Risk factors and causative organisms in microbial keratitis in daily disposable contact lens wear

ObjectiveMicrobial keratitis is a sight-threatening complication of contact lens wear, which affects thousands of patients and causes a significant burden on healthcare services. This study aims to identify compliance with contact lens care recommendations and identify personal hygiene risk factors in patients who develop contact lens-related microbial keratitis.Methods and analysisA case–control study was conducted at the University Hospital Southampton Eye Casualty from October to December 2015. Two participant groups were recruited: cases were contact lens wearers presenting with microbial keratitis and controls were contact lens wearers without infection. Participants underwent face-to-face interviews to identify lens wear practices, including lens type, hours of wear, personal hygiene and sleeping and showering in lenses. Univariate and multivariate regression models were used to compare groups.Results37 cases and 41 controls were identified. Showering in contact lenses was identified as the greatest risk factor (OR, 3.1; 95% CI, 1.2 to 8.5; p=0.03), with showering daily in lenses compared with never, increasing the risk of microbial keratitis by over seven times (OR, 7.1; 95% CI, 2.1 to 24.6; p=0.002). Other risks included sleeping in lenses (OR, 3.1; 95% CI, 1.1 to 8.6; p=0.026), and being aged 25–39 (OR, 6.38; 95% CI, 1.56 to 26.10; p=0.010) and 40–54 (OR, 4.00; 95% CI 0.96 to 16.61; p=0.056).ConclusionThe greatest personal hygiene risk factor for contact lens-related microbial keratitis was showering while wearing lenses, with an OR of 3.1, which increased to 7.1 if patients showered daily in lenses. The OR for sleeping in lenses was 3.1, and the most at-risk age group was 25–54.

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The Risk of Contact Lens Wear and the Avoidance of Complications

International Journal of Medical Students ◽

10.5195/ijms.2013.209 ◽

2013 ◽

Vol 1 (2) ◽

pp. 80-85 ◽

Cited By ~ 1

Author(s):

Farihah Tariq ◽

Peter Koay

Keyword(s):

Risk Factors ◽

Contact Lens ◽

Contact Lenses ◽

Health Concern ◽

Refractive Errors ◽

Microbial Keratitis ◽

Contact Lens Wear ◽

Good Contact ◽

Number Of Individuals ◽

Lens Wear

Contact lenses are lenses placed on the surface of the cornea to correct refractive errors such as myopia (short-sightedness), hypermetropia (far-sightedness) and astigmatism. Lens-related complications are becoming a greater health concern as increasing number of individuals are using them as an alternative to spectacles. Contact lenses alter the natural ocular environment and reduce the efficacy of the innate defences. Although many complications are minor, microbial keratitis is potentially blinding and suspected cases should be rapidly diagnosed and referred to an ophthalmologist for treatment. Several risk factors have been identified with extended wear, poor hand hygiene, inadequate lens and lens-case care being the most significant. Promotion of good contact lens hygiene and practices are essential to reduce the adverse effects of contact lens wear.

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Risk Factors for the Development of Corneal Infiltrative Events Associated with Contact Lens Wear

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.05-0133 ◽

2005 ◽

Vol 46 (9) ◽

pp. 3136 ◽

Cited By ~ 89

Author(s):

Philip B. Morgan ◽

Nathan Efron ◽

Noel A. Brennan ◽

Elizabeth A. Hill ◽

Mathew K. Raynor ◽

...

Keyword(s):

Risk Factors ◽

Contact Lens ◽

Contact Lens Wear ◽

Lens Wear

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Risk Factors for Interruption to Soft Contact Lens Wear in Children and Young Adults

Optometry and Vision Science ◽

10.1097/opx.0b013e31821ffe14 ◽

2011 ◽

Vol 88 (8) ◽

pp. 973-980 ◽

Cited By ~ 27

Author(s):

Heidi Wagner ◽

Robin L. Chalmers ◽

G. Lynn Mitchell ◽

Meredith E. Jansen ◽

Beth T. Kinoshita ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Contact Lens ◽

Soft Contact ◽

Contact Lens Wear ◽

Soft Contact Lens ◽

Children And Young Adults ◽

Lens Wear

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How to Reduce Lasik Complications during Surgery

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr.02.04.00005 ◽

2019 ◽

Vol 2 (4) ◽

Keyword(s):

Risk Factors ◽

Contact Lens ◽

Free Flaps ◽

Contact Lens Wear ◽

Lasik Complications ◽

Lens Wear

Most of the complications on a Lasik surgery happen during flap cut. Partial or irregular flaps, buttonholes, epithelial defects and free flaps. Risk factors for these complications include increased age, preoperative hyperopia, and years of contact lens wear. In order to avoid these complications I suggest following these steps before each surgery

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Risk Factors, Clinical Outcomes and Prognostic Factors of Bacterial Keratitis: The Nottingham Infectious Keratitis Study

10.1101/2021.05.26.21257881 ◽

2021 ◽

Author(s):

