Fighting Fusarium Is A Matter Of Simple Hygiene —

 ‘Tear Your Eyes Away’ From Eye Fungus

By Kendra Bobowick

Contact lens wearers are concerned about contracting Fusarium keratitis — an eye fungus quickly gaining recognition since last year and most recently since April 11.

“In a year’s worth of tracking we’ll see maybe three dozen cases worldwide,” said optometrist Margaret Marcone, OD, with Danbury Eye Physicians and Surgeons. The Center for Disease Control (CDC), however, has investigated 109 reports of Fusarium cases from 17 states since June 2005.

Federal and state health officials have interviewed just 30 of those patients. Of the 28 who wore soft contact lenses, 26 reported using the ReNu brand or a generic type of solution also made by Bausch & Lomb. Five of the 26 patients also reported using other types of solutions in addition to ReNu, Bausch & Lomb said. And nine said they wore their lenses overnight, which is known to increase the risk of infection, the CDC said.

The CDC’s investigation prompted removal of some Bausch & Lomb merchandise from stores. Most recently, Bausch & Lomb manufacturers have requested that retailers remove their eye care product from shelves, said Dr Marcone. A full-page advertisement from Bausch & Lomb appeared in the Sunday, April 16, edition of The New York Times stating, “When reports of a rare eye infection, seemingly associated with our product, began to surface, we began a series of exhaustive tests on our products, and a thorough inspection of our US plant…we’ve stopped shipments of ReNu with MoistureLoc from the US plant, and are asking retailers to take the product off the shelves…No link has been found between Bausch & Lomb Inc’s ReNu brand and the infection, but an elevated number of the affected people had used the solution, according to reports.”

Also included in the manufacturer’s April 16 ad is the statement, “…the available scientific evidence does not establish ReNu with MoistureLoc as the cause [of Fusarium keratitus]. However, data released from the Centers for Disease Control and Prevention identified a disproportionate association of a small number of events with ReNu…”

Is Bauch & Lomb responsible? Dr Marcone does not think so. A swell in reported Fusarium cases, “has definitely been linked, but we don’t think there is contamination.”

Confident in the reassurance she offers her own patients, Dr Marcone said, “The crux — most people have a better chance of being struck by lightning on a clear day than they have of getting this.”

The medical professionals are not sure why the fungal infection has increased, she said, but offers some advice for those concerned.

“At this point if you are using ReNu, don’t panic,” she said. “Contact your doctor for a different solution until we figure this out.”

She also admonishes those with poor eye-care habits. Mentioning her theory, she said, “People may be abusing their lenses and using them more than they should.” Two-week throwaway lenses may still be in use after nearly a month, for example.

“If you wear them longer than you should, you could be predisposed.”

Eying other misuses, she said, “I theorize there is abuse of solution as well.” Dr Marcone gave a detailed scenario of what not to do with lenses and solutions not only to prevent against Fusarium, but infections in general.

“We theorize that [people] are using the same solution night after night, and a solution isn’t strong enough to go night after night,” she said. Fungus or bacteria will eventually overcome the solution, she said, after which, “you’re putting that contact back into your eye.”

She said, “It’s like using the same bath water night after night,” she said.

Her advice to protect against infection is simple.

“Good, proper hygiene,” she said.

For those who wear contacts, she advises, “Keep the cases clean, dispose of lenses as recommended by professionals, and care for your cases and replace as needed.”

Further enhancing this scenario is the general mechanics of wearing contacts, Dr Marcone explained.

“By wearing them we are putting an artificial substance into our eyes and the cornea can be a bit less resistant to microbes.”

She anticipates that to partially counteract the Fusarium and possible misuse, consumers will see bolstered eye products.

“I think we’ll find they reformulate things to be more durable against abuse,” Dr Marcone said.

The good news is that the condition is easily prevented and chances of infection are slim, according to Dr Marcone. Theories about the increase in cases are the only explanations so far, she said.

What the eye care community can say for certain is that Fusarium is an ordinary fungus. Dr Marcone said, “What it comes down to is it’s a common fungus and it’s everywhere.” More prevalent in warmer areas as is any fungus, Ms Marcone said that fewer cases occur in the Northeast.

For those experiencing any kind of eye irritation, decreased vision, burning, etc should seek medical help. The longer the fungus goes untreated, the harder it is to deal with, she said.

“Just like any bacteria or fungus, it breaches the cornea’s defense just like getting a cut,” said Dr Marcone. She also offered the assurance that the condition is not permanent, but requires proper treatment.

The first couple of cases initially threw doctors off the right trail, she explained.

“[They] thought it was bacteria and it advanced before tests were done for fungus,” she said. “But now we’re looking for fungus immediately, and this should make it easier to treat.”

As of March 31, Dr Marcone knows of just one case reported in the area. The person wore contacts and used ReNu.

The Associated Press reports that shares of Bauch & Lomb plunged nearly 20 percent after the eye-care company voluntarily suspended shipments of a contact lens solution linked by federal health officials to a fungal eye infection that can cause temporary blindness.

Its stock, which peaked at $87.89 in July after more than two years of robust growth, dipped $11.14, or 19.4 percent, to a two-year low of $46.30 at the start of trading Tuesday on the New York Stock Exchange. Analysts cut their ratings on the shares, citing concerns that the news could hurt sales the company’s other products.

The company, which makes contact lenses, ophthalmic drugs, and vision-correction surgical instruments, said late Monday it would temporarily suspend shipments of its ReNu with MoistureLoc contact lens solution made at its Greenville, S.C., plant.

In February, the company stopped shipments of ReNu in Singapore and Hong Kong after a similar spike in fungal keratitis was reported.

Bausch & Lomb’s chief executive, Ron Zarella, said the CDC data “are both troubling and perplexing, as there is an apparent disproportionate representation of US-manufactured ReNu with MoistureLoc in the underlying data. The source of these infections has not been determined.”

The company had already had to deal with a host of accounting troubles in recent months. On March 17, it moved to reduce its reported net sales by a combined $9.3 million after an internal investigation determined its South Korean subsidiary engaged in improper sales practices from 2002 to 2005.

In December, the company moved to restate financial results back to 2001 because of accounting shenanigans at its Brazilian unit. Several class-action lawsuits were filed against the company last month alleging insider trading in connection with the investigations.

Dr Daniel Schultz, director of the Food and Drug Administration’s Center for Devices and Radiological Health, said it was too early to determine if Bausch & Lomb’s solution was the cause of the infections. Both the FDA and CDC are investigating a growing number of reports of infection by the fungus. An estimated 30 million Americans wear soft contact lenses.

Without treatment, which can last two to three months, the infection can scar the cornea and blind its victims. Eight US patients have required cornea transplants.

The fungus is commonly found in plant material and soil in tropical and subtropical areas. Singapore health officials noticed an increase in reports of infection in January and discovered 39 cases involving contact lens users from 2005 to February of this year. Cases have also been reported in Malaysia and Hong Kong.

Find more information on the American Optometric Association, aoa.org, website. Additionally, many news sites contain current information about the Fusarium fungus. Bausch & Lomb also welcomes inquiries at its Help Center line, 888-666-2258.