Contact Lens Warning: The #1 Risk Factor for Dangerous Keratitis

What Is Keratitis?

Keratitis is inflammation of the cornea (the clear front layer of the eye). It can be infectious (caused by bacteria, viruses, fungi, or parasites) or non-infectious (due to injury, dryness, or contact lens misuse).

Key Facts (American Academy of Ophthalmology [AAO]):
✔ Contact lens wearers are at higher risk (especially with improper use).
✔ Herpes simplex virus (HSV) is a common viral cause.
✔ Can lead to vision loss if untreated.

Types of Keratitis (CDC & AAO)

1. Infectious Keratitis:
   • Bacterial (Pseudomonas, Staphylococcus) – common in contact lens wearers.
   • Viral (HSV, varicella-zoster) – often recurrent.
   • Fungal (Fusarium, Candida) – linked to plant injuries or contaminated solutions.
   • Acanthamoeba – rare but severe, from contaminated water or lenses.
2. Non-Infectious Keratitis:
   • Dry eye-related (severe dryness causes damage).
   • Photokeratitis (UV light exposure, e.g., welding or snow blindness).
   • Traumatic (scratches, chemical burns).

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Symptoms (Mayo Clinic)

✔ Eye redness and pain (often severe)
✔ Blurred vision or light sensitivity (photophobia)
✔ Excessive tearing or discharge (pus if bacterial)
✔ Feeling of something in the eye (foreign body sensation)
✔ White spot on the cornea (in severe cases)

Acanthamoeba keratitis symptoms:

• Extreme pain (disproportionate to redness)
• Ring-shaped ulcer on the cornea

Diagnosis (AAO)

1. Slit-lamp exam – checks for corneal damage.
2. Corneal scraping – lab testing for bacteria, fungi, or Acanthamoeba.
3. Fluorescein stain – highlights corneal abrasions.
4. PCR testing – for viral causes (HSV).

Treatment (NIH & FDA)

1. Infectious Keratitis:

• Bacterial: Antibiotic drops (e.g., fluoroquinolones).
• Viral (HSV): Antivirals (acyclovir ointment or oral meds).
• Fungal: Antifungal drops (natamycin, amphotericin B).
• Acanthamoeba: Special antiseptic drops (PHMB, chlorhexidine).

2. Non-Infectious Keratitis:

• Artificial tears (for dry eye).
• Bandage contact lens (for corneal abrasions).
• Steroid drops (caution: can worsen infections).

Never use steroid drops without a doctor’s approval!

Prevention (CDC & AAO)

Contact lens hygiene:

• Wash hands before handling lenses.
• Never sleep in lenses (unless prescribed).
• Replace solution daily (no “topping off”).

Avoid water exposure:

• No swimming/showering in contacts.
• Use daily disposables if possible.

Wear protective eyewear when:

• Working with chemicals.
• In bright sunlight (UV-blocking sunglasses).

Manage dry eye:

• Use preservative-free artificial tears.
• Stay hydrated.

Red Flags: When to See a Doctor (AAO)

Seek emergency care if:

• Severe eye pain + vision loss
• White spot on the cornea
• No improvement after 24 hours of treatment
• History of HSV eye infections

See an ophthalmologist within 24 hours if:

• Redness/persistent discomfort in a contact lens wearer.
• Light sensitivity + tearing lasts >1 day.