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Grading cases of contact lens-related microbial keratitis can aid comparison of disease burden
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When comparing disease burden among cases of contact lens-related microbial keratitis, using a clinical grading system to rank disease severity can help identify patients who might be of noninfectious etiology or patients with a microbial cause of low virulence and morbidity, according to a study.
Lisa Keay, PhD, and colleagues used a clinical grading system to evaluate disease severity among 278 cases of presumed lens-related microbial keratitis and subsequently examined the relationship between associated costs and disease duration. All cases were graded as having either severe microbial keratitis with vision loss of at least two lines, severe microbial keratitis without vision loss but with a positive culture or a lesion located centrally in the cornea, or mild microbial keratitis.
For cost analysis, direct costs included medical care, pathology and medications; indirect costs included loss of income, assistance of caregivers and purchase of spectacles.
The investigators found that 47 cases of microbial keratitis (16.3%) were severe with vision loss, 137 cases (49.3%) were severe without vision loss and 94 cases (33.8%) were mild.
The median duration of disease was 18 days for severe cases with vision loss, 7 days for severe cases without vision loss and 4 days for mild cases (P < .001).
Median associated costs were AU$5,515 (US$5,266.76) for severe cases with vision loss, AU$1,596 (US$1,553.12) for severe cases without vision loss and AU$795 (US$773.66) for mild cases (P < .001).
"Costs and symptom duration were greatest for severe disease with vision loss, less for the severe disease without vision loss and lowest for the mild disease (P < .003)," the authors said in the study, published in the July issue of Optometry and Vision Science.