Effect of antihistamine-releasing contact lenses on ocular symptoms and treatment behavior in patients with seasonal allergic conjunctivitis: A retrospective study.

Purpose: This study aimed to compare subjective allergic conjunctivitis symptoms and anti-allergic eye drop use patterns between antihistamine-releasing contact lens users and daily disposable soft contact lens users during Japan's hay fever season. Methods: This web-based retrospective cohort study included daily disposable soft contact lens or antihistamine-releasing contact lens users with a history of seasonal allergic conjunctivitis who regularly used daily disposable soft contact lenses since the previous year. The total ocular symptom score (range 0-20) based on 5-item questionnaire scores and time from the start of the hay fever season to the initiation of anti-allergic eye drop treatment were compared between antihistamine-releasing contact lens users and daily disposable soft contact lens users. Results: The study included 24 participants: 17 using daily disposable soft contact lenses and 7 using antihistamine-releasing contact lenses. Antihistamine-releasing contact lens users experienced a greater reduction in total ocular symptom score from 2021 to 2022 compared with daily disposable soft contact lens users (mean total ocular symptom score [standard deviation]: daily disposable soft contact lens: -0.65 [1.4], antihistamine-releasing contact lens: -4.7 [3.6]; n = 24; Mann-Whitney U test, P = 0.010). Fourteen daily disposable soft contact lens users and five antihistamine-releasing contact lens users eventually required anti-allergic eye drops. Kaplan-Meier analysis revealed a significant delay in the initiation of anti-allergic eye drop treatment among those using antihistamine-releasing contact lenses compared with those using daily disposable soft contact lenses (median days, daily disposable soft contact lenses: 19 days, antihistamine-releasing contact lens: 57 days; n = 24; log-rank test, P = 0.045). Conclusions: Antihistamine-releasing contact lenses can potentially mitigate worsening ocular allergic responses during the hay fever season when used appropriately as a preventive measure.

Presence of Acanthamoeba and diversified bacterial flora in poorly maintained contact lens cases.

Acanthamoeba can cause visually destructive Acanthamoeba keratitis (AK) in contact lens (CL) users. The purpose of this study was to determine whether Acanthamoeba was present in the CL cases of CL wearers and to develop techniques to prevent the contaminations. To accomplish this, 512 CL case samples were collected from 305 healthy CL wearers. Using real-time PCR, Acanthamoeba DNA was detected in 19.1% of CL cases, however their presence was not directly associated with poor CL case care. Instead, the presence of Acanthamoeba DNA was associated with significant levels of many different bacterial species. When the CL cases underwent metagenomic analysis, the most abundant bacterial orders were Enterobacteriales followed by Burkholderiales, Pseudomonadales, and Flavobacteriales. The presence of Acanthamoeba was characterized by Propionibacterium acnes and Rothia aeria and was also associated with an increase in the α diversity. Collectively, Acanthamoeba contamination occurs when a diversified bacterial flora is present in CL cases. This can effectively be prevented by careful and thorough CL case care.

Reconsideration of the most appropriate criterion in the lowest classification of vision disability in Japan.

PURPOSE: To verify the current Japanese classification of vision disability in regard to visual acuity. METHODS: A questionnaire was sent to 100 ophthalmology services in Japan. Each service was asked to extract 300 of their outpatient records. From these records, patients who had a sum of corrected visual acuity in both eyes of less than or equal to 0.62 were selected for the questionnaire. The questionnaire consisted of items related to prevalence, age, sex, with or without vision-disabled certification at any grade, the corrected visual acuity of each eye and the name of any disease the subject may have had. RESULTS: Sixty-five services responded, and, of 20,235 total records reviewed, 971 patients were eligible for the questionnaire. The average age was 66.9 ± 20.0 years, and 74.6% were over 60 years old. The distribution of corrected visual acuity showed three categories. CONCLUSIONS: Our analysis indicates that a new candidate criterion for vision-disabled certification is needed for the sixth grade, which, at present is defined as, "The sum of the corrected visual acuity of both eyes is more than 0.2, but less than or equal to 0.4."

Bifocal contact lenses: History, types, characteristics, and actual state and problems.

Since people who wear contact lenses (CL) often continue using CL even when they develop presbyopia, there are growing expectations for bifocal CL. To understand actual state and problems, history, types, and their characteristics are summarized in this review. Bifocal CL have a long history over 70 years. Recently, bifocal CL have achieved remarkable progress. However, there still is an impression that prescription of bifocal CL is not easy. It should also be remembered that bifocal CL have limits, including limited addition for near vision, as well as the effects of aging and eye diseases in the aged, such as dry eye, astigmatism, cataract, etc. Analysis of the long-term users of bifocal CL among our patients has revealed the disappearance of bifocal CL that achieved unsatisfactory vision and poor contrast compared with those provided by other types of CL. Changing the prescription up to 3 times for lenses of the same brand may be appropriate. Lenses that provide poor contrast sensitivity, suffer from glare, or give unsatisfactory vision have been weeded out. The repeated replacement of products due to the emergence of improved or new products will be guessed.