Contact Lens Associated Keratitis

Contact Lens Associated Keratitis. Corneal edema with hypopyon in the anterior chamber © 2019 American Academy of Ophthalmology

Eye Care Professionals Link Leading Contact Lens Solution with Infiltrative Keratitis





Clinicians Neal A. Sher and Jason Jedlicka have linked leading contact lens solution Opti-Free Replenish contact lens solution by Alcon with contact lens-associated infiltrative Keratitis (CLAIK). A rise in this condition due to the use of this contact solution has been found. In fact, over 35 cases have been reported.

According to Sher, cases of CLAIK were first noticed in 2008 or 2009. However, medical professionals did not yet know what the symptoms were caused by. It has just been in the last year or two that researchers have found a strong correlation between the use of Opti-Free Replenish with the development of CLAIK.

This patient had symptoms such as inflammation, mild edema, infiltrates, and punctuate keratitis. The downside of this report is that it didn’t contain information about what product lot the particular solution came from. As a result, Alcon was not able to review the particular product lot in order to test the lot for safety

Fortunately, the cases associated with infiltrative keratitis and uses of Opti-Free Replenish were resolved with antibiotic-steroids or antibiotics. No one affected in the cases experienced permanent scarring or vision loss. However, the cause of the association is still important to prevent further cases.




Sher and his associates believe that the contact solution does not contain sufficient ingredients to ward off certain types of bacteria. As a result, a Biofilm develops that causes an adverse immune reaction. As Sher said, “What we’re seeing is basically an immune type of focal keratitis. It makes sense from a mechanism point of view.

While contact solutions must go through a series of tests before they reach the market, there are flaws in the testing system. For example, a certain type of contact solution may only be tested with one type of contact lens. Testing all brands of contact lens would be impractical, yet problems, such as contact lens associated keratitis, may occur due to gaps in testing.

The interplay between solutions and different brands of contact lenses, and a number of other factors, may not become known until after the product hits the market. This was the case with Opti-Free Replenish and the development of CLAIK.




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