Individuals who purchase their contact lenses over the Internet are 4.76 times more likely to develop contact lens-related microbial keratitis (MK) than patients who purchase contact lenses from their optometrist, according to a study in Junes Ophthalmology.

These patients were also less likely to employ good eye care hygiene. The study suggested that overnight use, poor storage case hygiene and smoking were other primary risk factors for MK development.

In this population-based survey in Australia, researchers attempted to establish the absolute risk and incidence of MK among contact lens wearers. Of 35,914 individuals interviewed, the researchers identified 285 cases of MK. They concluded that five in 10,000 contact lens wearers develop MK because of one or more risk factors.

Jack Schaeffer, O.D., of Birmingham, Ala., is not at all surprised that Internet-purchased contact lenses increase a patients risk for MK. In todays market, with so many people wearing contact lenses, there is an absolute need for a strong, intact doctor/patient relationship to facilitate proper compliance, lens care education, and most importantly, overall ocular health, he says. If patients purchase contact lenses from an Internet-based source instead of an optometrist, that relationship breaks down, and youll see a dramatic increase in infectious problems, such as microbial keratitis.

Stapleton F, Keay L, Edwards K, et al. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology 2008 Jun 5. [Epub ahead of print].