May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Characteristics of and Risk Factors for Contact Lens Related Microbial Keratitis in a Tertiary Referral Hospital
Author Affiliations & Notes
  • K. Edwards
    Optometry/Vision Science, Uni of NSW, Sydney, Australia
    VisionCRC, Sydney, Australia
  • L. Keay
    Optometry/Vision Science, Uni of NSW, Sydney, Australia
    VisionCRC, Sydney, Australia
  • T. Naduvilath
    VisionCRC, Sydney, Australia
  • G. Snibson
    Centre for Eye Research Australia, University of Melbourne, Australia
    Corneal Unit, Royal Victoria Eye and Ear Hospital, Melbourne, Australia
  • H. Taylor
    VisionCRC, Sydney, Australia
    Centre for Eye Research Australia, University of Melbourne, Australia
  • F. Stapleton
    Optometry/Vision Science, Uni of NSW, Sydney, Australia
    VisionCRC, Sydney, Australia
  • Footnotes
    Commercial Relationships K. Edwards, None; L. Keay, None; T. Naduvilath, None; G. Snibson, None; H. Taylor, None; F. Stapleton, None.
  • Footnotes
    Support Australian Government Cooperative Research Centres Grant
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 778. doi:
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      K. Edwards, L. Keay, T. Naduvilath, G. Snibson, H. Taylor, F. Stapleton; Characteristics of and Risk Factors for Contact Lens Related Microbial Keratitis in a Tertiary Referral Hospital. Invest. Ophthalmol. Vis. Sci. 2007;48(13):778.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: A retrospective case control study was conducted at a tertiary referral hospital in Australia to determine the characteristics of and risk factors for contact lens related microbial keratitis.

Methods:: 291 cases of microbial keratitis were retrospectively identified at a tertiary referral hospital over a 2-year period. Hospital records were reviewed for a history of contact lens wear, and where identified, these records were further reviewed for lens type and mode of wear, demographic data, clinical characteristics, and visual outcome. 186 contact lens wearing controls were generated in a telephone survey.

Results:: Ninety-nine (99/291, 34%) new cases of microbial keratitis associated with contact lens wear were retrospectively identified. Overnight use of soft lenses was associated with an increased risk of infection compared to daily disposable lens wear (Odds ratio [OR]: 8.03, 95% confidence interval [CI]:1.82-35.46). Compared with older lens wearers (35-64 years), 15-24 year olds had a 3.5 times greater risk of infection (OR, 95% CI:1.7-7.4), and for 25-34 year olds this risk was 2.5 times (OR, 95% CI:1.3-5.0). Of the 84 cases where data were available, 24 (29%) lost two or more lines of best corrected visual acuity. Those who delayed seeking treatment by 49-72 hours had a 4.5 times (OR, 95% CI:1.4-14.9) greater risk of visual loss compared to those who sought treatment early (0-48 hours after initial symptoms). Of the 99 cases of infection, 88 were scraped and 78% (69/88) of these returned a positive culture. 13 lesions were polymicrobial. Gram-positive bacteria were the predominant causative organisms (64/69), followed by Gram-negative bacteria (16/69) and Acanthamoeba (3/69). 17 of the 99 cases had a history of recent travel.

Conclusions:: Overnight use of lenses and youth carry a greater risk of infection. Practitioners should remind their patients of the importance of proper lens care at all times, particularly when traveling. The importance of rapid presentation to appropriate treatment within 48 hours of the onset of adverse symptoms should also be stressed.

Keywords: contact lens • clinical (human) or epidemiologic studies: risk factor assessment • keratitis 
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