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Epidemiological comparison of central and peripheral infective corneal infiltration: influence of contact lens wear and other risk factors
Author(s) -
Seal D.,
Devonshire P.,
Hay J.,
Kirkness C.,
Bennett H.
Publication year - 1997
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1046/j.1475-1313.1997.97807284.x
Subject(s) - acanthamoeba keratitis , contact lens , keratitis , medicine , epidemiology , ophthalmology , surgery , dermatology
Purpose: Risk factors for microbial keratitis (mk) are previous ocular surface, disease, contact lens (CL) wear and trauma. Their respective roles for central and peripheral infiltration (CI and PI) reflect changing primary car practice influencing predisposing causes. This study quantifies risk factors. Methods: The study was conducted over nine months. All cases of putative mk were investigated using intensive culture of corneal scrapes. Risk factor data were recorded. All patients receiving antimicrobial therapy were included. Results: 26/54 patients (48%) had CI (46% wore CL), 3/54 (6%) had paraxial infiltration and 25/54 (46%) had PI (40% wore CL). For CI, 14/26 (54%) yielded Acanthamoeba sp. (4), S. aureus (3), S. pneumoniae (3), S. viridans (1), Ps. aeruginosa (2) and Acinetobacter sp. (1); 8/14 (57%) wore CL [FDA groups 1(2), 2(1), 4(5)], the former 3 extended wear, the latter 5, 4‐weekly use of ‘disposable’ CL. 5 CI had ocular surface disease (4 HSV); 1 had trauma (mascara brush) with contaminated drops. For PI, 2/25 (8%) were cultured‐positive (1 S. aureus and 1 S. pneumoniae ); neither wore CL and other recognized factors were absent. Conclusions: Predisposing factors in culture‐positive CI were CL wear and previous HSV keratitis. Compliant use of hydrogen peroxide disinfection in CL wearers was not associated with culture‐positive infiltration.