G A Stern1. 1. University of Florida College of Medicine, Gainesville, USA.
Abstract
PURPOSE: This paper reviews the medical history of the pathogenesis of contact lens related bacterial keratitis and its relationship to the development of successive generations of soft contact lenses. METHODS: The Methods section presents a literature review and the author's personal experience. RESULTS: Bacterial corneal infections have been a significant complication limiting the overall success of soft contact lenses for visual correction. Experience with different types of lenses has pointed to specific causes for the frequency of infection. However, there has been a general understanding that the health of the patient's epithelium, the patient's lens care practices, and the hypoxic effects of overnight wear each significantly contribute to the development of corneal infection. CONCLUSIONS: A complete understanding of the pathogenesis of contact lens associated bacterial infection would allow the development of strategies to prevent infectious complications of lens wear. Progress appears to have been made with a trend toward fewer and less severe infections. As the possibility of a reasonably priced daily wear disposable lens with better oxygen transmissibility and surface modifications to limit deposits and bacterial adherence evolves, safer lenses will continue to be developed.
PURPOSE: This paper reviews the medical history of the pathogenesis of contact lens related bacterial keratitis and its relationship to the development of successive generations of soft contact lenses. METHODS: The Methods section presents a literature review and the author's personal experience. RESULTS: Bacterial corneal infections have been a significant complication limiting the overall success of soft contact lenses for visual correction. Experience with different types of lenses has pointed to specific causes for the frequency of infection. However, there has been a general understanding that the health of the patient's epithelium, the patient's lens care practices, and the hypoxic effects of overnight wear each significantly contribute to the development of corneal infection. CONCLUSIONS: A complete understanding of the pathogenesis of contact lens associated bacterial infection would allow the development of strategies to prevent infectious complications of lens wear. Progress appears to have been made with a trend toward fewer and less severe infections. As the possibility of a reasonably priced daily wear disposable lens with better oxygen transmissibility and surface modifications to limit deposits and bacterial adherence evolves, safer lenses will continue to be developed.