Contact lens related corneal ulcers at the Ohio State University Hospitals 1983-1987

We reviewed the records of patients with ulcerative keratitis associated with contact lens wear admitted to The Ohio State University Hospitals from January 1, 1983 through December 31, 1987. Of 127 cases of infectious ulcerative keratitis, 25 (19%) were associated with the use of contact lenses. Of these 25, 21 cases (84%) were associated with the use of soft lenses (40% aphakic, 40% cosmetic). Seventy-six percent (19 of 25) were culture-positive; Pseudomonas was the most common isolate (12 of 19, 63% of culture-positive cases). When compared with daily wear soft contact lenses, cosmetic and aphakic extended wear contact lens related ulcers were associated with a delay in definitive diagnosis and a worse prognosis. Patching and steroid use were associated with more severe ulcers. Gram stain findings were of value only when gram-negative rods were noted. The findings emphasize the need for patients to understand: 1) the risks of extended wear; 2) the necessity of removing the lenses at the first sign of irritation; and 3) the importance of having prompt, intensive care readily available.