• Vol. 42 No. 10, 499–506
  • 15 October 2013

Demographics and Behaviour of Patients with Contact Lens-Related Infectious Keratitis in Singapore



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Introduction: This study aims to identify the demographics and hygiene behaviours associated with contact lens (CL)-related microbial keratitis in Singapore.

Materials and Methods: The hygiene and social behaviours of lens wearers presenting with infectious keratitis in Singapore were examined using an externally validated questionnaire. Fiftyeight consecutive lens wearers who presented with infectious keratitis at Singapore National Eye Centre were surveyed using a self-administered questionnaire. Patients’ demographics, CL-related behaviour, attitude to aftercare visits and microbial study results were collected and analysed.

Results: More than half (55%) of the patients surveyed were female, and the average age of the participants was 25.7 ± 6.4 years. Ninety-six percent of participants used soft CL, with the majority wearing monthly disposable lenses (74.1%). Myopia was the commonest reason for use of CL. CL overwear (81%), sleeping (50.9%) and swimming (33%) with their CL were the major non-compliant behaviours discovered. When encountered with eye discomfort as a result of lens-related infective keratitis, 83% of patients sought the advice of general medical practitioners prior to presentation at the hospital. Many (59%) patients have encountered media coverage but only 24% had any behavioural change as a result. Many patients relied on the recommendations of eyecare practitioners when purchasing disinfecting solutions (26%) and other hygiene practices. Pseudomonas Aeruginosa was the most common organism grown in 22.4% of patients while 47% of patients were culture-negative.

Conclusion: Inadequate lens cleaning, poor aftercare, sleeping and swimming with CL were the major non-compliant behaviours among participants, and these are significant factors when assessing risks in acquiring CL-related infectious keratitis. General eyecare practitioners are the first-line of contact in patients presenting with keratitis symptoms and play an important role in emphasising the need for regular aftercare and good hygiene practices to CL wearers.

Contact lenses (CL) are a convenient method of correcting refractive error, and offer many advantages over spectacles. However, CL wear has its complications, which may be severe, resulting in vision loss. CL-related microbial keratitis is one of the most severe complications as it can lead to corneal scarring or perforation with permanent loss of vision. In addition, microbial keratitis is also associated with a significant disease burden, including income loss due to days off work and treatment costs.

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