Abstract
Purpose :
Understanding associated demographic factors and causative organisms for corneal ulcers is important for designing possible preventative measures and developing rational treatment algorithms. These factors differ by geographic location and there is a paucity of data for Southern Arizona. We report the frequency of demographic factors and causative organisms for corneal ulcers in Southern Arizona.
Methods :
We performed a retrospective chart review of all patients with the diagnosis of corneal ulcer (over a 5-year timespan Sept 2017 to Sept 2022, based on ICD 9/10 codes) in Banner University Healthcare System, Tucson, AZ We collected data on age, sex, race/ethnicity, employment status, medical insurance, incarceration, homelessness, psychiatric comorbidity, illicit drug use based on urine testing, contact lens use, and causative organism(s) by culture. Continuous data were reported as mean (SD), and categorical as % with 95% CIs using binomial distributions.
Results :
A total of 279 patients with corneal ulcers were identified over the 5-year period. The mean age was 54 years (SD, 17) years, 52% (95% CI 46%,58%) were female, 61% (95% CI 55%,66%)) were Caucasian and 27% (95% CI 22%,32%) were Hispanic. 48% (95% CI 42%,54%) of patients were not employed, 43% (95% CI 37%,49%) were on Medicaid insurance, 2.2% (95% CI 0.3%,3.6%) were in custody, 8.2% (95% CI 5%,11%) were homeless and 22% (95% CI 17%,27%) of patients had a psychiatric diagnosis. The most commonly identified illicit drugs were amphetamines 12% (95% CI 8%,16%), opioids 11% (95% CI 7%,15%), and methamphetamines 8.6% (95% CI 5%,12%). 32% (95% CI 27%,37%) reported wearing contact lens and 16% (95% CI 12%,20%) reported sleeping in contact lenses. 73% of patients had corneal cultures performed and of the patients cultured the most commonly identified organisms were coagulase-negative Staphylococcus 34%, (95% CI 27%,41%), Pseudomonas aeruginosa 14%, (95% CI 9%,19%), Corynebacterium species 11% (95% CI 7%,16%) and Moraxella species 9% (95% CI 5%,13%). 23% (95% CI 17%,29%) had no growth.
Conclusions :
Common associations with corneal ulcers in Southern Arizona were unemployment, Medicaid insurance, homelessness, psychiatric conditions, illicit drug use (amphetamines, opioids, and methamphetamines), and contact lens use (particularly sleeping in contact lenses). Prevention of corneal ulcers in Southern Arizona should be directed at many of these modifiable associated factors.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.