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Introduction: microbial keratitis is a significant health concern for the one million wearers of contact lenses and their ophthalmologists, with some potentially modifiable risk factors. The number of risk factors for contact lens-related microbial keratitis has been described, but many of them still remain assumed or unknown., Patients and Methods: a multicenter prospective case-control study was conducted in 12 French university hospitals (Besançon, Bordeaux, Dijon, Fort-de-France, Grenoble, Limoges, Lyon, Nancy, Nantes, Paris, Marseille and Strasbourg) beginning in July 2007 on contact lens wearers presenting with microbial keratitis and on healthy contact lens wearers. Patients and healthy wearers were interviewed using a 51-item anonymous standardized questionnaire to determine subject demographics and contact lens wear history., Results: two hundred and fifty-six patients with microbial keratitis were included. One hundred and thirteen healthy contact lenses wearers were surveyed. Cosmetic contact lens wear highly increased the relative risk (RR) of microbial keratitis (RR, 16.5). Time since the last visit to an ophthalmologist longer than 1 year (RR, 3.4) or prescription by someone other than an ophthalmologist (RR, 7.6) also increased the risk of microbial keratitis. Education on lens care and handling was deficient (hand washing: RR, 2.2; rub and rinse: RR, 2.7)., Discussion: a standardized questionnaire is a powerful tool to determine risk factors for contact lens-related microbial keratitis, but also to analyze individual mistakes in contact lenses use and care., (2010 Elsevier Masson SAS. All rights reserved.)

Purpose To assess the osmolarity of tears in eyes affected by recurrent herpetic stromal keratitis. Methods All the patients referred for a recurrent unilateral stromal keratitis infection by either Herpes simplex virus (VZV) or varicella‐zoster virus (VZV). All the patients have been finally tested for dry eye conditions when all clinical signs of ongoing keratitis had resolved. The osmolority was assessed using the TearLab® and then the corneal sensitivity was tested with the Cochet‐Bonnet esthesiometer (Luneau™). Values were compared using non‐parametric tests, and statistical significance was defined as p<0.05 (2‐tailed). Results Fifteen patients (mean age: 57 years +/‐ 11) were consecutively included in the study. The corneal sensitivity was strongly reduced in the affected side (9g/mm2 +/‐ 3.8) compared to the non‐affected side (0.55g/mm2 +/‐ 0.09, p=0.001). There was a trend (p=0.15) for a lower osmolarity in the affected eye (317.3 mosm/l +/‐ 6.2) compared to the non‐affected eye (321.2 mosm/l +/‐ 9.8), but the difference was not significant due to some affected eyes with high values of osmolarity. Indeed, we observed a relationship (p=0.1 for correlation test) between the loss of corneal sensitivity and the modification of tear osmolarity, with relative hypo‐osmolarity when corneal hyposesthesia was moderate and relative hyperosmolarity when corneal aesthesia was severly impaired. Conclusion This study suggests that recurrent stromal herpetic keratitis induces first an increase of tears production, as showed by hypo‐osmolarity with moderate relative hypoesthesia, and then a reduction of tears production when corneal sensitivity decreases below a threshold that remains to be more precisely defined. [ABSTRACT FROM AUTHOR]