Continuous epidemic of rare eye infection in contact lens wearers

(CNN) – A new study reveals that a rare epidemic of a rare eye infection has been detected in lens wearers in the UK.

Researchers from University College London found that keratitis rates in Acanthamoeba, a corneal infection, had nearly tripled since 2011 in southeastern England.

Infection with Acanthamoeba, a microorganism forming a cyst, causes inflammation of the cornea. Symptoms include excessive pain and compromised vision.

The disease is largely preventable, said Dr. John Dart, a consultant ophthalmologist at Moorfields Eye Hospital, who led the research.

"It was clear that there was a problem," he said. "Acanthamoeba keratitis is one of the worst infections of the cornea."

According to Moorfields Eye Hospital, studies suggest that approximately 2 to 100,000 lens wearers in the UK are affected each year, which means that the number of cases is higher in the United Kingdom than in any other country. other parts of the world. .

In the United States, the Centers for Disease Control and Prevention estimates the frequency to one or two cases in a million lens wearers; 85% of cases will occur in lens wearers.

The new study has identified a push in the UK.

The Dart team analyzed the incidence data collected by Moorfields, where cases are treated in southeastern England, and found an average of 50.3 cases of keratitis at Acanthamoeba per year between 2011 and 2016, compared to 18.5 in previous years.

"Acanthamoeba keratitis is a rare infection, but when it occurs, it has a devastating effect for a long time on the patient's life," said Dart. "Only 70% of patients were cured within 12 months.For the remaining 30%, treatment took more than a year."

The researchers say their findings apply in the UK, as Moorfields Eye Hospital treats over 35% of cases in the country.

Acanthamoeba keratitis is 20 times less likely than bacterial infections in lens wearers. According to the new study, severe cases require up to 10 months of treatment with antiseptic drops, followed by 38 months of follow-up visits.

The most severe cases also lead to a permanent 75% decrease in vision due to corneal scarring, a quarter of patients requiring a corneal transplant, Dart said. He explained that corneal transplant surgeries are sometimes required to treat holes in patients' eyes due to ulcers caused by the infection or to restore vision.

Irenie Ekkeshis, 39, who wears contact lenses daily, was diagnosed with keratitis in Acanthamoeba in 2011, despite strict lens hygiene.

She remembers her awakening on a January morning with excruciating pain and a sore eye "that was very sensitive to bright light". The pain worsened over time, and Ekkeshis knew that something was wrong with his eye.

His treatment lasted three years as the standard antiseptic droplet treatment was not effective. She had to undergo several other procedures, including two cornea transplant surgeries, she said.

Dr. Frank Larkin, Lecturer at the Institute of Ophthalmology UCL and at the Faculty of Medicine at Imperial College, Current treatments are "not good enough".

"The Acanthamoeba body is very resistant to drugs, which is the main reason why some patients' treatments take a lot of time," said Larkin, who was not involved in the new study.

Nearly eight years after his diagnosis, Ekkeshis regularly visits Moorfields because of problems with his cornea transplant.

She is now campaigning to increase awareness of the infection, specifically advocating a written warning about the packaging of contact lenses on the importance of avoiding their contamination by water – a way to prevent the infection.

Ninety percent of cases of Acanthamoeba keratitis in the UK are found in contact lens wearers, because of most of the risk factors related to lens hygiene, said Dart.

The infection occurs most often in hard water areas, where limestone provides an optimal environment for the development of the Acanthamoeba microorganism.

A separate study conducted in the study of more than 270 people using reusable contact lenses found that the risk of developing the disease was more than three times higher for people with poor contact lens hygiene. their lenses, those that used disinfectant products containing Oxipol (now eliminated by the manufacturer) and those who carried their lenses in pools or hot tubs.

The study shows that showering and washing the face while wearing contact lenses are also risk factors.

"There is an increased risk with a particular disinfectant, Oxipol, and it's good news that the manufacturer has shut down," said Dr. Ravi Goel, American ophthalmologist and spokesperson for the company. American Academy of Ophthalmology. the new study. "Any infection related to the use of contact lenses is serious. [This] is a rare form of infection, so we must educate our patients. "

"You can not designate a single risk factor – it's the most important part of the study."

Dart advises contact users to purchase disposable contacts daily or to ensure that lenses and their containers are not contaminated by tap water.

Larkin thinks that "contact lens wearers should be concerned".

"There has been a gradual and significant increase in AK in contact lens wearers, although more and more people are using disposable contact lenses, which pose a lower risk of infection. "

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