Can subtypes of contact lens-associated corneal infiltrative events be clinically differentiated?

Efron, Nathan & Morgan, Philip B. (2006) Can subtypes of contact lens-associated corneal infiltrative events be clinically differentiated? Cornea, 25(5), pp. 540-544.

Abstract

PURPOSE: A schema has recently been described for clinical differentiation among 4 symptomatic subtypes of contact lens-associated corneal infiltrative events (CIEs): microbial keratitis (MK), contact lens-induced peripheral ulcer (CLPU), contact lens-induced acute red eye (CLARE), and infiltrative keratitis (IK). The clinical utility of this schema has been challenged in the literature. The aim of this study is to determine whether it is possible to clinically differentiate among these conditions. METHODS: Criteria for MK, CLPU, CLARE, and IK were applied to a data set of 111 contact lens-associated CIEs, spanning a wide range of clinical severities, presenting consecutively to a hospital clinic. A Venn diagram analysis was used to determine the extent to which these conditions can be clinically differentiated. RESULTS: Of the 111 CIEs, 20% could be classified unambiguously as MK, CLPU, CLARE, or IK, 56% could be classified as 1 of 2 conditions, 13% could be classified as 1 of 3 conditions, and 0% could be classified as 1 of 4 conditions. Eleven percent of CIEs could not be classified as any of the 4 conditions. CONCLUSIONS: Although the etiology of CIEs is multifactorial, the considerable overlap between the clinical presentation of MK, CLPU, CLARE, and IK is such that it is not possible to clinically differentiate between them with any degree of certainty. A preferred approach might be to consider CIEs as part of a disease continuum whereby these events can manifest in various degrees of severity, depending as well on the point at which the condition is observed in the course of the natural history of the disease.

Impact and interest:

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ID Code: 11266
Item Type: Journal Article
Refereed: Yes
Additional Information: For more information, please refer to the journal’s website (see hypertext link) or contact the author.
Author contact details: n.efron@qut.edu.au
Additional URLs:
Keywords: corneal infiltrative events, contact lens, microbial keratitis, contact lens peripheral ulcer, contact lens acute red eye, infiltrative keratitis
ISSN: 0277-3740
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2006 Lippincott, Williams & Wilkins
Deposited On: 04 Jan 2008 00:00
Last Modified: 29 Feb 2012 13:23

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