Update on Contact Lens Related Fungal Corneal Infections

12 Apr 2006

There has been an additional 36 cases of fungal corneal infection reported since the last update in late February (39 cases). In total, 75 cases of fungal corneal infection (which tested positive for Fusarium) with a history of contact lens use have been reported for the period 1 Nov 2004 to 12 April 2006. This compares with two reported cases from 1 Jan to 31 Oct 2004.

In view of the potentially serious adverse visual consequences of fungal corneal infection, the Ministry of Health had on 17 Feb 2006 advised all contact lens users as a precautionary measure to discontinue the use of Bausch and Lomb's ReNu multipurpose contact lens solution for the time being, until the causes behind this recent increase in infections can be more clearly ascertained.  Bausch & Lomb (S) Pte Ltd (B & L) has since voluntarily suspended sales of its ReNu multipurpose solution.

The Ministry has noted that the number of recently acquired cases has fallen to four in Mar, as compared to 14 cases in the months of January and February respectively. All four cases with onset in March used Bausch and Lomb's ReNu contact lens solution and had decided to finish the remaining solution before switching brands. Out of the 75 cases, 59 were sure of the contact lens solution used. Of these, 56 (94.9%) said that they had used ReNu. 

A comprehensive case-control study (comparing contact lens users with infection and contact lens users without corneal infection) was undertaken in Feb-Mar 2006 to investigate risk factors for the spike in fungal corneal infection. The study found a strong association between corneal infection and the use of ReNu solution. This association remained strong even after taking into consideration socio-demographic, lens, hygiene and environmental factors. The findings are also consistent with recent observations made in the US and Hong Kong.

Investigations by HSA into biological links are still in progress. The tests include microbiological investigations, excluding possible batch contamination, and assessing disinfectant efficacy. HSA has been working closely with its international counterparts and has also been in discussion with the manufacturer, Bausch and Lomb.

The Ministry of Health would like to reiterate its advisory for all contact lens users to discontinue, as a precautionary measure, the use of B & L ReNu multipurpose contact lens solution for the time being.

Contact lens users are also advised to practise proper contact lens care as recommended by their contact lens practitioners (please see key points at Annex). For those who have experienced any symptoms of infection such as redness of eyes or pain or itchiness, they should consult a doctor immediately.

The Ministry will keep the public informed of any further developments.

ANNEX

Proper Use of Contact Lens

• 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.