A young Florida man has gone partially blind after falling asleep with his contact lenses on and a flesh-eating bacterium ripped through his eye.
Michael Krumholz, 21, a sports management student from Lake Worth, near Miami, took a 40-minute nap in December while wearing his daily contacts. When he woke up, his left eye was blood red and his vision was distorted.
He shrugged and simply took off his contact lenses. In the days to come, he would slowly lose his sight and experience excruciating pain.
After a month of uncertainty, doctors finally diagnosed him with a flesh-eating bacterial infection known as acanthamoeba keratitis (AK), which can cause permanent and significant vision loss.
Mr. Krumholz can no longer see anything with his left eye, apart from “black and gray” flashing colors, which he compares to the noise of a television.
WARNING: GRAPHIC CONTENT
Michael Krumholz, 21, of Lake Worth, near Miami, was attending college and was working part-time last year while working with children when he was diagnosed with an eye infection. He says it was caused by sleeping while wearing his contacts
AK is a rare bacterial infection that eats away at the surface of the eye. If not treated quickly, it can lead to vision loss
Doctors say he may only be able to regain 10 percent of his vision after a cornea transplant, but the patient told he would take 1 percent.
The infection has forced him to quit his job and hobbies, including hanging out with friends, baseball and working out at the gym.
He told : “I’m 21 years old and I’ve been trying to find a sports management job in the industry but it seems impossible.
“Nowadays it’s no work, no social life, really, social media gets you through the day.”
He has also developed photosensitivity, which means that exposure to direct sunlight is painful for him.
The Floridian now spends most of his time indoors, with the curtains drawn and a pair of sunglasses.
Mr. Krumholz wore Acuvue Oasys daily lenses for two to three years prior to the infection. The vision in his right eye is unaffected.
The condition is a rare bacterial infection. About 80 percent of cases occur in people who wear contact lenses, with a rate of one to two cases per million people per year.
The bacteria that cause the infection are usually harmless and very common.
They are found in lakes, streams, oceans and soil. They can also get into tap water, heating, ventilation, and air conditioning systems.
If they get into the eyes through microcracks and scratches, they can provoke infection.
Every contact lens wearer is at risk. However, people who wear their contact lenses at night are at greater risk as they can cause abrasions.
They also deprive the cornea of oxygen at night—which is avoided by blinking during the day—which can reduce its ability to fight off bacterial infection.
Contact lens manufacturers advise users not to wear their lenses at night to reduce the risk. They also urge people to wash their hands when inserting or removing lenses and to take spare glasses with them.
After taking a nap on December 19, Mr. Krumholz said his eyes felt uncomfortable.
“My contact lenses just felt very irritated, like they were floating in my eye [after I woke up from the nap]’ he told the British newspaper Daily Star.
“So I took them out and there was nothing wrong. I woke up the next morning, went to play baseball and immediately had to take out my contact lenses.
“I said to my parents: ‘I have to go to the eye doctor, something is wrong’.
“I thought I had conjunctivitis or something and he [the doctor] took a picture of the back of my eye after the dilation and he said something is wrong.”
Doctors first diagnosed Mr. Krumholz with herpes simplex virus type 1 (HSV-1) – which people can get by touching a cold sore and then touching their eyes.
But despite treatment with antibiotics, the inflammation in his eye got worse every day. Doctors next tried steroids, but the inflammation in his eye kept getting worse.
Five ophthalmologists and two corneal specialists finally took a scratch from his eye on January 21, which tested positive for AK.
Doctors first diagnosed Mr. Krumholz with herpes simplex virus type 1 (HSV-1) – which people can get by touching a cold sore and then touching their eyes
Doctors also tried steroids on his eyes, but the situation only got worse
He was in his senior year of college studying sports management and living with two friends when the infection struck
Of the pain the infection caused, he said: “I couldn’t really explain the pain in my life like that.
“It’s like a constant shock, it’s a constant pain. I’m pretty proud of my pain tolerance, but I was screaming in pain.”
He added: “For the first two weeks this was diagnosed there was no pain at all. I wish I had exaggerated.”
