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Nathan M Kerr, Sue Ormonde
Cosmetic, or novelty, contact lenses are soft hydrogel lenses worn solely to change the colour or appearance of the eye. The popularity of these lenses is increasing worldwide, particularly amongst teenage adolescents.1 Although possessing no optical power, these lenses pose the same physiological impact on the eye and carry the same risks as vision-correcting contact lenses.
Reported complications from cosmetic contact lenses include contact lens overwear syndrome, tight lens syndrome, corneal abrasions, Pseudomonas aeruginosa keratitis causing vision loss requiring corneal grafting, and presumed herpes simplex keratitis resulting in corneal scarring and legal blindness.2
We present the first reported case in New Zealand of Acanthamoeba keratitis, a rare and potentially blinding infection, resulting from the use of cosmetic contact lenses.
Case report
A 19-year-old Maori woman was referred with a red and painful right eye after wearing coloured cosmetic contact lenses that she had purchased from a flea market. She did not receive any information at the time of purchase--and being unaware of proper lens hygiene, regularly cleaned and stored the lenses in tap water.
On examination her unaided visual acuity was 6/18 in the right eye and 6/6 in the left eye. Slit-lamp biomicroscopy of the right eye showed conjunctival injection, corneal epithelial irregularity, microcystic corneal oedema, and patchy anterior stromal infiltrates (Figure 1).
Figure 1. Colour photograph of the right eye of a patient with Acanthamoeba keratitis resulting from cosmetic contact lens wear
[Image omitted. See PDF]
Corneal scrapings revealed Acanthamoeba trophozoites and treatment was commenced with topical chlorhexidine 0.02% and propamidine isethionate 0.1%.
The patient's symptoms and keratitis responded well to treatment and at follow-up her unaided visual acuity was...