Orthokeratology lens-related Acanthamoeba keratitis: case report and analytical review

Abstract

Acanthamoeba keratitis (AK) is a rare but severe ocular infection with a significant risk of vision loss. Contact lens use is the main risk factor for AK. The orthokeratology (OK) lens, a specially designed contact lens, has been used worldwide as an effective method of myopia control. However, the OK lens is associated with an increased risk of Acanthamoeba infection. Many primary practitioners are concerned about this infection because of its relative rarity, the lack of promising therapeutic medications, and the need for referral. We herein report two cases of AK associated with OK lenses, present a systematic review of such cases, and discuss the possible reasons for the higher incidence rate of this infection in patients who wear OK lenses. We combined the clinical knowledge and skills of corneal specialists and lens experts with the sole objective of addressing these OK lens-related AK cases. We found that the most common risk factors were rinsing the lenses or lens cases with tap water. Prompt and accurate diagnosis along with adequate amoebicidal treatment are essential to ensure desirable outcomes for OK lens wearers who develop AK. Appropriate OK lens parameters and regular checkups are also important.

Does Orthokeratology Wearing Affect the Tear Quality of Children?

“…Since the use of distilled water to rinse the lens may change the tear quality during subsequent wearing due to its tendency to change the pH and osmotic pressure of the tear, the use of saline solution, which is close to the physiological osmotic pressure of tears, can help reduce irritation and may be appropriate for lens rinsing. In order to avoid lens-related corneal infections, tap water is not recommended for lens rinsing due to the diverse sterilizing standards of tap water in different countries ( 34 , 35 ).…”