The UK has experienced a surge in the number of Acanthamoeba keratitis (AK) infections since 2011. AK is an infection of the cornea at the front of the eye. It can be painful, and in severe cases lead to significantly reduced vision or blindness.
Acanthamoeba is commonly found in lakes, river, oceans, domestic tap water, and swimming pools. AK is a preventable disease that contact lens wearers are more prone to contracting if proper hygiene is not observed. This spike in AK is concerning because the majority of patients affected are economically active adult contact lens users, and although AK is treatable, any damage to vision is irreversible.
According to a recent article published in the British Medical Journal of Ophthalmology, results from a case-control study have shown that incidence of AK in 2010–2011 was three times than observed in 2004–2009. Apart from collecting data on the frequency of AK in the population treated at Moorfields Eye Hospital, the study also looked at potential factors contributing to the outbreak. Some of the elements investigated in the study were lens disinfectant solution, and hygiene practices such as hand washing and showering while wearing contact lenses. No single principal cause of the outbreak was identified; instead, results from the analysis pointed to a combination of aspects relating to poor contact lens hygiene as the cause for the outbreak.
These findings could prompt a change in the usual services and care provided by the optical sector, in order to increase awareness of the risks of improper contact lens hygiene. Possible public health interventions could be including cautions on contact lens packages, or notices at sports facilities regarding contact lens use and water activities. These would be important warnings given that Acanthamoeba is commonly found in tap water and swimming pools. Another suggestion presented in the paper is to add Acanthamoeba screening to tap water surveillance. Interventions targeting tap water screening and behavioural changes could help reduce the burden of AK in the UK.