香港九龍亞皆老街 147C 號 2 樓 2/F, 147C Argyle Street, Kowloon, Hong Kong

Surveillance And

Epidemiology Branch

監測及流行病學處

本署檔號 Our Ref.: ( 1 ) in DH/SEB/CD/8/20/1 來函檔號 Your Ref.:

電 話 TEL.:

傳 真 FAX No.: 20 February 2006

Dear Doctor, Contact Lens Related Fungal Corneal Infections

You may be aware that Singapore Ministry of Health (MoH) has issued a press

release on February 18 alerting public to a recent increase in incidence of contact lens related fungal corneal infections. I am writing to provide an update on the latest situation of fungal keratitis among contact lens users in Hong Kong, and to solicit your assistance in offering health advice to your clients to prevent contact lens related keratitis.

According to Singapore MoH, there was a spike of 7 cases of fungal corneal infections due to Fusarium species in January 2006. This compares with about 1-2 cases per month since May 2005 (total: 19 patients). All the patients used disposable soft contact lenses, which were cleaned and stored with multi-purpose contact lens solution. 18 of the 19 patients reported that they had used Bausch and Lomb’s (B&L) ReNu multipurpose contact lens solution.

In Hong Kong, the Centre for Health Protection (CHP) in August 2005 announced in a press release about an apparent increase in number of contact-lens associated microbial keratitis (i.e., corneal infections), and gave health advice to the public concerning proper cleaning of disposable contact lens. Since then, CHP worked with the Hospital Authority (HA) to monitor the occurrence of fungal keratitis.

Based on HA hospital discharge data, 17 patients suffering from fungal keratitis

caused by Fusarium species had been admitted to public hospitals since June 2005, with an average of 2 to 3 patients per month. One patient was admitted in January 2006. The presenting symptoms included eye pain, redness, photophobia, tearing, foreign body sensation, swelling and eye discharge.

衞生防護中心乃衞

生署轄下執行疾病

預防 及控制的專業架構

The Centre for Health Protection is a professional arm

of the Department of Health for disease

prevention and control

香港九龍亞皆老街 147C 號 2 樓 2/F, 147C Argyle Street, Kowloon, Hong Kong

Sterility tests performed by the Public Health Laboratory Services Branch on 3 intact samples of the B&L ReNu Multipurpose product in September 2005 showed negative results. In response to the new report from Singapore MoH, the CHP/DH contacted the B&L manufacturer to obtain more updated information. More contact lens solutions will be sampled and tested.

Although its incidence is unknown, keratitis is not uncommonly seen especially

among contact lens users. Patients with keratitis commonly present with eye pain, redness, foreign body sensation, and sometimes fear of light. The condition may or may not have an infective cause. Contact lens related microbial keratitis is usually caused by bacteria (e.g., Pseudomonas aeruginosa, staphylococci) and fungi (e.g., Fusarium spp.).

Improper lens hygiene practice, overnight wear, long duration of continuous wear, and smoking in contact lens wearer had been reported previously to be associated with increased risk of contact lens-related microbial keratitis.

To prevent microbial keratitis, contact lens users are advised to practice proper

hand hygiene and cleansing of the contact lens case. Contact lens disinfectants should be discarded one month after opening. Your assistance is solicited to provide health advice to your clients on proper disinfection of contact lens and its accessories. If you come across clients presented with symptoms and signs of keratitis, please refer them to consult an ophthalmologist for assessment and treatment.

Yours sincerely, (Dr Thomas TSANG) Consultant Community Medicine (Communicable Disease) Centre for Health Protection Department of Health

衞生防護中心乃衞生署

轄下執行疾病預防 及控制的專業架構

The Centre for Health Protection is a

professional arm of the Department of Health for

disease prevention and control