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Characteristics of and risk factors for contact lens-related microbial keratitis in a tertiary referral hospital.
Eye (Lond). 2009 Jan; 23(1):153-60.E

Abstract

AIM

A retrospective case-control study was conducted at a tertiary referral hospital to determine the characteristics of and risk factors for contact lens (CL) related presumed microbial keratitis.

METHODS

Two hundred and ninety-one cases of presumed microbial keratitis were retrospectively identified over a 2-year period. Records were reviewed for a history of CL wear and, where identified, CL, demographic, and clinical data were collected. Lens wearing controls (n=186) were identified by a community telephone survey. Multiple logistic regression estimated risk factors for infection and vision loss.

RESULTS

Ninety-nine (34%) new cases of presumed microbial keratitis were associated with CL wear. Overnight soft CL use was associated with an increased risk of infection compared to daily disposable CL wear (odds ratio (OR): 8.03, 95% confidence interval (CI): 1.82-35.46). Compared with older CL wearers, 15-24 year olds had a 3.5 times greater risk of infection (OR, 95% CI: 1.7-7.4). Of the 84 cases with available data, 24 (29%) lost two or more lines of best-corrected visual acuity. Delaying treatment by 49-72 h had a 4.5 times (OR, 95% CI: 1.4-14.9) greater risk of visual loss compared to seeking treatment early. Of the 99 cases of infection, 88 were scraped and 78% (69/88) of these returned a positive culture. Gram-positive bacteria were the predominant causative organisms.

CONCLUSION

Overnight use of CL and youth carry a greater risk of infection. Practitioners should reinforce the importance of proper CL care at all times, and early presentation following the onset of symptoms.

Authors+Show Affiliations

School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17704759

Citation

Edwards, K, et al. "Characteristics of and Risk Factors for Contact Lens-related Microbial Keratitis in a Tertiary Referral Hospital." Eye (London, England), vol. 23, no. 1, 2009, pp. 153-60.
Edwards K, Keay L, Naduvilath T, et al. Characteristics of and risk factors for contact lens-related microbial keratitis in a tertiary referral hospital. Eye (Lond). 2009;23(1):153-60.
Edwards, K., Keay, L., Naduvilath, T., Snibson, G., Taylor, H., & Stapleton, F. (2009). Characteristics of and risk factors for contact lens-related microbial keratitis in a tertiary referral hospital. Eye (London, England), 23(1), 153-60.
Edwards K, et al. Characteristics of and Risk Factors for Contact Lens-related Microbial Keratitis in a Tertiary Referral Hospital. Eye (Lond). 2009;23(1):153-60. PubMed PMID: 17704759.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of and risk factors for contact lens-related microbial keratitis in a tertiary referral hospital. AU - Edwards,K, AU - Keay,L, AU - Naduvilath,T, AU - Snibson,G, AU - Taylor,H, AU - Stapleton,F, Y1 - 2007/08/17/ PY - 2007/8/21/pubmed PY - 2009/7/23/medline PY - 2007/8/21/entrez SP - 153 EP - 60 JF - Eye (London, England) JO - Eye (Lond) VL - 23 IS - 1 N2 - AIM: A retrospective case-control study was conducted at a tertiary referral hospital to determine the characteristics of and risk factors for contact lens (CL) related presumed microbial keratitis. METHODS: Two hundred and ninety-one cases of presumed microbial keratitis were retrospectively identified over a 2-year period. Records were reviewed for a history of CL wear and, where identified, CL, demographic, and clinical data were collected. Lens wearing controls (n=186) were identified by a community telephone survey. Multiple logistic regression estimated risk factors for infection and vision loss. RESULTS: Ninety-nine (34%) new cases of presumed microbial keratitis were associated with CL wear. Overnight soft CL use was associated with an increased risk of infection compared to daily disposable CL wear (odds ratio (OR): 8.03, 95% confidence interval (CI): 1.82-35.46). Compared with older CL wearers, 15-24 year olds had a 3.5 times greater risk of infection (OR, 95% CI: 1.7-7.4). Of the 84 cases with available data, 24 (29%) lost two or more lines of best-corrected visual acuity. Delaying treatment by 49-72 h had a 4.5 times (OR, 95% CI: 1.4-14.9) greater risk of visual loss compared to seeking treatment early. Of the 99 cases of infection, 88 were scraped and 78% (69/88) of these returned a positive culture. Gram-positive bacteria were the predominant causative organisms. CONCLUSION: Overnight use of CL and youth carry a greater risk of infection. Practitioners should reinforce the importance of proper CL care at all times, and early presentation following the onset of symptoms. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/17704759/Characteristics_of_and_risk_factors_for_contact_lens_related_microbial_keratitis_in_a_tertiary_referral_hospital_ L2 - https://doi.org/10.1038/sj.eye.6702953 DB - PRIME DP - Unbound Medicine ER -