Stapleton F, Keay L, Jalbert I, Cole N. The epidemiology of contact lens related infiltrates. Optom Vis Sci 84: 257-72

Vision Cooperative Research Centre, University of New South Wales, Sydney, Australia.
Optometry and Vision Science (Impact Factor: 1.6). 05/2007; 84(4):257-72. DOI: 10.1097/OPX.0b013e3180485d5f
Source: PubMed


With estimated numbers of contact lens wearers worldwide exceeding 140 million, even complications with a low incidence will affect a significant number of individuals. Although contact lenses clearly have many advantages for wearers, certain risks have been associated with their use. Differences in risk for different types of contact lenses and wearing patterns have been demonstrated for both rare and common lens related complications. This review particularly focuses on the incidence and etiology of contact lens related corneal infection and inflammation. An understanding of the risks and contributory factors to these conditions is important for practitioners and will enable an informed choice of safer lens wear modalities, wear schedules, and hygiene regimes to be made.

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Available from: Lisa Keay
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    • "Pseudomonas aeruginosa is a Gram-negative, opportunistic pathogen implicated in sight-threatening ocular infectious diseases such as keratitis (Sharma et al., 2006; Willcox, 2007; Green et al., 2008a). Pseudomonas keratitis is a serious ocular infection that can lead to corneal scarring and severe visual disability if aggressive and appropriate therapy is not promptly initiated (Keay et al., 2006; Stapleton et al., 2007). Until recently, most cases of bacterial keratitis were associated with ocular trauma, ocular surface disease and prior ocular surgery (Bourcier et al., 2003; Green et al., 2007). "
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    ABSTRACT: Pseudomonas aeruginosa is one of the common pathogens associated with corneal infection, particularly in contact lens-related keratitis events. The pathogenesis of P. aeruginosa in keratitis is attributed to the production of virulence factors under certain environmental conditions. The aim of this study was to determine differences in the virulence factors of P. aeruginosa isolated from contact lens- and non-contact lens-related keratitis. Associations were assessed between type III secretion toxin-encoding genes, protease profiles, biofilm formation, serotypes and antibiotic-resistance patterns among 27 non-contact lens- and 28 contact lens-related P. aeruginosa keratitis isolates from Australia. Strains with a exoS+/exoU- genotype and a type I protease profile predominated in the non-contact lens-related keratitis isolates, whereas the exoS-/exoU+ and a type II protease profile was associated with contact lens-related isolates (P<0.05). A strong biofilm formation phenotype was found to be associated with the possession of the exoU gene, and serotypes E, I and C. The exoS gene was strongly associated with serotypes G, A and B, while exoU was associated with serotypes E and C. Six out of fifty-five (11 %) clinical isolates were non-susceptible (intermediate-resistant or resistant) to ofloxacin and moxifloxacin. All resistant isolates were from non-contact lens-related keratitis. The results suggest that P. aeruginosa isolates from different infection origins may have different characteristics. A better understanding of these differences may lead to further development of evidence-based clinical guidelines for the management of keratitis.
    Preview · Article · Dec 2008 · Journal of Medical Microbiology
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    • "The role of QS in microbial keratitis Microbial keratitis (MK) is a significant disease with annualized incidence rates during contact lens wear of up to 19/10 000 people per year (Stapleton et al., 2007). With 80–140 million contact lens wearers worldwide, this represents a significant risk to sight. "
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    ABSTRACT: Pseudomonas aeruginosa is a ubiquitous bacterium that causes opportunistic infections in a range of host tissues and organs. Infections by P. aeruginosa are difficult to treat and hence there is interest in the development of effective therapeutics. One of the key mechanisms that P. aeruginosa uses to control the expression of many virulence factors is the N-acylated homoserine lactone (AHL) regulatory system. Hence, there is considerable interest in targeting this regulatory pathway to develop novel therapeutics for infection control. P. aeruginosa is the principal cause of microbial keratitis and of infections in cystic fibrosis (CF) sufferers, and AHL-dependent cell-to-cell signalling has been shown to be important for both infection types. However, keratitis tends to be an acute infection whereas infection of CF patients develops into a chronic, life-long infection. Thus, it is unclear whether AHL-regulated virulence plays the same role during these infections. This review presents a comparison of the role of AHL signalling in P. aeruginosa-mediated microbial keratitis and chronic lung infections of CF patients.
    Full-text · Article · Sep 2008 · Microbiology
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    • "Although superior in terms of oxygen permeability compared with poly HEMA-based lenses, silicone hydrogels lenses are still not problem-free [18]. A significant proportion of contact lens wearers still experience ocular discomfort, inflammation, and infection with these lenses [1,19]. It has been estimated that 80% of clinical problems and 30% of aftercare visits relating to wearing extended wear of conventional contact lenses may be attributed to deposition of tear-derived substances on the lens surface [37,38]. "
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    ABSTRACT: Previous studies have demonstrated deposition of tear proteins onto worn contact lenses. In this study, we used proteomic techniques to analyze the protein deposits extracted from worn daily wear silicone hydrogel contact lenses in combination with different lens care solutions. Worn lenses were collected and protein deposits extracted using urea and surfactant. Protein extracts were desalted, concentrated, and then separated using one-dimensional gel electrophoresis. Individual protein components in extracts were identified using liquid chromatography combined with tandem mass spectrometry (LC-MS-MS) after trypsin digestion. One-dimensional gel electrophoresis revealed that lysozyme and other small proteins (around 20 kDa) were the most abundant proteins in the extracts. LC-MS-MS revealed a wide array of proteins in lens extracts with lysozyme and lipocalin 1 being the most commonly identified in deposit extracts. Worn contact lenses deposit a wide array of proteins from tear film and other sources. Protein deposit profiles varied and were specific for each contact lens material.
    Full-text · Article · Feb 2008 · Molecular vision
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