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Zhu Q, Wang Y, Wang L, Su G. Elucidating acceptance and clinical indications to support the rational design of drug-eluting contact lenses. Int J Pharm 2024; 665:124702. [PMID: 39270761 DOI: 10.1016/j.ijpharm.2024.124702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/22/2024] [Accepted: 09/10/2024] [Indexed: 09/15/2024]
Abstract
The advent of drug-eluting contact lenses (DECLs) has opened up new avenues for the treatment of eye diseases. DECLs is expected to partially overcome the shortcomings of eye drops due to single-dose packaging, accurate dosing, prolonged drug elution behavior, and simplified dosing procedures. Currently, a significant proportion of the DECLs design effort has been directed towards enhancing the compatibility of contact lenses with drugs. The appropriate elution time for the drug remains unclear. Additionally, it is ambiguous for which ophthalmic diseases DECLs offers the greatest therapeutic advantage. To rationally design DECLs in practice, it is necessary to understand the acceptance of DECLs by patients and practitioners and to clarify the indications for DECLs. This review will first focus on the acceptance of DECLs by different patients and practitioners and discuss the factors that influence its acceptance. Secondly, this review presents an overview of the current effectiveness of DECLs treatments in animals and in the clinical phase, with a particular focus on the suitability of DECLs for the treatment of ophthalmic diseases. Overall, patients and practitioners expressed positive attitudes towards DECLs. However, this is related to factors such as DECLs' treatment cycle, safety, and price. In addition, DECLs has good application prospects for ocular wound healing, postoperative management, and treatment of contact lenses-related complications. Furthermore, chronic diseases such as glaucoma that necessitate long-term medication and intraocular diseases that require implants or injections represent additional potential applications for DECLs. It is hoped that this review will facilitate a deeper understanding of DECLs acceptance and indications, thereby supporting the rational design of DECLs. At the same time, this review provides a reference for the design of other drug-device combination products.
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Affiliation(s)
- Qiang Zhu
- School of Pharmacy, Jiangsu Key Laboratory of Inflammation and Molecular Drug Targets, Nantong University, Nantong 226001, China
| | - Yong Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Nantong University and First People's Hospital of Nantong City, Nantong 226001, China
| | - Linlin Wang
- Department of Food Engineering, Shandong Business Institute, Yantai 264670, China
| | - Gaoxing Su
- School of Pharmacy, Jiangsu Key Laboratory of Inflammation and Molecular Drug Targets, Nantong University, Nantong 226001, China.
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Caffery B, Pucker AD, Chidi-Egboka NC, Obinwanne CJ, Harkness B, Carnt NA, Liu SH, Ng A. Lubricating drops for contact lens discomfort in adults. Cochrane Database Syst Rev 2024; 9:CD015751. [PMID: 39234924 PMCID: PMC11375780 DOI: 10.1002/14651858.cd015751.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
BACKGROUND Contact lens discomfort is a symptom-based clinical diagnosis that affects 13% to 75% of contact lens wearers. The Tear Film and Ocular Surface Society defines contact lens discomfort as "a condition characterized by episodic or persistent adverse ocular sensations related to lens wear either with or without visual disturbance, resulting from reduced compatibility between the lens and ocular environment, which can lead to decreased wearing time and discontinuation from lens wear." Signs of the condition include conjunctival hyperemia, corneal and conjunctival staining, altered blinking patterns, lid wiper epitheliopathy, and meibomian gland dysfunction. Eye care specialists often treat contact lens discomfort with lubricating drops, including saline, although there is no clear evidence showing this treatment is effective and safe. OBJECTIVES To evaluate the efficacy and safety of lubricating drops for ocular discomfort associated with contact lens wear in adults. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE, Embase.com, two other databases, and two trials registries to May 2024, without date or language restrictions. SELECTION CRITERIA We included parallel-group randomized controlled trials (RCTs) that evaluated lubricating drops, including saline, versus no treatment, or that evaluated lubricating drops versus saline, in adult contact lens wearers. We included studies regardless of publication status, language, or year of publication. DATA COLLECTION AND ANALYSIS We applied standard Cochrane methodology. The critical outcome was contact lens discomfort. Important outcomes were corneal fluorescein staining and conjunctival redness. Adverse outcomes were incident microbial keratitis, inflammatory corneal infiltrates, and participant discontinuation. We assessed risk of bias for outcomes reported in the summary of findings table using the Cochrane risk of bias tool RoB 2, and we rated the certainty of the evidence using GRADE. MAIN RESULTS We included seven RCTs conducted in the USA, Canada, Italy, and France. They randomized a total of 463 participants to lubricating drops, saline, or no treatment. Four trials evaluated lubricating drops and saline versus no treatment, but one of them provided no usable outcome data. Three trials evaluated lubricating drops versus saline. Study characteristics All trial participants were adults, and the mean age ranged from 25.7 years to 36.7 years. The proportion of women varied from 15% to 82%. The trials lasted between one and four weeks. Of the five trials that reported contact lens discomfort, we judged three at high risk of bias, and considered the other two had some risk of bias concerns. Lubricating drops (including saline) versus no treatment Lubricating drops compared with no treatment may reduce contact lens discomfort, measured on a 37-point scale (lower is better), but the evidence is very uncertain (mean difference [MD] -5.9 points, 95% confidence interval [CI] -3.74 to -8.05; 2 RCTs; 119 participants). One trial found no difference between lubricating drops and no treatment in "end-of-day" comfort. The trial that compared saline with no treatment provided no results for the control group. Two studies measured corneal fluorescein staining on a scale of 0 to 20 (lower is better). We found low-certainty evidence of little to no difference between lubricating drops and no treatment in changes in the extent (MD -0.15 points, 95% CI -0.86 to 0.56; 2 RCTs; 119 participants), depth (MD -0.01 points, 95% CI -0.44 to 0.42; 2 RCTs; 119 participants), or type (MD 0.04 points, 95% CI -0.38 to 0.46; 2 RCTs; 119 participants) of corneal fluorescein staining scores. Regarding conjunctival redness, measured on a scale of 0 to 4 (lower is better), there was low-certainty evidence of little to no difference between lubricating drops and no treatment in nasal region scores (MD 0.10, 95% CI -0.29 to 0.49; 1 RCT; 73 participants) and temporal region scores (MD 0.00, 95% CI -0.39 to 0.39; 1 RCT; 73 participants). No studies reported microbial keratitis or inflammatory corneal infiltrates, and no trials reported vision-threatening adverse events up to four weeks of treatment. All trials reported the proportion of participants who discontinued participation. In two trials, no participants left any treatment group. Our meta-analysis of another two studies suggests little difference in the number of people who dropped out of the lubricating treatment group versus the no treatment group (risk ratio [RR] 1.42, 95% CI 0.19 to 10.94; 138 participants; low-certainty evidence). Lubricating drops versus saline Lubricating drops may have little to no effect compared with saline on contact lens discomfort measured on a visual analog scale of 0 to 100 (lower is better), but the evidence is very uncertain (MD 9.5 points, 95% CI -4.65 to 23.65; 1 RCT; 39 participants). No studies reported corneal fluorescein staining or conjunctival redness. No studies reported microbial keratitis or inflammatory corneal infiltrates, and no trials reported vision-threatening adverse events up to four weeks of treatment. Our meta-analysis of three studies suggests little difference in the number of people who dropped out of the lubricating treatment group versus the saline group (RR 1.56, 95% CI 0.47 to 5.12; 269 participants; low-certainty evidence). AUTHORS' CONCLUSIONS Very low-certainty evidence suggests that lubricating drops may improve contact lens discomfort compared with no treatment, but may have little or no effect on contact lens discomfort compared with saline. Low-certainty evidence also suggests that lubricating drops may have no unwanted effects that would lead to discontinuation over one to four weeks. Current evidence suggests that prescribing lubricating drops (including saline) to people with contact lens discomfort is a viable option. However, most studies did not assess patient-reported contact lens (dis)comfort using a validated instrument. Therefore, further well-designed trials are needed to generate high-certainty evidence on patient-reported outcomes as well as on longer-term safety outcomes.
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Affiliation(s)
| | - Andrew D Pucker
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ngozi C Chidi-Egboka
- School of Optometry and Vision Science, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
- Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Brooke Harkness
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Nicole A Carnt
- School of Optometry and Vision Science, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
- Institute of Ophthalmology, University College London, London, UK
| | - Su-Hsun Liu
- Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alison Ng
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
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Mimura T, Yamaguchi M, Noma H, Shinbo K. Subjective Symptoms of First-Time Wearers of Verofilcon A Silicone Hydrogel One-Day Disposable Contact Lenses: A First Time Use of Verofilcon A (FTVeA) Study. Cureus 2024; 16:e62344. [PMID: 39006615 PMCID: PMC11246540 DOI: 10.7759/cureus.62344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose: Verofilcon A, a new daily disposable silicone hydrogel soft contact lens (SCL), is expected to be more comfortable to wear due to its smooth surface. This study aims to compare the comfort level of verofilcon A with eyeglasses in first-time SCL wearers. Methods: A total of 58 new SCL wearers participated in this study. Participants' comfort scores while wearing glasses or verofilcon A were examined at baseline (glasses) and one and four weeks after starting to wear the SCLs. Results: At the end of the one-month study period, no participants had abandoned wearing the SCLs due to discomfort. The vision scores (1-10) for glasses (baseline) and SCLs (week one, week four) were better with SCLs than glasses in the morning (7.9 ± 1.9 vs 8.9 ± 1.3, 9.0 ± 1.2, p<0.01), during the day (8.0 ± 1.6 vs 9.0 ± 1.1, 8.9 ± 1.2, p<0.01), at the end of the day (7.2 ± 2.1 vs 8.5 ± 1.5, 8.7 ± 1.4, p<0.01), and the entire day (7.7 ± 1.7 vs 8.9 ± 1.2, 8.7 ± 1.3, p<0.01). The percentages of participants who agreed that wearing SCLs at week four was as good as or better than glasses in terms of overall vision, peripheral vision, vision at the end of the day, comfort during the day, comfort at the end of the day, less fatigue during the day, and less fatigue at the end of the day were 91.4%, 100.0%, 91.4%, 89.7%, 82.8%, 87.9%, and 89.7%, respectively. Of the participants, 93.1%, 100.0%, and 93.1% felt that the SCLs were easy to wear, more comfortable than expected, and would like to purchase the same lenses in the future, respectively. Conclusion: These findings suggest that verofilcon A is more comfortable than glasses and is effective as an introductory lens for first-time SCL wearers.
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Affiliation(s)
- Tatsuya Mimura
- Ophthalmology, Teikyo University School of Medicine, Tokyo, JPN
| | | | - Hidetaka Noma
- Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Hachioji, JPN
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Ravikumar A, Queener HM, Osae EA, Ritchey ER. A Hue-Value method for semi-automated assessment of Lid Wiper Epitheliopathy. Cont Lens Anterior Eye 2024; 47:102090. [PMID: 37977904 DOI: 10.1016/j.clae.2023.102090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Lid wiper epitheliopathy (LWE) is a marker of an abnormal lid/cornea interaction. This study proposes an automated Hue-Value grading algorithm of LWE staining following manual selection of the region of interest. METHODS Images of LWE staining were processed using Hue and Value from HSV (Hue-Saturation-Value) color space with a custom MATLAB program. Thirty-one images were successfully analyzed. Examiners analyzed images in random order twice, separated by more than a week. Bland Altman and Intraclass Correlation Coefficients (ICC) were performed. RESULTS There was no difference (p > 0.05) between upper (UL) and lower (LL) eyelids for LWE height (UL: 0.12 ± 0.12 mm, LL: 0.12 ± 0.07 mm), width (UL: 10.70 ± 3.84 mm, LL: 10.26 ± 3.49 mm), or area (UL: 2.85 ± 2.67 mm2, LL: 2.63 ± 1.71 mm2). There was no between examiner difference for all eyelid LWE height or area (p > 0.05), but a difference in LWE width (0.16 mm; p = 0.031). ICC for LWE height, width and area were 0.996 (95% CI: 0.993 to 0.998), 0.997 (95% CI: 0.992 to 0.998) and 0.999 (95% CI: 0.998 to 0.999). There was no between examiner difference for height or area (p > 0.05) for UL, but a difference in LWE width (0.28 mm; p = 0.026). ICC for height, width and area were 0.999 (95% CI: 0.996 to 1.00), 0.995 (95% CI: 0.982 to 0.999) and 1.00 (95% CI: 0.999 to 1.00). There was no difference in LWE height, width or area for LL (all p > 0.05). ICC were 0.991 (95% CI: 0.973 to 0.997) for height, 0.998 (95% CI: 0.995 to 0.999) for width and 0.997 (95% CI: 0.990 to 0.999) for area. CONCLUSIONS This novel method results in highly repeatable interexaminer measures of LWE staining after general lid region delineation. Small differences in LWE width were observed between examiners.
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Affiliation(s)
| | - Hope M Queener
- The University of Houston College of Optometry, Houston, TX, USA
| | - Eugene A Osae
- The University of Houston College of Optometry, Houston, TX, USA
| | - Eric R Ritchey
- The University of Houston College of Optometry, Houston, TX, USA.
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Itokawa T, Yamasaki K, Suzuki T, Koh S. Advances in Contact Lens Care Solutions: PVP-I Disinfectant and HAD Wetting Agents From Japan. Eye Contact Lens 2024; 50:91-101. [PMID: 38019569 DOI: 10.1097/icl.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2023] [Indexed: 11/30/2023]
Abstract
ABSTRACT Half of the individuals who wear contact lenses use reusable lenses that require proper care. Improper contact lens (CL) care and using inadequate disinfecting solutions can lead to lens contamination, CL-related microbial keratitis, and Acanthamoeba keratitis. Oxidative disinfecting solutions, such as hydrogen peroxide, show higher efficacy than multipurpose solutions. Povidone-iodine (PVP-I), an oxidative disinfectant used in ophthalmic surgery, has been proven to be safe and effective. The PVP-I system, a CL disinfecting solution developed in Japan, has demonstrated excellent antimicrobial and antiviral properties. Although CL discomfort does not have a risk of ocular disorders with poor visual prognosis, such as keratitis, CL discomfort can still lead to lens dropout and thus needs to be addressed. To mitigate CL discomfort, it is essential to use disinfecting solutions containing surfactants and wetting agents that improve wettability of the lens surface. A CL solution containing hyaluronic acid derivatives (HADs) as wetting agents that permanently adhere to the lens surface to improve wettability of the lens surface was developed in Japan. There is potential for HAD to be integrated into various solutions. This article reviews the efficacy of novel PVP-I-based disinfecting solution and HAD wetting agents.
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Affiliation(s)
- Takashi Itokawa
- Department of Ophthalmology (T.I., T.S.), Toho University, Tokyo, Japan; OPHTECS Corporation (K.Y.), Kobe Research Center, Kobe, Japan; Ishizuchi Eye Clinic (T.S.), Ehime, Japan; Department of Innovative Visual Science (S.K.), Osaka University Graduate School of Medicine, Osaka, Japan; and Department of Ophthalmology (S.K.), Osaka University Graduate School of Medicine, Osaka, Japan
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Preoteasa LD, Preoteasa D. Assessment of the prevalence and risk factors for dry eye symptoms among Romanian medical students using the ocular surface disease index - a cross-sectional study. BMC Ophthalmol 2024; 24:12. [PMID: 38182974 PMCID: PMC10768241 DOI: 10.1186/s12886-023-03260-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND This study aims to assess how Romanian medical students suffer from dry eye disease symptoms, establish the prevalence and severity of dry eye (DE) symptoms and identify potential risk factors. METHODS An analytical, cross-sectional study was conducted on students from "Carol Davila" University of Medicine, Romania, after the final examination period of July 2022. The OSDI score (Ocular Surface Disease Index©) was applied in an online survey. The study adopted the standards used by other authors, who defined symptomatic DED as an OSDI score greater than 12. The chi-square test was used to establish statistical significance at a cutoff value of p < 0.05. The predictive model was created using linear logistic regression analysis. The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test. When the severity outcome had a nominal categorical form, multinomial regression analysis with normal subjects as a reference was performed. The distribution of the severe type of symptomatology across sex categories and years of study was analyzed using a nonparametric test (Independent-Samples Kruskal-Wallis Test). RESULTS A total of 274 answers were received from 81.4% females and 18.6% males with a response rate of 35.58%. The mean age was 22.7 years ± 1.66 with an age range between 20 and 25 years old. Using the OSDI score, we established that the overall prevalence of DE symptoms was 83.6% (95%CI: 79.6%, 88%), with an 85.2% (95%CI: 80.5%, 89.8%) prevalence in females and 76.5% (95%CI: 65%,88%) in males. The severe form of DE was the most prevalent, regardless of the study year or sex. Increased screen time (p-value < 0.05) and non-smokers (p-value < 0.05) were proven risk factors. The predictive model which includes the explanatory variables (sex, contact lens wearers, smoking, oral contraceptives, screen time) proved an 84.7% predictability for symptomatic DE and was able to better predict the dependent variable than the intercept model only (p-value < 0.05). Smoking (p = 0.002) and screen time (p = 0.009) preserved their significance in the multinominal regression as well. CONCLUSIONS This is the first study to report the epidemiology of DE symptoms among Romanian medical students. OSDI revealed a high prevalence of symptomatic DE in medical students. Screen time, although not the only factor, likely plays a role in exacerbating the disease. This information can be used to inform healthcare policies, establish occupational health guidelines, and implement preventive measures for individuals in similar high-stress academic or professional environments.
