Orthokeratology lens-related corneal ulcers in children: a case series.
OBJECTIVE
Orthokeratology is a process by which the corneal curvature is flattened by sequentially fitting rigid gas permeable contact lenses of decreasing central curvature. There has been a resurgence of interest with the recent introduction of reverse geometry lenses. Although promising results have been described in reducing the myopic refractive error, the use of these lenses can be associated with corneal problems, as reported in this case series.


METHODS
Observational case series.


METHODS
Six children with orthokeratology-related corneal ulcers.


METHODS
Consecutive cases of orthokeratology lens (OKL)-related corneal ulcers in children presented to a tertiary referral center (March 1999-June 2001) were reviewed.


METHODS
Preinfection and postinfection visual acuity, refraction, any organisms identified.


RESULTS
Six children between the ages of 9 and 14 years (mean = 12.1) were treated. The male:female ratio was 1:5. All cases were unilateral, with equal numbers of left and right eyes. All children wore the OKL at night for a duration of 8 to 12 hours, with the onset of infection between 3 and 36 months (mean = 16.6) of OKL wear. All of the patients suffered a resultant best-corrected visual acuity loss. Five of the 6 cases were culture positive for Pseudomonas aeruginosa.


CONCLUSIONS
In view of the temporary benefits of orthokeratology, together with a known increased risk of infection associated with overnight lens wear, parents of children considering orthokeratology must be informed and warned of the potential for permanent loss of vision. The ophthalmic community should have a heightened awareness of the associated complications.
Young
Alvin L
AL
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People's Republic of China.
Leung
Alfred T S
AT
Cheng
Lulu L
LL
Law
Ricky W K
RW
Wong
Angus K K
AK
Lam
Dennis S C
DS
D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D003261:Contact Lenses / Q000009:adverse effects*; D003315:Cornea / Q000382:microbiology; D003320:Corneal Ulcer / Q000188:drug therapy / Q000209:etiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000628:therapy; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012029:Refraction, Ocular; D014792:Visual Acuity
D000890:Anti-Infective Agents