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Fulltext Contact lens--related corneal ulcer: a two-year review

Goh PP, Shamala R, Chandamalar S, Tai XY, National Eye Database Study Group

Med J Malaysia, 2010 Jun;65 Suppl A:120-3.
PMID: 21488471

To create a national registry of contact-lens related corneal ulcers (CLRCU) patients in Malaysia with the aim of detecting outbreaks, identifying pattern of causative organisms, determining patient demography, risk factors, wearing patterns and monitoring outcome of treatment. The CLRCU registry is an ongoing patient registry established in 2007 as a surveillance tool used by Malaysian Ministry of Health ophthalmology departments. Notification of patients clinically suspected of CLRCU was performed online through the National Eye Database (NED). Data collected included patient demography, contact lens type, causative organism and treatment outcome. During 2007-2008, a total of 202 patients were notified to the CLRCU registry with a mean age of 26.7 years (71.8% female). All registered patients wore soft contact lens and monthly disposable lenses were the most popular (83.5%). The majority of patients had bacterial CLRCU and the most common causative organism was Pseudomonas (79.7% of bacterial cases). No epidemics were identified during the period of data examination. Use of contact lenses, which is increasing during modern times, may lead to CLRCU as a severe complication. The CLRCU registry is an effective tool which uses a web-based notification system that allows quick and up to date reports of CLRCU cases. This provides the ability to monitor outbreaks of disease and identify important causative and associated factors of the disease which may be used to reduce future incidence.

Matched MeSH terms: Corneal Ulcer/etiology*
Actinomycetic corneal ulcer

Singh M, Kaur B

Eye (Lond), 1989;3 ( Pt 4):460-2.
PMID: 2606221

A rare case of keratoactinomycosis developing in the absence of any known ocular trauma is described. It showed a dramatic response to penicillin therapy. Steroids should be cautiously used in the presence of active corneal disease. This case highlights the importance of repeated examination of corneal scrapings.

Matched MeSH terms: Corneal Ulcer/etiology*
Bilateral simultaneous infectious keratitis secondary to contact lens wear: an unusual case report with rare organisms

Ali NA, Reddy SC

Eye Contact Lens, 2007 Nov;33(6 Pt 1):338-40.
PMID: 17993833

PURPOSE: To report an unusual case of bilateral simultaneous hypopyon corneal ulcer in a contact lens wearer caused by polymicrobial infection with rare organisms.
METHODS: A case report of a 21-year-old soft contact lens wearer, who visited the emergency department with a 3-day history of pain, redness, decreased vision, photophobia, and tearing in both eyes. Examination showed a central corneal ulcer with hypopyon in both eyes. The cultures from corneal scrapings of both eyes, the contact lenses, and the contact lens solution showed heavy growth of Pseudomonas aeruginosa, Alkaligenes species, and Flavobacterium meningosepticum.
RESULTS: The corneal ulcers healed completely with aggressive antibiotic treatment for 4 weeks. The best-corrected visual acuity after 6 months of follow-up was 20/400 in the right eye and 20/60 in the left eye.
CONCLUSIONS: The possibility of infectious keratitis should be kept in mind for an acute red eye in contact lens wearers, and appropriate initial management is essential for a successful outcome. It is believed that this is the first report of Flavobacterium meningosepticum as a causative organism in contact lens-related keratitis.

Matched MeSH terms: Corneal Ulcer/etiology
Fulltext Differences in Perspectives of Medical Device Adverse Events: Observational Results in Training Program Using Virtual Cases

Yoon C, Nam KC, Lee YK, Kang Y, Choi SJ, Shin HM, et al.

J Korean Med Sci, 2019 Oct 14;34(39):e255.
PMID: 31602825 DOI: 10.3346/jkms.2019.34.e255

BACKGROUND: Medical device adverse event reporting is an essential activity for mitigating device-related risks. Reporting of adverse events can be done by anyone like healthcare workers, patients, and others. However, for an individual to determine the reporting, he or she should recognize the current situation as an adverse event. The objective of this report is to share observed individual differences in the perception of a medical device adverse event, which may affect the judgment and the reporting of adverse events.
METHODS: We trained twenty-three participants from twelve Asia-Pacific Economic Cooperation (APEC) member economies about international guidelines for medical device vigilance. We developed and used six virtual cases and six questions. We divided participants into six groups and compared their opinions. We also surveyed the country's opinion to investigate the beginning point of 'patient use'. The phases of 'patient use' are divided into: 1) inspecting, 2) preparing, and 3) applying medical device.
RESULTS: As for the question on the beginning point of 'patient use,' 28.6%, 35.7%, and 35.7% of participants provided answers regarding the first, second, and third phases, respectively. In training for applying international guidelines to virtual cases, only one of the six questions reached a consensus between the two groups in all six virtual cases. For the other five questions, different judgments were given in at least two groups.
CONCLUSION: From training courses using virtual cases, we found that there was no consensus on 'patient use' point of view of medical devices. There was a significant difference in applying definitions of adverse events written in guidelines regarding the medical device associated incidents. Our results point out that international harmonization effort is needed not only to harmonize differences in regulations between countries but also to overcome diversity in perspectives existing at the site of medical device use.

Matched MeSH terms: Corneal Ulcer/etiology