Contact Lenses and Corneal Ulcers

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Abstract
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