Profiling of non-polar lipids in tears of contact lens wearers during the day.

PURPOSE: This study explored whether the non-polar lipids in the human tear fluid lipidome show diurnal variation with and without contact lens wear. It also addressed the relationship between changes in ocular comfort during the day with the level of non-polar lipids. METHODS: Tear samples were collected in the morning and evening with and without contact lenses using fine glass capillary tubes and were analysed by chip-based nano-electrospray ionization tandem mass spectrometric techniques. Tear levels of cholesteryl esters (CE), wax esters (WE) and triacylglycerides (TAG) were quantified. RESULTS: TAG 48:0, 52:0 and WE 26:0/16:0, and 27:0/17:0 increased from morning to evening. TAG 52:2, WE 21:0/16:0, 21:0/18:1 and 28:0/18:1 decreased during the day when no lenses were worn. CE 21:0 was the only non-polar lipid that increased from morning to evening in contact lens wear. WE 21:0/16:0 and 27:0/17:0 were lower in the morning in contact lens wear compared to no lens wear (p ≤ 0.05). The level of non-polar lipids did not correlate with ocular comfort at the end of the day. CONCLUSION: Even though the level of some of non-polar lipid species changed from morning to evening the total level of major tear non-polar lipids remained unchanged during the day with and without contact lens wear. The effect of change in the quantity and structure of lipid species on tear stability and ocular comfort warrants more investigation.

Relationship Between Contact Lens and Pinguecula.

PURPOSE: To investigate the effects of contact lens (CL) on the frequency of pinguecula, and the relationship between dry eye disease and pinguecula. METHODS: Two hundred and 33 cases of soft CL wearers and 230 age-matched nonwearers were enrolled in the study. Schirmer I test (ST) scores and tear break-up time (TBUT) were determined in all participants. A questionnaire including ocular surface disease index (OSDI), age, sex, and duration of CL wear was implemented to the participants before the examination. RESULTS: The prevalence of pinguecula was 27.8% (n: 65) in the CL group and 26.5% (n: 61) in the control group. There was no significant difference between the groups (P=0.841). The prevalence of pinguecula increased with age in both groups. There was no significant difference in the prevalence of pinguecula when users were divided into three groups according to the duration of CL wear (P=0.575). The TBUT scores were lower, and the OSDI scores were higher in the CL group. The TBUT scores were lower in patients with pinguecula in both groups. The OSDI scores were higher in the CL group. There was no significant difference regarding the OSDI scores between patients with pinguecula and healthy participants in the CL group; however, OSDI scores were significantly higher in patients with pinguecula in control group. There were no significant differences in the ST scores between the groups, and between patients with pinguecula and healthy participants. CONCLUSION: This is the second study that evaluates the effects of soft CL wearing on pinguecula prevalence. We found that CL wearing does not affect the prevalence of pinguecula. Considering the OSDI scores in patients with pinguecula in the CL group, CL may suppress the irritant symptoms of pinguecula.

Patient-Reported Wearing Experience From Hydrogel Daily Disposable Wearers Older Than 40 Years From the TEMPO Registry.