Darren Shu Jeng Ting ◽

Jessica Cairns ◽

Bhavesh Gopal ◽

Charlotte Ho ◽

Lazar Krstic ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

Contact Lens ◽

Visual Outcome ◽

Bacterial Keratitis ◽

Contact Lens Wear ◽

Poor Visual Outcome ◽

Corrected Distance Visual Acuity ◽

Culture Positive ◽

Lens Wear

Background/aim: To examine the risk factors, clinical characteristics, outcomes and prognostic factors of bacterial keratitis (BK) in Nottingham, UK. Methods: This was a retrospective study of patients who presented to the Queens Medical Centre, Nottingham, with suspected BK during 2015-2019. Relevant data, including the demographic factors, risk factors, clinical outcomes, and potential prognostic factors, were analysed. Results: A total of 283 patients (n=283 eyes) were included; mean age was 54.4+/-21.0 years and 50.9% were male. Of 283 cases, 128 (45.2%) cases were culture-positive. Relevant risk factors were identified in 96.5% patients, with ocular surface diseases (47.3%), contact lens wear (35.3%) and systemic immunosuppression (18.4%) being the most common factors. Contact lens wear was most commonly associated with P. aeruginosa whereas Staphylococci spp. were most commonly implicated in non-contact lens-related BK cases (p=0.017). At presentation, culture-positive cases were associated with older age, worse presenting corrected-distance-visual-acuity (CDVA), larger epithelial defect and infiltrate, central location and hypopyon (all p<0.01), when compared to culture-negative cases. Hospitalisation was required in 57.2% patients, with a mean length of stay of 8.0 +/- 8.3 days. Surgical intervention was required in 16.3% patients. Significant complications such as threatened/actual corneal perforation (8.8%), loss of perception of light vision (3.9%), and evisceration/enucleation (1.4%) were noted. Poor visual outcome (final corrected-distance-visual-acuity of <0.6 logMAR) and delayed corneal healing (>30 days from initial presentation) were significantly affected by age >50 years, infiltrate size >3mm, and reduced presenting vision (all p<0.05). Conclusion: BK represents a significant ocular morbidity in the UK. Culture positivity is associated with more severe disease at presentation but has no significant influence on the final outcome. Older age, large infiltrate, and poor presenting vision were predictive of poor visual outcome and delayed corneal healing, highlighting the importance of primary prevention and early intervention for BK.

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Microbial Keratitis Profile at a University Hospital in Hong Kong

International Scholarly Research Notices ◽

10.1155/2014/689742 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

Tracy H. T. Lai ◽

Vishal Jhanji ◽

Alvin L. Young

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Risk Factor ◽

Hong Kong ◽

Contact Lens ◽

University Hospital ◽

Major Risk Factor ◽

Sampled Data ◽

Microbial Keratitis ◽

Contact Lens Wear

Purpose. To evaluate the recent trends in demographics, risk factors, and microbiological profiles of microbial keratitis at a university hospital in Hong Kong. Design. Retrospective review. Methods. The medical records of 51 patients admitted to the Prince of Wales Hospital for microbial keratitis from January 2010 to June 2012 were reviewed. Demographics, risk factors, clinical features, microbiological results, and treatment were recorded. Data was analyzed and compared to our historical sampled data collected 11 years ago. Results. The mean age of patients was 41.6 ± 20.3 years. Contact lens use was the major risk factor (45%), followed by injury (12%). The culture positive rate was 59%, of which 37% were Gram-positive organisms and 53% were Gram-negative organisms. Pseudomonas aeruginosa (50%) and coagulase-negative Staphylococcus (13%) were the most commonly isolated pathogens. No resistance to fluoroquinolones was identified. Conclusions. Our study showed that contact lens wear remained the major risk factor for microbial keratitis in Hong Kong and Pseudomonas aeruginosa remained the commonest bacterium isolated. This is comparable to our historical data and other studies conducted in East Asia.

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Life on contact lenses: Exploiting a modern habitat

The Biochemist ◽

10.1042/bio03104026 ◽

2009 ◽

Vol 31 (4) ◽

pp. 26-27

Author(s):

James Lonnen

Keyword(s):

Contact Lens ◽

Contact Lenses ◽

Risk Of Infection ◽

Microbial Keratitis ◽

Corneal Epithelial ◽

Contact Lens Wear ◽

The World ◽

Micro Organisms ◽

And Storage ◽

Lens Wear

There are an estimated 125 million contact lens wearers across the world, and the majority experience few complications; however, it is well known that contact lens wear is a risk factor for microbial keratitis (infection of the cornea of the eye). Owing to the ubiquitous distribution of micro-organisms, it is extremely di cult to prevent them from colonizing contact lens storage cases. Bacteria, fungi and protozoa have all been found in contact lens storage cases; these micro-organisms can adhere to the contact lens, which then acts as a vector to transport the microbes on to the surface of the eye. Bacteria such as Pseudomonas aeruginosa, fungi such as Fusarium solani and the protazoan parasite Acanthamoeba–to name but a few–can cause infection of the corneal epithelial cells, which, if untreated, can lead to blindness. It is therefore essential that wearers clean and disinfect their contact lenses and storage cases e ectively to minimize the risk of infection.

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