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Eye fungus sparking lawsuits

Sixty of the 186 cases of a rare eye infection are in Florida. Some blame a contact lens solution.

By LEONORA LAPETER
Published April 28, 2006

It's rare, dangerous and striking more and more contact lens wearers.

The number of Florida cases of fungal keratitis, a debilitating eye infection, has risen steadily with 60 cases reported, up from 30 three weeks ago.

They comprise a third of the 186 cases in 29 states reported to the Centers for Disease Control and Prevention.

On Thursday, a 63-year-old New Port Richey woman filed a federal lawsuit in Tampa against Bausch & Lomb Inc., blaming the company's ReNu with MoistureLoc solution for causing the infection that can lead to blindness.

Mary Scorzafava suffered 80 percent loss of vision in her eye and had to have her scarred cornea "scraped" during surgery to remove infected tissue, said her lawyer, Joseph Saunders of Pinellas Park.

"Mary went through about 31/2 months of severe agony," Saunders said.

A Sarasota woman filed a similar lawsuit last week in U.S. District Court in Tampa. Many of the Florida cases appear to have originated in the Miami area, but the infection has been reported in Tampa, Palm Harbor, Venice, Jacksonville, Coral Springs, Sarasota, Lakeland and Boca Raton.

Bausch & Lomb officials have said recent tests on its ReNu contact lens solutions found no connection to the infections, but the company stopped shipping the product April 10.

Local ophthalmologists fear the numbers of cases will grow as more and more people become aware of the infection, which eye doctors often see only a few times in their careers. About 30-million Americans wear contacts.

"Everybody is just sort of waking up to this now because it's getting publicized," said Dr. Bradley Fouraker, 49, a Brandon ophthalmologist who specializes in these cornea infections. He is treating four patients with the infection.

One of them contracted fungal keratitis nearly a year ago, requiring two corneal transplants in the same eye over the span of three months.

The Palm Harbor woman, who visited Fouraker on Thursday for a checkup, thought she'd gotten the infection from her son's pool. But her husband, a fastidious note-taker, looked at his notes and realized the fungal infection had turned up right after she switched to ReNu with MoistureLoc last May.

But some eye doctors wonder if perhaps the problem lies elsewhere and ReNu is being blamed because so many people use it.

"If most everyone uses ReNu and people got (the infection), it's going to be determined to be related," said Dr. Mark Sibley, 55, a St. Petersburg ophthalmologist who is also a cornea specialist and an assistant professor at the University of South Florida. "I'm not standing up for ReNu ... but studies have shown no fungus in anything they've tested."

The Food and Drug Administration and the CDC are conducting tests at Bausch & Lomb's Greenville, S.C., plant. In February, the company suspended sales of its ReNu multipurpose solutions in Singapore and Hong Kong after an outbreak of fungal keratitis there. Of the 39 identified cases in Singapore initially, for example, 34 had used ReNu products.

The CDC began looking into the problem in the United States in March after a New Jersey doctor reported three cases in the previous three months, all but unheard of in the Northeast.

The Fusarium fungus, which causes the infection, is commonly found on plant material, soil and other organic matter. It can enter the cornea through a scratch or abrasions that commonly occur from contact lens use. It is seen most often in the southernmost United States, where humidity allows it to grow.

Nine out of 10 eye infections typically involv e bacteria rather than fungus. A bacterial infection can be just as debilitating but easier to cure.

At Sibley's office last week, Charlene Williams, 26, felt excruciating pain because pseudomonas, the most common bacteria, was eating away at her corneas. People who wear their contact lenses overnight, as Williams did, can get small abrasions on their eyes. Once bacteria gets into the abrasions, it can do devastating damage.

"I'm just really, really scared," said Williams, an AAA dispatcher, through tears as Sibley doused her eyes with antibiotics over and over. "I don't know if I ever want to wear contact lenses again."

Kevin Tapp, 17, a St. Pete Catholic High student, can't see much out of one eye because pseudomonas scarred his cornea two years ago after he wore contacts.

Kevin needs a corneal transplant but doesn't want to get it yet because he plays football and basketball and the transplant would require him to give up sports.

"It was probably the worst challenge we'd had with our kids," said his mother, Carrie Tapp, 49. "We'd never had anything like this. Just to imagine your son losing his eye ..."

Kevin wears a contact in his other eye.

Ophthalmologists here and abroad are seeing a pattern: It appears to be more common among younger contact lens users.

"We're thinking it's perhaps because they don't take all the appropriate care they should in cleaning and taking care of (them) and they have a big tendency to wear them overnight." said Fouraker.

Fouraker said he contacted the Bascom Palmer Eye Institute at the University of Miami, which reported 21 patients with the infection, and also noticed a large percentage were young adults.

The severity of the infection has lawyers from around the country circling for clients.

A New York lawyer says he is representing the parents of a 3-month-old from Florida who became infected with the fungus after the parents used MoistureLoc to combat the baby's dry eyes. The baby needs a double corneal transplant.

"This is out of control," said Jerrold Parker, 54, whose New York law firm has received 1,000 calls from potential victims.

Part of the frenzy may lie in the fact that Bausch & Lomb did not pull the product off shelves in the United States until long after it knew there was a problem in Asia. On Thursday, the company said it was alerted last fall to an increase among lens wearers in Hong Kong, but a review of the cases found no link to MoistureLoc.

"I think they were thinking, "What happens in Asia, stays in Asia,' but if it's the same product, why make that assumption?" said Robert J. Carroll, 63, a Clearwater personal injury Clearwater who has been approached by at least four potential victims. "How could they be blind to the horror of this spreading?"

Times staff writer Justin George contributed to this report, which includes information from the Associated Press.

Symptoms of fungal keratitis:

"I think the most important message is that people shouldn't be sleeping in their contact lenses unless they absolutely have to," said Dr. Clifford Salinger, an ophthalmologist and cornea specialist from Palm Beach Gardens. The American Optometric Association says contact lenses are a safe and effective way to correct vision, but using them improperly can lead to infections. The AOA recommends:

Replace lenses on the prescribed schedule.

Don't sleep in your lenses if your doctor has not prescribed continuous wear lenses.

Always wash your hands before handling contact lenses.

Clean contact lenses carefully by rubbing the lenses with fingers and rinsing thoroughly before soaking lenses overnight.

Store lenses in the proper case and replace the case every three months.

Discard the solution every time the lenses are placed in the case.

[Last modified April 28, 2006, 02:23:40]