Being able to see well is a vital aspect of performing daily activities for most people. Worldwide, many people rely on contact lenses (as well as glasses and eye surgery) to improve their sight. Contact lenses can provide many benefits, but they are not risk-free—especially if contact lens wearers don’t practice healthy habits and take care of their contact lenses and supplies. If patients seek care quickly, most complications can be easily treated by an eye doctor. However, more serious infections can cause pain and even permanent vision loss, depending on the cause and how long the patient waits to seek treatment.

Keratitis

Contact lens wear is linked to higher risk of keratitis, or inflammation of the cornea (the clear dome that covers the colored part of the eye). Many contact lens wearers do not care for their contact lenses and supplies as instructed, which increases their risk of eye problems like keratitis.

Keratitis in contact lens wearers can be caused by many factors. One type of keratitis, called microbial keratitis, can occur when germs invade the cornea. These germs—such as viruses, bacteria, fungi, or parasites (amebae)—are more likely to invade the eyes when contact lenses are worn for too long or are not cared for correctly. Microbial keratitis is a serious type of eye infection in contact lens wearers, which can lead to blindness or the need for corneal transplant in the most severe cases.

Types of Microbial Keratitis

• Bacterial Keratitis
• Fungal Keratitis
• Parasitic/Amebic Keratitis
• Viral Keratitis

Symptoms of Eye Infection

• Irritated, red eyes
• Worsening pain in or around the eyes—even after contact lens removal
• Light sensitivity
• Sudden blurry vision
• Unusually watery eyes or discharge

Prevention

Microbial keratitis can usually be prevented through healthy habits and proper care of contact lenses and supplies. Keep your eyes healthy while wearing contact lenses by following these tips, and always be sure to carry a pair of glasses with you—just in case you have to take out your contact lenses.

What is bacterial keratitis?

Bacterial keratitis is an infection of the cornea (the clear dome covering the colored part of the eye) that is caused by bacteria. It can affect contact lens wearers, and also sometimes people who do not wear contact lenses. Types of bacteria that commonly cause bacterial keratitis include:

• Pseudomonas aeruginosa
• Staphylococcus aureus

What are the symptoms of bacterial keratitis?

Symptoms of bacterial keratitis include:

• Eye pain
• Eye redness
• Blurred vision
• Sensitivity to light
• Excessive tearing
• Eye discharge

If you experience any of these symptoms, remove your contact lenses (if you wear them) and call your eye doctor right away. If left untreated, bacterial keratitis can result in vision loss or blindness.

Where are these bacteria found?

Bacteria are common in nature and found in the environment and on the human body. Pseudomonas bacteria can be found in soil and water. Staphylococcus aureus bacteria normally live on human skin and on the protective lining inside the body called the mucous membrane. Bacterial keratitis cannot be spread from person to person.

What puts people at risk for bacterial keratitis?

Risks for developing bacterial keratitis include:

• Wearing contact lenses, especially:
  • Overnight wear
  • Temporary reshaping of the cornea (to correct nearsightedness) by wearing a rigid contact lens overnight, otherwise known as orthokeratology (Ortho-K)
  • Not disinfecting contact lenses well
  • Not cleaning contact lens cases
  • Storing or rinsing contact lenses in water
  • Using visibly contaminated lens solution
  • “Topping off” lens solution rather than discarding used solution and replacing
  • Sharing non-corrective contact lenses used for cosmetic purposes
• Recent eye injury
• Eye disease
• Weakened immune system
• Problems with the eyelids or tearing

How is bacterial keratitis diagnosed?

It is critical that when you first notice unusual eye irritation that you remove your contact lenses and not wear them again until instructed to do so by your eye doctor. Your eye doctor will examine your eye. He or she may take a tiny scraping of your cornea and send a sample to a laboratory to be analyzed.

How do you prevent bacterial keratitis?

Follow these tips to keep your eyes healthy while wearing contact lenses. Your daily habits, your contact lenses and supplies, and your eye doctor are all important.

What is fungal keratitis?

Fungal keratitis is an infection of the cornea (the clear dome covering the colored part of the eye) that is caused by a fungus. Some fungi that have been known to commonly cause fungal keratitis include:

• Fusarium species
• Aspergillus species
• Candida species

What are symptoms of fungal keratitis?

