But hey!!!!!! Don’t listen to any of us, check these folks out!
Case one
A 21-year-old male returned to the UK from a beach holiday. He presented to casualty at Manchester Royal Eye Hospital (MREH) with a painful right eye for 1 day, with hand movements acuity and a 7 mm times 8 mm infiltrated corneal ulcer with hypopyon (Photograph 1, top). He had been wearing a pair of SiH lenses for 1 week and had swum in the sea without goggles each day. Corneal scrape cultured moderate growth of Pseudomonas aeruginosa, sensitive to ofloxacin, ciprofloxacin, ceftazidime, and gentamicin. He was initially treated with intensive topical ofloxacin 0.3%, with topical prednisolone added once healing was underway. After 2 months, acuity was 6/12 with pinhole with a 4.5 mm central scar and small epithelial defect.
Case two
A 28-year-old male presented to MREH with a painful red eye with a central infected ulcer after wearing an SiH lens overnight for 1 night only. He had previously worn hydrogel soft contact lenses on a daily wear basis for 7 years with no problems. At 3 days before presentation, he commenced wearing a pair of SiH lenses for the first time. As instructed, he wore them during the day only for the first 2 days, removing them in the evening and disinfecting them with the solution provided by his contact lens practitioner. On the third day, he was to wear them overnight and be reviewed by the contact lens practitioner the following day. That day he woke with an extremely painful red left eye, unable to see, removed the lenses and presented to casualty at MREH. The acuity was 6/5 RE, light perception LE, with a dense central circular infiltrate and ulcer (Photograph 1, middle). Both corneal scrape and contact lens cultures isolated moderate growths of P. aeruginosa sensitive to ofloxacin, ciprofloxacin, gentamicin, and imipenem. He responded to intensive guttae ofloxacin, with topical steroid added once improvement was apparent.
After 3 months, with a depressed facetted dense paracentral corneal scar of 3.5 mm diameter, the acuity is 6/18 unaided not improving with pinhole.
Case three
A 42-year-old SiH contact lens wearer presented to Bristol Eye Hospital after developing some discomfort in the 3 eye three days previously and having removed the contact lens at that time. He had been wearing the lenses for 5 days, which his contact lens practitioner changed on a weekly basis. Visual acuity was reduced to 6/12. A circular 2 mm corneal abscess was present in the upper one-third of the cornea (Photograph 1, bottom). Cultures yielded a scanty growth of coagulase-negative staphylococci. He responded well to cefuroxime and gentamicin over a period of 7 days. Topical steroids were administered for several days in order to reduce inflammation and scarring. He was discharged 6 weeks after his initial visit, with acuity returning to normal.
Case four
A 25-year-old male presented to MREH casualty on return from a holiday abroad. He had a central corneal ulcer in the right eye with 1 mm hypopyon. His vision was reduced to hand movements compared to 6/4 in the left eye. He had been a user of monthly disposable SiH extended wear lenses for 2 years, but admitted that he sometimes took the lenses out at night and stored them in hydrogen peroxide and also that he had been swimming in the sea wearing lenses prior to developing his current problem.
A growth of P. aeruginosa was cultured from the corneal scrape and this was sensitive to ofloxacin. He responded to treatment with intensive topical ofloxacin 0.3% and later topical prednisolone but has been left with a 1.6 mm central facetted scar and reduced vision of 6/9 at 1 month.
I don't normally cut and paste in to Fluther.com but I felt that this may be needed to extended the worry that everyone is expressing. It pretty much just boils down to not being lazy. Spend the 3 minutes it takes to do what is needed. Please. The last thing any of us need is to be hot on the street and killed because someone did not take care of their eyes.
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