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Fallon Ukpe, Stephanie Youlios, Bela Parekh, Jai Parekh; Traveler's Contact Lens Associated Keratitis (TCLAK): Establishing Preventive and Treatment Guidelines To Close A Gap in Ophthalmic Care. Invest. Ophthalmol. Vis. Sci. 2013;54(15):511.
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To evaluate preventive care and education provided to patients with contact lenses in order to prevent infectious keratitis. The authors propose the categorization of contact lens related infectious keratitis acquired during travel as Traveler's Contact Lens Associated Keratitis (TCLAK) and recommend specific preventive and treatment measures for contact lens wearing patients. While the incidence of contact lens associated keratitis is low, there are increasing numbers of cases we have defined as TCLAK due to higher contact lens usage, longer duration of lens wear, and increasing international travel. This is relevant as TCLAK presents higher morbidity risks since there is often decreased access to ophthalmic care abroad, thereby leading to a delay in treatment and poorer prognosis and outcomes.
Conducted a review of guidelines for safe contact lens use and care from the American Association of Ophthalmology (AAO), the Contact Lens Association of Ophthalmologists (CLAO), the Centers for Disease Control (CDC), and the Food and Drug Administration (FDA). More specifically, the review searched for preventive and educational care guidelines for contact lens wearers prior to travel.
While guidelines for contact lens use and care caution patients in order to prevent complications through appropriate lens cleaning and disinfection as well as discarding lenses after the prescribed duration of wear, there are no specific recommendations regarding precautions to take when traveling internationally; furthermore, there are no warnings of the potentially higher risks of keratitis due to conditions abroad and the prevalence of certain infectious microbes in particular areas.
The lack of preventive patient education and provider care guidelines specifically aimed at decreasing the incidence of TCLAK is a gap that requires attention. As patients with TCLAK have a higher risk for devastating outcomes such as loss of sight or even enucleation, the specific recognition of TCLAK infections as a group as well as the development of preventive guidelines for patients and clinical care guidelines for providers is essential. The authors have designed a set of guidelines to specifically address this gap and recommend dissemination of these guidelines for patients traveling with contact lenses and for providers caring for contact lens wearing patients.
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