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Ulcerative keratitis associated with contact lens wear
A Koidou-Tsiligianni1, E Alfonso, R K Forster
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.
American Journal of Ophthalmology
|July 15, 1989
Summary
Contact lens wear, particularly extended wear for cosmetic reasons, is linked to ulcerative keratitis caused by Pseudomonas. Fungal keratitis was absent in contact lens wearers, unlike non-wearers.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Ulcerative keratitis is a significant cause of vision loss.
- Contact lens wear is an established risk factor for microbial keratitis.
Purpose of the Study:
- To analyze trends in ulcerative keratitis, focusing on contact lens-related cases.
- To identify causative organisms and risk factors in a contemporary cohort.
Main Methods:
- Retrospective analysis of 658 ulcerative keratitis cases from October 1982 to June 1986.
- Comparison with a previous study cohort (January 1977 to September 1982).
- Microbial cultures performed on ulcer exudates.
Main Results:
- 196 cases (30%) were contact lens-related.
- Pseudomonas species was the most common isolate in contact lens-related keratitis.
- No fungal keratitis cases were observed in contact lens wearers, compared to 17% in non-wearers.
- A notable increase in extended-wear contact lenses for cosmetic purposes (59 vs 1) and a younger patient demographic were observed.
Conclusions:
- Extended wear of contact lenses, especially for cosmetic reasons, presents a growing risk for Pseudomonas keratitis.
- Contact lens wearers appear to have a lower risk of fungal keratitis.
- Ophthalmologists should be vigilant for contact lens-related microbial keratitis in younger patients using extended-wear lenses.