Daytime orthokeratology associated with infectious keratitis by multiple gram-negative bacilli: Burkholderia cepacia, Pseudomonas putida, and Pseudomonas aeruginosa.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101160941 Publication Model: Print Cited Medium: Print ISSN: 1542-2321 (Print) Linking ISSN: 15422321 NLM ISO Abbreviation: Eye Contact Lens Subsets: MEDLINE

Original Publication: Hagerstown, Md. : Lippincott Williams & Wilkins, c2003-

Burkholderia Infections/*microbiology ; Contact Lenses/*adverse effects ; Corneal Ulcer/*microbiology ; Eye Infections, Bacterial/*microbiology ; Gram-Negative Bacteria/*isolation & purification ; Pseudomonas Infections/*microbiology; Adolescent ; Astigmatism/therapy ; Burkholderia Infections/pathology ; Burkholderia cepacia/isolation & purification ; Contact Lenses/microbiology ; Corneal Topography ; Corneal Ulcer/pathology ; Diagnosis, Differential ; Eye Infections, Bacterial/pathology ; Female ; Follow-Up Studies ; Humans ; Myopia/therapy ; Pseudomonas Infections/pathology ; Pseudomonas aeruginosa/isolation & purification ; Pseudomonas putida/isolation & purification ; Time Factors

Purpose: To report a case of a corneal ulcer in a patient who wore orthokeratology contact lenses during the day.
Methods: Case report.
Results: A 16-year-old girl who underwent orthokeratology treatment developed a corneal ulcer in her right eye. The refractive status of the affected eye was -5.75 -1.75 x 180, and the best-corrected visual acuity was 20/40. Corneal topography showed the temporal upper dislocation of a central flattened zone in the right eye. The patient had worn orthokeratology contact lenses during the day for more than 4 years. Her ulcer became worse after treatment with tobramycin and gentamicin for 1 day. After treatment with ciprofloxacin, the ulcer healed, and visual acuity returned to 20/20 with spectacle correction. Cultures of the cornea, contact lens, and lens solution all grew Burkholderia cepacia, Pseudomonas putida, and Pseudomonas aeruginosa.
Conclusions: Improper fitting of lenses and contamination of lenses or solutions in orthokeratology therapy are risk factors for a corneal ulcer, even when patients wear orthokeratology lenses only during the day.

Date Created: 20060118 Date Completed: 20060404 Latest Revision: 20220321

20231215

10.1097/01.icl.0000167714.53847.8c

16415688