Epidemiology, Microbiology, and Genetics of Contact Lens-Related and Non-Contact Lens-Related Infectious Keratitis

Infectious keratitis is a rare but severe condition associated with a range of ocular and systemic predisposing conditions, including ocular trauma, prior surgery, surface disease, and contact lens (CL) wear. This review explores the epidemiology of infectious keratitis, specifically the differences in disease incidence and risk factors, causative organism profile and virulence characteristics and host microbiome, genetics, gene expression, proteomics, and metabolomic characteristics in CL-related and non-CL-related diseases. Differences exist in the epidemiology, demographics, causative organisms, and their virulence characteristics in CL-related and non-CL-related diseases, and there is less evidence to support differences between these groups of individuals in the ocular surface microbiome, genetics, and pathways of disease. Genetic variations, however, in the host immune profile are implicated in both the onset and severity of infectious keratitis in CL and non-CL wearers. As technologies in metabolomics, proteomics, and genomics improved to be better able to process small-volume samples from the ocular surface, there will be improved understanding of the interplay between the CL, ocular surface, host immune profile, and the microbial environment. This may result in a more personalized approach in the management of disease to reduce disease severity.

Automated summary

This review examines the epidemiology of infectious keratitis and the differences between CL-related and non-CL-related diseases in terms of disease incidence, causative organisms, and virulence characteristics. The study found that there are differences in the epidemiology and characteristics of causative organisms between the two groups, but less evidence to support differences in the ocular surface microbiome, genetics, and disease pathways. However, genetic variations in the host immune profile are implicated in the onset and severity of infectious keratitis in both CL and non-CL wearers. Improvements in metabolomics, proteomics, and genomics technologies will further enhance our understanding of the interactions between CL, the ocular surface, host immune profile, and the microbial environment, potentially leading to more personalized approaches in disease management.