In the aftermath of the Fusarium keratitis outbreak: What have we learned?

Abstract

The 2005-2006 outbreak of Fusarium keratitis associated with soft hydrophilic contact lens wear was both unprecedented and unexpected. More than 250 cases have been reported worldwide that have primarily been associated with Bausch & Lomb ReNu with MoistureLoc and, more recently, with Bausch and Lomb ReNu MultiPlus multipurpose contact lens disinfecting solutions. This article documents the outbreak, presenting the time line and the historical and scientific basis for its occurrence. Underlying causes are explored including likely mechanisms of contamination and subsequent corneal infection. Thorough exploration of this unique occurrence affords the opportunity to examine contact lens and lens care actions and interactions and to develop greater understanding of possible associated risks and ways to minimize them.

Keywords: Bausch & Lomb; PHMB; ReNu MultiPlus; ReNu with MoistureLoc; alexidine; contact lens; fusarium keratitis; fusarium solani; microbial keratitis.

Figure 1

Staining grid (Used by permission of Gary Andrasko, OD).

Figure 2

Key elements of Fusarium infection.