First contact diagnosis and management of contact lens-related complications

• Published in: International ophthalmology Vol. 32; no. 4; pp. 321 - 327
• Main Authors: Fagan, Xavier J., Jhanji, Vishal, Constantinou, Marios, Amirul Islam, F. M., Taylor, Hugh R., Vajpayee, Rasik B.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.08.2012; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - therapeutic use; Contact Lenses - adverse effects; Contact Lenses - statistics & numerical data; Corneal Stroma - pathology; Epithelium, Corneal - pathology; Female; Humans; Keratitis - diagnosis; Keratitis - drug therapy; Keratitis - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmic Solutions - therapeutic use; Ophthalmology; Original Paper; Referral and Consultation - statistics & numerical data; Refractive Errors - epidemiology; Refractive Errors - therapy; Retrospective Studies; Risk Factors; Steroids - therapeutic use; Vision Disorders - diagnosis; Vision Disorders - drug therapy; Vision Disorders - epidemiology; Young Adult; Contact lens; Complications; Management
• ISSN: 0165-5701; 1573-2630; 1573-2630
• DOI: 10.1007/s10792-012-9563-z

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.