Fusarium Eye Fungus Infections in Contact-Lens Wearers

Update 13 Apr 06: Thanks to the rapid transmission of news today, companies must react immediately to negative developments. Bausch & Lomb has done that by telling stores to remove their ReNu brand contact-lens solution from shelves, advising users to switch to a different brand, and offering to refund the money of anyone who returns their ReNu product to Bausch.

Update 11 Apr 06: B&L's stock dropped more than 15% today as news spread of the linkage of the ReNu brand contact-lens solution to the Fusarium fungus outbreak.

"We've never had an instance where a contact-lens care product has had any direct link to infection of this scale," Art Epstein, a Long Island optometrist who chairs the American Optometric Association's contact lens and cornea section, told USA Today. "My guess is that there are significantly more patients in the field who have this infection or will have this infection and be subject to analysis.

"Hygiene definitely plays a role in this — patients don't get infected from thin air," Epstein said. "There is usually a lapse, but not always, in the basic tenets of hygiene, like washing hands before handling lenses, using fresh solutions every day, discarding lenses at appropriate schedules.
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Bausch and Lomb has stopped shipping its ReNu MoistureLoc brand contact-lens solution. [B&L press release.] This follows reports to the CDC of 109 cases of suspected fungal keratitis -- eight of which were so bad that the suffers received corneal transplants.

Of the 109 cases, 26 patients remembered which products they used, and all 26 reported using a Bausch & Lomb ReNu brand contact-lens solution in the month prior to the onset of infection.

The CDC and FDA are investigating these reports, as are state and local health departments and contact-lens solutions manufacturers, to figure out which combinations of patient behavior and product use put contact-lens wearers at increased risk for Fusarium keratitis.

Clusters of Fusarium keratitis were reported among contact-lens users in Asia beginning in February 2006. At that time, Bausch & Lomb voluntarily stopped selling ReNu multipurpose solutions in Singapore and Hong Kong, pending their investigations, after multiple reports of Fusarium keratitis among contact lens users there.

The FDA offered the following advice:

1. For healthcare providers:

* If a patient presents with a microbial keratitis, consider that a fungal infection may be involved and obtain a specimen for laboratory analysis.
* Refer patients to an ophthalmologist for immediate treatment.
* Report cases of fungal keratitis in contact lens wearers to FDA.

2. For contact-lens wearers:

* Wash hands with soap and water, and dry (lint-free method) before handling lenses.
* Wear and replace lenses according to the schedule prescribed by the doctor.
* Follow the specific lens cleaning and storage guidelines from the doctor and the solution manufacturer.
* Keep the contact lens case clean, and replace every 3-6 months.
* Remove the lenses and consult your doctor immediately if you experience symptoms such as redness, pain, tearing, increased light sensitivity, blurry vision, discharge or swelling.

In addition, says the FDA, regardless of which cleaning/disinfecting solution used, wearers may want to consider performing a "rub and rinse" lens-cleaning method, rather than a no-rub method, in order to minimize the number of germs and reduce the chances of infection.

* More info for contact-lens wearers on fungal-infection risk.
* More info on this topic and how to report fungal-infection cases to the FDA.