OBJECTIVES: To describe the patient-reported wearing experience over time among wearers of hydrogel daily disposable (HydDD) contact lenses (CLs) in the TruEye and Moist Performance Overview (TEMPO) Registry (NCT01467557). METHODS: Registered wearers older than 40 years who were recently fit with 1-DAY ACUVUE MOIST HydDDs completed self-administered questionnaires four times during a year-long Registry. Overall opinion of CLs, replacement schedules, Contact Lens Dry Eye Questionnaire (CLDEQ-8), and compliance were queried. Data were analyzed with analysis of variance and signed rank tests. RESULTS: A total of 86 subjects (24% men, age 50.2±7.1 years) completed the Registry. Approximately 76% were new to daily disposable lenses, and 8% were neophytes. Overall opinion of CLs improved significantly after refitting with HydDDs (baseline 57% excellent/very good vs. 69%-79% at follow-ups, P<0.05 all vs. baseline). Changing to HydDDs maintained average and comfortable wear time (P>0.05), and it did significantly improve CLDEQ-8 scores at all follow-ups (baseline, 11.2±7.3 vs. 2 weeks, 7.8±5.8, P<0.0001; 4 months, 8.6±6.5, P=0.0006; 12 months, 9.3±6.5, P=0.01). Self-assessment of compliance was excellent/very good for 80% at baseline, and improved to 92% to 98% at follow-ups (P<0.0001). More than 90% never slept in their HydDDs, although compliance to daily replacement diminished from 2-week to 4-month surveys (93% vs. 84%, P=0.007). CONCLUSIONS: After refitting with HydDDs, older wearers reported significantly higher overall opinions of their lenses, better CLDEQ-8 symptom scores, and most were compliant with proper daily disposable lens use. Diminishing daily replacement rates from 2 weeks to 4 months indicate a need to reinforce that recommendation. Wearers of HydDD CLs older than 40 years experienced many benefits from refitting with these daily disposable lenses.

[TREATMENTS FOR SLOWING THE PROGRESSION OF MYOPIA].

INTRODUCTION: Myopia is the most common refractive error and is now endemic over the entire industrial world, particularly in Asia. High myopia is one of the major causes of blindness in the world. Slowing the progress of myopia is possible, the most effective treatment being atropine ophthalmic drops, given in a dose-dependent fashion. Although high-dose atropine (1% and 0.5%) was found to be highly effective in slowing myopia progression, low-dose atropine (0.01%) was found to have the lowest rebound effect (accelerated myopia progression after treatment cessation) and was therefore, the most effective treatment in the long term. Moderately effective treatments include pirenzepine drops, cyclopentolate drops, orthokeratology, contact lenses which are designed to reduce the peripheral hyperopic blur and distance-center soft multifocal contact lenses. Less effective treatments include multifocal spectacle lenses, bifocal spectacle lenses, bifocal soft contact lenses and outdoor activity in daylight. Visual therapy, biofeedback, full-spectacle correction, under-correction, spectacles designed to reduce the peripheral hyperopic blur, single-vision rigid gas-permeable contact lenses, single-vision soft contact lenses, tropicamide drops and timolol drops were all found to be ineffective.

Effect of Masking on Subjective Responses to Daily Disposable Contact Lenses.

PURPOSE: To explore the effect of masking on subjective responses when wearing daily disposable (DD) contact lenses. METHODS: In an adaptation phase, habitual wearers of Manufacturer-A (MFA) (n = 43) and Manufacturer-B (MFB) (n = 53) wore MFA-brand 1 or MFB-brand 1 DDs, respectively, for 30 days, open-label. Subjects were then randomly assigned to one of two experiments. Each experiment included two, 3-day crossover phases. An enhanced version of MFA and MFB lenses (MFA-brand 2 and MFB-brand 2) were worn contralaterally to evaluate potential differences in masking result between manufacturers. Experiment 1: subjects were fully masked to lens and packaging (FM) then unmasked (UM). Experiment 2: subjects were FM then partially masked using an over-label (PM). Comfort ratings (0-100) were recorded for each lens daily and preference between lenses was recorded on day 3 for each crossover phase. The mean difference between 0-100 ratings or preference when FM or PM versus UM for the same lens was considered a measurement of the effect associated with masking. The purpose of the study was withheld from subjects to minimize bias. RESULTS: The effect associated with masking for habitual wearers of MFA and MFB lenses was less than 1 out of 100 (0 ± 2.5) in both experiments. Fifty-eight subjects (60%) expressed no preference when FM. This decreased to 29 (30%) when UM or PM (proportion test, p < 0.001). Approximately half the subjects had a change in lens preference when they were UM or PM, primarily in favor of their habitual lens manufacturer. CONCLUSIONS: Masking did not have a measurable impact on 0-100 ratings with the DD lenses used in this study but did have an impact on lens preference. Subjects were more likely to express a preference when they handled the lenses and were exposed to the lens packaging and, in some cases, able to read the lens brand and lens manufacturer.

