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Jay C. Erie, MD; Martin P. Nevitt, MD, MPH; David O. Hodge, MS; David J. Ballard, MD, PhD

Arch Ophthalmol. 1993;111(12):1665-1671.

Abstract
Objective
To determine the incidence of ulcerative keratitis and to assess trends in risk factors leading to ulcerative keratitis.

Design
Retrospective incidence cohort study.

Setting
General community.

Patients
Population-based sample of residents of Olmsted County, Minnesota, in the 39-year period between 1950 and 1988.

Main Outcome Measure
Cases of ulcerative keratitis.

Results
One hundred forty-one cases of ulcerative keratitis were diagnosed among 131 residents (64 men and 67 women) of Olmsted County. The mean annual ageadjusted incidence per 100 000 people was 5.3 (95% confidence interval, 4.4 to 6.2). A 435% increase in the incidence of ulcerative keratitis was observed in Olmsted County residents from the 1950s (2.5 per 100 000 people) to the 1980s (11.0 per 100000 people) (P=.001). The cases of ulcerative keratitis associated with contact lens wear increased from 0% in the 1950s and 1960s to 32% in the 1970s and 52% in the 1980s.

Conclusion
The incidence of ulcerative keratitis has increased significantly in this community. Contact lens wear was the most important risk factor for the development of ulcerative keratitis during the last decade.

Author Affiliations
From the Department of Ophthalmology (Drs Erie and Nevitt) and the Section of Biostatistics, Mayo Clinic, Rochester, Minn (Mr Hodge), and the Thomas Jefferson Health Policy Institute and University of Virginia School of Medicine, Charlottesville (Dr Ballard).

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