Characteristics of and risk factors for contact lens-related microbial keratitis in a tertiary referral hospital

Edwards, Katie P., Keay, Lisa, Naduvilath, Thomas, Snibson, Grant, Taylor, Hugh R., & Stapleton, Fiona (2009) Characteristics of and risk factors for contact lens-related microbial keratitis in a tertiary referral hospital. Eye, 23(1), pp. 153-160.

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Aim: A retrospective case–control study was conducted at a tertiary referral hospital to determine the characteristics of and risk factors for contact lens (CL) related presumed microbial keratitis.-----

Methods: Two hundred and ninety-one cases of presumed microbial keratitis were retrospectively identified over a 2-year period. Records were reviewed for a history of CL wear and, where identified, CL, demographic, and clinical data were collected. Lens wearing controls (n=186) were identified by a community telephone survey. Multiple logistic regression estimated risk factors for infection and vision loss.-----

Results: Ninety-nine (34%) new cases of presumed microbial keratitis were associated with CL wear. Overnight soft CL use was associated with an increased risk of infection compared to daily disposable CL wear (odds ratio (OR): 8.03, 95% confidence interval (CI): 1.82–35.46). Compared with older CL wearers, 15–24 year olds had a 3.5 times greater risk of infection (OR, 95% CI: 1.7–7.4). Of the 84 cases with available data, 24 (29%) lost two or more lines of best-corrected visual acuity. Delaying treatment by 49–72 h had a 4.5 times (OR, 95% CI: 1.4–14.9) greater risk of visual loss compared to seeking treatment early. Of the 99 cases of infection, 88 were scraped and 78% (69/88) of these returned a positive culture. Gram-positive bacteria were the predominant causative organisms.-----

Conclusion: Overnight use of CL and youth carry a greater risk of infection. Practitioners should reinforce the importance of proper CL care at all times, and early presentation following the onset of symptoms.

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ID Code: 20556
Item Type: Journal Article
Refereed: Yes
Additional Information: Article
Accession Number: 36113213; Edwards, K. 1,2 Keay, L. 1,2 Naduvilath, T. 2 Snibson, G. 3,4 Taylor, H. 2,3,4 Stapleton, F. 1,2; Email Address:; Affiliation: 1: School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia [2] 2Vision Cooperative Research Centre, Sydney, Australia 2: Vision Cooperative Research Centre, Sydney, Australia 3: Centre for Eye Research Australia, The University of Melbourne, Melbourne, Australia 4: Corneal Unit, Royal Victoria Eye and Ear Hospital, Melbourne, Australia; Source Info: Jan2009, Vol. 23 Issue 1, p153; Subject Term: KERATITIS; Subject Term: GRAM-positive bacterial infections; Subject Term: CONTACT lenses; Subject Term: CORNEA -- Diseases; Subject Term: EYE -- Inflammation; Author-Supplied Keyword: case-control studies; Author-Supplied Keyword: contact lenses; Author-Supplied Keyword: keratitis; Number of Pages: 8p; Document Type: Article
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Keywords: keratitis, gram positive bacterial infections, contact lenses, cornea diseases, eye inflammation, case-control studies
DOI: 10.1038/sj.eye.6702953
ISSN: 0950-222X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Divisions: Current > Institutes > Institute of Health and Biomedical Innovation
Deposited On: 20 May 2009 21:54
Last Modified: 29 Feb 2012 14:08

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