Symptoms of fungal keratitis include:

• Eye pain
• Eye redness
• Blurred vision
• Sensitivity to light
• Excessive tearing
• Eye discharge

If you experience any of these symptoms, remove your contact lenses (if you wear them) and call your eye doctor right away. Fungal keratitis is a very rare condition, but if left untreated, it can become serious and result in vision loss or blindness.

Where are these fungi found?

Fusarium and Aspergillus species live in the environment. Candida species normally live on human skin and on the protective lining inside the body called the mucous membrane. Fungal keratitis is most common in tropical and sub-tropical regions of the world, but can also occur in areas of the world with milder temperatures. It cannot be spread from person to person.

What puts people at risk for fungal keratitis?

The most common way that someone gets fungal keratitis is after experiencing trauma to the eye— especially trauma caused by a stick, thorn, or plant.

Risks for developing fungal keratitis include:

• Recent eye trauma, particularly involving plants (for example, thorns or sticks)
• Underlying eye disease
• Weakened immune system
• Contact lens use

In 2006, CDC investigated an outbreak of Fusarium keratitis that was associated with a specific type of contact lens solution, which was withdrawn from the market.

How is fungal keratitis diagnosed?

Your eye doctor will examine your eye and may possibly take a tiny scraping of your cornea. The sample will be sent to a laboratory to be analyzed.

How is fungal keratitis treated?

Fungal keratitis must be treated with prescription antifungal medicine for several months. Patients who do not get better after skin treatment and oral antifungal medications may require surgery, including corneal transplantation.

How do you prevent fungal keratitis?

Protective eyewear is recommended for people who are at risk for eye trauma involving plants, such as agricultural workers.

Follow these tips to keep your eyes healthy while wearing contact lenses. Your daily habits, your contact lenses and supplies, and your eye doctor are all important.

What is Acanthamoeba keratitis?

Acanthamoeba keratitis, or AK, is a rare but serious infection of the eye that can cause permanent vision loss or blindness. This infection is caused by a tiny ameba (single-celled living organism) called Acanthamoeba.Acanthamoeba causes Acanthamoeba keratitis when it infects the cornea, the clear dome that covers the colored part of the eye.

What are the symptoms of Acanthamoeba keratitis?

Symptoms of AK include:

• Sensation of something in the eye
• Eye pain
• Eye redness
• Blurred vision
• Sensitivity to light
• Excessive tearing

If you experience any of these symptoms, remove your contact lenses (if you wear them) and call your eye doctor right away. AK is a rare condition, but if left untreated it can result in vision loss or blindness.

Where is Acanthamoeba found?

Acanthamoeba is very common in nature and can be found in bodies of water (for example, lakes and oceans) and soil. It can also be found in tap water, heating, ventilating, and air conditioning units, and whirlpools. Infection of the eye occurs when the Acanthamoeba organisms contained in water or contact lens solution enter the eye through small scrapes that can be caused by contact lens wear or other minor eye injuries. The Acanthamoeba organism has to make contact directly with the eyes in order to cause AK, so this type of corneal infection cannot occur from drinking or inhaling water that has this ameba in it. AK cannot be spread from person to person.

What puts people at risk for Acanthamoeba keratitis?

In the United States, an estimated 85% of AK cases occur in contact lens wearers. For people who wear contact lenses, the risk of getting Acanthamoeba keratitis is higher if they:

• Do not store or handle contact lenses properly. This can include not washing hands before touching contact lenses, not rubbing and rinsing lenses after taking them out, and not storing them in the recommended contact lens solution
• Do not disinfect contact lenses properly. This can include using tap water to clean the lenses or lens case, or adding fresh solution to existing used solution in the case instead of using only fresh solution when storing contact lenses
• Swim, use a hot tub, or shower while wearing lenses
• Have a history of trauma to the cornea, such as a previous eye injury

In 2007, CDC investigated a nationwide outbreak of Acanthamoeba keratitis which led to the recall of a specific type of contact lens solution from the market. Another nationwide outbreak in 2011 pointed to inadequate hygiene among contact lens wearers, in addition to water exposure and “topping off”—adding fresh solution to old solution—in the contact case.

How is Acanthamoeba keratitis diagnosed?

Early diagnosis is important because early treatment can prevent AK infections from becoming more severe. The infection is usually diagnosed by an eye doctor based on symptoms, lab results from a scraping of the eye, and/or through a close-up eye exam that allows the eye doctor to see the ameba.

