Microbial keratitis secondary to cosmetic contact lenses wear: a foreseeable disaster

Abstract

Abstract Purpose The aim of our study is to illustrate the implications of the cosmetic contact lenses (CCL) on ocular surface health and the occurence of microbial keratitis (MK). Methods A prospective multicenter study was conducted in 10 French University Hospitals on all non‐cosmetic CL wearers presenting with MK (CLRMK) between July 2007 and July 2009, including CCL wearers, and on healthy CL wearers. Cases and healthy wearers were interviewed by a 50 items anonymous standardized "questionnaire" to determine subject demographics and CL wear history. Results Two hundred fifty six patients were included for CLRMK. Thirty‐two of them (12.5%) were seen for MK after wearing CCL. One hundred thirteen healthy CL wearers were surveyed. Compared with healthy wearers, the relative risk of CL related MK is highly increased with CCL (OR, 16.5). Compared with CLRMK, CCL wearers are younger (21 versus 27 years of age) and recent CL wearers (3 versus 9 years). CCL were rarely dispensed by eye care professionals increasing the risk of MK (OR, 12.3). Education about lens care and handling was deficient (OR, 26.5). MK were more severe in the CCL wearers as compared as others CLRMK patients, with a high prevalence of gram negative bacillus and acanthamoeba keratitis. Conclusion Patients who acquire CCL are less likely to be instructed on appropriate lense use. Consequently, CCL wearers are experiencing acute vision‐threatening infections.