Global trends in myopia management attitudes and strategies in clinical practice - 2019 Update.

PURPOSE: A survey in 2015 identified a high level of eye care practitioner concern about myopia with a reported moderately high level of activity, but the vast majority still prescribed single vision interventions to young myopes. This research aimed to update these findings 4 years later. METHODS: A self-administrated, internet-based questionnaire was distributed in eight languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy of available strategies and adoption levels of such strategies, and reasons for not adopting specific strategies. RESULTS: Of the 1336 respondents, concern was highest (9.0 ±â€¯1.6; p < 0.001) in Asia and lowest (7.6 ±â€¯2.2; p < 0.001) in Australasia. Practitioners from Asia also considered their clinical practice of myopia control to be the most active (7.7 ±â€¯2.3; p < 0.001), the North American practitioners being the least active (6.3 ±â€¯2.9; p < 0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by pharmaceutical approaches and approved myopia control soft contact lenses (p < 0.001). Although significant intra-regional differences existed, overall, most practitioners did not consider single-vision distance under-correction to be an effective strategy for attenuating myopia progression (79.6 %), but prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients (63.6 ±â€¯21.8 %). The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (20.6 %) and inadequate information (17.6 %). CONCLUSIONS: While practitioner concern about myopia and the reported level of activity have increased over the last 4 years, the vast majority of eye care clinicians still prescribe single vision interventions to young myopes. With recent global consensus evidence-based guidelines having been published, it is hoped that this will inform the practice of myopia management in future.

Trends in US Contact Lens Prescribing 2002 to 2014.

PURPOSE: To document contact lens prescribing patterns in the United States between 2002 and 2014. METHODS: A survey of contact lens prescribing trends was conducted each year between 2002 and 2014, inclusive. Randomly selected contact lens practitioners were asked to provide information relating to 10 consecutive contact lens fits between January and March each year. RESULTS: Over the 13-year survey period, 1650 survey forms were received from US practitioners representing details of 7702 contact lens fits. The mean (±SD) age of lens wearers was 33.6 (±15.2) years, of whom 65.2% were female. Rigid lens new fits decreased from 13.0% in 2002 to 9.4% in 2014. Across this period, silicone hydrogels have replaced mid water contact lens hydrogels as the soft lens material of choice. Toric lenses represented about 25 to 30% of all soft lens fits. Multifocal soft lenses are generally preferred to monovision. Daily disposable lens fits have recently increased, and in 2014, they represented 27.1% of all soft lens fits. Most lenses are prescribed on 1 to 2 weekly or monthly lens replacement regimen. Extended wear remains a minority lens wearing modality. The vast majority of those wearing reusable lenses use multipurpose lens care solutions. Lenses are mostly worn 7 d/wk. CONCLUSIONS: This survey has revealed prescribing trends and preferences in the United States over the past 13 years.

Trend of soft contact lens prescribing in an optometry centre in India: a 6-year analysis.

This six-year retrospective longitudinal study was conducted to examine the changes in the pattern of prescribing soft contact lenses in an optometry centre located in a University in South India. Details regarding the type of lenses, lens material, wearing pattern and the clinical diagnoses were analyzed from January 2006 to December 2011. A total of 1273 soft contact lens fits (n=1273) were analyzed. Two-third of the total lenses dispensed was for females and their mean age (24.0±8.3 yrs) was less than that of male (27.0±11.2 yrs) lens users. Nearly 70% of them had myopia and 48% wore conventional soft contact lenses. During the studied six years, the percentage of conventional lenses declined by 60%. This study demonstrated a gradual and significant increase in popularity of disposable contact lenses and silicone hydrogel lens material which is comparable to the global trend.

Corneal vascularisation and contact lenses / Vascularización corneal y lentes de contacto

No disponible

Soft contact lens polymers: an evolution.

A review of patents and literature reveals an evolution in materials technologies. The evolution has been driven by an increased understanding of the physiological needs of the cornea, beginning with the first hydrogel lenses developed by Wichterle, followed by a variety of high water hydrogels. Oxygen transmission requirements have been addressed through the use of siloxane and fluorosiloxane containing hydrogels. An important development has been the appreciation of the importance of polymer phase morphology on lens movement on the eye. In parallel with these activities have come the advancements in materials suitable to high volume, low cost production necessary for today's daily disposable lenses.

Contact lens associated bacterial keratitis: past, present, and future.

PURPOSE: This paper reviews the medical history of the pathogenesis of contact lens related bacterial keratitis and its relationship to the development of successive generations of soft contact lenses. METHODS: The Methods section presents a literature review and the author's personal experience. RESULTS: Bacterial corneal infections have been a significant complication limiting the overall success of soft contact lenses for visual correction. Experience with different types of lenses has pointed to specific causes for the frequency of infection. However, there has been a general understanding that the health of the patient's epithelium, the patient's lens care practices, and the hypoxic effects of overnight wear each significantly contribute to the development of corneal infection. CONCLUSIONS: A complete understanding of the pathogenesis of contact lens associated bacterial infection would allow the development of strategies to prevent infectious complications of lens wear. Progress appears to have been made with a trend toward fewer and less severe infections. As the possibility of a reasonably priced daily wear disposable lens with better oxygen transmissibility and surface modifications to limit deposits and bacterial adherence evolves, safer lenses will continue to be developed.