Would you fit a patient who had recently had microbial keratitis with contact lenses?

A panel of College members grapple with a controversial question.

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Yes I would, provided that the vision still improved with contact lens (CL) wear and the patient took steps to minimise subsequent infections, such as using either daily disposable soft CLs or gas permeables with a daily rub-and-rinse cleaning regime, and no orthokeratology.

The ocular surface must be re-evaluated to exclude sources of infection such as chronic staphylococcal blepharitis, ensure no tear film deficiency and check the fit of the lens for clearance. Re-education for the patient on CL hygiene is a necessity.

Damian Lake Consultant Ophthalmologist, Queen Victoria Hospital, East Grinstead



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