Effect of Short Recovery Periods on Ocular Comfort During Daily Lens Wear.

PURPOSE: To assess the impact of lens-free intervals of varying lengths on end-of-day comfort with soft contact lenses. METHODS: Twenty-five symptomatic lens wearers participated in this randomized, cross-over study involving nine individual 12-hour days: one spectacle (no lens) and eight lens wear days. On each lens wear day, lenses were worn bilaterally in 2-hour intervals, separated by lens-free (recovery) periods of 0, 30, 60, or 80 minutes (repeated throughout the day). For each 2-hour lens wear interval, new lenses were worn. Ocular comfort was rated on a 0 to 100 visual analogue scale (0 = extremely uncomfortable); tear film and ocular parameters were assessed at the beginning and end of each study day. This study involved two different types of silicone hydrogel lenses, and the order of lens type and length of recovery period was randomized. Participants were unaware of the true study purpose and that a new lens pair was used for each lens wear interval. RESULTS: End-of-day comfort on lens wear days was significantly worse than on the spectacle day (p < 0.002). There was no significant effect of the recovery periods on end-of-day comfort (p > 0.05). Although lens wear affected noninvasive tear film break-up time and conjunctival staining, there were no effects of recovery period length on noninvasive tear film break-up time (p > 0.05), tear meniscus height (p > 0.05), corneal staining (p > 0.05), conjunctival staining (p > 0.05), bulbar conjunctival redness (p > 0.05), or limbal redness (p > 0.05). There was no consistent effect of recovery period length on lid margin staining. CONCLUSIONS: Lens-free recovery periods during a 12-hour lens wear day did not positively impact end-of-day comfort in this study. Cumulative lens wear times ranged from 8 to 12 hours, and the results suggest that once the length of lens wear exceeds the usual comfortable wear time, there is no benefit of short recovery periods.

Development of the Contact Lens User Experience: CLUE Scales.

PURPOSE: The field of optometry has become increasingly interested in patient-reported outcomes, reflecting a common trend occurring across the spectrum of healthcare. This article reviews the development of the Contact Lens User Experience: CLUE system designed to assess patient evaluations of contact lenses. CLUE was built using modern psychometric methods such as factor analysis and item response theory. METHODS: The qualitative process through which relevant domains were identified is outlined as well as the process of creating initial item banks. Psychometric analyses were conducted on the initial item banks and refinements were made to the domains and items. Following this data-driven refinement phase, a second round of data was collected to further refine the items and obtain final item response theory item parameters estimates. RESULTS: Extensive qualitative work identified three key areas patients consider important when describing their experience with contact lenses. Based on item content and psychometric dimensionality assessments, the developing CLUE instruments were ultimately focused around four domains: comfort, vision, handling, and packaging. Item response theory parameters were estimated for the CLUE item banks (377 items), and the resulting scales were found to provide precise and reliable assignment of scores detailing users' subjective experiences with contact lenses. CONCLUSIONS: The CLUE family of instruments, as it currently exists, exhibits excellent psychometric properties.

Diurnal Variation in Comfort in Contact Lens and Non-contact Lens Wearers.

