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R. P. Coe, M. Hajee, A. Kartvelishvili, D. Lazzaro; Evaluation of Corneal Ulcers in a Brooklyn, NY Population: Retrospective Analysis of Associated Contact Lens Wear and Causative Organisms. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5935.
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Contact lens wear is a well-established risk factor in the development of corneal ulcers, being associated with 22% to 52% of corneal ulcers in prior studies. The prevalence of a particular causative organism is dependent on the geographic location, as well as other risk factors, including contact lens wear. This study is designed to investigate the prevalence of contact lens use in patients who developed corneal ulcers and the positively cultured organisms in a Brooklyn, NY population.
A retrospective chart review was performed on 41 consecutive patients diagnosed with corneal ulcers in a Brooklyn, NY population. Consecutive patients with a diagnosis code of "corneal ulcer" were included in the study from a period ranging from June 2005 to November 2007. Chart review included the evaluation of concomitant use of contact lenses and corneal culture results.
Only 28 out of 41 patients had documentation addressing the use of contact lenses. Among these 28 patients, 82% reported contact lens use. Among the 41 patients included in the study, 43% (17) had corneal cultures sent for analysis. Pseudomonas aeruginosa was isolated in 17% of the corneal cultures sent for analysis, followed by Herpes simplex virus accounting for 11%. Other organisms isolated included: Acanthoamoeba, Streptococcus pneumonia, Enterococcus spp, Escherichia Coli, MSSA, MRSA, Chryseobacterium meningosepticum, Klebsiella oxytoca, Candida spp, other fungal (not otherwise specified). In addition, there was 1 culture with no growth and 2 cultures that had no reported result.
Our study demonstrates that corneal ulcers are associated with contact lens wear in 82% of patients in this Brooklyn, NY population. This finding is much greater than the 22-52% associated risk reported in prior studies. Causative organisms included a variety of different pathogens, with Pseudomonas aeruginosa having the greatest prevalence, similar to other previously reported studies.  Green M, Apel A, Stapleton F. Risk factors and causative organisms in microbial keratitis. Cornea. 2008 Jan;27(1):22-7Erie JC, Nevitt MP, Hodge DO, Ballard DJ.Arch Ophthalmol. Incidence of ulcerative keratitis in a defined population from 1950 through 1988. 1993 Dec;111(12):1665-71.Dart JK. Predisposing factors in microbial keratitis: the significance of contact lens wear. Br J Ophthalmol. 1988 Dec;72(12):926-30.Sirikul T, Prabriputaloong T, Smathivat A, Chuck RS, Vongthongsri A. Predisposing factors and etiologic diagnosis of ulcerative keratitis. Cornea. 2008 Apr;27(3):283-7.
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