EYE INFECTION DETECTION
If you wear contacts, your risk of getting a blinding eye infection goes up. Until recently there has been no easy way to diagnose the infection, but, a new technique is helping patients keep their eyesight.
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Lori McRae used to live in darkness.
Lori McRae
Had eye parasite infection
"We put black plastic over all the windows, and basically tried to shut out all light in the house."
She was in extreme pain and losing sight in one eye. She went to six different doctors before getting the correct diagnosis - a parasite called Acanthamoeba
William Mathers, M.D.
Ophthalmologist
Oregon Health & Science University
Portland, OR
"It's extremely common. There's amoeba everywhere. It's in our drinking water. It's all in the soil, and in all water."
Lori doesn't know how she got the infection. The amoeba could have been in the water when she washed her hands before putting in her contacts.
Whatever the cause, she was lucky to find doctor mathers. He uses a special microscope to look for the infection.
William Mathers, M.D.
"We can actually see the organisms in the eye, living in the eye without hurting the person at all.
The more common way to diagnose the infection is to culture the amoeba. Many doctors don't go to the trouble because the symptoms are similar to other eye infections.
Lori was treated for pink eye and herpes first. She was finally given the right medications, but it was too late for them to work.
She needed a cornea transplant to restore her sight. She says she hopes the new microscope will prevent others from having to go through what she has.
Lori McRae
"I'm very lucky to have come from that point to be where I am."
Even if she could, lori says she'll never go back to contacts.
If you're going to wear contacts, Doctor Mathers suggests disposable or daily wear lenses. He says people who wear their contacts overnight are ten times more likely to get infections.
EYE OPENER: Researchers at the Casey Eye Institute say if you wear contact lenses you are at risk for an eye infection that could lead to blindness. The study found the water and soil-born parasite acanthamoeba is more prevalent than most ophthalmologists think. "Amoeba are very common organisms, they are all over the globe, in fact they're one of the original life forms" says Bill Mathers, professor of Ophthalmology at the Casey Eye Institute. Mathers has been studying the organism for nearly twenty years, and has diagnosed over 400 patients. He says patients are given antibiotics but, these drugs don't work against the parasite—so the problem persists and if it goes untreated, patients can lose their eyesight. "This is a kind of amoeba that has the characteristic of forming a cyst or shell around it so it can hide from predators or destruction, and can be very difficult to kill."
SEEING THE PROBLEM: The amoeba is extremely difficult to identify, but according to researchers at the Casey Eye Institute, a confocal microscope may offer doctors the best chance at diagnosing the amoeba as the source of an eye infection. Here's how the microscope works: by having a confocal pinhole, the microscope is really efficient at rejecting out of focus fluorescent light. The practical effect of this is that your image comes from a thin section of your sample (you have a small depth of field). By scanning many thin sections through your sample, you can build up a very clean three-dimensional image of the sample. The bottom line is this: a confocal microscope has slightly better resolution horizontally, as well as vertically. In practice, the best horizontal resolution of a confocal microscope is about 0.2 microns, and the best vertical resolution is about 0.5 microns. Because of the confocul microscope's very high magnification, the Acanthamoeba is detectable when it's used to view cornea cells.
DIAGNOSIS: Clinical trials show the microscope can achieve earlier diagnosis and treatment of Acanthamoeba keratitis. A study of 25 cases of Acanthamoeba keratitis revealed those whose diagnoses was delayed suffered from poorer vision after treatment. The average delay between first symptoms and diagnosis was two months. Nine eyes received surgical treatment: penetrating keratoplasty in eight cases, conjunctival flap in one case, and enucliation in another case. Visual outcome was less than 20/60 in ten eyes because of delayed diagnosis.
TREATMENT: The Casey Eye Institute is developing new methods to test antibiotics that are active against this devastating problem. Such tests are currently unavailable anywhere. Doctors hope to provide clinicians with a resource to test infections and to determine the best treatments. Also, they are developing tests to determine the virulence of different strains of acanthamoeba, which vary greatly. Improved detection of acanthamoeba is also being pursued with advances using DNA detection methods.
Jim Newman
Oregon Health and Science University
3181 SW Sam Jackson Park Rd.
Portland, OR 97239
(503) 494-4158
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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