Original articleRisk Factors for Moderate and Severe Microbial Keratitis in Daily Wear Contact Lens Users
Section snippets
Case Ascertainment
New cases of CL-related microbial keratitis were identified in a 12-month, prospective, national surveillance study of all ophthalmic practitioners in Australia, carried out between October 2003 and September 2004. Practitioners were identified through the membership register of the Royal Australian and New Zealand College of Ophthalmologists and were actively surveyed at the end of each 2-month reporting period. Optometrists were identified through the state registration boards and
Results
There were 125 eligible daily wear cases reported during the 12-month study period, including a subgroup of 90 cases of moderate or severe keratitis. Of the 90 cases, 63 were scraped for smear and culture and 41 of 63 (65%) were culture proven. Environmental organisms (Gram-negative bacteria, fungi, and Acanthamoeba) caused severe disease in 32 of 41 (78%) of culture proven cases, with 2 cases (5%) attributed to Acanthamoeba spp. There were no cases of fungal keratitis reported in this cohort.
Discussion
The recent publication of incidence rates for all CL-related microbial keratitis5 has demonstrated that, despite the many advances in CL materials and solutions over the past 15 years, the incidence of infection has remained stable.1, 2, 3 One possible approach to limiting disease morbidity is to identify and address modifiable risk factors associated with moderate or severe microbial keratitis, a subset of microbial keratitis associated with greater morbidity in terms of vision loss, disease
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Manuscript no. 2011-1147
Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
This study was supported by the Brien Holden Vision Institute (F.S., T.N.), CIBA Vision (all authors), the University of New South Wales (F.S.), the Vision Cooperative Research Centre (K.E., L.K.), the National Health and Medical Research Council (L.K.). The authors were responsible for design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. A draft of the manuscript was provided to the Brien Holden Vision Institute and CIBA Vision before publication, and modifications were limited to clarification and editorial changes.
The Vision CRC and Brien Holden Vision Institute receive a royalty on the sales of certain contact lenses.