Poor Contact Lens Hygiene Driving Eye Infection Rates

Nearly one million patient visits are made to doctors offices, outpatient clinics, and emergency departments for keratitis each year in the United States, with contact lens wear as the single largest risk factor for microbial keratitis. The results of this study by the Centers for Disease Control and Prevention (CDC) were published in the Morbidity and Mortality Weekly Report (MMWR).

To estimate the incidence and cost of keratitis, data from national ambulatory care and emergency departments were analyzed; because there is no specific ICD-9-CM code for microbial keratitis, a set of related codes that could apply to microbial keratitis patients were developed that included corneal ulcer, other forms of keratitis resulting from an underlying condition, unspecified keratitis, and corneal disorders involving contact lens use. Approximately 930,000 doctor’s office and outpatient clinic visits and 58,000 emergency department visits for keratitis or contact lens disorders were found to occur annually, with 76.5% of keratitis visits resulting in antimicrobial prescriptions. These episodes of keratitis and contact lens disorders were estimated to cost $175 million in direct health care expenditures each year, including $58 million for Medicare patients and $12 million for Medicaid patients. These clinic visits also occupied more than 250,000 hours of clinician time annually. Women accounted for 63% of office visits and 55% of emergency department visits.

Because poor storage case hygiene, infrequent storage case replacement, and overnight lens wear are established preventable risk factors for microbial keratitis, contact lens–related inflammation, and other eye complications, patients should be aware of the risks associated with improper contact lens habits.

Surveillance, improved estimates of the burden of disease, and vigorous health promotion activities focused on contact lens users and eye care professionals (ophthalmologists, optometrists, and opticians) are also recommended.

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