Contact lens referrals to Hull Royal Infirmary Ophthalmic A&E Unit

Abstract 

Purpose

To investigate the quantity and severity of contact lens complications referred into Hull Royal Infirmary Ophthalmic A&E, their impact on resources and whether their management and treatment was appropriate.

Methods

A survey was conducted over a 7-month period at Hull Royal Infirmary Ophthalmic A&E Unit. In this time 100 patients were enrolled, all completed a questionnaire including information about lens type and wearing schedule, and were photographed. All were examined, and where necessary treated by the Ophthalmic A&E doctor.

Results

Contact lens complications accounted for 9.1% of the referrals into Ophthalmic A&E, a total of 323 appointments. Microbial keratitis was the most common diagnosis (22%), and Klebsiella and Pseudomonas the most common pathogen implicated. A case of Fusarium was also recorded. Optometrists/contact lens practitioners were the most common referral source (41%). Soft lens wearers were most common (67%), followed by silicone hydrogel wearers (28%) and least common were rigid gas permeable wearers (5%). Ten percent of the patients referred into the department were admitted.

Conclusion

Education of the patient in their wear schedule and hygiene are still significant factors in their risk of developing contact lens complications. A closer working relationship needs to be fostered between Community Optometrists and Eye Departments to give the most appropriate management of contact lens related problems which would help alleviate undue burdens on Ophthalmic A&E.

Keywords: Microbial keratitis, Contact lenses, Ophthalmic A&E, Fusarium