Microbial Keratitis Secondary to Therapeutic Contact Lens Wear

Abstract

Therapeutic contact lenses are commonly used to treat various ocular surface conditions that require restoration or maintenance of the corneal epithelium. While this is a very successful treatment modality, it is not without risk. The primary risk associated with bandage contact lens wear is microbial keratitis. This paper will review the literature on the occurrence and outcomes of microbial keratitis in the setting of therapeutic contact lens use, including orthokeratology. Therapeutic contact lenses are used in various situations including ocular surface disease, post-keratorefractive surgery, and post-corneal crosslinking. Orthokeratology utilizes a rigid contact lens for therapeutic purposes. Though an uncommon occurrence in the setting of therapeutic contact lenses, microbial keratitis can occur and can lead to vision loss even in the setting of prophylactic topical antibiotics. Despite improvements in contact lens materials that would reduce infection rates, use of modern therapeutic contact lenses can still result in microbial keratitis, even with the use of prophylactic antibiotics. Although incidence rates for microbial keratitis in with therapeutic contact lens use are not available, numerous reports confirm that care must be taken when using therapeutic contact lenses to avoid sight-threatening infections.