Many reported cases of serious eye damage result from misusing contact lenses, including sleeping in them or wearing them beyond their recommended use, a report released Thursday by the Centers for Disease Control and Prevention (CDC) suggests.
Between 2005 and 2015, the Food and Drug Administration (FDA) received reports of 1,075 contact lens-related corneal infections that involved ulcers or keratitis, which is inflammation of the cornea, according to a CDC news release. About 20 percent of these reports involved serious eye damage, but about a quarter of those cases could have been avoided with proper contact lens use.
"Although contact lenses are a safe and effective form of vision correction if worn and cared for as directed, they pose an infection risk to wearers if not worn and cared for properly," researchers wrote in the report, which was published in the CDC’s Morbidity and Mortality Weekly Report.
About 41 million Americans wear contact lenses, and in 2014, more than 99 percent of patients surveyed reported having at least one behavior that puts them at risk for a contact lens-related eye infection, the CDC noted. Keratitis sends an estimated 1 million patients to clinics and ERs annually, and in 2010 those visits accounted for $175 million in direct health care expenditures, according to the report. Researchers defined serious eye damage as having a central corneal scar, a decrease in vision, or the need of a corneal transplant.
The most common contact lens abuse was wearing them for an extended period when not approved for that use (about 11 percent)— which often led the patients to discontinue using them— followed by wearing contact lenses beyond their prescription (8 percent), and occasional overnight wear or napping in lenses (7 percent). Other patients abused contact lenses by using expired products, storing lenses in water, or wearing lenses while swimming.
The pathogen that caused patients’ infections was reported in about 13 percent of the cases, and the most common pathogens were Pseudomonas, Acanthamoeba, Fusarium and Staphylococcus, the CDC reported.
Researchers noted their findings are limited by several factors, partly because they don’t represent the incidence or prevalence of contact lens misuse. They also said the source from which they drew the cases, the FDA’s Medical Device Report (MDR) database, may be subject to “incomplete, inaccurate, untimely, unverified, or biased information,” so their report may not reveal the true extent of contact lens abuse. Contact lens manufacturers reported about 86 percent of the studied cases, while about 14 percent were reported by a patient or eye care provider.
“Health promotion activities should focus on informing contact lens wearers of common behaviors that might put them at risk for eye infections, such as sleeping in contact lenses and exposing lenses to tap water, distilled water, or recreational water,” the CDC wrote. “Additionally, prompt reporting of adverse events can help [the] FDA identify and understand the risks associated with the use of contact lenses.”