PURPOSE: The purpose of this investigation was to evaluate the diurnal variation in symptoms associated with ocular discomfort in contact lens (CL) wearers and non-CL wearers. METHODS: The study population comprised 604 individuals attending pre-screening visits at the OTG-i research clinic; 60% were current soft CL wearers (hydrogel and silicone hydrogel) and 40% were non-CL wearers. Symptomatology status was determined by the OSDI questionnaire (58% asymptomatic, 42% symptomatic). Participants were asked to grade their comfort, vision, and other symptoms during the day and in the evening (before lens removal for CL wearers) on 0 to 100 visual analogue scales. RESULTS: Diurnal decrease in comfort was significantly greater for CL wearers (-16.0 vs. -6.3, p < 0.001) and symptomatic participants (p = 0.015). Diurnal decrease in subjective vision was also significantly greater for CL wearers (-10.4 vs. -6.9, p = 0.005) and symptomatic participants (p = 0.001), and the interaction between these factors was also significant (p = 0.019). Dryness, grittiness, and irritation increased significantly more for CL wearers (p < 0.001, p = 0.012, and p = 0.004, respectively) and grittiness, irritation, and stinging for symptomatic participants (p = 0.016, p < 0.001, and p < 0.001, respectively). For the CL wearers, there was a significant interaction between dryness and age (p = 0.026) with the diurnal increase in dryness being greater in those under 40 (+15.6 vs. +10.0). CONCLUSIONS: The diurnal decrease in comfort and subjective vision, and the diurnal increase in dryness, grittiness, and irritation, were significantly more marked for CL wearers than non-CL wearers. Diurnal changes in comfort, grittiness, stinging, irritation, and vision were influenced by the subject's overall symptomatology as assessed by the OSDI questionnaire. For dryness symptoms, the diurnal decrease was most marked in young CL wearers. For the symptoms of stinging and vision, the diurnal changes were most pronounced in the symptomatic groups.

Soft Contact Lens-Related Symptoms in North America and the United Kingdom.

PURPOSE: To characterize and compare the prevalence of soft contact lens-related (SCL) dryness symptoms in large populations of SCL wearers in North America (NAm) and the United Kingdom (UK). METHODS: SCL wearers from NAm (n = 1443) and UK (n = 932) sites completed self-administered questionnaires on SCL symptoms and wearing experiences. A categorization for contact lens-related dry eye (CL-DE) was applied that combined Contact Lens Dry Eye Questionnaire (CLDEQ) items on dryness frequency and intensity at the end of the day (CL-DE+ = constantly/frequently/sometimes plus intensity = 3-5, and CL-DE- = never/rarely plus intensity = 0-1, Marginal = all other ratings). Data were analyzed across regions and categories, with p-values <0.05 significant. RESULTS: Compared to UK wearers, those in NAm wore fewer toric and multifocal designs, and reported significantly longer average and comfortable wearing times (p < 0.001) but similar levels of general and end-of-day comfort. The prevalence of CL-DE+ differed between the UK and NAm: CL-DE+: 31 vs. 39%, Marginal CL-DE: 13 vs. 14%, and CL-DE-: 56 vs. 47%, p = 0.0001. Although daily disposable (DD) lenses were worn more commonly in the UK than NAm (33 vs. 10%, p < 0.0001), their use did not impact the overall prevalence of dryness symptoms. Between regions, NAm wearers reported significantly more frequent and intense end-of-day discomfort and dryness (p < 0.0001) and were significantly more likely to use treatments for CL-related symptoms yet experienced a lower degree of relief. CONCLUSIONS: SCL wearers in NAm reported longer hours of wear with significantly more symptoms of dryness and discomfort. NAm wearers used dryness treatments more often, but experienced less relief than UK wearers. In both regions, the CL-DE categorization was useful to predict poorer comfort, shorter comfortable wearing time, and increased use of treatments. These results highlight the need to benchmark SCL performance locally or regionally to understand and focus on the challenges to the lens wearing experience.

Relationships among Tear Film Stability, Osmolarity, and Dryness Symptoms.

