PURPOSE: To examine factors influencing the severity of soft contact lens (SCL)-related microbial keratitis. METHODS: Cases were detected via surveillance studies in Australia and New Zealand. Factors affecting disease severity (costs, days of symptoms, and 2 or more lines of vision loss) were examined and included age; gender; delay in SCL removal, seeking consultation, or receiving treatment; overnight wear; SCL material (hydrogel or silicone hydrogel [SiH]); and causative organism. RESULTS: Two hundred ninety-seven cases were identified: 61% female, age: 35 +/- 13 years (mean +/- SD). Treatment costs were (median [interquartile range]) $760 [1859] and indirect costs were $468 [1810]. Patients were symptomatic for 7 [11] days, and vision loss occurred in 14.3% of cases. Cases with pathogenic causative organisms (66/297, 22%) were 11.4 times (95% confidence interval [CI], 4.2-30.9) more likely to result in vision loss, had longer duration of symptoms (21 [40] vs. 6 [8] days, P < 0.001) and incurred higher costs (5,512 [14,733] vs. 1,048[8,325], P < 0.001). Delays (>12 hours) before treatment increased the likelihood of vision loss (P = 0.048) disease duration (P = 0.004), and associated costs (P = 0.009). Remoteness increased the risk of vision loss (odds ratio [OR] = 5.1; 95% CI 1.6-16.6), and individuals over 28 years of age had longer disease duration (P = 0.02). In overnight wear and after adjustment for culture result and treatment delays, SiH wearers had slightly shorter disease duration (4 [4] vs. 7 [10] days, P = 0.02) but a rate of vision loss and cost similar to those of hydrogel wearers. CONCLUSIONS: The causative organism was the major determinant of severity; however, modifiable factors such as delays in treatment had considerable influence. Duration of symptoms was shorter in SiH wearers, but other factors dominated disease outcome in this population study.
PURPOSE: To examine factors influencing the severity of soft contact lens (SCL)-related microbial keratitis. METHODS: Cases were detected via surveillance studies in Australia and New Zealand. Factors affecting disease severity (costs, days of symptoms, and 2 or more lines of vision loss) were examined and included age; gender; delay in SCL removal, seeking consultation, or receiving treatment; overnight wear; SCL material (hydrogel or silicone hydrogel [SiH]); and causative organism. RESULTS: Two hundred ninety-seven cases were identified: 61% female, age: 35 +/- 13 years (mean +/- SD). Treatment costs were (median [interquartile range]) $760 [1859] and indirect costs were $468 [1810]. Patients were symptomatic for 7 [11] days, and vision loss occurred in 14.3% of cases. Cases with pathogenic causative organisms (66/297, 22%) were 11.4 times (95% confidence interval [CI], 4.2-30.9) more likely to result in vision loss, had longer duration of symptoms (21 [40] vs. 6 [8] days, P < 0.001) and incurred higher costs (5,512 [14,733] vs. 1,048[8,325], P < 0.001). Delays (>12 hours) before treatment increased the likelihood of vision loss (P = 0.048) disease duration (P = 0.004), and associated costs (P = 0.009). Remoteness increased the risk of vision loss (odds ratio [OR] = 5.1; 95% CI 1.6-16.6), and individuals over 28 years of age had longer disease duration (P = 0.02). In overnight wear and after adjustment for culture result and treatment delays, SiH wearers had slightly shorter disease duration (4 [4] vs. 7 [10] days, P = 0.02) but a rate of vision loss and cost similar to those of hydrogel wearers. CONCLUSIONS: The causative organism was the major determinant of severity; however, modifiable factors such as delays in treatment had considerable influence. Duration of symptoms was shorter in SiH wearers, but other factors dominated disease outcome in this population study.
Authors: Charlotte E Joslin; Elmer Y Tu; Megan E Shoff; Gregory C Booton; Paul A Fuerst; Timothy T McMahon; Robert J Anderson; Mark S Dworkin; Joel Sugar; Faith G Davis; Leslie T Stayner Journal: Am J Ophthalmol Date: 2007-06-22 Impact factor: 5.258
Authors: Erin W Norcross; Melissa E Sanders; Quincy C Moore; Sidney D Taylor; Nathan A Tullos; Rhonda R Caston; Sherrina N Dixon; Moon H Nahm; Robert L Burton; Hilary Thompson; Larry S McDaniel; Mary E Marquart Journal: Invest Ophthalmol Vis Sci Date: 2011-11-29 Impact factor: 4.799
Authors: Eric Pearlman; Angela Johnson; Gautam Adhikary; Yan Sun; Holly R Chinnery; Todd Fox; Mark Kester; Paul G McMenamin Journal: Ocul Surf Date: 2008-07 Impact factor: 5.033