Department of Ophthalmology and Visual Sciences (J.I.A., A.S., and R.R.S.), Case Western Reserve University and University Hospitals Eye Institute, Cleveland, OH; Skyvision Centers (D.E.W.), Westlake, OH; and Division of Cornea and Refractive Surgery (N.A.A.), Shiley Eye Institute, University of California San Diego, San Diego, CA.
Eye Contact Lens. 2020 Jan;46(1):e1-e4. doi: 10.1097/ICL.0000000000000587.
To help clinicians diagnose and manage unilateral recalcitrant chronic bacterial conjunctivitis secondary to a retained soft contact lens and describe the first report of Gram-negative bacteria causing this condition.
Chart review of successive cases presenting with unilateral chronic conjunctivitis with positive cultures and a retained contact lens.
Three cases were identified and described. Culturing of the retained contact lenses grew Pseudomonas aeruginosa in the first case, Achromobacter xylosoxidans in the second, and Staphylococcus epidermidis in the third. All three patients were successfully treated with removal of the retained lens and targeted antibiotic eyedrop therapy.
Unilateral chronic recurrent or recalcitrant purulent papillary conjunctivitis is rare, and a retained contact lens should be suspected in patients with a history of wearing contact lenses. Careful examination with double eversion of the upper eyelid and sweeping of the fornices can recover the offending lens. Although only Gram-positive organisms have been isolated in previous reports, two of our three cultures grew Gram-negative organisms, highlighting the importance of broad-spectrum antibiotic usage for these cases.
帮助临床医生诊断和治疗因软性隐形眼镜滞留引起的单侧难治性慢性细菌性结膜炎，并描述首例由革兰氏阴性菌引起这种情况的报告。
对连续出现单侧慢性结膜炎、培养阳性和隐形眼镜滞留的病例进行图表回顾。
确定并描述了三例病例。第一例培养出绿脓假单胞菌，第二例培养出木糖氧化无色杆菌，第三例培养出表皮葡萄球菌。所有三例患者均成功接受了隐形眼镜取出和靶向抗生素滴眼治疗。
单侧慢性复发性或难治性脓性乳头结膜炎罕见，有隐形眼镜佩戴史的患者应怀疑有隐形眼镜滞留。仔细检查，上睑双重翻转并清扫穹窿部，可以找到致病隐形眼镜。尽管以前的报告中仅分离出革兰氏阳性菌，但我们的三种培养物中有两种培养出革兰氏阴性菌，突出了这些病例广谱抗生素使用的重要性。
