在发达国家感染性角膜炎发病率逐年增加,主要由于接触镜配戴率增高所致,现已增长到每年 2-11/10 万人。[3]Erie JC, Nevitt MP, Hodge DO, et al. Incidence of ulcerative keratitis in a defined population from 1950 through 1988. Arch Ophthalmol. 1993;111:1665-1671.http://www.ncbi.nlm.nih.gov/pubmed/8155038?tool=bestpractice.com[4]Lam DS, Houang E, Fan DS, et al. Hong Kong Microbial Keratitis Study Group. Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America. Eye. 2002;16:608-618.http://www.nature.com/eye/journal/v16/n5/full/6700151a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/12194077?tool=bestpractice.com[5]Basak SK, Basak S, Mohanta A, et al. Epidemiological and microbiological diagnosis of suppurative keratitis in gangetic West Bengal, Eastern India. Indian J Ophthalmol. 2005;53:17-22.http://www.ncbi.nlm.nih.gov/pubmed/15829742?tool=bestpractice.com来自香港的一项研究发现非接触镜配戴者每年发病率为 0.63/1 万人,而接触镜配戴者为 3.4/1 万人。[4]Lam DS, Houang E, Fan DS, et al. Hong Kong Microbial Keratitis Study Group. Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America. Eye. 2002;16:608-618.http://www.nature.com/eye/journal/v16/n5/full/6700151a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/12194077?tool=bestpractice.com棘阿米巴角膜炎于 1973 年首次被报道,现占全部角膜炎病例的 1%,并且配戴接触镜也为其一项主要危险因素。[6]Kinota S, Wong KW, Biswas J, et al. Changing patterns of infectious keratitis: overview of clinical and histopathologic features of keratitis due to Acanthamoeba or atypical Mycobacteria, and of infectious crystalline keratopathy. Indian J Ophthalmol. 1993;41:3-14.http://www.ijo.in/article.asp?issn=0301-4738;year=1993;volume=41;issue=1;spage=3;epage=14;aulast=Kinotahttp://www.ncbi.nlm.nih.gov/pubmed/8225521?tool=bestpractice.com[7]Toshida H, Kogure N, Inoue N, et al. Trends in microbial keratitis in Japan. Eye Contact Lens. 2007;33:70-73.http://www.ncbi.nlm.nih.gov/pubmed/17496698?tool=bestpractice.com在接触镜配戴者中,大多数患者年龄为 20-29 岁,这反映了接触镜使用者的年龄分布,[4]Lam DS, Houang E, Fan DS, et al. Hong Kong Microbial Keratitis Study Group. Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America. Eye. 2002;16:608-618.http://www.nature.com/eye/journal/v16/n5/full/6700151a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/12194077?tool=bestpractice.com[6]Kinota S, Wong KW, Biswas J, et al. Changing patterns of infectious keratitis: overview of clinical and histopathologic features of keratitis due to Acanthamoeba or atypical Mycobacteria, and of infectious crystalline keratopathy. Indian J Ophthalmol. 1993;41:3-14.http://www.ijo.in/article.asp?issn=0301-4738;year=1993;volume=41;issue=1;spage=3;epage=14;aulast=Kinotahttp://www.ncbi.nlm.nih.gov/pubmed/8225521?tool=bestpractice.com尽管接触镜相关感染也发生在低龄和老年患者中。流行病学研究并没有发现性别差异。[3]Erie JC, Nevitt MP, Hodge DO, et al. Incidence of ulcerative keratitis in a defined population from 1950 through 1988. Arch Ophthalmol. 1993;111:1665-1671.http://www.ncbi.nlm.nih.gov/pubmed/8155038?tool=bestpractice.com[4]Lam DS, Houang E, Fan DS, et al. Hong Kong Microbial Keratitis Study Group. Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America. Eye. 2002;16:608-618.http://www.nature.com/eye/journal/v16/n5/full/6700151a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/12194077?tool=bestpractice.com[6]Kinota S, Wong KW, Biswas J, et al. Changing patterns of infectious keratitis: overview of clinical and histopathologic features of keratitis due to Acanthamoeba or atypical Mycobacteria, and of infectious crystalline keratopathy. Indian J Ophthalmol. 1993;41:3-14.http://www.ijo.in/article.asp?issn=0301-4738;year=1993;volume=41;issue=1;spage=3;epage=14;aulast=Kinotahttp://www.ncbi.nlm.nih.gov/pubmed/8225521?tool=bestpractice.com在发展中国家感染性角膜炎发病率非常高。例如在尼泊尔,年发病率高达 799/10 万人。[8]Upadhyay MP, Karmacharya PC, Koirala S, et al. The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal. Br J Ophthalmol. 2001;85:388-392.http://www.ncbi.nlm.nih.gov/pubmed/11264124?tool=bestpractice.com大约 6% 真菌性角膜炎患者生活在温带气候,热带地区所占比例更高。[7]Toshida H, Kogure N, Inoue N, et al. Trends in microbial keratitis in Japan. Eye Contact Lens. 2007;33:70-73.http://www.ncbi.nlm.nih.gov/pubmed/17496698?tool=bestpractice.com在印度南部,角膜溃疡中 35% 源于细菌,32% 源于真菌。[9]Bharathi MJ, Ramakrishnan R, Vasu S, et al. Aetiological diagnosis of microbial keratitis in South India: a study of 1618 cases. Indian J Med Microbiol. 2002;20:19-24.http://www.ijmm.org/article.asp?issn=0255-0857;year=2002;volume=20;issue=1;spage=19;epage=24;aulast=Bharathihttp://www.ncbi.nlm.nih.gov/pubmed/17657018?tool=bestpractice.com另一项在印度东部的研究发现 62% 的角膜溃疡源于真菌。[5]Basak SK, Basak S, Mohanta A, et al. Epidemiological and microbiological diagnosis of suppurative keratitis in gangetic West Bengal, Eastern India. Indian J Ophthalmol. 2005;53:17-22.http://www.ncbi.nlm.nih.gov/pubmed/15829742?tool=bestpractice.com
非感染性角膜炎是多样化的,其发生率取决于潜在的病因。周边溃疡性角膜炎(一种自身免疫性角膜炎)常与系统性自身免疫性疾病有关,首诊医生特别要注意。据英国一项研究显示,周边溃疡性角膜炎年发病率为百万分之三。[10]McKibbin M, Isaacs JD, Morrell AJ. Incidence of corneal melting in association with systemic disease in the Yorkshire Region, 1995-7. Br J Ophthalmol. 1999;83:941-943.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1723151/pdf/v083p00941.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10413698?tool=bestpractice.com