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Purpose: To identify microbiologic characteristics of infectious keratitis associated with contact lenses., Methods: The authors retrospectively examined the microorganism isolated from patients with microbial corneal ulcer associated with contact lenses during a 5-year period. Herpetic and other viral infections were excluded from this study. Patient age, sex, type of contact lens, and isolated organisms were collected from medical records., Results: Sixty-seven eyes of 66 patients (54.5%) who possibly had contact lens-induced infectious keratitis were reviewed. Cultures of corneal scrapings or eye discharge were positive in 30 (44.8%) of 67 eyes. A total of 35 strains of bacteria were detected, among which there were 29 (82.9%) gram-positive bacteria, two (5.7%) gram-negative bacteria, three (8.6%) fungi, and one (2.9%) species of Acanthamoeba. The most common type of contact lens was a conventional soft contact lens (25 eyes, including extended wear in seven eyes), whereas hard contact lenses, including rigid gas-permeable contact lenses, were worn in 19 eyes. In addition, frequent-replacement lenses were used in 17 eyes, whereas weekly lenses and daily lenses were used for three eyes each. The largest age group was the 20s for all types of lenses., Conclusions: The results of isolation and culture are essential for improving the cure rate, especially for patients who have severe corneal ulcers.

Purpose: To identify microbiologic characteristics of infectious keratitis and predisposing factors., Methods: The microorganisms isolated from patients with infectious corneal ulcers during the 5 years between January 1999 and December 2003 were retrospectively examined. Herpetic and other viral infections were excluded from this study. Patient age, sex, risk factors, and isolated organisms were collected., Results: In 123 eyes of 122 patients, organisms were isolated from 72 (58.5%) eyes. In total, 99 different organisms were isolated. Among these, 77 (77.8%) were gram-positive bacteria; 18 (18.2%) were gram-negative bacteria; six (6.1%) were fungi; and one (1.0%) was acanthamoeba. Contact lens wear was the main risk factor (54.5%), and ocular surface disease and previous ocular surgery were present in 20.5% and 13.1% of cases, respectively. Posttreatment visual acuity was significantly improved by pretreatment in culture-positive groups treated according to the antibiotic susceptibilities (Wilcoxon t test, P<0.01)., Conclusions: The results are changing to those reported by other countries and generations. Contact lens wear is the most important risk factor in Japan. The results of isolation and culture are essential for improving the cure rate.

We report an unusual case of iris rubeosis and hyphema caused by chemical injury due to household detergent. A 74-year-old man with a 15-year history of diabetes mellitus was refilling a container with household detergent at home. He splashed the detergent in his eyes. Slit-lamp examination revealed extensive epithelial damage to the left eye, leading to a persistent corneal epithelial defect. We used a bandage soft contact lens with levofloxacin eye drops as concomitant therapy in order to promote healing. However, a strain of fluoroquinolone-resistant Corynebacterium colonized the eye, so that the corneal ulcer eventually became severe. Use of the bandage soft contact lens was discontinued. His antimicrobial agent was changed to cefmenoxime, a drug to which fluoroquinolone-resistant Corynebacterium is sensitive, and topical instillation of autologous serum subsequently promoted improvement of the ulcer. On day 38 after injury, iris rubeosis led to hyphema and ghost cell glaucoma. With improvement of his corneal epithelial defect, the iris rubeosis and hyphema regressed and his visual acuity improved to 20/25 on the left eye. To the best of our knowledge, this is the first report of a case resulting in severe complications due to chemical injury by a neutral detergent. Ophthalmologists should be aware that corneal epithelial damage may become prolonged in elderly patients with diabetes, and unexpectedly severe when wearing bandage soft contact lens, with infection of Corynebacterium resistant to fluoroquinolones, even if the chemical agent is a neutral detergent. [ABSTRACT FROM AUTHOR]

Purpose: To assess the use of multipurpose lens care products via an online survey conducted among soft contact lens (SCL) wearers in Japan. Methods: The subjects were 1000 men and women aged 15--44 years who reported that they cleaned their SCL by using multipurpose solution at least twice a week. Via the internet, they were asked questions about SCL care, the use of a rubbing step when cleaning SCL, cleaning and replacing lens cases, and recommended SCL care methods. Results: Of the 1000 SCL wearers enrolled, 94.3% performed lens care every day lenses were worn, 64.2% reported rubbing the lenses every time, 57.9% rubbed the lenses for at least 10 seconds per side, and 64.7% reported they rubbed the lenses on both sides. Further, 61.2% reported that they had been given an explanation of SCL cleaning at an eye clinic or contact lens store. Only 49.8% of subjects reported that they cleaned the lens case every time and 61.7% replaced the case within 3 months. Only 19.5% had been given an explanation about lens case care. Half of the subjects reported they had been given no recommendation to use specific SCL care products or could not remember whether or not they had. The most common reason for the recommendation was good compatibility with their type of lens. Conclusion: More education is needed in Japan regarding methods of SCL care to ensure correct lens cleaning with inclusion of a rubbing step, as well as sufficient cleaning and replacement of the lens case. Of particular interest is the finding that many subjects were not given an explanation about proper SCL care and lens case cleaning and replacement at the time of lens purchase or prescription. [ABSTRACT FROM AUTHOR]

Objective: To determine the trends of conjunctival sac bacterial flora isolated from patients prior to cataract surgery. Subjects and methods: The study comprised 579 patients (579 eyes) who underwent cataract surgery. Specimens were collected by lightly rubbing the inferior palpebral conjunctival sac with a sterile cotton swab 2 weeks before surgery, and then cultured for isolation of bacteria and antimicrobial sensitivity testing. The bacterial isolates and percentage of drug-resistant isolates were compared among age groups and according to whether or not patients had diabetes mellitus, hyperlipidemia, dialysis therapy, oral steroid use, dry eye syndrome, or allergic conjunctivitis. Results: The bacterial isolation rate was 39.2%. There were 191 strains of Gram-positive cocci, accounting for the majority of all isolates (67.0%), among which methicillin-sensitive coagulase-negative staphylococci was the most frequent (127 strains, 44.5%), followed by methicillin-resistant coagulase-negative staphylococci (37 strains, 12.7%). All 76 Gram-positive bacillary isolates (26.7%) were from the genus Corynebacterium. Among the 16 Gram-negative bacillary isolates (5.9%), the most frequent was Escherichia coli (1.0%). The bacterial isolation rate was higher in patients .60 years old, and was lower in patients with dry eye syndrome, patients under topical treatment for other ocular disorders, and patients with hyperlipidemia. There was no significant difference in bacterial isolation rate with respect to the presence/ absence of diabetes mellitus, steroid therapy, dialysis, or a history of allergic conjunctivitis. Methicillin-resistant coagulase-negative staphylococci showed a significantly higher detection rate in diabetic patients than nondiabetic patients (20.3% versus 7.0%, P , 0.05). The percentage of all isolates resistant to levofloxacin, cefmenoxime, and tobramycin was 14.0%, 15.2%, and 17.9%, respectively, with no significant differences among these drugs. Conclusion: The high bacterial isolation rate in patients .60 years old and the high methicillinresistant coagulase-negative staphylococci isolation rate in patients with diabetes are important to consider for prevention of perioperative infections. [ABSTRACT FROM AUTHOR]