PURPOSE: To examine the relationships among tear osmolarity, tear film stability, and several measures of dry eye (DE) symptoms in a multivariable analysis. METHODS: A cross-sectional study was conducted with 137 subjects (68 non-contact lens [CL] wearers and 69 soft CL wearers) recruited from a university campus. Tear breakup time (TBUT) was measured noninvasively (NITBUT) and with fluorescein (FTBUT). Tear osmolarity was measured by an osmometer. Dry eye symptoms were assessed using the Dry Eye Flow Chart and several different questionnaires. RESULTS: Subjects ranged in age from 18 to 67 years, with a mean of 28 years. Subjects had a mean (SD) osmolarity of 293 (10) mOsm/L, NITBUT of 14.1 (10.9) seconds, and FTBUT of 14.8 (12.6) seconds. Shorter NITBUT and FTBUT were significantly associated with female sex (p = 0.001 and p = 0.027, respectively) and Asian ethnicity (p = 0.030 and p = 0.004, respectively). There were no clinically significant relationships between tear osmolarity and FTBUT, NITBUT, or DE symptoms. Higher Dry Eye Flow Chart score (i.e., worse symptoms) was associated with older age (p < 0.001), female sex (p = 0.014), CL wear (p < 0.001), shorter NITBUT (p < 0.001), and shorter FTBUT (p = 0.028). The sensitivities and specificities for using clinical measurements to diagnose moderate to severe DE were as follows: osmolarity, 0.67 and 0.46, respectively; NITBUT, 0.72 and 0.52, respectively; and FTBUT, 0.68 and 0.57, respectively. CONCLUSIONS: In a population of asymptomatic, mild and moderate DE patients, increased tear osmolarity was not significantly associated with reported symptom severity and frequency. Tear osmolarity, NITBUT, and FTBUT exhibited similar sensitivities and specificities when used to diagnose moderate to severe DE.

Consequences of wear interruption for discomfort with contact lenses.

PURPOSE: To establish whether increased end-of-day discomfort during soft contact lens wear is associated with short-term changes occurring to the lens itself. METHODS: Twenty-seven subjects wore hydrogel lenses (Focus Dailies; Alcon) bilaterally for 10 hours on two separate days. Comfort was reported using 1-100 numerical rating scales (1 = intolerable discomfort, 100 = lens cannot be felt). Day 1 ratings were taken before lens insertion and at 0.05, 5, and 10 hours post-insertion. Day 2 ratings occurred at similar times, but lenses were removed after the 5-hour assessment and either reinserted (n = 14) or newly replaced (n = 12). An additional rating was taken 5 minutes after re-insertion. Wear then continued to the 10-hour point. In a separate study, 24 different subjects repeated these procedures using a silicone hydrogel lens (AirOptix Aqua; Alcon) with wear taking place on 3 days to permit lens replacement to be with existing as well as new lenses in all subjects. RESULTS: For hydrogel lenses, comfort scores (mean ± 95% CI) reported after 10 hours were 79.4 ± 8.3 when lenses were worn un-replaced, compared with 73.2 ± 9.2 for replacement with the existing lens. When replacement was with a brand new lens, the corresponding values were 72.9 ± 10.9 (un-replaced) versus 69.2 ± 12.8 (new lens replacement). For silicone hydrogel lenses, 10-hour comfort was 90.3 ± 3.2 (un-replaced) versus 92.2 ± 2.9 (replacement with existing lens) versus 90.0 ± 3.3 (replacement with new lens). Differences between replacement conditions were not significant in any case (analysis of variance, p > 0.05). CONCLUSIONS: Final comfort was not influenced by replacing lenses midway through the wearing period. Comfort decrements experienced by users of these daily contact lenses towards the later part of the wearing period are not caused by changes occurring to the lenses on this time scale. Possible alternative etiological factors include a fatigue-like response in one or more ocular tissues or stimulation of ocular surface nociceptors induced by the presence of the contact lens.

Corneal inflammatory events with daily silicone hydrogel lens wear.

