'Sterile' corneal infiltrates in contact lens wearers

Ninety four patients with 'sterile' keratitis presenting consecutively over a nine month period to the Accident and Emergency Department of Moorfields Eye Hospital were studied. This condition was found to account for 0.49% of all new casualties. A significant association was found in these patients, compared with controls, with contact lens hygiene, particularly for daily wear soft contact lenses, and contact lens case contamination by bacteria suggesting that these may be important factors in the aetiology of 'sterile' keratitis. Compared to gas permeable hard contact lenses the relative risk of developing 'sterile' keratitis in our patients was found to be 2.3 times higher with extended wear soft contact lenses, 1.56 times higher with daily wear soft contact lenses and 0.509 with polymethylmethacrylate lenses (test of trend p-value less than 0.05). The results indicate that 'sterile' corneal infiltrates are related to contact lens hygiene and in part to contact lens case contamination by bacteria and also to the type of lens worn.