As niCIE are associated with contact lens wear and contact lenses may provide a surface where bacteria can attach and colonize as a biofilm [30], it is perhaps not surprising that possession of icaD was more common in niCIE isolates and suggests that biofilm formation mediated by this gene is not critical for ocular surface infection (i.e., MK or conjunctivitis). The gene discussed is DFFA; the disease is conjunctivitis.