PURPOSE: This study aimed to determine the probability and risk factors for developing a corneal inflammatory event (CIE) during daily wear of lotrafilcon A silicone hydrogel contact lenses. METHODS: Eligible participants (n = 218) were fit with lotrafilcon A lenses for daily wear and followed up for 12 months. Participants were randomized to either a polyhexamethylene biguanide-preserved multipurpose solution or a one-step peroxide disinfection system. The main exposures of interest were bacterial contamination of lenses, cases, lid margins, and ocular surface. Kaplan-Meier (KM) plots were used to estimate the cumulative unadjusted probability of remaining free from a CIE, and multivariate Cox proportional hazards regression was used to model the hazard of experiencing a CIE. RESULTS: The KM unadjusted cumulative probability of remaining free from a CIE for both lens care groups combined was 92.3% (95% confidence interval [CI], 88.1 to 96.5%). There was one participant with microbial keratitis, five participants with asymptomatic infiltrates, and seven participants with contact lens peripheral ulcers, providing KM survival estimates of 92.8% (95% CI, 88.6 to 96.9%) and 98.1% (95% CI, 95.8 to 100.0%) for remaining free from noninfectious and symptomatic CIEs, respectively. The presence of substantial (>100 colony-forming units) coagulase-negative staphylococci bioburden on lid margins was associated with about a five-fold increased risk for the development of a CIE (p = 0.04). CONCLUSIONS: The probability of experiencing a CIE during daily wear of lotrafilcon A contact lenses is low, and symptomatic CIEs are rare. Patient factors, such as high levels of bacterial bioburden on lid margins, contribute to the development of noninfectious CIEs during daily wear of silicone hydrogel lenses.

Long-term contact lens wear of children and teens.

OBJECTIVE: To compare current symptoms, compliance, ocular health, and previous adverse events between current successful long-term contact lens wearers fit as children or as teenagers. METHODS: People who had successfully worn soft contact lenses for at least 10 years completed an online survey about demographics, current wearing status, compliance, symptoms, and previous adverse events. A subset reported for a slit-lamp examination, autorefraction, autokeratometry, and specular microscopy. Statistical comparisons were made between those fit as children (12 years or younger) and those fit as teenagers (13 years or older). RESULTS: Of the 175 subjects completing the online survey, 86 (49.2%) were fit as children and 89 (50.8%) fit as teenagers. Those fit as children wore their contact lenses for an average of 14.8 ± 3.4 hours per day, compared with 14.7 ± 3.6 hours per day for those fit as teenagers (P=0.74). Eighteen (20.9%) fit as children and 17 (19.1%) fit as teenagers reported ever having had a painful, red eye that required a doctor visit (P=0.76). Overall, there were no differences in ocular health between the groups. Those fit as children were more myopic than those fit as teenagers (-4.30 ± 1.69 and -2.87 ± 2.75, respectively; P=0.02). CONCLUSIONS: Successful contact lens wearers fit as children are no more likely to report previous contact lens-related adverse events, problems with compliance, decreased wearing time, or worse ocular health than those fit as teenagers, so practitioners should not use age as a primary determinant in fitting children in contact lenses.

The use of contact lenses during water-polo play: a 20-year study of Japanese college players.

This study investigated the extent of contact-lens use in Japanese college water-polo male players over 20 years (1991-2011, once every five years). Information about the use of contact lenses during play and the types of contact lens was obtained through a self-report questionnaire. The proportion of contact lens use among the players while playing water polo differed from 1991 to 2011 (χ2(4) = 25.28, P < 0.001, Cohen's d = 0.63). Fifty-four per cent of the players used contact lenses while playing in 1991 (P < 0.001); more than 74% in 1996; 89% in 2001; 84% in 2006; and 86% in 2011. While 96% of the contact lenses used by the players in 1991 were the soft type, 74%, 92%, 86%, and 88% of the contact lenses used in 1996, 2001, 2006, and 2011, respectively, were the disposable type. These findings indicated a high percentage of players were using contact lenses while playing water polo between 1996 and 2011. This could be because the majority of players used disposable lenses. The results suggest that increasing use of contact lenses by water-polo players is beneficial.

Effects of LASIK on corneal endothelium using the 15-kHz IntraLase femtosecond laser.

