Incidence and clinical features of contact lens related microbial keratitis.

Purpose: To determine the incidence, clinical features and outcome of contact lens related corneal ulcer.Design: Retrospective cross sectional study, conducted in Hospital Unversiti Sains Malaysia (HUSM).Methods: A five-year review of contact lens related Microbial keratitis admitted to a tertiary government referral centre at the north-eastern part of Malaysia.Results: 132 cases of corneal ulcer were reviewed from 1 January 2000 to 30 April 2005, from which 20 patients (14.9%) were diagnosed with contact lens related microbial keratitis. Eleven were females and 9 males, with mean age of 25 +/- 6.81 years. All of them were soft contact lens wearers. Most patients presented with eye pain (75%), conjunctival congestion (65%) and blurred vision (60%). Majority of cases (55%) presented with hypopyon and one corneal perforation. In 65% corneal scraping culture isolated Pseudomonas aeruginosa. In 30%, cleaning and storage solutions also isolated Pseudomonas aeruginosa. Eleven cases (55%) showed microbial resistance to chloramphenicol.Conclusion: Contact lens wear remains a major risk factor for ocular morbidity due to microbial keratitis, especially involving the young population, even in the present advances in technology. Stricter contact lens prescription guideline and emphasis on compliance to hygienic regime are mandatory to prevent this complication. The routine use of chloramphenicol as topical use of choice is not recommended. [ABSTRACT FROM AUTHOR]