Severe Pseudomonas aeruginosa keratitis shortly after initiation of corneal refractive therapy.

PURPOSE: To report the development of severe ulcerative keratitis in an adolescent, shortly after initiating corneal refractive therapy.

METHODS

A teenager developed severe ulcerative keratitis shortly after being fitted with reverse-geometry contact lenses. The contact lenses were worn daily and only one night before the occurrence of severe ulcerative keratitis. Pseudomonas aeruginosa was identified as the causative organism.

RESULTS

The patient was treated with intensive, fortified antibiotics with gradual resolution of the corneal ulcer, leaving a permanent central stromal scar.

CONCLUSIONS

Corneal refractive therapy contact lenses can cause severe bacterial keratitis even after a short wearing time. Significant caution should be used before prescribing corneal refractive therapy lenses, and informed consent should include potential sight-threatening infectious keratitis.