Acanthamoeba Keratitis: The Eye Infection That Can Make You Blind
What is Acanthamoeba keratitis (AK)?
This is an infection of the cornea or the surface of the eye caused by a microorganism.
How do I get the disease?
It is most common in contact lens wearers but can infect anyone.
The disease is triggered when the microorganism gets into your eye, either by putting contact lenses in your eye with dirty hands, or by showering or swimming while wearing the lenses.
It then gets into the eye via tiny cracks on the surface and triggers an infection.
What are the symptoms?
Symptoms include blurred vision, a cloudy or dirty-looking cornea, eye pain, eye redness, and watery eyes.
It can take several days to weeks for these to appear after infection.
Does it affect my vision?
Left untreated, the infection can lead to permanent vision loss and complete blindness, according to the CDC.
Other complications include painful eye inflammation and partial vision loss.
What is the treatment?
Patients are usually offered an antiseptic to clear the infection from the eye, which is applied directly to the surface of the eye.
This may need to be taken for six months to a year.
Patients may also be prescribed antibiotics and, in some cases, surgery may be required.
Source: CDC
After being diagnosed at the Bascom Palmer Eye Institute in Miami, he underwent conjunctival flap surgery.
In this procedure, surgeons cut the “whites” out of the patient’s eyes and place it over their pupil to help them fight the parasite. It is left on for a period of time to help the cornea recover.
Mr. Krumholz also received photodynamic therapy – usually reserved for cancer patients – which uses light energy and a drug to destroy cancerous and pre-cancerous cells. It can also be used to kill bacteria in AK infections.
Doctors have suggested he could now have a cornea transplant to get some of his vision back. He was due to have one last week but when he got to the doctors he was told the infection in his eye was still ongoing – a month later – and he would not be able to get the transplant.
He told : “After all this, if I get a cornea transplant I might even get 10 per cent of my sight back – but I would only take 1 per cent.
“The most painful part is all the waiting.
“I’m on so many meds and eye drops and have been on treatment since January 21st – so about a month.
‘[But] The infection is still ongoing. They did a biopsy and it stopped growing and they say it might be slowing down – but it hasn’t completely gone away.
When asked how it affected his life, he said: “One day I’m screaming in pain and yelling at people I don’t want to yell at because of the pain.
“And the next minute I’m kind of fine, but I’ve spent months sitting in a dark room.
“I couldn’t leave the house except to visit the hospital.
“I used to drive. My hobbies were baseball and sports, but I can’t do them now.’
Describing his sensitivity to light, he said: “Oh my god it’s just the worst. Every light it emits is like an instant shock to your head and eyes, and they just start watering.
“I wish I wasn’t too dramatic.”
Speaking to the Daily Star, he appeared in front of the camera wearing sunglasses and in an almost completely dark room due to his sensitivity to light.
Patients who have received photodynamic therapy are advised to avoid exposure to sunlight for at least 40 hours after treatment. This is because the skin is still sensitive to light and any further exposure can cause further damage or burns.
Before the infection, Mr. Krumholz said he occasionally suffered from conjunctivitis, an inflammation of the transparent membrane lining the eyeball caused by a bacterial infection or allergies.
People who wear contact lenses have a higher risk of infection.
Mr. Krumholz added: “There are a lot of people who wear contact lenses right now who have been like, ‘Hey, I just slept in my contacts, should I go to the doctor?
“I used to sleep in my contacts with no problems, but I’m trying to get the message out that there are problems with them.
‘It’s not okay now.’
When asked what advice he would have for other contact lens wearers, he said: “It doesn’t seem to be anything I know because I used to sleep in it, but please don’t.
“Anybody in school in middle school or high school that goes to sleepovers and spends the night there has a consequence and this is like the worst case scenario.”
He said he received help from the Acanthamoeba Keratitis AK Support Group Facebook group. He said they gave him regular medical advice, listened to his story and even texted and messages him on the day of his surgery.
Mr. Krumholz has started an online fundraiser to raise awareness of the risks of wearing contact lenses while you sleep.
It was published on GoFundMe and has so far raised $3,000 out of a $10,000 target.