Skip to main content
NCBI home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1996 May;80(5):409–412. doi: 10.1136/bjo.80.5.409

Infectious keratitis with corneal perforation associated with corneal hydrops and contact lens wear in keratoconus.

E D Donnenfeld 1, A Schrier 1, H D Perry 1, H J Ingraham 1, R Lasonde 1, A Epstein 1, B Farber 1
PMCID: PMC505490  PMID: 8695560

Abstract

BACKGROUND: Corneal perforation is an uncommon complication associated with keratoconus. The first cases of infectious keratitis and corneal perforation associated with corneal hydrops and contact lens wear are reported in two keratoconus patients. METHODS: A retrospective chart review and histopathological examination were carried out. RESULTS: Both patients progressed to corneal perforation and emergency penetrating keratoplasty. One patient cultured Fusarium and the second patient Serratia marcesens. Both patients wore contact lenses against medical advice. CONCLUSIONS: The tear in Descement's membrane, stromal oedema, and epithelial bedewing associated with corneal hydrops results in loss of the epithelial-endothelial barrier of the cornea, creating a conduit for infectious organisms through the cornea. Acute hydrops associated with epithelial keratitis, stromal swelling, and a Descement's membrane tear may be a significant risk factor for infectious keratitis and corneal perforation. Contact lenses should not be worn during an active corneal hydrops owing to the increased risk for severe infectious keratitis and corneal perforation.

Full text

PDF
409

Images in this article

409Image
on p.409
410Image
on p.410
410Image
on p.410
410Image
on p.410
411Image
on p.411
411Image
on p.411

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alfonso E., Mandelbaum S., Fox M. J., Forster R. K. Ulcerative keratitis associated with contact lens wear. Am J Ophthalmol. 1986 Apr 15;101(4):429–433. doi: 10.1016/0002-9394(86)90641-0. [DOI] [PubMed] [Google Scholar]
  2. Andrew N. C., Woodward E. G. The bandage lens in bullous keratopathy. Ophthalmic Physiol Opt. 1989 Jan;9(1):66–68. doi: 10.1111/j.1475-1313.1989.tb00808.x. [DOI] [PubMed] [Google Scholar]
  3. Chalupa E., Swarbrick H. A., Holden B. A., Sjöstrand J. Severe corneal infections associated with contact lens wear. Ophthalmology. 1987 Jan;94(1):17–22. doi: 10.1016/s0161-6420(87)33513-4. [DOI] [PubMed] [Google Scholar]
  4. Dart J. K. Predisposing factors in microbial keratitis: the significance of contact lens wear. Br J Ophthalmol. 1988 Dec;72(12):926–930. doi: 10.1136/bjo.72.12.926. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Donnenfeld E. D., Cohen E. J., Arentsen J. J., Genvert G. I., Laibson P. R. Changing trends in contact lens associated corneal ulcers: an overview of 116 cases. CLAO J. 1986 Jul-Sep;12(3):145–149. [PubMed] [Google Scholar]
  6. Galentine P. G., Cohen E. J., Laibson P. R., Adams C. P., Michaud R., Arentsen J. J. Corneal ulcers associated with contact lens wear. Arch Ophthalmol. 1984 Jun;102(6):891–894. doi: 10.1001/archopht.1984.01040030711025. [DOI] [PubMed] [Google Scholar]
  7. Ingraham H. J., Donnenfeld E. D., Perry H. D. Keratoconus with spontaneous perforation of the cornea. Arch Ophthalmol. 1991 Dec;109(12):1651–1652. doi: 10.1001/archopht.1991.01080120033016. [DOI] [PubMed] [Google Scholar]
  8. Koch J. M., Refojo M. F., Hanninen L. A., Leong F. L., Kenyon K. R. Experimental Pseudomonas aeruginosa keratitis from extended wear of soft contact lenses. Arch Ophthalmol. 1990 Oct;108(10):1453–1459. doi: 10.1001/archopht.1990.01070120101038. [DOI] [PubMed] [Google Scholar]
  9. Koidou-Tsiligianni A., Alfonso E., Forster R. K. Ulcerative keratitis associated with contact lens wear. Am J Ophthalmol. 1989 Jul 15;108(1):64–67. doi: 10.1016/s0002-9394(14)73262-3. [DOI] [PubMed] [Google Scholar]
  10. Krachmer J. H., Feder R. S., Belin M. W. Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol. 1984 Jan-Feb;28(4):293–322. doi: 10.1016/0039-6257(84)90094-8. [DOI] [PubMed] [Google Scholar]
  11. Mondino B. J., Weissman B. A., Farb M. D., Pettit T. H. Corneal ulcers associated with daily-wear and extended-wear contact lenses. Am J Ophthalmol. 1986 Jul 15;102(1):58–65. doi: 10.1016/0002-9394(86)90210-2. [DOI] [PubMed] [Google Scholar]
  12. Ormerod L. D., Smith R. E. Contact lens-associated microbial keratitis. Arch Ophthalmol. 1986 Jan;104(1):79–83. doi: 10.1001/archopht.1986.01050130089027. [DOI] [PubMed] [Google Scholar]
  13. Schein O. D., Ormerod L. D., Barraquer E., Alfonso E., Egan K. M., Paton B. G., Kenyon K. R. Microbiology of contact lens-related keratitis. Cornea. 1989 Dec;8(4):281–285. [PubMed] [Google Scholar]
  14. Schein O. D., Poggio E. C. Ulcerative keratitis in contact lens wearers. Incidence and risk factors. Cornea. 1990;9 (Suppl 1):S55–S63. doi: 10.1097/00003226-199010001-00023. [DOI] [PubMed] [Google Scholar]
  15. Stern G. A. Corneal infections in contact lens wearers. Int Ophthalmol Clin. 1991 Spring;31(2):147–161. doi: 10.1097/00004397-199103120-00016. [DOI] [PubMed] [Google Scholar]
  16. Stern G. A. Pseudomonas keratitis and contact lens wear: the lens/eye is at fault. Cornea. 1990;9 (Suppl 1):S36–S40. doi: 10.1097/00003226-199010001-00015. [DOI] [PubMed] [Google Scholar]
  17. Wilhelmus K. R., Robinson N. M., Font R. A., Hamill M. B., Jones D. B. Fungal keratitis in contact lens wearers. Am J Ophthalmol. 1988 Dec 15;106(6):708–714. doi: 10.1016/0002-9394(88)90705-2. [DOI] [PubMed] [Google Scholar]
  18. Wilson L. A., Ahearn D. G. Association of fungi with extended-wear soft contact lenses. Am J Ophthalmol. 1986 Apr 15;101(4):434–436. doi: 10.1016/0002-9394(86)90642-2. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES