Image- and impression-based technology for scleral lens fitting for keratoconus: Efficiency of the fitting process.

PURPOSE: This study describes efficiency of diagnostic, image-based, and impression-based fitting methods by eye care providers who prescribe scleral lenses (SL) for patients with keratoconus. METHODS: An electronic survey was distributed to eye care providers with an interest in SL fitting. Demographic data including practice modality, country of residence, and fitting volume were collected. Efficiency of each fitting method (diagnostic, image, and impression-guided) was queried including time required for initial evaluation, number of lenses ordered, and number of office visits required. Practitioners with access to image and impression-based technology were also asked time required to acquire data and to estimate the percentage of time a lens could be manufactured from the initial images or impressions. RESULTS: 423 practitioners who prescribe SL for patients with keratoconus reported completing a median [IQR] 100 [280] SL fittings. There was no difference in the median time required for initial evaluation (30 min; p = 0.5) or median number of lenses ordered during the fitting process (2 lenses; p = 0.2) between diagnostic, image-based, or impression-based SL fitting methods. Median time to acquire initial images was 10 [7] minutes and 15 [10] minutes to obtain impressions. Images obtained were adequate to order an initial lens 80 [45]% of the time while initial impressions were adequate 90 [40]%. CONCLUSION: In this study, practitioner-reported efficiency of SL fitting was similar between diagnostic, image-based and impression-based methods for patients with keratoconus.

Wear Experiences with Two Soft Contact Lenses for Astigmatism of Different Modalities.

Introduction: Patients expect to have excellent vision and comfort when wearing soft contact lenses. The purpose of this study was to compare the wear experiences of participants with astigmatism when wearing a daily disposable soft toric lens to an established, commonly used reusable toric lens. Methods: In this crossover study, habitual soft toric lens wearers were fit with a daily replacement soft toric lens (delefilcon A) and a reusable, 1-month replacement soft toric lens (comfilcon A) in a randomized order. After 30 days of wear, Visual analog scale (VAS) surveys were used to assess wear experience, including vision and comfort, for overall wear and end-of-day wear. Scores were compared statistically with mixed-effects linear models. Participants also responded to questions about convenience, ease of use, and satisfaction with both lenses and preference questions based upon comfort, vision, and overall performance. Results: Fifty-nine participants completed the multi-site crossover study. VAS scores [mean(std dev)] for overall quality of vision for the delefilcon A [80.4(16.4)] and comfilcon A [66.8(27.7)] lenses were statistically significant (P=0.002). The difference in the mean overall comfort scores for the delefilcon A lenses [71.6(26.3)] and comfilcon A lenses [63.2(28.9)] was 8.4, which exceeds the establish criteria for clinical significance, although not statistically significant (P=0.08). Overall satisfaction scores were 68.8(26.9) for the delefilcon A and 59.7(30.3) for the comfilcon A lenses (P=0.08). Both lenses provided mean binocular visual acuities better than 20/20 Snellen equivalent. Over half of the participants preferred the delefilcon A lenses based upon comfort, vision, and overall performance. Convenience, ease of use, and satisfaction all scored higher with delefilcon A lenses. Conclusion: The results of this study show that wear experience with delefilcon A lenses for astigmatism can meet or exceed that of comfilcon A toric lenses while also providing healthy, daily disposable lens wear.

Patient-Reported Dry Eye Treatment and Burden of Care.

OBJECTIVES: Dry eye is a common condition that can decrease the quality of life. This survey-based study of persons with dry eye investigated self-reported treatments (initial, current), out-of-pocket expenses, time spent on self-management, sources of care, and sources of information about their condition. METHODS: Online dry eye newsletters and support groups were emailed a link to an electronic survey asking members to participate. Survey respondents were not required to answer every question. RESULTS: In total, 639 persons with self-reported dry eye responded (86% women, 14% men [n=623]; mean ± SD age, 55 ± 14 years [n=595]). Artificial tears were the most reported intervention (76% initially, 71% currently). The median (interquartile range) out-of-pocket treatment cost annually was $500 ($200-$1,320 [n=506]). In addition, 55% (n=544) estimated 5 to 20 min daily on self-management; 22% spent an hour or more. Ophthalmologists provided most dry eye care (67%, n=520). Only 48% (n=524) reported that their primary source of dry eye information came from their eye care clinician. CONCLUSIONS: Artificial tears are the primary treatment for dry eye. Ophthalmologists provide most dry eye care, but half of patients report that their eye care provider is not their primary source of information. Almost one fourth of patients spend an hour or more daily on treatments.

Lens and solution properties in patients with and without midday fogging.

INTRODUCTION: Midday fogging is a complication of scleral lens (SL) wear that interrupts clear vision during the course of wear. SLs can be made with a variety of gas permeable materials, sizes and surface treatments, and various solutions are available for storing the lenses and for filling them before application on the eye. Many of these factors have been implicated as possible contributors to midday fogging. This study explored the lens and solution properties in habitual SL wearers with and without midday fogging. METHODS: In this prospective study, 48 habitual SL wearers were evaluated and asked to report whether they experienced midday fogging and if they removed their lenses during the day. They completed the Ocular Surface Disease Index (OSDI), which is a validated tool for dry eye assessment. Lens parameters (material, coatings and diameter) and lens storage and filling solutions were documented. Backward elimination of regression terms evaluated the lens and solution properties in those with and without fogging. OSDI scores were compared using the Mann-Whitney analysis. RESULTS: Collectively, the lens properties and solutions accounted for 27.7% of the variance related to midday fogging. None of the factors alone had a significant impact upon midday fogging. The median (interquartile range) OSDI score for those with fogging [37 (35)] was significantly different from those without fogging [10 (15)], with the scores corresponding to severe dry eye and normal eyes, respectively. CONCLUSION: SL wearers with midday fogging exhibited similar symptoms to patients with severe dry eye. Lens and solution characteristics may play a small role in patients with midday fogging, although changing just a single factor is not likely to impact its presence.

Process and Outcomes of Fitting Corneoscleral Profilometry-Driven Scleral Lenses for Patients With Ocular Surface Disease.

OBJECTIVES: To assess the feasibility of obtaining cornea scleral profile (CSP) measurements using Scheimpflug imaging and report on the fitting process of free-form custom scleral lenses (SLs) for patients with ocular surface disease (OSD). METHODS: This prospective study of patients fit with free-form SLs collected data on the following: demographics, indications for wear, corneal and scleral tomography, scan acquisition process, and SL fitting process. RESULTS: Cornea scleral profile scans were acquired on 15 eyes of nine patients. Mean scan time for right eyes was 10.7, and 9.7 min for left eyes. A mean of 2.9 follow-up visits were required to complete SL fitting, with a mean of 2.1 lenses ordered. One eye did not tolerate lens wear, and one eye could not be fit using the CSP scan because of insufficient data. The initial lens ordered was dispensed at the first follow-up visit for seven of the remaining 13 eyes, all of which were ultimately fit successfully in free-form lenses. CONCLUSIONS: In this study of profilometry-guided SL fitting for eyes with OSD and low magnitude corneal astigmatism, the number of lenses and follow-up visits required were similar to outcomes of previous studies that described the diagnostic approach to SL fitting. In addition, imaging technology does not negate the need for skilled clinical observation while fitting SLs.

Patient Experiences With Therapeutic Contact Lenses and Dry Eye Disease.

OBJECTIVES: To report patient-reported experiences with dry eye disease and therapeutic contact lenses. METHODS: A survey was distributed to patients with dry eye disease. Demographics, Ocular Surface Disease Index (OSDI), systemic disease, contact lens history, and burden of care information were collected. Descriptive statistics are presented and categorized by nonlens, soft lens, and scleral lens (SL) wearers. RESULTS: Of 639 respondents, 15% (94/639) were currently using therapeutic soft or SLs (47 soft and 69 SL). Mid-day fogging or clouding of vision was reported by SL (75%, 50/67) and soft lens (62%, 29/47) wearers. Seventy-two percent of SL wearers spent more than 20 min daily on dry eye treatment while 43% of soft lens wearers spent more than 20 min. Median annual expenditure was higher for SL ($1,500, n=63) than nonlens ($500, n=371) or soft lens wearers ($700, n=43). Mean OSDI scores in all groups were in the severe category (51±22 years, n=401 nonlens wearers; mean age; 45±22 years, n=47 soft lens wearers; 60±24 years, n=69 SL wearers). CONCLUSIONS: Mid-day fogging and blurring of vision was reported by most of the individuals using therapeutic lenses for dry eye disease. SL wearers allocate the most resources for dry eye care.

Studies of Vision in Cricket-A Narrative Review.

Vision is thought to play a substantial role in hitting and fielding in cricket. An understanding of which visual skills contribute during cricket play could inform future clinical training trials. This paper reviews what has been reported thus far regarding the relationship of visual skills to cricket performance and reviews the results of clinical trials in which the impact of visual skills training on cricket performance has been addressed. Fundamental or low-level visual skills, with the exception of color vision and perhaps near stereopsis and dynamic visual acuity, are similar between cricket players and the general population. Simple reaction time has been found to be shorter in cricket players in some but not all studies. While there is mixed or no evidence that the aforementioned visual skills are superior in cricket players compared to non-players, comparisons of eye and head movements and gaze tracking have revealed consistent differences between elite cricket batters and sub-elite batters. Future training studies could examine whether teaching sub-elite batters to emulate the gaze tracking patterns of elite batters is beneficial for batting. Lastly, clinical trials in which visual skills of cricket players have been trained have in many cases resulted in positive effects on visual skills, or judgments required in cricket, or cricket play. However, clinical trials with larger and more diverse groups of participants and correlations to on-field metrics and on-field performance (i.e., domain-specific assessments) are necessary before conclusions can be drawn regarding the efficacy of vision training.

Graduating optometry student perceptions of their scleral lens fitting knowledge.

Although optometric programs have incorporated scleral lens (SL) education into their curricula, actual student experiences with SL fitting varies widely. This survey study describes the SL fitting and training experiences of graduating optometry students in US schools and colleges. Participants (323) were fourth-year students preparing to graduate in 2020 (19% response rate). Students appeared to have insufficient SL fitting practice, the median number of SL evaluations completed before graduation was 5 (range 0-110) and 63% reported less than 10 fits. Students with an interest in fitting SLs may wish to pursue additional training opportunities, such as residency, to acquire further experience before achieving sufficient proficiency with SLs.

Novel silicone elastomer contact lenses designed for simultaneous viewing of distance and near eye displays.

SIGNIFICANCE: As technology advances, there is a need for a safe and well-fitting contact lens that can be utilized to carry embedded components without concerns of decreasing oxygen permeability to the eye. PURPOSE: The purpose of this study was to assess fitting characteristics, vision and performance of a novel ultra-high Dk silicone elastomer contact lens having a fully encapsulated two-state polarizing filter and a high-powered central lenslet that allows viewing at distance and viewing of a near eye display, while managing the concomitant high water vapor permeability of the material. METHODS: 15 participants were fit with the silicone elastomer study lenses. Biomicroscopy was conducted before and after lens wear. Visual acuity with manifest refraction and visual acuity with an over-refraction while wearing the plano-powered study lenses were measured. Participants wore spectacles with micro-displays at the focal length of the lenslet on each eye. Lens fit was assessed including ease of lens removal. Subjective assessments of viewing the micro-displays were completed on a 1(unable) to 10(immediate/profound/stable) scale. RESULTS: Biomicroscopy revealed no eyes had moderate or severe corneal staining after study lens wear. Mean (±standard deviation) LogMAR acuity for all eyes was -0.13(0.08) with best corrected refraction and -0.03(0.06) with the study lenses and over-refraction. Mean spherical equivalent of the manifest refraction for both eyes was -3.12 D and was -2.75 D over the plano study lenses. Subjective assessments revealed a mean score of 7.67(1.91) for ease of obtaining fusion; 8.47(1.30) for ease of observing three-dimensional vision, and 8.27(1.49) for stability of the fused binocular display vision. CONCLUSION: The silicone elastomer study lenses with a two-state polarizing filter and central lenslet allow for vision at distance and on spectacle mounted micro-displays.

Efficacy and Safety of 0.01% and 0.02% Atropine for the Treatment of Pediatric Myopia Progression Over 3 Years: A Randomized Clinical Trial.

Importance: The global prevalence of myopia is predicted to approach 50% by 2050, increasing the risk of visual impairment later in life. No pharmacologic therapy is approved for treating childhood myopia progression. Objective: To assess the safety and efficacy of NVK002 (Vyluma), a novel, preservative-free, 0.01% and 0.02% low-dose atropine formulation for treating myopia progression. Design, Setting, and Participants: This was a double-masked, placebo-controlled, parallel-group, randomized phase 3 clinical trial conducted from November 20, 2017, through August 22, 2022, of placebo vs low-dose atropine, 0.01% and 0.02% (2:2:3 ratio). Participants were recruited from 26 clinical sites in North America and 5 countries in Europe. Enrolled participants were 3 to 16 years of age with -0.50 diopter (D) to -6.00 D spherical equivalent refractive error (SER) and no worse than -1.50 D astigmatism. Interventions: Once-daily placebo, low-dose atropine, 0.01%, or low-dose atropine, 0.02%, eye drops for 36 months. Main Outcomes and Measures: The primary, prespecified end point was the proportion of participants' eyes responding to 0.02% atropine vs placebo therapy (<0.50 D myopia progression at 36 months [responder analysis]). Secondary efficacy end points included responder analysis for atropine, 0.01%, and mean change from baseline in SER and axial length at month 36 in a modified intention-to-treat population (mITT; participants 6-10 years of age at baseline). Safety measurements for treated participants (3-16 years of age) were reported. Results: A total of 576 participants were randomly assigned to treatment groups. Of these, 573 participants (99.5%; mean [SD] age, 8.9 [2.0] years; 315 female [54.7%]) received trial treatment (3 participants who were randomized did not receive trial drug) and were included in the safety set. The 489 participants (84.9%) who were 6 to 10 years of age at randomization composed the mITT set. At month 36, compared with placebo, low-dose atropine, 0.02%, did not significantly increase the responder proportion (odds ratio [OR], 1.77; 95% CI, 0.50-6.26; P = .37) or slow mean SER progression (least squares mean [LSM] difference, 0.10 D; 95% CI, -0.02 D to 0.22 D; P = .10) but did slow mean axial elongation (LSM difference, -0.08 mm; 95% CI, -0.13 mm to -0.02 mm; P = .005); however, at month 36, compared with placebo, low-dose atropine, 0.01%, significantly increased the responder proportion (OR, 4.54; 95% CI, 1.15-17.97; P = .03), slowed mean SER progression (LSM difference, 0.24 D; 95% CI, 0.11 D-0.37 D; P < .001), and slowed axial elongation (LSM difference, -0.13 mm; 95% CI, -0.19 mm to -0.07 mm; P < .001). There were no serious ocular adverse events and few serious nonocular events; none was judged as associated with atropine. Conclusions and Relevance: This randomized clinical trial found that 0.02% atropine did not significantly increase the proportion of participants' eyes responding to therapy but suggested efficacy for 0.01% atropine across all 3 main end points compared with placebo. The efficacy and safety observed suggest that low-dose atropine may provide a treatment option for childhood myopia progression. Trial Registration: ClinicalTrials.gov Identifier: NCT03350620.

Prescription Habits of Scleral Lenses for the Management of Corneal Irregularity and Ocular Surface Disease Among Scleral Lens Practitioners.

OBJECTIVES: To describe prescribing patterns of therapeutic scleral lenses (SLs) in the management of corneal irregularity and ocular surface disease among practitioners who prescribe SLs. METHODS: Participants ranked treatment options for corneal irregularity and ocular surface disease in the order they would generally consider using them in an electronic survey. Median rank score for each option is reported, along with the percentage of participants assigning first place ranking to each option. The percentage of participants assigning first, second, or third place ranking to each option is also reported. RESULTS: Seven hundred and seventy-eight practitioners participated. Scleral lenses are most frequently considered as the first choice for the management of corneal irregularity based on overall median rank, followed by corneal rigid lenses (rigid gas-permeable [RGPs]). Scleral lenses were the first choice of 42% of participants, followed by RGPs (20%). For ocular surface disease, lubricant drops are most frequently used first, followed by meibomian gland expression, topical cyclosporine or lifitegrast, topical steroids, punctal plugs, and SLs, respectively. Lubricant drops were the first therapeutic option considered for ocular surface disease by 63% of participants and 45% ranked SLs as their sixth, seventh or eighth treatment based on median overall rank. CONCLUSIONS: Scleral lenses were identified as the first option for management of corneal irregularity more frequently than RGPs. Scleral lenses are considered for management of ocular surface disease before surgical intervention but after meibomian gland expression, punctal occlusion, and topical medical therapy are attempted.

Scleral lens prescription and management practices: Emerging consensus.

PURPOSE: To describe international scleral lens prescription and management practices across multiple practice types. METHODS: For this cross-sectional study, scleral lens practitioners were asked to complete an electronic survey that requested information about a single scleral lens patient. Data collected included practitioner demographics (practice type, country, years of experience) and patient indications for scleral lens wear, fitting process, lens design, and care products. RESULTS: Data were collected for 259 patients (419 eyes). Most participants (60%) practiced in the US, 75% worked primarily in community practice, and 58% claimed more than 5 years' experience fitting scleral lenses. Indications for scleral lens wear were corneal irregularity (87%), ocular surface disease (9%), and uncomplicated refractive error (4%). During the fitting process, the mean (SD) number of lenses ordered was 2.4 (1.6) (range, 1-16 lenses) during 3.8 (2.4) visits (range, 1-18 visits). Of patients, 62% used a daily surfactant cleaner, 47% used hydrogen peroxide disinfection, and 67% used single-use vials of nonpreserved saline. Mean lens diameter was 16.2 (1.1) mm (range, 11.8-23.0 mm). The landing zones were spherical (64%), toric (26%), quadrant-specific (7%), and custom (3%) designs. Optical power was spherical in 70%, toric in 27%, and higher-order aberration correcting in 3% of lenses. Only 5 lenses had multifocal optics. CONCLUSIONS: General consensus regarding prescribing patterns (lens design, wearing schedules, care products) between US vs non-US, community vs academic, and new vs established providers is reported in this study. Relatively low percentages of patients wearing lenses with advanced landing zones or optical designs suggest that these new options have not been widely adopted.

Trends in Scleral Lens Fitting Practices: 2020 Scleral Lenses in Current Ophthalmic Practice Evaluation Survey.

OBJECTIVES: To explore trends in demographic characteristics of scleral lens (SL) practitioners and primary indications for SL fitting over 5 years. METHODS: An online survey similar to the 2015 Scleral Lenses in Current Ophthalmic Practice Evaluation (SCOPE) study was designed and administered from November 8, 2019, through March 31, 2020, to attendees at two international contact lens meetings, members of the Scleral Lens Education Society, and participants in the 2015 SCOPE study. Practitioners reporting at least five completed SL fits were included in the analysis. RESULTS: Of 922 respondents, 777 had fit at least five SLs: 63% from the United States (59 other countries were represented), findings similar to the 2015 survey, in which 799 respondents (72%) were US-based and 49 from other countries. Most practitioners were in community practice (76%) than academic practice (24%). In 2015, 64% were in community practice and 36% in academic practice. A median of 84% of SLs were fit for corneal irregularity, 10% for ocular surface disease, and 2% for uncomplicated refractive error. In comparison, the 2015 indications were 74%, 16%, and 10%, respectively. The median number of fits completed per practitioner was 100 (range, 5-10,000; mean [SD] 284 [717]; n=752). In 2015, the median was 36 (range, 5-3,600; mean [SD] 125 [299]; n=678). CONCLUSIONS: The number of experienced SL practitioners is increasing, as is international representation. Most practitioners practice in community rather than academic settings. SLs continue to be primarily prescribed for corneal irregularity and are rarely used solely for correction of refractive error.

Wear Experience with a daily disposable soft contact lens for astigmatism in current wearers of a reusable soft toric contact lens.

Objective: The purpose of this study was to evaluate the wear experience of satisfied wearers of a particular reusable toric soft contact lens when refit into a water surface technology daily disposable toric soft contact lens. Methods: 30 participants completed the study over three visits. At the first visit, subjects were refit into with their habitual reusable toric soft contact lens (comfilcon A) to maximize fit and vision. Subjects returned after one week and were then refit into the study daily disposable soft contact lenses (verofilcon A) and completed surveys of their initial impressions of comfort, vision, and satisfaction. Participants wore the study lenses for two weeks, and then returned for their final visit to complete a vision and ocular health check. At the final visit, subjects also completed surveys to rate their overall and end-of-day comfort, quality of vision, stability of vision, and dryness using a visual analog scale (VAS). Participants also answered questions about their wear experience with the lenses. Overall median and interquartile range (IQR) of all data and surveys was calculated. Results: Initial impressions of the study lenses revealed a median (IQR) score of 85 (28) for vision, 91 (25) for comfort, and 87 (21) for satisfaction. Overall VAS scores after two weeks of wear found median scores of 93 (16) for quality of vision, 88 (28) for stability of vision, and 91 (20) for comfort. End-of-day median scores were 82(27) for quality of vision, 90 (35) for stability of vision, and 80 (38) for comfort. Overall dryness scores were 20(45) and end-of-day dryness was 39 (46). Median(IQR) binocular logMAR visual acuity with the study lenses was -0.16(0.1). Median rotation of the lenses was 0(4.3) degrees. Conclusion: Participants wearing the daily disposable study lenses for astigmatism gave high scores in vision and comfort both at initial fitting and after two weeks of lens wear. Results showed that satisfied wearers of comfilcon A reusable toric soft contact lenses can be successfully refit with verofilcon A daily disposable contact lenses.

Normative Performance Profiles of College Aged Esport Athletes in a Pilot Study.

Aims: This study aimed to holistically assess the physical and cognitive attributes of esport athletes. Methods and Results: Forty-six adults between 18 and 32 years old with experience playing videogames were enrolled in this study. Participants completed assessments in five areas: demographics, self-report questionnaires, cognitive performance, physical performance, and gaming performance. Participants self-reported Overwatch ranking and physical activity participation (Pediatric Physical Activity Measure), and grip strength was measured with a handheld dynamometer. Seven domains of physical, mental, and social health and well-being were measured with the Patient Reported Outcomes Measurement Information System (PROMIS-29). The List Sorting Working Memory Test and Picture Sequence Memory Test from the National Institutes of Health (NIH) Toolbox Cognition Batteries were used to measure cognitive performance. Finally, esports performance was measured using a series of tasks through Alienware Academy and AIM Booster to record accuracy, reaction time, and targets hit. Participants were separated into high and low ranking groups for comparisons. This sample of esport athletes was similar to the general population for grip strength, each of the PROMIS-29 metrics, the List Sorting Working Memory Test, and the Picture Sequence Memory Test. Reaction time was the variable with the only significant difference between ranking groups. Conclusion: This study represents a primary investigation of esport athletes using a holistic approach. By incorporating physical and cognitive components, the most important factors to esport athletes' health and performance can be better understood and applied.

Evaluation of Wear Experience with Soft Daily Disposable Lenses for Astigmatism over 16 Hours of Wear.

Objective: The purpose of this study was to assess the wear experience of participants while wearing a toric daily disposable contact lens with water surface technology over long days of lens wear. Methods: Existing soft toric contact lens wearers were fit with the daily disposable study lenses. Participants assessed their initial comfort, vision, and satisfaction with the lenses by visual analog scale (VAS) survey. After a successful 1-week follow-up visit, participants were scheduled for 5 survey days, in which surveys were deployed to their smartphones for immediate assessments of comfort and quality of vision on a 1-10 scale at 10, 12, 14, and 16 hours of lens wear on 5 subsequent weeknights. The final study visit assessed visual acuity, and overall lens wear experience surveys were completed with VAS surveys. The overall median and interquartile (IQR) range of all surveys were calculated. Results: Thirty bilateral toric lens wearers completed the study. Median (IQR) initial impression VAS scores were 97(12) for quality of vision, 100(9) for comfort, and 96(10) for satisfaction. Median evening surveys resulted in comfort scores of 10(1) at 10 hours, 9(2) at 12 hours, 9(2) at 14 hours, and 8(2) at 16 hours of wear. Median evening surveys resulted in quality of vision scores of 10(1) at 10 hours, 10(2) at 12 hours, 9(2) at 14 hours, and 9(3) at 16 hours of wear. VAS scores for overall experience were 97(9) for comfort, 95(13) for vision, and 8(31) for dryness. End-of-day VAS scores were 93(21) for comfort, 90(15) for vision, and 21(38) for dryness. Mean (±standard deviation) OU LogMAR visual acuity with the study lenses was -0.19(0.06). Conclusion: Surveys of wear experience resulted in high scores for comfort and vision over the course of a long day of wear with the daily disposable study lenses in this population of patients with astigmatism.

Long Day Wear Experience with Water Surface Daily Disposable Contact Lenses.

Objective: The purpose of this study was to assess the wear experience of silicone hydrogel daily disposable contact lenses with water surface technology over a long day of lens wear. Methods: Thirty-five soft contact lens wearers were refit with the daily disposable study lenses and participants scored their initial impressions of comfort, vision and satisfaction using a visual analog scale (VAS). Participants used their smart phones to complete surveys of comfort and vision on a scale of 1-10 at 10, 12, 14, and 16 hours of lens wear on 5 weeknights. A participant score for each time point was calculated by averaging the evening responses. End of study VAS surveys of symptoms were also completed. Results: Median (Interquartile Range) VAS initial impression scores were 99.00 (12.00) for quality of vision, 98.00 (16.00) for comfort, and 100.00 (13.00) for satisfaction. The end of study surveys found end of day median VAS scores of 87.00 (19.00) for end of day quality of vision and 75.00 (24.50) for end of day comfort. The median score for overall quality of vision was 93.00 (14.00) and for overall comfort was 93.00 (16.50). The median score for end of day dryness was 37.00 (55.00) and overall dryness was 13.00 (34.00). Conclusion: The daily disposable lenses with water surface treatment used in this study maintained high median scores for comfort and quality of vision for up to 16 hours of wear.

Arousal/Stress Effects of "Overwatch" eSports Game Competition in Collegiate Gamers.

ABSTRACT: Kraemer, WJ, Caldwell, LK, Post, EM, Beeler, MK, Emerson, A, Volek, JS, Maresh, CM, Fogt, JS, Fogt, N, Häkkinen, K, Newton, RU, Lopez, P, Sanchez, BN, and Onate, JA. Arousal/stress effects of "Overwatch" eSports game competition in collegiate gamers. J Strength Cond Res 36(10): 2671-2675, 2022-To date, no physical response data are available for one of the most popular eSport games, Overwatch . The purpose of this investigation was to describe the stress signaling associated with competitive Overwatch play and to understand how acute hormonal responses may affect performance. Thirty-two male college-aged gamers (age: 21.3 ± 2.7 years; estimated time played per week: 18 ± 15 hours) completed the study. Subjects were randomly assigned to a 6-player team to compete in a tournament-style match. Salivary measures of cortisol and testosterone were collected immediately before (PRE) and after (POST) the first-round game, with the heart rate recorded continuously during the match. The mean characteristics were calculated for each variable and comparisons made by the skill level. Significance was defined as p ≤ 0.05. There were no differences in measures of salivary cortisol. A differential response pattern was observed by the skill level for testosterone. The low skill group displayed a significant increase in testosterone with game play (mean ± SD , testosterone PRE: 418.3 ± 89.5 pmol·L -1 , POST: 527.6 ± 132.4 pmol·L -1 , p < 0.001), whereas no change was observed in the high skill group. There were no differences in heart rate characteristics between skill groups. Overall, the average heart rate was 107.2 ± 17.8 bpm with an average max heart rate of 133.3 ± 19.1 bpm. This study provides unique physiological evidence that a sedentary Overwatch match modulates endocrine and cardiovascular responses, with the skill level emerging as a potential modulator.

