PURPOSE: The aim of this study was to characterize the clinical signs, symptoms, and ocular and systemic comorbidities in a large case series of contact lens-related microbial keratitis. METHODS: Two hundred ninety-seven cases of contact lens-related microbial keratitis, aged between 15 and 64 years were detected through surveillance of hospital and community based ophthalmic practitioners in Australia and New Zealand. Full clinical data were available for 190 cases and 90 were interviewed by telephone. Clinical data included the size, location, and degree of anterior chamber response. Symptom data were available from the practitioner and from participant self-report. Associations between symptoms and disease severity were evaluated. Data on ocular and systemic disease were collected from participants and practitioners. The frequency of comorbidities was compared between the different severities of disease and to population norms. RESULTS: More severe disease was associated with greater symptom severity and pain was the most prevalent symptom reported. Ninety-one percent of cases showed progression of ocular symptoms after lens removal, and symptom progression was associated with all severities of disease. Twenty-five percent of cases reported prior episodes requiring emergency attention. Thyroid disease (p = 0.05) and self-reported poor health (p = 0.001) were more common in cases compared with age-matched population norms. DISCUSSION: Information on the signs, symptoms, and comorbidities associated with contact lens-related microbial keratitis may be useful in patient education and for practitioners involved in the fitting of lenses and management of complications. Although pain was the most common symptom experienced, progression of symptoms despite lens removal was close to universal. Poor general health, particularly respiratory disease and thyroid disease was more common in cases than in the general population, which may prompt practitioners to recommend flexibility in wear schedules when in poor health or the selection of a lower risk wear schedule in at risk patients.
AD - Vision Cooperative Research Centre, University of New South Wales, Sydeney, New South Wales, Australia. lkeay@george.org.au AN - 19543137 BT - Optometry and Vision Science DA - 204516668797 ET - 2009/06/23 LA - eng M1 - 7 N1 - Keay, LisaEdwards, KatieStapleton, FionaR01 EY017678/EY/NEI NIH HHS/United StatesR01 EY03532/EY/NEI NIH HHS/United StatesR01 EY08882/EY/NEI NIH HHS/United StatesComparative StudyResearch Support, N.I.H., ExtramuralUnited StatesOptometry and vision science : official publication of the American Academy of OptometryOptom Vis Sci. 2009 Jul;86(7):803-9. N2 -PURPOSE: The aim of this study was to characterize the clinical signs, symptoms, and ocular and systemic comorbidities in a large case series of contact lens-related microbial keratitis. METHODS: Two hundred ninety-seven cases of contact lens-related microbial keratitis, aged between 15 and 64 years were detected through surveillance of hospital and community based ophthalmic practitioners in Australia and New Zealand. Full clinical data were available for 190 cases and 90 were interviewed by telephone. Clinical data included the size, location, and degree of anterior chamber response. Symptom data were available from the practitioner and from participant self-report. Associations between symptoms and disease severity were evaluated. Data on ocular and systemic disease were collected from participants and practitioners. The frequency of comorbidities was compared between the different severities of disease and to population norms. RESULTS: More severe disease was associated with greater symptom severity and pain was the most prevalent symptom reported. Ninety-one percent of cases showed progression of ocular symptoms after lens removal, and symptom progression was associated with all severities of disease. Twenty-five percent of cases reported prior episodes requiring emergency attention. Thyroid disease (p = 0.05) and self-reported poor health (p = 0.001) were more common in cases compared with age-matched population norms. DISCUSSION: Information on the signs, symptoms, and comorbidities associated with contact lens-related microbial keratitis may be useful in patient education and for practitioners involved in the fitting of lenses and management of complications. Although pain was the most common symptom experienced, progression of symptoms despite lens removal was close to universal. Poor general health, particularly respiratory disease and thyroid disease was more common in cases than in the general population, which may prompt practitioners to recommend flexibility in wear schedules when in poor health or the selection of a lower risk wear schedule in at risk patients.
PY - 2009 SN - 1538-9235 (Electronic)1040-5488 (Linking) SP - 803 EP - 9 T2 - Optometry and Vision Science TI - Signs, symptoms, and comorbidities in contact lens-related microbial keratitis VL - 86 ER -