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February 1994

Contact Lenses and Corneal UlcersClinical and Laboratory Correlations

Author Affiliations

Chicago, Ill

Arch Ophthalmol. 1994;112(2):173-174. doi:10.1001/archopht.1994.01090140049019

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CORNEAL ULCERATION, especially suppurative bacterial corneal ulceration, can cause significant morbidity and visual loss. In the December 1993 issue of the Archives, Erie et al1 reviewed the incidence of ulcerative keratitis in Olmsted County, Minnesota, and drew two major conclusions. First, they concluded that the incidence of corneal ulceration in their population rose dramatically, 435%, from the 1950s to the 1980s; second, contact lens wear has become the most significant risk factor, accounting for 52% of corneal ulcers seen between 1980 and 1988. Based on their data, they estimated an annual incidence of 27 000 corneal ulcers in the United States.

Numerous other authors have reported an association between contact lens wear and corneal ulceration. In 1989, Schein et al2 further defined the issue by demonstrating that soft contact lenses worn overnight increased the risk of corneal ulceration 10-fold to 15-fold. Dart and coworkers3 found this to

Erie JC, Nevitt MP, Hodge DO. Ballard DJ.  Incidence of ulcerative keratitis in a defined population from 1950 through 1988 . Arch Ophthalmol . 1993;111:1665-1671.Article
Schein OD, Glynn RJ, Poggio EC, Seddon JM, Kenyon KR, the Microbial Keratitis Study Group.  The relative risk of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses: a case-control study . N Engl J Med . 1989;321:773-778.Article
Dart JKG, Stapleton F, Minassian D.  Contact lenses and other risk factors in microbial keratitis . Lancet . 1991;338:650-653.Article
Buehler PO, Schein OD, Stamler JF, Verdier DD, Katz J.  The increased risk of ulcerative keratitis among disposable soft contact lens users . Arch Ophthalmol . 1992;110:1555-1558.Article
Matthews TD, Frazer DG, Minassian DC, Radford CF, Dart JKG.  Risks of keratitis and patterns of use with disposable contact lenses . Arch Ophthalmol . 1992;110:1559-1562.Article
Schein OD, Buehler PO, Stamler JF, Verdier DD, Katz J.  The impact of over-night wear on the risk of contact lens-associated ulcerative keratitis . Arch Ophthalmol . 1994;112:186-190.Article
Imayasu M, Petroll WM, Jester JV, Patel SK, Cavanagh HD. The relationship between contact lens oxygen transmissibility and binding of Pseudomonas aeruginosa to the cornea after overnight wear. Ophthalmology. In press.