To help clinicians diagnose and manage unilateral recalcitrant chronic bacterial conjunctivitis
secondary to a retained soft contact lens
and describe the first report of Gram-negative bacteria causing this condition.
Chart review of successive cases presenting with unilateral chronic conjunctivitis
with positive cultures and a retained contact lens
Three cases were identified and described. Culturing of the retained contact lenses grew Pseudomonas aeruginosa
in the first case, Achromobacter xylosoxidans
in the second, and Staphylococcus epidermidis
in the third. All three patients were successfully treated with removal of the retained lens and targeted antibiotic eyedrop therapy.
Unilateral chronic recurrent or recalcitrant purulent papillary conjunctivitis
is rare, and a retained contact lens
should be suspected in patients with a history of wearing contact lenses. Careful examination with double eversion of the upper eyelid and sweeping of the fornices can recover the offending lens. Although only Gram-positive organisms have been isolated in previous reports, two of our three cultures grew Gram-negative organisms, highlighting the importance of broad-spectrum antibiotic usage for these cases.