The association between contact lens use and microbial keratitis during the COVID-19 pandemic: a review

Purpose: Coronavirus disease 2019 (COVID-19) remains a worldwide threat by causing various respiratory, gastrointestinal, liver, neurological diseases, and eye infections. Rigid gas-permeable (RGP) and soft contact lenses should be adequately stored and sterilized by soaking them in a solution for 6-8 hours daily. Bacterial contamination can lead to microbial keratitis (MK) or contact lens-induced acute red eye (CLARE) when improperly sterilized contact lenses are worn for extended periods. This review aimed to determine the association between contact lens use and MK during the COVID-19 pandemic. Methods: Reviewed the association between COVID-19 and contact lenses based on literature published in 2022. In addition, each search was adjusted for the following keywords used in various combinations: "coronavirus" and "contact lenses," COVID-19 and eyes", and "contact lenses and COVID-19". These search terms were applied to two databases: PubMed and Google scholar. Results: MK was a devastating ocular complication associated with inappropriate contact lens use (prevalence,.2-6.9% per 10,000 wearers). Lens cases were the most contaminated item (62%), followed by lenses (56%), solution bottles (48%), and lens care solutions (42%). Furthermore, people who occasionally wore contact lenses showed a higher infection rate than those who wore them regularly. Conclusion: COVID-19 may be acquired through the conjunctiva. Therefore, practitioners must remain vigilant, remind contact lens wearers to practice proper hygiene and handling of contact lenses, and follow all precautions while directly touching the eye at all times.