The clinical presentation, prevalence, and risk factors of focal corneal infiltrates in soft contact lens wearers.
OBJECTIVE
We evaluated the clinical presentation, prevalence, and associated risk factors for focal corneal infiltrates with overlying fluorescein staining in a population of soft contact lens wearers.


METHODS
We measured the prevalence of focal stromal infiltrates with overlying fluorescein staining among contact lens wearers in a large cross-sectional, masked, multicenter study.


RESULTS
The practice-based occurrence of infiltrates with overlying staining was 1.6%, or 38 of 2,324 patients examined. The events were milder than those reported in studies conducted in specialty eye care centers; were usually noted during unscheduled office visits; and were accompanied by symptoms of redness, photophobia, pain, and foreign body sensation. The infiltrates were located in all corneal zones, with 44.7% of the infiltrates involving the central zone, none of which caused significant loss of acuity at follow-up. The risk factors of overnight wear, lens modality (e.g., conventional, disposable), and smoking have been confirmed. Overnight wear showed a prevalence ratio of 1.88 compared with daily wear (P < 0.055, chi-square); lens modality showed an increased risk for disposables compared with conventional lenses of 2.1 (P = 0.036, chi-square). Smoking was associated with an increased prevalence of events; 1.2% of "never" and 2.2% and 2.4% of "former" and "current" smokers, respectively, experienced an infiltrate, for a prevalence ratio of 2.0 (P < 0.04). Smoking and lens modality also interacted positively with extended wear, amplifying the risk associated with those factors.


CONCLUSIONS
We found a 1.6% practice-based prevalence and a wide range of clinical presentation of focal infiltrates in soft contact lens wearers, and we measured the relative risks of extended wear, lens modality, and smoking in a general practice population. In these cases, there was no distinct pattern in location or severity of corneal infiltrates, and visual acuity following the events was not compromised.
Cutter
G R
GR
Pythagoras, Inc., Denver, CO, USA.
Chalmers
R L
RL
Roseman
M
M
D000328:Adult; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003316:Corneal Diseases / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D003319:Corneal Stroma / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D013194:Staining and Labeling; D014792:Visual Acuity