title: Contact lens referrals to Hull Royal Infirmary Ophthalmic A&E Unit.
abstract: OBJECTIVE
  To investigate the quantity and severity of contact lens complications referred into Hull Royal Infirmary Ophthalmic A&E, their impact on resources and whether their management and treatment was appropriate.
  
  
  METHODS
  A survey was conducted over a 7-month period at Hull Royal Infirmary Ophthalmic A&E Unit. In this time 100 patients were enrolled, all completed a questionnaire including information about lens type and wearing schedule, and were photographed. All were examined, and where necessary treated by the Ophthalmic A&E doctor.
  
  
  RESULTS
  Contact lens complications accounted for 9.1% of the referrals into Ophthalmic A&E, a total of 323 appointments. Microbial keratitis was the most common diagnosis (22%), and Klebsiella and Pseudomonas the most common pathogen implicated. A case of Fusarium was also recorded. Optometrists/contact lens practitioners were the most common referral source (41%). Soft lens wearers were most common (67%), followed by silicone hydrogel wearers (28%) and least common were rigid gas permeable wearers (5%). Ten percent of the patients referred into the department were admitted.
  
  
  CONCLUSIONS
  Education of the patient in their wear schedule and hygiene are still significant factors in their risk of developing contact lens complications. A closer working relationship needs to be fostered between Community Optometrists and Eye Departments to give the most appropriate management of contact lens related problems which would help alleviate undue burdens on Ophthalmic A&E.
authors.affiliation: Eye Department, Hull Royal Infirmary, Anlaby Road, Hull, East Yorkshire HU3 2JZ, United Kingdom. brian.melia@hey.nhs.uk
authors.forename: Brian
authors.initials: B
authors.lastname: Melia
authors.forename: Tahir
authors.initials: T
authors.lastname: Islam
authors.forename: Indira
authors.initials: I
authors.lastname: Madgula
authors.forename: Ellen
authors.initials: E
authors.lastname: Youngs
mesh_terms: D000328:Adult; D003261:Contact Lenses / Q000009:adverse effects*; D015817:Eye Infections / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006782:Hospitals, Special / Q000706:statistics & numerical data*; D006801:Humans; D007634:Keratitis / Q000382:microbiology; D008297:Male; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom