Pseudomonas Corneal Ulcers Associated with Soft Contact-lens Wear

Seven Pseudomonas corneal ulcers in six patients were associated with soft contact-lens wear and use of saline solutions prepared from distilled water and sodium chloride tablets. The same species of Pseudomonas isolated from the corneal ulcers were also isolated from the home-prepared saline and in one instance from the water used to prepare the saline solution. In three of the six patients, the pseudomonad isolated from the corneal ulcer was of the same serotype and biochemically identical to the pseudomonad from the patients' saline solution. Commercially available distilled water, even brands recommended for use with soft contact lenses, was found to be contaminated with gram-negative bacteria before use. Clinical histories disclosed that all patients inappropriately used the home-prepared saline as a wetting agent, or eyedrop, or bath, after thermal disinfection of the contact lens. Self-inoculation of the eye with contaminated saline is a hazard for soft contact-lens wearers who use home-prepared saline solution.