Public Alert on Increasing Incidence of Contact Lens Related Fungal Corneal Infections

17 Feb 2006

The Ministry of Health (MOH) would like to alert the public to the increasing incidence of contact lens related fungal corneal infections. The Singapore National Eye Centre (SNEC) had noticed a spike of 7 cases of fungal corneal infections in January this year. A retrospective review of cases in SNEC revealed a total of 19 patients had been treated at SNEC for culture positive fungal corneal infections due to the Fusarium fungus species since May 2005 (ie about one to two cases per month). The Ministry was further notified this week of 3 new cases in Changi General Hospital.

The high incidence of fungal corneal infections is unprecedented as most corneal infections related to contact lens use had previously been bacterial in nature. Fungal infections of the cornea are also more difficult to treat and can have adverse visual consequences if diagnosed and treated late.

Some of the patients have suffered significant loss of vision in the affected eye as a result of the fungal corneal infection. Three patients had to undergo urgent corneal transplantation.

All the patients used disposable soft contact lenses, which were cleaned and stored with multi-purpose contact lens solution. 18 of the 19 patients seen by SNEC as well as the 3 patients from CGH reported that they had used Bausch and Lomb's ReNu multipurpose contact lens solution. Health Sciences Authority (HSA) has notified Bausch and Lomb of the association with ReNu multipurpose contact lens solution.

The Ministry of Health is working with the HSA and the SNEC to investigate the cause of the increased incidence of contact lens related fungal corneal infections. HSA is following up with Bausch and Lomb to investigate the association with ReNu multipurpose contact lens solution. MOH and the Contact Lens Practitioners' Board (CLPB) have also alerted medical practitioners and contact lens practitioners to be on the look out for suspicion of potential fungal infections of the cornea and refer the lens user to an ophthalmologist early.

The CLPB reminds contact lens users of the following:

• Practise proper contact lens cleaning and care regimes. Lenses must be rubbed with the fingers and rinsed thoroughly before soaking overnight in a multi-purpose solution.

• Disposable contact lenses must not be used beyond their recommended disposal period.

• The multi-purpose solution in the lens storage case must be changed everyday even if the lenses are not used daily.

• Contact lens storage cases should be replaced at least every three months.

• Users should stop wearing the lenses if they develop any redness, blurring of vision or pain of the eye and to seek consultation with a doctor or contact lens practitioner. 

• Alternatively contact lens users may wish to use spectacles instead for the time being.

The Ministry of Health strongly advises all contact lens users to heed the above advisory, and will keep the public informed of any further developments.