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Category: Volume 06 Issue 02 February 2018
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Title: The Pattern of Microbial Keratitis in soft Contact Lens Wearers in a Tertiary Care Hospital in Eastern India

Authors: Debabrata Datta, Syamal Modi, Krishanu Pal, Smriti Modi, Suman Adhikari, Shankar Prakash

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.127

Abstract

Background: Soft contact lenses are increasing in trend since a decade and are being used for both cosmetic and therapeutic purposes. Lack of compliance and poor hygiene towards lens care is one of the main causes associated with microbial contamination and eye infections. Microbial keratitis (MK) is one of the serious vision threatening outcomes of inappropriate contact lens use and may even lead to permanent damage to the cornea. About 43% of the corneal ulcers are mainly due to soft contact lens use. Pseudomonus aeruginosa and Acanthamoeba spp.  are associated more significantly with soft contact lens wearers apart from others like Staphylococcus aureus and Candida albicans. This study attempts to explore the risk of microbial contamination associated with inappropriate use and maintenance of contact lenses, type of microbial flora involved and their profile as regards ophthalmic infections in contact lens wearers.

Methods: The case control study consists of 68 subjects studied over a period of 6 months. One sample each was collected from the concave surface of contact lenses, lens case and tip of the solution bottles with the help of sterile cotton tipped swabs that were pre- moistened with sterile brain heart infusion (BHI) broth. Samples of lens care solution were directly cultured on solid media. All samples were inoculated onto 5% sheep blood agar, Chocolate agar, Mac Conkey's agar and Sabouraud's dextrose agar. The plates were incubated and the organisms grown identified using standard microbiological techniques. The statistical analysis was done using Chi square test.

Results: 66.2% subjects showed growth of organisms in at least one of the samples. The overall rate of microbial contamination among the total samples was 73.53%. Lens case was the most contaminated sample (64.5%) followed by lenses (58.2%), tip of solution bottles (55.6%) and lens care solution (45.5%). 158 samples were positive on culture for bacteria and 42 for fungi. Pseudomonas species and Staphylococci were the main bacteria whereas all the fungal isolates were Candida albicans. Infection associated with the use of contact lens was more in occasional users (67.6%) than daily users (32.4%). The subjects using contact lens for more than 2 years showed less contamination (66.6%) than those using for less than 2 years (81.8%). The subjects using contact lens for cosmetic purpose (38.2%) had more contamination (84.6%) than subjects using for therapeutic purpose (73.8%).

Conclusions: Our results showed that the soft contact lens care practices amongst the subjects were not satisfactory which results in high level contamination. To avoid complications, it is necessary to avoid continuous use of contact lenses, change CL wearing schedules, lens material and care solutions.

Keywords: Contact lens, keratitis, Candida, Pseudomonas, Staphylococci.

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Corresponding Author

Dr. Syamal Modi

Associate Professor, Department of Microbiology, E.S.I.C. Medical College and E.S.I.C. Hospital Joka,

Diamond Harbour Road, Kolkata - 700104, West Bengal, India

Ph: +91- (M) 9007474520, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.