Keratitis
What is it?
Misuse or poor hygiene of contact lenses can cause various eye problems, including inflammation of the cornea, or keratitis, which can be caused by dryness, tenderness or infection and can lead to vision loss. Contact lenses are elements that we use to neutralize the ametropia (myopia, astigmatism, farsightedness and presbyopia) with very good results and minimal complications. The cornea is the transparent layer above the eye and on her the lens is placed.
We have soft and gas permeable rigid lenses. They can be of daily use, both disposable and reusable, or prolonged use with large oxygen permeability, and they can be slept with for a maximum of thirty days.
Symptoms
Symptoms of keratitis include red eye, foreign body sensation, blurred vision, discharge, tearing, discomfort to light and pain. In cases of severe infection hypopyon (pus deposit in the anterior chamber of the eye) and deep ulceration with risk of perforation
Treatment
It depends on the etiologic agent. If they are caused by herpes virus, even though it usually has little relation to the use of contact lenses, it will be treated with antivirals. Bacterial keratitis, which is the more dangerous Pseudomonas, it is reinforced with topical antibiotics. Those produced by fungi are more resistant and difficult to treat, and can also cause uveitis. They are treated systemically with antifungals. It is sometimes necessary to aspirate hypopyon and washing the anterior chamber in the operating room with diluted antifungal. Another type of keratitis is caused by Acanthamoeba, which has trophozoites and cysts. It occurs mainly in patients with soft lenses bathing in pools or in the sea with them on. They are treated with Antiamoebic for at least 6 months.
Sometimes, in severe cases, it is necessary to complete the clinical treatment with a corneal transplant.
Prevention
For any type of keratitis and treatment we must know what is the cause that produces it, for which we make a detailed history.
Factors contributing to infection with contact lenses are the lack of cleanliness during use, inadequate disinfection, environmental pollution, lack of lubrication, sleep with contact lenses, bathing in pools or in the sea with them or use them more time advised. Contact lenses that produce less infectious problems are rigid, gas permeable or soft disposable lenses. In addition, regular checks for wearers of contact lenses are recommended.