BACKGROUND: Keratitis, inflammation of the cornea, can result in partial or total loss of vision and can be caused by infectious agents including bacteria, fungi, and amebae. Contact lens wear is the principal risk factor for microbial keratitis. An estimated 41 million U.S. adults wear contact lenses. Keratitis from all causes, including contact lens wear, results in approximately 1 million clinic and emergency department visits annually, with an estimated cost of $175 million in direct health care expenditures in 2010. Poor contact lens hygiene is a major risk factor for microbial keratitis and other contact lens–related inflammation. In an online survey of contact lens wearers, approximately 99% of wearers reported at least one contact lens hygiene risk behavior (e.g., sleeping in lenses, topping off disinfecting solution, exposing lenses to water) and one third reported ever having experienced a contact lens-related red or painful eye that required a doctor's visit; however, awareness that these behaviors put them at risk for eye infections is low. Outbreaks of Fusarium and Acanthamoeba keratitis investigated by CDC have been associated with contact lens multipurpose solution use; in 2011, an outbreak of keratitis was associated with poor contact lens hygiene.
METHODS: In 2013, as a result of these multistate outbreak investigations, CDC launched the Healthy Contact Lens Program with a mission to increase awareness of behaviors and risk factors that can affect the eye health of U.S. contact lens wearers. CDC worked with FDA, eye care providers, and contact lens manufacturers to develop clear and consistent recommendations about proper wear and maintenance of contact lenses.
RESULTS: Strategies employed by the program have included the development of a comprehensive website (http://www.cdc.gov/contactlenses/index.html), conducting epidemiologic analyses to fill data gaps, and engaging with eye health experts in multiple sectors to amplify our messages. CDC developed contact lens health promotion materials (e.g., posters, infographics, provider tear-off pads) that are freely available to eye care providers, public health, and the public. Health promotion campaigns have included Contact Lens Health Week held each August, spring break contact lens health tips, and Halloween contact lens health tips targeting decorative lens wearers.
CONCLUSIONS: Further research and increased public awareness are needed on the risks of contact lens-related eye infections and contributing behaviors; CSTE membership can assist in improved surveillance through utilization of additional data sources and increased health promotion campaigns at the state and local level to decrease the public health burden.