{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T03:08:30Z","timestamp":1773457710257,"version":"3.50.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>The aim of this study was to determine risk factors and clinical course of corneal ulcers in the setting of opioid use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A retrospective cohort study was performed of patients presenting with bacterial or fungal keratitis at a county hospital from 2010 to 2021. Subjects were separated into 3 groups: opioid drug users (heroin, methadone, and fentanyl), nonopioid drug users, and nondrug users. Twenty-four opioid users, 77 nonopioid drug users, and 38 nondrug users were included in the study. Chi-square and <jats:italic toggle=\"yes\">t<\/jats:italic>-tests were used to compare hospitalization for corneal ulcer treatment, length of hospitalization, loss to follow-up, final best-corrected visual acuity (BCVA), medication noncompliance, time to ulcer resolution, and visual disability (defined by either the legal limit for driving in California or the federal limit for blindness).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Opioid users had higher rates of unemployment (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002), homelessness (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.018), and psychiatric conditions (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.024) compared with nonopioid and nondrug users. They had more severe presentations, with worse initial BCVA of the affected eye (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.003), larger ulcer size (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.023), and higher rates of individuals below the legal vision thresholds for driving (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.009) and blindness (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.033) at initial presentation. Opioid use was associated with increased rates of hospitalization (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), higher fortified antibiotic use (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.009), worse final BCVA of the affected eye (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.020), and increased rates of BCVA worse than the legal vision thresholds for driving (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.043) and blindness (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) on final presentation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Infectious keratitis associated with opioid use is associated with more severe presentations and poorer outcomes, including higher rates of visual disability.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/coa.0000000000000010","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T19:01:32Z","timestamp":1679598092000},"page":"e0010","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Characterization of Infectious Keratitis in Opioid Users in a County Hospital Setting"],"prefix":"10.1097","volume":"2","author":[{"given":"Jacqueline B.","family":"Lopez","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of California, San Francisco, San Francisco, CA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of California, San Francisco, San Francisco, CA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murtaza","family":"Saifee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of California, San Francisco, San Francisco, CA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerami D.","family":"Seitzman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of California, San Francisco, San Francisco, CA;"},{"name":"Francis I. 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