How is Acanthamoeba keratitis treated?

AK can be difficult to treat, and the best treatment regimen for each patient should be determined by an eye doctor. AK usually requires aggressive medical and surgical treatment. If you think that your eye may be infected with Acanthamoeba, see an eye doctor immediately.

How do you prevent Acanthamoeba keratitis?

Follow these tips to keep your eyes healthy while wearing contact lenses. Your daily habits, your contact lenses and supplies, and your eye doctor are all important.

What is HSV (Herpes Simplex Virus) keratitis?

HSV (Herpes Simplex Virus) keratitis is an infection of the cornea—the clear dome that covers the colored part of the eye—that is caused by HSV. The infection usually heals without damaging the eye, but more severe infections can lead to scarring of the cornea or blindness. HSV keratitis is a major cause of blindness worldwide. HSV-1, which is the type of HSV that also causes cold sores on the mouth, is the most common cause of corneal infections.

What are the symptoms of HSV keratitis?

Symptoms of HSV keratitis include:

• Eye pain
• Eye redness
• Blurred vision
• Sensitivity to light
• Watery discharge

If you experience any of these symptoms, remove your contact lenses (if you wear them) and call your eye doctor right away. If left untreated, HSV keratitis can result in vision loss or blindness.

Where is HSV found?

HSV is only found in humans and is spread through direct contact with someone who is infected with the virus. Most HSV keratitis infections happen after another part of the body—most commonly the mouth—has already been infected by HSV. HSV keratitis is often the result of a “flare up” (reactivation) of the earlier infection.

What puts people at risk for HSV keratitis?

People who have had HSV keratitis are at risk for recurrences of the same infection. For these people, wearing contact lenses may further increase the risk.

People most at risk for HSV-1 (but not necessarily HSV keratitis) are:

• Female
• Non-Hispanic black or Mexican American
• Born outside the United States
• Sexually active, or have had 3 or more lifetime sex partners

How is HSV keratitis diagnosed?

HSV keratitis is usually diagnosed based on a patient’s health history and findings from an eye exam. Lab testing is not usually necessary, but certain lab tests may further help to confirm HSV-1.

How is HSV keratitis treated?

The treatment of HSV keratitis usually involves medicine, including eye drops or antiviral medications taken by mouth. Surgery is rarely necessary but may be considered if scarring on the eye from HSV keratitis causes vision problems. Each case of HSV keratitis is unique, and an eye doctor should determine the best treatment for each patient. While some treatments can greatly lower the severity and recurrence of symptoms, there is no cure for HSV.

How do you prevent HSV keratitis?

Currently there are no proven methods for preventing HSV keratitis, but some steps available from the Mayo Clinic may help to control HSV keratitis recurrences:

• Avoid touching your eyes or the area around your eyes unless you have washed your hands properly—especially if you have a cold sore or herpes blister.
• Only use eye drops that have been prescribed or recommended by an eye doctor or health care provider.

Your daily habits, your contact lenses and supplies, and your eye doctor are all important.

You only have one pair of eyes, so take care of them! Healthy Habits = Healthy Eyes. Taking proper care of your contact lenses can help you see better and keep your eyes healthy.

When cared for properly, contact lenses can provide a safe and effective way to correct your vision. In fact, more than 45 million Americans wear contact lenses. However, wearing contact lenses can increase your chance of getting an eye infection—especially if you do not care for your lenses the right way.

Contact Lens Health Starts with You

Your habits, supplies, and eye care provider are all essential to keeping your eyes healthy. Both contact lens wearers and eye care providers play an important role in proper eye care. By following your eye care provider’s instructions on how to properly wear, clean, and store your lenses, you can enjoy the comfort and benefits of contact lenses while lowering your chances of an eye infection.

Follow these healthy habits to safely wear contact lenses and help protect your eyes:

Tips for Hard, or Rigid Gas Permeable (RGP), Contact Lens Wearers

The wear and care recommendations for soft contact lenses also apply to hard, or rigid gas permeable (RGP or GP), contact lenses. Follow these extra tips:

• Follow the lens cleaning guidance of your eye care provider and the lens solution use instructions. Take care to avoid using tap water to rinse or store your hard contact lenses.
• Hard contact lenses can last much longer than soft contact lenses if cared for properly. Replace your hard contact lenses when recommended to do so by your eye care provider.