A 17-year-old girl is fighting against blindness in both eyes after developing a rare contact-lens related infection.
Jade’s* corneas have been attacked by acanthamoeba, a very painful and potentially blinding eye parasite that hitches a ride on contact lenses and invades the vulnerable eye.
Her condition is particularly rare and unfortunate since the infection struck both eyes. There have been few reports worldwide of bilateral acanthamoeba.
One of Malta’s leading ophthalmic surgeons, Franco Mercieca, who saw Jade, explained the infection is usually associated with improper contact lens care.
Mr Mercieca said few are instructed in the proper use of contact lenses so consequently bad habits develop putting users at risk of myriad infections.
“We are seeing more complications from contact lens wear than we do with laser. The most acute corneal problems are contact-lens related,” he said.
“I’m not saying don’t wear contact lenses but it’s important to follow an aseptic technique, and it’s best to use dailies to avoid any problems that may arise from preservation,” he added.
He also stressed it was important that contact lenses were worn for less than eight hours at a stretch and that whoever worked on a computer while wearing lenses should frequently lubricate their lenses.
In Malta, Mr Mercieca has only seen three cases of acanthamoeba keratitis in 10 years, but anybody can be at risk since in about 90 per cent of the cases this excruciatingly painful infection occurs in those who wear contact lenses.
Jade decided to come forward and tell her story in the hope of raising awareness on proper contact lens use and encourage wearers to take all the precautions because she was never warned of the risks.
“Nobody ever explained anything to me or gave me any literature on how to use contact lenses and I know many of my friends who have no idea either. Once the lens of a friend of mine fell on the floor and she put it straight back in her eyes,” she told The Sunday Times.
“At the moment I’m seeing everyone as if they’re going through a thick fog of smoke,” Jade said, as her lower lip protruded wistfully.
Sitting in the kitchen with all the curtains drawn to keep out the sun’s rays, Jade said she had started wearing contact lenses one year after she needed spectacles because she could never get used to them.
She often spent an entire day with her lenses on, only taking them off if she had an afternoon nap. One Sunday last August she went swimming, but she was careful not to wet her face or hair. Three days later the trouble started.
She woke up with her right eye watering and red, so she went to her GP who prescribed drops and warned her not to wear her contact lenses. She was later urged by another doctor to throw away everything – the saline solution, lenses and case. In Jade’s case it is being suspected that her acanthamoeba could have been caused by expired contact lens solution.
Discarding everything turned out to be poor advice because it made the specialists’ work to diagnose and treat the type of organism attacking her corneas doubly hard.
“My advice is to keep everything if you have an infection because we will need to culture organisms from it to establish the exact cause,” Mr Mercieca said.
The classic signs of acanthamoeba are disproportionate pain but remote signs of an infection, and light sensitivity, which is what Jade presented herself with at the hospital after the drops and a visit to a private specialist – who treated her for another condition – failed to bring any relief.
By then two weeks had passed and her left eye started going red. Any light caused unbearable pain – “it felt as if somebody was searing my eyes with a lit match”.
She was kept in hospital for three weeks until it was finally established she had acanthamoeba keratitis, but the only place she could be treated was at Moorfields Eye Hospital in London.
“The doctor came up to us and asked if we had passports – we were shocked, but by then I couldn’t see from either eye,” Jade said.
For the past three months Jade and her family have been shuttling between Malta and the UK for her treatment and the family have no idea how long this will take.
“Some doctors told me I will never regain my full eyesight, while others told me not to lose heart. I’d rather not ask, sometimes it’s better not to know; fate is a closed book,” she said, adding she was trying to take life one day at a time.
Two weeks ago she was thrilled when she was able to see images on television and make out the words in a book, but she suffered a setback when veins emerged in her cornea and the treatment severely hampered her vision.
“Not being able to see has really restricted my life and I barely venture outdoors. I had enrolled in an accounts course but I have had to give it up for now. Who knows when I will be able to see again,” she said.
The teenager forced a smile and tried to sound upbeat, but she admitted she switched off the radio when she heard promotions of Christmas parties she knew she was unable to attend.
“I sleep a lot now to pass the time. It’s a respite from the misery where I don’t need to think about what I’m missing, and where I can see clearly in my dreams.”
* Name has been changed.
Safety tips for contact lens wearers
• See a doctor immediately if you experience symptoms of eye infection such as redness, pain, excessive tearing, increased light sensitivity, blurry vision, and/or sensation of something in the eye.
• Remove your lenses before any activity involving water, including showering, using a hot tub, or swimming.
• Wash your hands with soap and water, and dry them before handling your lenses.
• Clean your lenses according to the manufacturer’s guidelines.
• Use fresh cleaning or disinfecting solution each time your lenses are cleaned and stored.
• Never reuse or top off old solution.
• Never use saline solution and rewetting drops to disinfect your lenses. Neither solution is an effective or approved disinfectant.
• Store your lenses in the proper storage case.
• Rinse your storage case with sterile contact lens solution (never use tap water) and leave the storage case open to dry after each use.
• Replace storage cases at least once every three months.
Source: US Food and Drug Administration