PURPOSE: To assess the effects of LASIK with the 15-kHz IntraLase femtosecond laser on corneal endothelium. METHODS: In a prospective, single-center clinical trial, 138 patients (mean age: 32.0 ± 7.1 years [range: 21 to 42 years]) underwent femtosecond LASIK for the correction of myopia -0.75 to -9.00 diopters (D) and cylinder up to 3.25 D. Patients were divided into two groups: contact lens group (n=76) and non-contact lens group (n=62). Pre- and 12-month postoperative specular microscopy of the central corneal endothelium was performed. The integrity of the central endothelium was assessed in terms of endothelial cell density and percentage of hexagonality. RESULTS: In the contact lens group, mean endothelial cell density improved significantly from 3401 ± 292 cells/mm(2) to 3587 ± 262 cells/mm(2) (P<.001) with a mean increase of 5.5%. The percentage of hexagonal cells was statistically significantly higher after surgery (32.5 ± 4.0%) compared with preoperative data (31.0 ± 5.1%) (P=.035). No statistically significant differences were noted regarding mean endothelial cell density (P=.126) or hexagonality (P=.56) before and 1 year after femtosecond LASIK in the non-contact lens group. CONCLUSIONS: Femtosecond LASIK to correct myopia was safe for the corneal endothelium. Improvement in mean endothelial cell density and percentage of hexagonality was observed in the contact lens group.

Contact lens assessment in youth: methods and baseline findings.

PURPOSE: To describe the Contact Lens Assessment in Youth (CLAY) Study design and report baseline data for a multicenter, retrospective, observational chart review of children, teenagers, and young adult soft contact lens (SCL) wearers. METHODS: Clinical charts of SCL wearers aged 8 to 33 years were reviewed at six colleges of optometry. Data were captured retrospectively for eye care visits from January 2006 through September 2009. Patient demographics, SCL parameters, wearing schedules, care systems, and biomicroscopy findings and complications that interrupted SCL wear were entered into an online database. RESULTS: Charts from 3549 patients (14,276 visits) were reviewed; 78.8% were current SCL wearers and 21.2% were new fits. Age distribution was 8 to <13 years (n = 260, 7.3%), 13 to <18 years (n = 879, 24.8%), 18 to <26 years (n = 1,274, 36.0%), and 26 to <34 years (n = 1,136, 32.0%). The sample was 63.2% females and 37.7% college students. At baseline, 85.2% wore spherical SCLs, 13.5% torics, and 0.1% multifocals. Silicone hydrogel lenses were worn by 39.3% of the cohort. Daily wear was reported by 82.1%, whereas 17.9% reported any or occasional overnight wear. Multipurpose care systems were used by 78.1%, whereas another 9.9% indicated hydrogen peroxide solutions use. CONCLUSIONS: This data represent the SCL prescribing and wearing patterns for children, teenager, and young adult SCL wearers who presented for eye care in North American academic clinics. This will provide insight into SCL utilization, change in SCL refractive correction, and risk factors for SCL-related complications by age group.

In vivo confocal microscopy: corneal changes of hydrogel contact lens wearers.

To evaluate the corneal findings in hydrogel contact lens wearers by in vivo confocal scanning microscopy. One hundred and forty-two eyes of 71 myopic contact lens wearers (group 1) and 142 eyes of 71 non-contact lens wearers (group 2), whose age, gender and refractive error matched, were enrolled in order to detect the corneal changes by in vivo confocal microscopy through the central cornea. The average age was 25.5 ± 5.7 (16-52) and 25.6 ± 5.6 (17-49) in groups 1 and 2, respectively. The mean duration of contact lens wear was 43.9 ± 15.3 (6-240) months. Anterior keratocyte density was 667.5 ± 128.3 cells/mm(2) in group 1 and 821.4 ± 136.7 cells/mm(2) in group 2 (P = 0.001). Posterior keratocyte densities of groups 1 and 2 were 540.2 ± 87.6 cells/mm(2) and 628.2 ± 72.4 cells/mm(2), respectively (P < 0.001). Endothelial cellular density was 2611.2 ± 298.4 cells/mm(2) in group 1 and 2643 ± 218.2 cells/mm(2) in group 2 (P = 0.52). Ratio of polymegethism was 44.6 ± 8.8% in group 1 and 31.3 ± 4.7% in group 2 (P < 0.001). Epithelial cellular enlargement was observed in eyes wearing contact lenses with a mean Dk/t ratio of 26.5 × 10(-9) ± 5.9 (8.9-32 × 10(-9)). Stromal microdots occurred with contact lenses with a mean Dk/t ratio of 13.2 × 10(-9) ± 17.5 × 10(-9) (8.9-20 × 10(-9)). In vivo examination of the cornea with confocal microscopy revealed a number of changes. These changes can be attributed both to the mechanical and the hypoxic effects of soft contact lenses. In soft contact lenses with a high Dk/t ratio, these changes would be less frequent.

