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Reports Characterize Fungal Eye Infections Among Soft Contact Lens Wearers

fection and were treated with antibiotics. The average time from the development of symptoms to accurate diagnosis was 9.1 days. After the diagnosis of fungal keratitis, patients were treated with topical (applied to the eye) or systemic (taken internally) antifungal medication for an average of 67.1 days. Two cases required surgery. The length of time between the first symptoms and the beginning of antifungal treatment appeared to be related to treatment outcomes; those patients for whom seven days or more passed between symptom onset and treatment had infections that took longer to cure. "Based on treatment experience in this series, it is our clinical impression that earlier correct diagnosis with institution of proper specific antifungal therapy resulted in a speedier resolution of the keratitis," the authors write.

The cause for the increased prevalence of Fusarium keratitis is not known, they continue; more research is needed. Until then, physicians should remain aware of the outbreak. "Ulcerative keratitis in a soft contact lens wearer should suggest possible Fusarium or other fungal species in addition to bacteria, parasites or viruses as causative organisms," the authors conclude. "Clinicians should conduct the necessary clinical and laboratory investigations to establish a specific diagnosis promptly to initiate the most specific, efficacious therapy."

In an additional report published online today in Archives of Ophthalmology, Maria D. Bernal, M.D., and colleagues at the University of California, San Francisco, report on four additional cases of Fusarium in soft contact lens wearers that occurred during five weeks in early 2006. "Our report strongly suggests that the current cluster represents an unusual spike over the background incidence of Fusarium keratitis seen during the prior 30 years at our institution," the authors report. "We, other laboratories, and the Centers for Disease Control and Prevention are currently
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