We report an outbreak of 43 episodes of presumed microbial
keratitis in 42 disposable
soft contact lens wearers seen in the Accident Room of Manchester Royal Eye Hospital during a period of 20 months, and compare this with the general incidence of
contact lens-related corneal
infection found in a retrospective survey of 6 months' Accident Room attendances during the same period. Thirty-seven patients had worn Acuvue
lenses, three had worn Nuvue, and there was no record in two cases. Corneal scrapes were taken for microbiological examination in 27 patients, and 6 of these were culture positive. Conjunctival swabs were taken from eight eyes and one was culture positive. The
contact lenses of 11 patients were sent for culture and all grew pathogenic organisms. Pseudomonas spp. were the most common organisms grown, having been found in three of six corneal scrapes and six of 11
contact lens cultures. All affected eyes responded promptly to cessation of
contact lens wear and topical
antibiotic therapy, with none sustaining severe or permanent visual loss. Reasons for the associated high risk of microbial
keratitis are discussed. Thirty-three of the 42 patients responded to a questionnaire regarding lens wear and care and their responses are reported. In consequence, we consider disposable
soft contact lenses to be relatively high-risk devices for the cosmetic management of simple
myopia, and their continued use must be called into question.