it could be in the ocean, it could be in pools, but it the most probable in hot tubs b/c of the heat.
it does happen in patients who don’t wear contacts but its improbable. its statistically more prevalent in contact lens wearers b/c:
1) when it gets under the lens the contact holds it onto the eye, vs “rinsing” away
2) most contact lens wearers have altered normal flora and slightly compromised epithelium (superficial punctate keratitis or “spk” is a common one)