Wear Experience of a Water Surface Daily Disposable Contact Lens in Existing Silicone Hydrogel Planned Replacement Lens Wearers.

Purpose: The health benefits of silicone hydrogel lens materials and a daily replacement modality have been demonstrated in previous studies; however, existing planned replacement lens wearers may resist changing to a new lens replacement schedule. The purpose of this study is to evaluate the wear experience of satisfied planned replacement silicone hydrogel wearers when refit into a silicone hydrogel daily disposable lens. Patients and Methods: In this open-label, non-comparison study, satisfied wearers of two week planned replacement contact lenses were evaluated for inclusion criteria and refit with optimized prescriptions in their habitual lenses. At a follow-up visit one week later, participants were refit with the study daily disposable lenses and completed visual analog scale (VAS) surveys of initial quality of vision, comfort, and satisfaction. Participants returned for a final visit after two weeks of wearing the study daily disposable lenses. At the final visit, VAS surveys for both overall and end of day (EOD) vision, comfort, and dryness were completed. Overall median and interquartile range (IQR) were assessed for all surveys in the study. Results: Thirty individuals completed the study (29.1 ± 7.8 years old; 19 female). Median (IQR) results for the initial impression VAS surveys were 92.50(11.75) for quality of vision, 92.50(18.00) for comfort, and 93.00(18.00) for satisfaction. Final VAS survey results revealed median scores of 87.50(25.00) for EOD quality of vision and 82.50(51.25) for EOD comfort. The median overall quality of vision was 91.00(17.00) and overall comfort was 93.00(28.50). Median (IQR) overall dryness was 28.50(49.00) and median EOD dryness was 30.50(64.25). Conclusion: The findings of this study suggest that providers can successfully refit satisfied wearers of early generation silicone hydrogel planned replacement lenses into a new generation silicone hydrogel daily disposable lens while maintaining satisfaction.

EVALUATION OF WEAR EXPERIENCE WITH WATER SURFACE DAILY DISPOSABLE LENSES IN SATISFIED REUSABLE SOFT CONTACT LENS WEARERS.

Introduction: Soft contact lens wearers are often prescribed the same lens material and modality for multiple years if patients express satisfaction and no significant problems with lens fit or ocular health are noted upon evaluation. Despite their satisfaction, it is possible that other lenses exist that could provide additional health or convenience benefits and still provide satisfied lens wear experience. Methods: In this study, wearers of a specific monthly replacement lens brand (comfilcon A) were recruited for an open-label study. The habitual contact lens prescription was optimized for 2 weeks of wear and participants confirmed that they were satisfied with their habitual lenses before being refit with daily disposable lenses (verofilcon A). Participants responded to visual analog scale (VAS) survey about their initial impressions of the lenses. After 2 weeks of lens wear, participants completed a final study visit and completed surveys about lens wear experiences with the daily disposable study lenses. Results: Fifteen male and 15 female participants completed the study. Median (IQR) binocular LogMAR visual acuity was -0.20(0.12), which is equivalent to 10/12.5 Snellen acuity. Initial impression surveys revealed median (interquartile range) of 92.5(22.3) for quality of vision; 95.0(19.3) for comfort; and 91.5(19.3) for satisfaction. At the final visit, median scores for EOD quality of vision was 86.5(24.0); EOD comfort was 84.5(30.3), and EOD dryness 25.5(47.0). Median overall VAS scores were 92.5(16.0) for vision; 88.0(18.3) for comfort, and 17.5(25.8) for dryness. Median satisfaction with the study lenses was scored 9(2.8) on a 1-10 scale. Conclusions: In this study, satisfied wearers of comfilcon A reusable lens were refit with Verofilcon A daily disposable lenses and showed high satisfaction scores with the new lenses, showing that refitting these patients can allow patients to have lenses with more frequent replacement and maintain satisfaction with daily lens wear.