By Erika Edwards - NBC News
Dr. Morgan Morelli, an infectious disease physician, didn't understand how the unusual bacteria had infected and blinded Nancy Montz's left eye.
The Ohio woman had been infected with Pseudomonas aeruginosa, a bacterium resistant to most antibiotics. Morelli, chief of the division of infectious diseases and HIV medicine at University Hospitals Cleveland Medical Center, had never seen this type of bacteria in an eye.
In fact, this particular type of highly drug-resistant bacteria had never been recorded in the United States.
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"We racked our brains trying to figure out how it happened," he said.
Montz, 72, of Perry, did not wear contact lenses, a common route for bacteria to enter the eyes. Last November, in cold northeastern Ohio, he hadn't bathed in any nearby lakes, another potential source of unusual bacteria.
"We thought it was a fortuitous accident," Morelli said. "We had no idea that this case was going to be related to a global manufacturing problem," he added.
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It took several months to confirm that Montz's infection came from a contaminated bottle of EzriCare artificial tears, a product since linked to dozens of similar eye infections across the country.
Details of Montz's case were published Thursday in Antimicrobial Agents and Chemotherapy, a journal of the American Society for Microbiology.
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According to the Centers for Disease Control and Prevention (CDC), as of March 14, at least 68 people in 16 states had been diagnosed with eye infections.
Eight patients, like Montz, lost vision in at least one eye. Four people had to have their eyeballs surgically removed. Three have died.
Petri dishes with antibiotic test dishes with Pseudomonas aeruginosa. Armin Weigel / Picture alliance via Getty Images
EzriCare artificial tears, as well as Delsam Pharma's artificial eye ointment, were recalled in February. The products had been manufactured by Global Pharma Healthcare in India and were mainly sold online.
The CDC expects more cases to be identified and plans to update its investigation into the cases in the coming weeks, a spokesperson said. The agency confirmed to NBC News that Montz is one of 68 patients so far in its ongoing investigation.
Montz's infection was advanced when he was diagnosed, and he is unlikely to see through that eye again.
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The first time she realized something was wrong was when she woke up with an unusual spot of yellow discharge on her pillow. His left eye was cloudy and he had trouble seeing for it.
The eye looked "very weird," Montz recalled. However, he didn't feel any pain or discomfort because a previous health problem had numbed his entire left side of his face, including his left eye.
Her husband encouraged her to go to the doctor, who prescribed antibiotics.
But the drugs, which almost always cure eye infections, didn't work. Within 48 hours, the eye got much worse. That's when Morelli stepped in.
His team discovered that the bacteria that had infected Montz's eye was also in the bottle of EzriCare artificial tears he had ordered through Amazon.
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"He probably accidentally scratched his left eye with the dropper and didn't realize it because he had no sensitivity," Morelli hypothesized. "That allowed the infection to enter that eye much more easily and quickly before it affected the right," he explained.
How to Reduce the Risk of Eye Infections
Morelli recommends several ways to reduce the risk of any type of eye infection:
- Wash your hands thoroughly before removing the cap from the bottle.
- Keep the dropper tip as sterile as possible. Do not touch it with your fingers or allow it to come into contact with other surfaces before putting the cap back on.
- Avoid using bottles of eye drops that are refillable.
- Discard expired products.
- Use only artificial tears and other eye drops recommended by your doctor.
