PT  - JOURNAL ARTICLE
AU  - Anna Stellwagen
AU  - Cheryl MacGregor
AU  - Roger Kung
AU  - Aristides Konstantopoulos
AU  - Parwez Hossain
TI  - Personal hygiene risk factors for contact lens-related microbial keratitis
AID  - 10.1136/bmjophth-2020-000476
DP  - 2020 Sep 01
TA  - BMJ Open Ophthalmology
PG  - e000476
VI  - 5
IP  - 1
4099  - http://bmjophth.bmj.com/content/5/1/e000476.short
4100  - http://bmjophth.bmj.com/content/5/1/e000476.full
SO  - BMJ Open Ophth2020 Sep 01; 5
AB  - Objective Microbial 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 analysis A 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.Results 37 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).Conclusion The 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.