A Case of Fungal Keratitis as a Complication of Orthokeratology Contact Lens

Ja Kyun Lee; Ji Eun Lee; Jong Soo Lee

doi:10.3341/jkos.2007.48.10.1415

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Lee, Lee, and Lee: A Case of Fungal Keratitis as a Complication of Orthokeratology Contact Lens

Original Article

J Korean Ophthalmol Soc 2007;48(10):1415-1418.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.10.1415

A Case of Fungal Keratitis as a Complication of Orthokeratology Contact Lens

Ja Kyun Lee, M.D.¹, Ji Eun Lee, M.D.¹, Jong Soo Lee, M.D.¹

¹The Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea

Address reprint requests to Ji Eun Lee, M.D., Department of Ophthalmology Pusan National University Hospital #1-10 Ami-dong, Seo-gu, Pusan 602-739, Korea, Tel: 82-51-240-7326, Fax: 82-51-242-7341, E-mail: Jiel75@hanmail.net

Received 4 January 2007 Accepted 7 June 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To present a case report of fungal keratitis related to prolonged overnight use of orthokeratology contact lenses.

Methods

A 13 year-old girl presented with a corneal ulcer in her left eye refractory to antibacterial medication. She had a history of wearing orthokeratology contact lenses overnight for seven months.

Results

The organism Aspergillus was isolated by corneal scraping, the contact lens itself, and from the storage case. The patient was treated with topical fluconazole and Natamycin pimaricin in addition to oral itraconazole, resulting in a resolution of the ocular lesion.

Conclusions

The risk of fungal infection as a potential complication of the use of overnight orthkeratology contact lenses should be considered when using these lenses.

Keywords: Aspergillus, Fungal keratitis, Natamycin, Orthokeratology

References

1. Wilson DR, Keeney AH. Corrective measures of myopia. Surv Ophthalmol. 1962; 34:294–304.

2. Alhharbi A, Swarbrick H. The effects of overnight orthokeratology lens wear on corneal thickness. Invest Ophthalmol Vis Sci. 2003; 44:2518–23.

3. Liesegang TJ. Contact lens-related microbial keratitis. Cornea. 1997; 16:125–31.

4. Berstein HN. Fungal growth into a Bionite hydrophilic contact lens. Ann Ophthalmol. 1973; 5:317–22.

5. Xuguang S, Huiying Zhao, Shijing Deng, et al. Infectious keratitis related to orthokeratology. Ophthal Physiol Opt. 2006; 26:133–6.

6. Wilson DR, Keeney AH. Corrective measures for myopia. Sur Ophthalmol. 1990; 34:294–5.

7. Lee YB, Tchah H. A case of microbial keratitis as a complication of orthokeratology contact lens wear. J Korean Ophthalmol Soc. 1999; 40:1401–4.

8. Xuguang S, Lin C, Yan Z, et al. Acanthamoeba keratitis as a complication of orthokeratology. Am J Ophthalmol. 2003; 136:1151–9.

9. Roth HW. The etiology of ocular irritation in soft lens wearers; distribution in a large clinical sample. Contact Intraocular Lens Med J. 1978; 4:38–47.

10. Eriken SP. Hydrophilic soft lens sterility and disinfection. In : Ruben M, editor. Soft Contact Lenses : Clinical and Applied Technology. 1st ed.New York: Wiley;1978. chap. 5.

11. Wilson LA, Ahearn DG. Association of fungi with extended-wear soft lenses. Am J Ophthalmol. 1986; 101:434–6.

12. Hammeke JC, Ellis PP. Mycotic flora of the conjunctiva. Am J Ophthalmol. 1960; 49:1174–8.

13. Lau LI, Wu CC, Lee SM, et al. Pseudomonas corneal ulcer related to overnight orthokeratology. Cornea. 2003; 22:262–4.

14. Young AL, Leung AT, Cheung EY, et al. Orthokeratology lens-related pseudomonas aeruginosa infectious keratitis. Cornea. 2003; 22:265–6.

15. Young AL, Leung AT, Cheung LL, et al. Orthokeratology lens-related corneal ulcers in children: a case series. Ophthalmology. 2004; 111:590–5.

Figure 1.

Slitlamp view of patient's left eye shows squareshaped, 3.5×3.5 mm sized irregular corneal infiltration which is located slightly inferior to the corneal center.

Figure 2.

Cotton blue staining of corneal scraping. Highpower photomicrograph shows hyphe elements of Aspergillus.

Figure 3.

After 3 months, residual corneal scarring remained.

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