Bilateral Pseudomonas corneal ulcer in a disposable contact lens wearer.
OBJECTIVE
To describe a case of bilateral corneal ulcers caused by Pseudomonas in a disposable soft contact lens wearer. This case study discusses the role of patient examination, contact lens care instruction, and adequate patient supervision in reducing the risk of serious potential complications.


RESULTS
A 17 year old student who had been using disposable soft contact lenses on an extended wear basis for 6 months presented complaining of pain in the left eye. When he was examined, a corneal ulcer with surrounding infiltrate was observed in the superior middle periphery of the left eye. Samples were collected for culture, and treatment with fortified cefalotin and gentamicin was started. After 8 hours the patient returned, now complaining of pain in the right eye. Examination of the right eye revealed a diffused keratitis with a mucopurulent discharge. A culture was taken, and the same treatment was instituted. The laboratory tests revealed Pseudomonas in both eyes. The bilateral corneal ulcers responded to therapy after 1 week of treatment.


CONCLUSIONS
We discuss the factors involved in the occurrence of infectious keratitis in contact lens wearers, and stress that even disposable contact lens wear can be associated with serious complications. This case also highlights extended wear as one of the main risk factors for complications in disposable soft contact lens wear.
Lipener
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Department of Ophthalmology, Federal University of São Paulo, Brazil.
Ribeiro
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D000293:Adolescent; D002511:Cephalosporins / Q000627:therapeutic use; D002512:Cephalothin / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects* / Q000382:microbiology; D003315:Cornea / Q000382:microbiology* / Q000473:pathology; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004209:Disposable Equipment / Q000382:microbiology*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D010353:Patient Education as Topic; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*
D002511:Cephalosporins; D005839:Gentamicins; D009883:Ophthalmic Solutions; D002512:Cephalothin