Infiltrative keratitis associated with extended wear of hydrogel lenses and Abiotrophia defectiva

Purpose. Infiltrative keratitis is a common complication associated with ex tended wear of hydrogel lenses. Causative bacteria are often isolated from the lens at the time of an event. We report a case where three repeated occ urrences of infiltrative keratitis were associated with contamination of th e contact lenses by Abiotrophia defectiva. Methods, A 34-year-old man parti cipating in a clinical trial of extended wear hydrogel contact lenses exper ienced three episodes of infiltrative keratitis. The clinical presentation was observed using a biomicroscope. At the time of each event, the contact lenses were removed aseptically and ocular swabs were taken fur bacterial i dentification and enumeration. The condition was monitored until full resol ution. Results. The condition was characterized by irritation, marked bulba r and limbal injection, and multiple focal subepithelial infiltrates. Many of the infiltrates also showed overlying staining with fluorescein. In each of the three events of infiltrative keratitis, A. defectiva was cultured f rom the contact lens and ocular swabs. Conclusion. This is the first report ed occurrence of infiltrative keratitis associated with A. defectiva contam ination of contact lenses.