title: First contact diagnosis and management of contact lens-related complications.
abstract: To describe the spectrum of contact lens-related problems in cases presenting to a tertiary referral eye hospital. A retrospective case record analysis of 111 eyes of 97 consecutive patients was undertaken over a period of five months at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Contact lens-related complications (CLRC) were classified into microbial keratitis, sterile corneal infiltrates, corneal epitheliopathy and contact lens-related red eye (CLARE). Main parameters examined were nature of the first contact, clinical diagnosis, and management pattern. Forty-two percent of the initial presentations were to health care practitioners (HCPs) other than ophthalmologists. Mean duration from the onset of symptoms to presentation was 6.3 ± 10.9 days. Forty-nine percent (n = 54) of patients had an associated risk factor, most commonly overnight use of contact lenses (n = 14, 13 %). Most common diagnosis at presentation was corneal epitheliopathy (68 %) followed by sterile infiltrates (10 %), CLARE (8 %) and microbial keratitis (6 %). No significant differences were found in the pattern of treatment modalities administered by ophthalmologists and other HCPs. HCPs other than ophthalmologists are the first contact for contact lens-related problems in a significant proportion of patients. These HCPs manage the majority of CLRC by direct treatment or immediate referral.
authors.affiliation: Royal Victorian Eye and Ear Hospital, 32, Gisborne Street, East Melbourne, VIC 3002, Australia.
authors.forename: Xavier J
authors.initials: XJ
authors.lastname: Fagan
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Marios
authors.initials: M
authors.lastname: Constantinou
authors.forename: F M
authors.initials: FM
authors.lastname: Amirul Islam
authors.forename: Hugh R
authors.initials: HR
authors.lastname: Taylor
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003261:Contact Lenses / Q000009:adverse effects* / Q000706:statistics & numerical data; D003319:Corneal Stroma / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012030:Refractive Errors / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D014786:Vision Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D013256:Steroids