ODwire.org Supporting Member
- Jun 28, 2009
- PA College of Optometry
- Santa Barbara
The vast majority of my CL related ulcers have been in EW wearers. My most recent patient with the Big Kahuna central corneal Pseudomonas ulcer had been an Air Optics N&D wearer. If was on day 3 of his newly replaced lens when he woke up with a painful photophobic red eye. That was on January 2nd. He is still being treated today and still has an epithelial defect(slowly improving) and significant surrounding infiltrate and a reduction in BVA. I speculate that if he were in DDs that he removed each evening, he would have been a much happier man today.
Maybe, maybe not.
Here's where you can be the forensic detective. He was on third day of having changed out lenses and it takes pseudomonas 24-48 hours to create it's biofilm (the reason why it's a bigger problem than other, less creepy and scary bugs) which strongly suggests he caught the bug at the time of changing lenses or shortly thereafter.
He removed a possibly slightly adherent old worn out lens and took a little cornea epithelium with it. The pseudomonas is really excited now. What would be better than new lens to trap them in there. And there is comes.
You might want to try to sleuth out where the bug came from. Most likely source is outside in the garden or woods. Another source might be the water supply. Did he handle the lenses with tap water on his hands or maybe even rinse them off under the tap? That could be a serious find and the water company might want to know. You might trigger an investigation of the water treatment plant and then your city has to spends millions of dollars repairing the problem and you become either the town hero or pariah.
Either way, you write a book about this and it is turned into a made-for-tv movie and you become fabulously wealthy and are therefore offered a job in the Trump administration.