• Comprehensive Ophthalmology, Cornea/External Disease

    Despite a nationwide recall of multipurpose contact lens solution following the Acanthamoeba keratitis (AK) outbreak of 2007, the infection rate has not returned to pre-outbreak levels. The Centers for Disease Control and Prevention (CDC) wants to know why.

    It has launched a follow-up multi-state investigation for which the CDC and the Academy would appreciate your support and participation should you and your patients be contacted by a member of the CDC for an interview. For any questions or comments, please contact Flora Lum, MD, policy director, Quality of Care and Knowledge Base Development, at AAO at flum@aao.org or by phone at 415.561.8592 or Allison Brown, PhD MPH, CDC at acbrown1@cdc.gov or by phone at 404.553.7513 or 1.877.232.4327.

    In the 2007 investigation, AMO Complete® MoisturePlusTM multi-purpose contact lens solution was identified as a risk factor for infection; which the manufacturer voluntarily recalled. Since 2007, CDC has been working with the same reference laboratories and ophthalmologic institutions to monitor the occurrence of laboratory-confirmed AK at these sites.  From these data, it appears that the collective number of AK cases at these sites has not returned to pre-outbreak levels following the product recall in 2007. This data coupled with concerns from centers and health departments about recent unusual clusters of cases has prompted the formation of another AK Investigation Team (AKIT). The AKIT is composed of multiple state health departments, academic institutions, and federal agencies. On March 21, 2011, AKIT initiated a multi-state outbreak investigation to characterize the current risk factors for AK to provide more information for public health action. 

    This investigation is taking place across multiple states, more than 30 so far, to identify and interview patients with signs and symptoms of AK who have laboratory-confirmed diagnoses occurring after Jan. 1, 2008. Because the majority of case-patients have identified themselves as contact lens wearers, the AKIT team is seeking to recruit contact lens users who have not had AK and are willing to participate in a 15 to 20 minute interview about the types of contact lenses and contact lens products they use, how often they wear their lenses, how they clean their lenses, and the activities they perform while wearing them. Interviewing contact lens wearers is essential to this investigation since it allows the team to find out what they do differently from people who have developed this disease. This information can help identify the risk factors for disease and mitigate the emergence of new cases.

    Data will also be solicited from case-patients' treating ophthalmologists and primary eye care providers. The AKIT team will contact a small sample of primary eye care providers in states where persons with AK have taken part in the ongoing investigation. Primary eye care providers are asked to assist with the recruitment of at least three volunteers from among their patients who would be willing to participate in a phone-based survey about their eye care habits. They are seeking contact lens wearers older than age 12 who have not had AK in order to understand the risk factors for disease. 

    Specifically, each provider would be asked to post recruitment materials in their waiting room, introduce the investigation, and discuss its importance to eye health and public health, and encourage their patients to volunteer. A recruitment flyer distributed in the waiting room, would contain all information needed to find more detailed information and to volunteer. Persons wishing to volunteer on-site may fill-out a form to be faxed by someone in the ophthalmology office to State Health Department personnel or toll-free to CDC.  

    Persons interested in volunteering could also do so either online or by phone after leaving their doctor's office. A website address would lead prospective volunteers to a CDC website they could learn more about the survey, get answers to Frequently Asked Questions, find contact information for the CDC Investigation Team, and enter their contact information to volunteer. Alternatively, prospective volunteers would be able to call a state or CDC Investigation Team directly to volunteer. 

    Volunteers would be asked to complete a 15-20 minute standardized interview administered over the phone at a phone number and time designated by the volunteer. This interview would be administered by trained CDC or state health department personnel who are part of the AK investigation team. CDC and state health department personnel would handle all coordination of recruitment material production and distribution to participating providers.