CLARE is associated with which of the following?

CLARE is associated with which of the following?

• A. Gram-negative bacteria, concomitant upper respiratory tract infection, and extended-wear contact lenses
• B. Gram-positive cocci, no eye infection history, daily wear CLs
• C. Fungal keratitis with no systemic symptoms
• D. Viral conjunctivitis with soft contact lenses

Answer: (A)

CLARE is an acute inflammatory reaction of the cornea and conjunctiva seen in contact lens wearers, most typically with extended-wear lenses. The hallmark is involvement by Gram-negative bacteria, such as Pseudomonas, that can colonize lenses and the tear film, triggering a rapid inflammatory response. A recent upper respiratory tract infection is a known risk factor that can predispose to this bacterial overgrowth and disruption of the ocular surface defenses. This combination—Gram-negative bacterial involvement, extended-wear lens use, and recent systemic or mucosal infection—best explains CLARE. This doesn’t fit fungal keratitis, which is usually linked to trauma and different organisms with a more aggressive, ulcerative course; nor does it fit viral conjunctivitis, which has a distinct viral etiology and presentation. Likewise, the scenario involving Gram-positive cocci with no infection history or daily-wear lenses doesn’t align with CLARE’s typical Gram-negative, extended-wear, infection-associated pattern.

CLARE is an acute inflammatory reaction of the cornea and conjunctiva seen in contact lens wearers, most typically with extended-wear lenses. The hallmark is involvement by Gram-negative bacteria, such as Pseudomonas, that can colonize lenses and the tear film, triggering a rapid inflammatory response. A recent upper respiratory tract infection is a known risk factor that can predispose to this bacterial overgrowth and disruption of the ocular surface defenses. This combination—Gram-negative bacterial involvement, extended-wear lens use, and recent systemic or mucosal infection—best explains CLARE.

This doesn’t fit fungal keratitis, which is usually linked to trauma and different organisms with a more aggressive, ulcerative course; nor does it fit viral conjunctivitis, which has a distinct viral etiology and presentation. Likewise, the scenario involving Gram-positive cocci with no infection history or daily-wear lenses doesn’t align with CLARE’s typical Gram-negative, extended-wear, infection-associated pattern.