A soft contact lens wearer developed pain and itching of the eye and showed a reticular pattern on the corneal epithelium. The cause could be –
**Core Concept**
The question is testing the student's knowledge of contact lens-related complications, specifically the development of a corneal infiltrate due to a bacterial or fungal infection. The underlying principle being tested is the pathogenesis of microbial keratitis in contact lens wearers.
**Why the Correct Answer is Right**
The correct answer is related to the development of a corneal infiltrate due to a bacterial or fungal infection, specifically **Pseudomonas aeruginosa**. This is because contact lens wearers are at an increased risk of developing microbial keratitis, particularly with Pseudomonas aeruginosa, which can lead to corneal ulceration and vision loss. The reticular pattern on the corneal epithelium is a characteristic feature of this condition.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because Acanthamoeba keratitis is a different type of contact lens-related complication, typically associated with swimming in contaminated water while wearing contact lenses. While it can also cause corneal infiltrates, the presentation is typically different from that of Pseudomonas aeruginosa.
* **Option B:** This option is incorrect because Herpes simplex keratitis is a viral infection that can cause corneal epithelial defects, but it typically does not present with a reticular pattern on the corneal epithelium.
* **Option C:** This option is incorrect because Fungal keratitis can cause corneal infiltrates, but it is less common than bacterial keratitis in contact lens wearers and typically presents with a more diffuse or feathery infiltrate.
**Clinical Pearl / High-Yield Fact**
Contact lens wearers are at an increased risk of developing microbial keratitis, particularly with Pseudomonas aeruginosa, and should be advised to follow proper hygiene and maintenance practices to reduce this risk.
**Correct Answer:** A. Pseudomonas aeruginosa.