Clinical Presentation and Microbial Analyses of Contact Lens Keratitis; an Epidemiologic Study.
BACKGROUND
Microbial keratitis is an infective process of the cornea with a potentially and serious visual impairments. Contact lenses are a major cause of microbial keratitis in the developed countries especially among young people. Therefore, the purpose of the present study was to evaluate the frequency and microbiological characteristic of CLK in patients referred to the emergency department (ED) of teaching hospitals, Babol, Iran.


METHODS
This is a cross-sectional study of all patients with contact lens induced corneal ulcers admitted to the teaching hospitals of Babol, Iran, from 2011- 2013. An ophthalmologist examined patients with the slit-lamp and clinical features of them were noted (including pain, redness, foreign body sensation, chemosis, epiphora, blurred vision, discomfort, photophobia, discharge, ocular redness and swelling). All suspected infectious corneal ulcers were scraped for microbial culture and two slides were prepared. Data were analyzed using SPSS software, version 18.0.


RESULTS
A total of 14 patients (17 eyes) were recruited into the study (100% female). The patients' age ranged from 16-37 years old (mean age 21.58±7.23 years). The most prevalent observed clinical signs were pain and redness. Three samples reported as sterile. The most common isolated causative organism was pseudomonas aeroginosa (78.6%), Staphylococcus aureus 14.3%, and enterobacter 7.1%, respectively. Treatment outcome was excellent in 23.5%, good in 47.1%, and poor in 29.4% of cases.


CONCLUSIONS
Improper lens wear and care as well as the lack of awareness about the importance of aftercare visits have been identified as potential risk factors for the corneal ulcer among contact lens wearers. Training and increasing the awareness of adequate lens care and disinfection practices, consulting with an ophthalmologist, and frequent replacement of contact lens storage cases would greatly help reducing the risk of microbial keratitis.
Department of Ophthalmology, Babol University of Medical Sciences, Babol, Iran.
Seyed Ahmad
SA
Rasoulinejad
Infectious Diseases Research Center, Babol University of Medical Sciences, Babol, Iran.
Mahmoud
M
Sadeghi
Young Researchers Club, Islamic Azad University, Babol branch, Babol, Iran.
Mohammad
M
Montazeri
Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Hesam
H
Hedayati Goudarzi
Young Researchers Club, Islamic Azad University, Babol branch, Babol, Iran.
Mahmood
M
Montazeri
School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran.
Nadali
N
Akbarian
Keratitis; anti-bacterial agents; contact lenses; epidemiology; ophthalmology