Abstract
Purpose :
Infectious keratitis is a major cause for blindness and visual impairment globally. Contact lens wear has been identified as one of the most common risk factors for infectious keratitis, particularly bacterial keratitis. This retrospective, observational study aimed to identify the clinical characteristics, risk factors and outcomes of contact lens-related bacterial keratitis (CLBK).
Methods :
All patients who presented to the Queen’s Medical Centre, Nottingham with suspected CLBK between October 2015 to September 2022 (a 7-year period) were included. Relevant data on patient demographics, types and behavior of CL wear (e.g., overwear, overnight wear and contact with water), causes, clinical characteristics and final outcomes were collected and analyzed.
Results :
A total of 138 eligible patients were included. The mean age was 42.9±18.9 years and 64 (46.4%) patients were female. The majority of CL was soft CL (94.5%), with monthly disposable (48.7%) and daily disposable (26.1%) being the most common subtypes. Of 120 patients (with CL behavior recorded), 73 (60.8%) patients were found to have at least one poor CL wear behavior. Among the 64 (46.4%) culture-positive cases (n=72 organisms), Pseudomonas aeruginosa (36, 50.0%) and Staphylococcus spp. (14, 19.4%) were the most commonly identified organisms. Most (134, 97.1%) patients were successfully treated with medical treatment only, with 110 (80.3%) achieving good final corrected-distance-visual-acuity (CDVA) of =/> 0.30 logMAR. Poor visual outcome (defined as final CDVA of <0.30 logMAR) was significantly associated with presenting CDVA of <0.6 logMAR (p=0.002) and central ulcer (p=0.004). Poor corneal healing (defined as complete healing of >30 days from initial presentation) was significantly associated with age >50 years (p=0.028), female gender (p=0.020), and infiltrate size >3mm (p=0.031).
Conclusions :
Poor CL wear behavior is commonly observed in CLBK, highlighting the importance of improved counselling and education regarding CL use and hygiene. When appropriately managed, most patients are able to achieve good clinical outcome with medical treatment alone.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.