The cornea is the transparent tissue located on the surface of the eye, in front of the iris. Corneal (or contact) lenses are prostheses that cover the outside of the cornea. Sometimes contact lens users suffer from eye complications that lead to a reduction in visual acuity or even loss of vision .
Most corneal damage caused by lenses falls into the category of infections (infectious keratitis). These can be caused either by corneal trauma (such as a scratch or wound to the cornea) or by bacteria or a fungus coming from dirty lenses or finally, more rarely, by parasites (or free amoebae). It is most often a lack of hygiene that is the cause of eye infections among contact lens wearers. Permanently worn lenses are an aggravating factor.
Different types of infectious keratitis can affect contact lens wearers. The most common is bacterial keratitis . This infection is caused by bacteria found in soil, water, drains and plants. Wearing lenses contributes to the appearance of bacterial keratitis, especially when certain hygiene standards are not respected during their daily maintenance.
It is then necessary to quickly search for the germs in question in order to find the appropriate antibiotic treatment. The infection can sometimes be so severe that it develops into a corneal abscess and a corneal transplant must be considered .
Less common, amoebic keratitis is a serious pathology caused by an amoeba found in tap water or swimming pools. It most often affects people who use running water to care for their lenses. It can lead to edema ,corneal abscesses or ulcers , or even cause blindness if anti-amoebic treatment is not taken in time.
When keratitis is caused by a fungus , it is called fungal keratitis . This painful corneal infection is rare in Europe where it represents less than 1% of corneal infections. On the other hand, it is more widespread in tropical countries or developing countries.
Finally, the corneal ulcer is an open wound on the outer surface of the cornea which can be caused by a scratch , for example when inserting or removing the lens.
What is the benefit of a second opinion for corneal infections under lenses?
Why seek a second opinion for corneal infections under lenses?
The second opinion in the context of infectious keratitis caused by wearing lenses is entirely relevant to confirm a diagnosis and more specifically the type of keratitis from which you suffer. It also allows you to ensure that the current treatment is suitable for your case.
Indeed, in certain cases, inflammation can threaten the visual prognosis, especially when treatment is started late, hence the importance of receiving the appropriate treatment as early as possible. In terms of keratoplasty, numerous operating techniques (transfixing, lamellar) exist. A second opinion may be relevant to know the ins and outsand outcomes of each technique.
Who is the specialist for corneal infections under lenses?
The point of contact for the diagnosis of corneal infections under lenses is an ophthalmologist and JLR Eye Hospital is the specialist in eye diseases.
What are the symptoms of corneal infections under lenses?
Symptoms of infectious keratitis typically include severe pain , eye redness , sensitivity to light ( photosensitivity ), tearing , and decreased visual acuity .
How to diagnose corneal infections under lenses?
The diagnosis of keratitis is firstly based on a questioning and a clinical examination by the doctor who looks in particular for the symptoms and risk factors of the disease. A slit lamp examination will be performed during the clinical examination.
It can be carried out in addition to the exploration of bacteriological samples from the cornea and the lens. A fundus examination and B-mode ultrasound may be necessary to look for complications of under-lens corneal infection .
How to treat corneal infections with lenses?
The choice of treatment depends:
- the type of infection diagnosed
- early diagnosis
- the degree of infection
- the type of germ (bacteriological, fungal or amoebic) which will have been discovered during the analysis
- the patient's ophthalmological history
- the age and general state of health of the patient, particularly in the case of keratoplasty.
Antibiotic-based treatments, which combine one or more antibiotics (depending on the severity of the condition), are generally prescribed in cases of bacterial keratitis or corneal ulcers. These treatments may require hospitalisation because the antibiotic eye drops are initially injected very frequently (every hour, including at night at the beginning). Healing eye drops are often combined.
The most serious forms (such as corneal abscess) may require inpatient treatment. A transplant is sometimes necessary to cure keratitis. A corneal transplant, also called keratoplasty, is proposed when the pain is irrepressible, and the inflammation persists, or in the event of perforation or abscess of the cornea.
This surgical procedure aims to replace the affected cornea, with tissue that comes from a donor whose eye health is good. When keratoplasty is successful, it results in a gradual improvement in vision.
In the case of amoebic keratitis, these are anti-amoebic drugs, which will be prescribed in the form of eye drops. However their effectiveness depends on how early the diagnosis is made.
Finally, treatments against fungal keratitis exist, but their real power is still undetermined. They usually consist of antifungal drops. The treatment and the frequency of instillation are adapted according to the germ and the clinical course.