Application of superficial keratectomy and soft contact lens for the treatment of symblepharon in a cat: a case report.

A 7-month-old intact female Persian cat was diagnosed with symblepharon accompanied by epiphora, brownish ocular discharge, and ocular discomfort in the left eye. Superficial keratectomy (SK) was performed to remove adhesions between the conjunctiva and cornea. To prevent re-adhesion after SK, the detached conjunctival tissue was sutured to the corneal limbus, and a soft contact lens (SCL) was inserted and a partial temporary tarsorrhaphy was performed. The SCL and tarsorrhaphy sutures were maintained for 22 days, and symblepharon did not recur 347 days postoperatively. SK combined with SCL is a relatively easy and cost-effective surgical option for feline symblepharon.

Soft contact lens wearers' compliance during the COVID-19 pandemic.

AIM: Contact lens wearers need to maintain optimal hygiene practices during the COVID-19 pandemic to minimise contact-lens complications including microbial keratitis and corneal infiltrative events. This online survey (UK and Ireland) explored contact lens wearers' compliance behaviours, attitudes and concerns during the pandemic. METHOD: The 60-item anonymous online survey was distributed during a 1-month period via Qualtrics (starting on 14/04/20). The survey captured: a) demographic information, b) type of lenses worn and compliance with lens wear and care procedures, c) adherence to recommendations and d) concerns associated with contact lens wear during the pandemic. RESULTS: Two hundred and forty seven responses were received (34.3 ±â€¯11.7 years old, 79% female). Seventy nine percent of participants reported that they were self-isolating or rigorously following social distance advice. Fifty-six percent of participants reported using their lenses less during the pandemic. Eighty-seven percent of respondents reported following the recommended 20-second rule most times/every time and 96% used soap and water during handwashing. Eleven percent of respondents admitted not following recommendations regarding disposal of lenses and 18% would not consider ceasing lens wear if unwell (with flu/cold) during the pandemic. CONCLUSION: Respondents reported wearing their contact lenses less than usual. Good compliance with handwashing was observed but soft reusable lens wearers showed a statistically significant lower compliance with lens wear and care compared to daily disposable lens wearers (p=<0.001).

Influence of the COVID-19 pandemic on contact lens wear in Spain.

PURPOSE: To investigate the behaviour of contact lens (CL) wearers in Spain during the COVID-19 pandemic. METHODS: An anonymized web-based questionnaire was used to assess demographics, CL history, and activity, CL wear habits and perceived risk of infection due to CL wear during the COVID-19 pandemic. RESULTS: A total of 737 participants with an average age of 27.4 (±9.3) years completed the online questionnaire. The vast majority of respondents were soft CL wearers and reported at least two years of CL wear. Patients concerns about the increased risk of SARS-CoV-2 infection due to CL wear (40.6 % of participants) were significantly related (χ2(1) = 11.195, p < 0.05) to CL discontinuation (46 % of participants) during the COVID-19 pandemic. This fact joins the significant changes in the frequency of CL wear during the COVID-19 pandemic (χ2(4) = 31.982, p < 0.05), with a tendency to increase occasional CL wear from 29.1 % to 61.8 %. Interestingly, the majority of respondent (87.9 %) indicated that no professional had offered them information related to CL wear and COVID-19, and that they had not sought it on their own (82.2 %). CONCLUSION: There is a relationship between the perceived risk of infection and CL dropout during the COVID-19 pandemic, and a tendency to change the CL frequency of wear, with an increase in occasional CL wear. During the ongoing pandemic, eye care practitioners should reinforce CL patient education to minimize the risk of SARS-CoV-2 infection and CL-related complications requiring clinical care.