Incidence of keratitis of varying severity among contact lens wearers

Morgan, Philip B., Efron, Nathan, Hill, Elizabeth A., Raynor, Mathew K., Whiting, Mark A., & Tullo, Andrew B. (2005) Incidence of keratitis of varying severity among contact lens wearers. British Journal of Ophthalmology, 89(4), pp. 430-436.

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AIM: To determine the incidence of non-severe keratitis (NSK) and severe keratitis (SK) among wearers of current generation contact lenses. METHODS: A 12 month, prospective, hospital based epidemiological study was conducted by examining all contact lens wearers presenting with a corneal infiltrate/ulcer to a hospital centre in Manchester. A clinical severity matrix was used to differentiate between NSK and SK, based on the severity of signs and symptoms. The size of the hospital catchment population and the wearing modalities (daily wear (DW) or extended wear (EW)) and lens types being used were estimated from relevant demographic and market data. RESULTS: During the survey period, 80 and 38 patients presented with NSK and SK, respectively. The annual incidences (cases per 10,000 wearers) for each wearing modality and lens type were: DW rigid--NSK 5.7, SK 2.9; DW hydrogel daily disposable--NSK 9.1, SK 4.9; DW hydrogel (excluding daily disposable)--NSK 14.1, SK 6.4; DW silicone hydrogel--NSK 55.9, SK 0.0; EW rigid--NSK 0.0, SK 0.0; EW hydrogel--NSK 48.2, SK 96.4; EW silicone hydrogel--NSK 98.8, SK 19.8. The difference in SK between EW hydrogel and EW silicone hydrogel was significant (p = 0.04). CONCLUSIONS: A clinical severity matrix has considerable utility in assessing contact lens related keratitis. There is a significantly higher incidence of SK in wearers who sleep in contact lenses compared with those who only use lenses during the waking hours. Those who choose to sleep in lenses should be advised to wear silicone hydrogel lenses, which carry a five times decreased risk of SK for extended wear compared with hydrogel lenses.

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162 citations in Scopus
129 citations in Web of Science®
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ID Code: 7974
Item Type: Journal Article
Refereed: Yes
Keywords: Contact lens, keratitis, severity, incidence, cornea
DOI: 10.1136/bjo.2004.052688
ISSN: 0007-1161
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Optometry and Ophthalmology not elsewhere classified (111399)
Divisions: Current > QUT Faculties and Divisions > Faculty of Education
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2005 BMJ Publishing Group
Copyright Statement: Reproduced in accordance with the copyright policy of the publisher.
Deposited On: 06 Jun 2007 00:00
Last Modified: 29 Feb 2012 13:29

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