Melia Brian, Islam Tahir, Madgula Indira, Youngs Ellen
Eye Department, Hull Royal Infirmary, Anlaby Road, Hull, East Yorkshire HU3 2JZ, United Kingdom.
Cont Lens Anterior Eye. 2008 Aug;31(4):195-9. doi: 10.1016/j.clae.2008.04.001. Epub 2008 Jul 2.
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.
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.
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.
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.
调查转诊至赫尔皇家医院眼科急诊的隐形眼镜并发症的数量和严重程度、其对资源的影响以及对其的处理和治疗是否恰当。
在赫尔皇家医院眼科急诊部进行了为期7个月的调查。在此期间，招募了100名患者，他们均填写了一份问卷，内容包括镜片类型和佩戴时间，并拍摄了照片。所有患者均接受了检查，必要时由眼科急诊医生进行治疗。
隐形眼镜并发症占转诊至眼科急诊病例的9.1%，共计323例预约。微生物性角膜炎是最常见的诊断（22%），肺炎克雷伯菌和铜绿假单胞菌是最常见的致病病原体。还记录了1例镰刀菌感染病例。验光师/隐形眼镜从业者是最常见的转诊来源（41%）。软性隐形眼镜佩戴者最为常见（67%），其次是硅水凝胶隐形眼镜佩戴者（28%），最不常见的是硬性透气性隐形眼镜佩戴者（5%）。转诊至该科室的患者中有10%被收治入院。
对患者进行佩戴时间和卫生方面的教育仍是其发生隐形眼镜并发症风险的重要因素。社区验光师和眼科之间需要建立更紧密的工作关系，以便对与隐形眼镜相关的问题进行最恰当的处理，这将有助于减轻眼科急诊的不必要负担。
