Fungal Keratitis Associated With Airborne Organic Debris and Soft Contacts Lenses: Case Reports and Review of the Literature

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Abstract

Objectives:

To report two cases of fungal keratitis in soft contact lens wearers who were exposed to environmental mold.

Methods:

Case reports, with review of the relevant literature.

Results:

Two otherwise healthy middle-aged women who were soft contact lens wearers developed fungal keratitis about 1 week after heavy exposure to environmental mold. Culture results showed Aspergillus from one patient and the unusual combination of Trichoderma and Penicillium from the other. Both were treated with topical natamycin, topical fluoroquinolone antibiotic prophylaxis, and periodic ulcer debridement. After many weeks of treatment, both ulcers healed with subsequent scarring. Because the ulcers were located in the peripheral cornea in both cases, excellent final visual acuities were achieved. Fungal keratitis cases like these are rarely seen at our referral clinic, which is located in the temperate climate of northeastern Indiana.

Conclusions:

In addition to the usual recommended contact lens care guidelines, it may be prudent for eye care providers to warn patients against wearing their contact lenses in situations likely to result in heavy exposure to organic matter or, at the very least, to wear tight-fitting goggles for eye protection.

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