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Personal hygiene risk factors for contact lens-related microbial keratitis

Personal hygiene risk factors for contact lens-related microbial keratitis
Personal hygiene risk factors for contact lens-related microbial keratitis
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.
contact lens, cornea, infection, microbiology, pathology
2397-3269
1-8
Stellwagen, Anna
b8c56dca-e368-431f-b41e-69783853abb1
MacGregor, Cheryl
79ee681e-f27c-4479-9582-f668301a1c05
Kung, Roger
0da8c8c9-8003-41ad-a7da-86fa18c43691
Konstantopoulos, Aristides
c54185a9-1ef3-4b6d-91a3-38de444cc4fb
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Stellwagen, Anna
b8c56dca-e368-431f-b41e-69783853abb1
MacGregor, Cheryl
79ee681e-f27c-4479-9582-f668301a1c05
Kung, Roger
0da8c8c9-8003-41ad-a7da-86fa18c43691
Konstantopoulos, Aristides
c54185a9-1ef3-4b6d-91a3-38de444cc4fb
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51

Stellwagen, Anna, MacGregor, Cheryl, Kung, Roger, Konstantopoulos, Aristides and Hossain, Parwez (2020) Personal hygiene risk factors for contact lens-related microbial keratitis. BMJ Open Ophthalmology, 5 (1), 1-8, [e000476]. (doi:10.1136/bmjophth-2020-000476).

Record type: Article

Abstract

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.

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Personal hygiene risk factors for contact lens-related microbial keratitis
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More information

Accepted/In Press date: 15 August 2020
Published date: 8 September 2020
Additional Information: PUBMED ID: 32953996
Keywords: contact lens, cornea, infection, microbiology, pathology

Identifiers

Local EPrints ID: 443903
URI: http://eprints.soton.ac.uk/id/eprint/443903
ISSN: 2397-3269
PURE UUID: a736c840-7e6d-4f65-8f5f-3e72b051b4fa
ORCID for Parwez Hossain: ORCID iD orcid.org/0000-0002-3131-2395

Catalogue record

Date deposited: 16 Sep 2020 16:34
Last modified: 15 Sep 2021 01:50

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