A 41-year-old man who led an active life is confined to staying indoors as he battles a rare contact-lens related infection that is threatening to blind him.

The news was a blow. I felt sad and a bit guilty that I had somehow brought this upon myself

Both corneas of Bernard Bonnici’s eyes were invaded by acanthamoeba, a potentially blinding parasite that hitches a ride on contact lenses; the second such case in Malta in just one year.

Acanthamoeba in both eyes is even more rare, but Mr Bonnici’s case echoes that of Jade*, 18, whose struggle against blindness was featured in The Sunday Times last year.

Ophthalmic surgeon Franco Mercieca had only ever seen three cases of acanthamoeba keratitis in 10 years so two similar cases occurring in such a short span is highly unusual.

“It is probably a combination of unfortunate circumstances and poor education on contact lens care,” he told The Sunday Times.

Ironically Mr Bonnici had read Jade’s story, but seeing it was so uncommon he thought it would never affect him.

He has decided to come forward and share his story in the hope of converting foolhardy contact-lens wearers who, like him, constantly and unknowingly tested the limits.

Activities that increase the risk of contracting acanthamoeba keratitis include using contaminated tap or well water on contact lenses, using homemade solutions to store and clean contacts, not using fresh solution to store lenses in, wearing contact lenses in a hot tub, and swimming or showering while wearing lenses.

Sitting in a dark room, as his eyes stream, Mr Bonnici admits to being guilty of breaking most of the rules, through lack of knowledge.

It was not the first time he had stored his lenses in water overnight whenever he slept at a friend’s place, or lubricated his lenses by putting them in his mouth.

“In 1998, when I took part in Life Cycle, I forgot to take contact lens liquid with me so I kept the lenses stored in the same solution for three days and nothing happened,” he said.

“I was never conscious of the danger posed by lenses coming into contact with water.”

His condition deteriorated until his eyesight started fogging up. That was when he was referred to Mr Mercieca who diagnosed acanthamoeba keratitis last month.

“The news was a blow. I felt sad, disappointed and a bit guilty that I had somehow brought this upon myself. I just wish I knew more,” he said wistfully, pointing out that in the UK contact lenses were only sold against a prescription.

Asked if Malta should introduce a similar system, Mr Mercieca said the most important thing was for the seller to insist on proper contact lens handling and storage.

“Early diagnosis is crucial. Therefore not only is awareness among contact lens wearers important, but even more so among eye care personnel who should have a high index of suspicion in any non-resolving contact lens-related keratitis,” he urged.

The condition, he said, could present itself as a sore gritty eye for weeks on end that was not responding to usual medication so he urged eye care professionals to be suspicious whenever this happened. Asked if patients fully recovered or if their eyesight was forever ruined, Mr Mercieca said early diagnosis led to the best prognosis.

Jade’s condition had been more advanced than Mr Bonnici’s when she was diagnosed and to date she is still fighting to regain her eyesight. She has already had a transplant and cataract extraction in one eye, but unfortunately, the transplant has been rejected. “This disease is a very long haul with lots of ups and downs till a stable state, with hopefully decent vision, is achieved,” Mr Mercieca said.

Mr Bonnici knows he has a long road ahead and tries to remain optimistic, even though he admits he does occasionally entertain dark thoughts. It has been very frustrating that he can no longer do outdoor sports and he has had to move back in with his parents, who he totally relies on – “they’re my nurses, chefs and main carers”.

“You become handicapped and it can be a very lonely existence, but you have to gather yourself and hope for the best,” he said, thanking his parents, five siblings and close friends for their constant encouragement and help.

His employers – he is an assistant principal at the government’s Capital Transfer Duty Department – have also been extremely supportive.

At the moment, Mr Bonnici can barely see his hands and life is a blur. He cannot watch television or send text messages and even though he attempts to do 30 minutes exercise on a stationary bike, the pain often takes over. Podcasts and BBC radio have become his best friends.

“I swear that if I ever regain my eyesight, I’ll never wear contact lenses again. My advice is if you do wear them never compromise on lens care – just don’t test the limits.”

* Jade had not wished to reveal her identity.

Contact lens care

• Contact lenses should be cleaned before putting them in your eyes and after removing them.

• Approved contact lens solution must be used. They should not come into contact with tap water, saliva, and so on.

• Soft contact lenses should not be allowed to dry (either in the eye or in the solution). If they dry throw them away.

• Never place contact lenses in the same solution twice. The solution has to be replaced every time. Check its expiry date and discard at least after six months from opening. Store in a cool dry place.

• Lens cases have to be replaced a minimum of every two to three months.

• Replace contact lenses on schedule – daily disposables should be thrown out every day; monthlies, every month.

• Don’t wear lenses if your eye is red, if you have a cold or have a cold sore.

• Remove contact lenses if your eyes are uncomfortable. It is essential to have updated spectacles to fall back on. If irritation persists seek medical advice.

• Never sleep with your lenses on with the exception of extended wear contact lenses and/or on medical advice.