrene (10, 17, 20, 22), glass (14, 27), and stainless steel (23). Bacteria prefer to attach to low-energy, hydrophobic surfaces such as polystyrene rather than to high-energy, hydrophilic surfaces such as glass. Most studies support a theory of "irreversible sorption," which is a time-dependent process, facilitated by the synthesis of an extracellular polymeric material that bridges the bacterial and substratum surface (3,7,8,14).Factors affecting the adherence of P. aeruginosa to contact lenses of varying polymer composition have not been examined. We have evaluated the interactions of eyeassociated isolates of nonmucoid P. aeruginosa with hydrogels under varying physiological and physicochemical conditions. * Corresponding author. MATERIALS AND METHODSOrganisms and culture conditions. Twenty cultures of nonmucoid P. aeruginosa isolated by Mayo et al. (15) from corneal ulcers and contact lens solutions and cases were grown overnight at 25°C on Trypticase soy agar (BBL Microbiology Systems, Cockeysville, Md.). Isolated colonies were used to inoculate 200 ml of tryptic soy broth (Difco Laboratories, Detroit, Mich.), pH 7.3, that ...

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Section: Methodsmentioning

confidence: 91%

mentioning

confidence: 99%

The Adherence of Pseudomonas aeruginosa to Hydrophilic Contact Lenses and Other Substrata

Miller¹,

Wilson²,

Ahearn³

1987

Cornea

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“…Spherical, multinucleate yeast-like cells (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) m in diameter) with single broad-based bud and refractile double-contoured walls; generally larger than those of cryptococci (301). Seen in KOH mounts of necrotic material or in tissue sections, and generally extracellularly (215,338), and in culture at 37°C.…”

Section: Blastomyces Dermatitidismentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

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“…One of the most common pathogens in corneal infection of hydrogel contact lens wearers is Pseudomonas aeruginosa (1,4). Two different genotypes of P. aeruginosa have been identified from corneal infections (16); invasive and acutely cytotoxic strains differ in certain genes that are regulated by ExsA (a transcriptional activator of genes encoding several secreted proteins) (15).…”

mentioning

confidence: 99%

Resistance of Pseudomonas aeruginosa Isolates to Hydrogel Contact Lens Disinfection Correlates with Cytotoxic Activity

Lakkis

Fleiszig

2001

J Clin Microbiol

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One of the most common pathogens in infection of hydrogel contact lens wearers is Pseudomonas aeruginosa, which can gain access to the eye via contamination of the lens, lens case, and lens care solutions. Only one strain per species is used in current regulatory testing for the marketing of chemical contact lens disinfectants. The aim of this study was to determine whether P. aeruginosa strains vary in their susceptibility to hydrogel contact lens disinfectants. A method for rapidly screening bacterial susceptibility to contact lens disinfectants was developed, based on measurement of the MIC. The susceptibility of 35 P. aeruginosa isolates to two chemical disinfectants was found to vary among strains. MICs ranged from 6.25 to 100% for both disinfectants at 37°C, and a number of strains were not inhibited by a 100% disinfectant concentration in the lens case environment at room temperature (22°C). Resistance to disinfection appeared to be an inherent rather than acquired trait, since some resistant strains had been isolated prior to the introduction of the disinfectants and some susceptible P. aeruginosa strains could not be made more resistant by repeated disinfectant exposure. A number of P. aeruginosa strains which were comparatively more resistant to short-term disinfectant exposure also demonstrated the ability to grow to levels above the initial inoculum in one chemical disinfectant after long-term (24 to 48 h) disinfectant exposure. Resistance was correlated with acute cytotoxic activity toward corneal epithelial cells and with exsA, which encodes a protein that regulates cytotoxicity via a complex type III secretion system. These results suggest that chemical disinfection solutions may select for contamination with cytotoxic strains. Further investigation of the mechanisms and factors responsible for resistance may also lead to strategies for reducing adverse responses to contact lens wear.

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Ulcerative Keratitis Associated with Contact Lens Wear

Cited by 210 publications

References 17 publications

The Adherence of Pseudomonas aeruginosa to Hydrophilic Contact Lenses and Other Substrata

The Adherence of Pseudomonas aeruginosa to Hydrophilic Contact Lenses and Other Substrata

Current Perspectives on Ophthalmic Mycoses

Resistance of Pseudomonas aeruginosa Isolates to Hydrogel Contact Lens Disinfection Correlates with Cytotoxic Activity

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