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 Acanthamoeba Keratitis in Contact Lens users - CDC Health Ad

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PostSubject: Acanthamoeba Keratitis in Contact Lens users - CDC Health Ad   Thu Sep 20, 2007 11:55 pm

Early Report of Serious Eye Infections Associated with Soft Contact Lens Solution



The Centers for Disease Control and Prevention (CDC), collaborating
with the Food and Drug Administration, state and other partners, has
identified an outbreak of a serious but rare eye infection called
Acanthamoeba keratitis (AK). This infection is caused by a free-living
ameba (Acanthamoeba) a microscopic organism found everywhere in nature.
Infections can result in permanent visual impairment or blindness. AK
primarily affects otherwise healthy people, most of whom wear contact
lenses. In the United States, an estimated 85% of cases of this
infection occur in contact lens users. The incidence of the disease in
the U.S. is approximately one to two cases per million contact lens
users.



CDC has received reports of 138 cases of culture-confirmed AK in 35
states and Puerto Rico, with complete patient data available for 46
case-patients. Thirty-nine of the 46 case-patients wore soft contact
lenses. Preliminary information obtained by CDC from patient interviews
indicates that, among soft contact lens users who reported the use of
any type of solution, 21 (58%) reported having used Advanced Medical
Optics (AMO) CompleteR MoisturePlusTM Multi-Purpose Solution in the
month prior to symptom onset. Out of the 37 case-patients for whom
clinical data was available, 9 (24%) failed medical therapy and
required or are expected to undergo corneal transplantation.



Based on these findings people who wear soft contact lenses who use
Advanced Medical Optics (AMO) CompleteR MoisturePlusTM Multi-Purpose
Solution should:



Stop using the product immediately and discard all remaining solution
including partially used or unopened bottles. Choose an alternative
contact lens solution.



Discard current lens storage container.



Discard current pair of soft lenses.



See a health care provider if experiencing any signs of eye
infection: Eye pain, eye redness, blurred vision, sensitivity to light,
sensation of something in the eye, or excessive tearing.



All contact lens users should closely follow prevention measures to help prevent eye infections, which include



See an eye care professional for regular eye examinations.



Wear and replace contact lenses according to the schedule prescribed by an eye care professional.



Remove contact lenses before any activity involving contact with
water, including showering, using a hot tub, or swimming.



Wash hands with soap and water and dry before handling contact lenses.



Clean contact lenses according to the manufacturer's guidelines and instructions from an eye care professional.



Use fresh cleaning or disinfecting solution each time lenses are
cleaned and stored. Never reuse or top off old solution.



Never use saline solution and rewetting drops to disinfect lenses.
Neither solution is an effective or approved disinfectant.



Store reusable lenses in the proper storage case.



Storage cases should be rinsed with sterile contact lens solution
(never use tap water) and left open to dry after each use.



Replace storage cases at least once every three months



Clinicians evaluating contact lens users with symptoms of eye pain or
redness, tearing, decreased visual acuity, discharge, sensitivity to
light, or foreign body sensation should consider AK and refer the
patient to an ophthalmologist, if appropriate. Diagnosis requires a
high degree of suspicion, especially in a contact lens wearer with a
recent diagnosis of another form of keratitis, such as herpes simplex
virus keratitis, who is not responding to therapy. Diagnosis is made on
the basis of clinical picture and isolation of organisms from corneal
culture or detection of trophozoites and/or cysts on histopathology.
However, a negative culture does not necessarily rule out Acanthamoeba
infection. Confocal microscopy and polymerase chain reaction assays to
detect Acanthamoeba may also assist with diagnosis. Early diagnosis can
greatly improve treatment efficacy.



Clinicians should consider obtaining clinical specimens (e.g., corneal scrapings) for culture before initiating treatment.



For more information, see the CDC website: http://www.cdc.gov/ncidod/dpd/parasi...oeba/index.htm















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