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Sharon Y. Lee, Yoon Hee Kim, Duncan Johnson, Bartley Mondino, Barry Weissman; Contact Lens Complications In An Urgent Care Population: The Ucla Contact Lens Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6495.
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To study the prevalence of complications with contact lens wearers and investigate whether extended wear is more likely than daily wear to result in complications that drive patients into emergency ophthalmic department.
The current report is a prospective study with data collection over a 6-month period between January and July 2010. For this cross sectional study, we established a recruitment goal of 50 patients to obtain a reasonable analysis of CL related complications in an urgent care setting.
1369 patients presented to JSEI urgent care with symptoms of eye problems. Of these, 49 patients were identified with diagnosis etiologically associated with their contact lens wear. The 5 most common ocular signs found in our study were: epithelial staining or abrasion/epithelial defect, conjunctival injection, papillae, corneal neovascularization, and presumed microbial keratitis. The mean number of complications were 3.43 per eye. Majority of our patients reported some form of extended wear. Analysis of our patients with PMK showed that extended wear increased the rate of PMK. Average age of lens was 48 days. The most common lens was a 2 week replacement lens. Average overwear was 19 days. The highest average of CL overwear occurred with 2 week lenses. Most solutions utilized by patients were chemical cold sterilization. Average age of case was 266 days. There appeared no statistical difference in the number of complications per symptomatic eye with hydrogel and silicone hydrogel lenses. However, 13 of our 15 patients with PMK were SiH wearers.
65% of our urgent care patients slept with contact lenses on their eye and 15 of 49 patients were diagnosed with presumed microbial keratitis (PMK). We studied various aspects of care and compliance in an urgent care population and found that overnight wear with silicone hydrogels was associated with the occurrence of PMK in our cohort. Age of lens, days of overwear, cleaning or rubbing lenses, water exposure, or age of CL case, were all not associated with PMK. At least 13 of our 15 patients diagnosed with PMK had worn silicone hydrogel lenses with at least 12 patients using these lenses as extended wear. None of our patients wearing daily lenses developed PMK. Separate analysis of the PMK group showed higher number of complications per symptomatic eye. When compared to an age and gender matched asymptomatic study group at UCLA, our cohort had a significnatly greater average number of complications per eye and increased rate of PMK. Extended wear may be a risk factor leading to increased ER visits.
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