Tuesday February 21, 10:17 PM
Rise in number of fungal infections among contact lens users
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SINGAPORE : There has been a rise in the number of fungal
infections of the eye among contact lens users.
A total of 39 cases were detected, up from the 22 reported
previously.
The Health Ministry has also strongly urged those using Bausch and
Lomb's ReNu multipurpose solution to stop, until investigations are
complete.
Bausch and Lomb's ReNu solution has a strong association with the
fungal infection cases, says the Health Ministry.
A total of 35 out of the 39 contact lens wearers infected with the
Fusarium solari fungus said they had used the solution.
Four were unsure of the brand they use while at least one use a
different brand.
A majority of the 39 cases started developing infection in the
second half of last year. Most of those infected were teenagers and
young adults, aged between 15 to 24 years old.
The Ministry says that it is currently looking at a spectrum of
factors in its investigations, including the solution itself and
the makeup of the fungus.
It is also looking into the hygiene habits of the contact lens
users.
The Ministry says that it is also collaborating with its
counterparts in other countries such as Hong Kong to see if there's
been a spike in the number of fungal infections there.
Dr Balaji Sadasivan, Senior Minister of State for Health, said: "In
other words although there is an association, it does not mean that
the solution contains the fungus.
"The solution may be perfectly alright but somewhere between the
solution and its use, there are many factors that come into play.
That is why we are carrying out investigations.
"It could be that the fungus has undergone a mutation that enables
it to grow selectively in a particular medium that's found in this
solution.
"So it may not be the solution in its original form to allow this
fungus to grow but that the fungus has changed its characteristics
so that while there is an association which is very strong, we have
no information to explain the mechanism that has given rise to
these infections."
Eye doctors say that the situation is worrying as fungal infections
among contact lens users is uncommon.
It is also more difficult to treat, although the fungus itself is
not contagious.
Dr Chan Wing Kwong, Head of Refractive Surgery Service at the
Singapore National Eye Centre, said: "The reason that we are
worried is that fungus is slow to present. In fact due to the
biology of the fungi, they grow quite easily in the eye without
causing too many symptoms and sometimes it can be days or weeks
later before they start to present.
"They will start to present similarly with redness and pain and
poor vision but they will present late and therefore the loci of
the infection are now bigger.
"Because they present late, they have time to establish a foothold
in the cornea and sometimes they threaten the integrity of the
cornea and the cornea may get thin or perforate and that's why in
the end three or four of some of these patients also has to undergo
corneal transplant."
Dr Chan adds that treatment of fungal infection is also more
difficult as anti-fungal agents are limited.
The 39 cases were traced from July last year when hospitals started
to see a spike in fungal infections with about five cases per
month, up from just one a month.
The largest number of cases reported was in January this year, with
10 cases.
Investigations are expected to take weeks, even months.
Doctors say that this is because fungus takes longer to culture as
compared to bacteria which takes about 24 to grow.
Dr Balaji added: "The purpose of this press conference is because
it is an issue of public safety. Once we know an association, then
we have to tell the public that there is an association and tell
the public to stop this product until investigations are
complete.
"The investigations itself is like detective work. If you watch
CSI, you know that you won't immediately have the answer but you
have to have an open mind, we will investigate using technology and
trying to piece things together."
Bausch and Lomb, which has suspended sales of ReNu, has about 40
percent of the market share in Singapore.
The company says that it will pick up the medical tabs of patients
if its solution is indeed found to be the cause of the
infections.
It will advise ReNu users what to do with the products that they
have bought within the next few days. - CNA/de
http://sg.news.yahoo.com/060221/5/singapore194315.html
