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Title: An investigation of infection risks of patients newly fitted with orthokeratology contact lenses
Authors: Boost, MV
Cho, P 
Chui, V
Issue Date: 2004
Source: 14th European Congress of Clinical Microbiology & Infectious Diseases, Prague, Czech Republic, May 1-4, 2004, p. 1175 How to cite?
Abstract: Objectives: Wearing contact lenses overnight has been reported to significantly increase risk of ocular infection. This study aimed to determine the normal ocular flora of overnight orthokeratology (ortho-K) patients, and levels of contamination of their lenses, lens case and accessories, and to correlate compliance with contamination.
Methods: The lower conjunctiva of 23 new patients was swabbed on two occasions for culture of normal eye flora before commencing ortho-K lens wear. On six follow-up visits, further specimens were collected, and cultures performed on swabs from the lens, the case and suction holder. All isolates were fully identified. Patients were interviewed on lens care after the fourth follow-up visit. Any patient with contamination with Pseudomonas aeruginosa or considerable numbers of non-normal flora organisms, indicating breaks in compliance, was warned about increased risks of infection and importance of good lens care reinforced.
Results: Cultures from 21 patients before lens use yielded normal eye flora only; 16 of these yielding only normal flora after lens wear. Staphylococcus aureus was isolated from two patients before lens wear and from one of these after lens wear. Potential pathogens isolated in low numbers from five patients on only one occasion after lens use, but not present in subsequent samples, were considered transient. Investigation of lens organisms yielded only normal flora organisms for 11 subjects on all occasions. Tap water organisms were occasionally isolated from lenses of two patients, and 10 patients had one isolate of potential pathogen. Four patients with lens contamination had the same organism contaminating their lens case. Suction holders of seven subjects were contaminated, three with organisms found in either the lens or the case. Following interview, 13 subjects were judged to have good compliance. eight patients reporting poor compliance had contamination of lens or accessories on one occasion. All were re-educated and improvement was observed.
Conclusions: Use of ortho-K lenses resulted in no change in levels or content of normal flora. Failure to regularly replace lens case, and disinfect lens case weekly were common errors correlating with presence of potential ocular pathogens. With one exception, patients reporting good compliance had minimal contamination of eyes, lenses or accessories. Intervention improved compliance and eliminated contamination, confirming the need for reinforcement of lens care procedures.
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