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Affiliation(s)
- Laura Denisa Preoteasa
- Carol Davila University of Medicine and Pharmacy, Dionisie Lupu street, no 37, Bucharest, 030167, Romania.
- Department of Ophthalmology, Clinical Emergency Eye Hospital, Bucharest, Romania.
- Onioptic Hospital, Craiova, Romania.
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Yokoi N, Furusawa Y, Kato H, Kusada N, Sotozono C, Eftimov P, Georgiev GA. Characteristics of Pre-Lens Tear Film Behavior in Eyes Wearing Delefilcon A Silicone Hydrogel Water Gradient Contact Lenses. Diagnostics (Basel) 2023; 13:3642. [PMID: 38132226 PMCID: PMC10742534 DOI: 10.3390/diagnostics13243642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
The pre-lens tear film (PLTF) over (i) delefilcon A silicone hydrogel water gradient (WG; 33-80% from core to surface) contact lenses (CLs) (SHWG-CLs) and (ii) subjects' own non-WG soft CLs (SCLs) (SO-SCLs) was studied in 30 eyes of 30 subjects to assess the hypothesized PLTF stabilization over SHWG-CLs. In both eyes, delefilcon A SHWG-CLs (DAILIES TOTAL1®; Alcon, Fort Worth, TX, USA) or SO-SCLs were worn. After 15 min of wearing each lens, the tear meniscus radius (TMR, mm), lipid-layer interference grade (IG) and spread grade (SG), and non-invasive breakup time (NIBUT, seconds) were evaluated and compared between the SHWG-CLs and the SO-SCLs. The comparison between the SHWG-CL and SO-SCL groups (SHWG-CL and SO-SCL, mean ± SD) revealed that TMRs temporarily decreased and reached a plateau value after 15 min (0.21 ± 0.06; 0.21 ± 0.06) compared to the value prior to CL insertion (0.24 ± 0.08; 0.25 ± 0.08), with no significant difference between the two groups. The NIBUT, IG, and SG values after 15 min of wearing the CLs were (9.7 ± 3.7; 4.7 ± 4.2), (1.0 ± 0.2; 1.8 ± 1.0), and (1.1 ± 0.4; 1.9 ± 1.5), respectively, and all values were significantly better in the SHWG-CL group (p < 0.0001, p = 0.0039, and p < 0.0001, respectively). We found that compared to the SO-SCLs, the maintenance of the PLTF on the SHWG-CLs was supported by the thicker and more stable PLTF.
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Affiliation(s)
- Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yuki Furusawa
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Hiroaki Kato
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Natsuki Kusada
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Petar Eftimov
- Department of Cell and Developmental Biology, Faculty of Biology, St. Kliment Ohridski University of Sofia, 1164 Sofia, Bulgaria;
| | - Georgi As. Georgiev
- Department of Optics and Spectroscopy, Faculty of Physics, St. Kliment Ohridski University of Sofia, 1164 Sofia, Bulgaria;
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Ballesteros-Sánchez A, Gargallo-Martínez B, Sánchez-González MC, Sánchez-González JM. Intense pulsed light and low-level light therapy for treating meibomian gland dysfunction and evaporative dry eye. Indian J Ophthalmol 2023; 71:3730. [PMID: 37991314 PMCID: PMC10788759 DOI: 10.4103/ijo.ijo_1422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Affiliation(s)
| | - Beatriz Gargallo-Martínez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain
- Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain
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9
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Mylona I, Aletras V. Validation of the Greek version of the contact lens dry eye questionnaire-8 (CLDEQ-8). Cont Lens Anterior Eye 2023; 46:101890. [PMID: 37419783 DOI: 10.1016/j.clae.2023.101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/16/2023] [Accepted: 07/03/2023] [Indexed: 07/09/2023]
Abstract
PURPOSE Contact lens discomfort (CLD) has been cited as one of the prime reasons for discontinuing contact lens wear. The CLDEQ-8 was created in 2008 to reflect status of and change in overall opinion of soft contact lenses. The purpose of this study is to examine the validity and reliability of a Greek version of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8), using Rasch statistical analysis. METHODS This an observational prospective study of 150 consecutive patients who received soft contact lenses and were followed through with a single follow-up appointment up to a year following their initial one. The patients filled in the Greek versions of the CLDEQ-8, the Ocular Surface Disease Index (OSDI) and a self-report item on their experience of contact lens use. The CLDEQ-8 was analyzed with Rasch analytic methodology. RESULTS The original scoring system of the CLDEQ-8 had to be altered regarding the response categories collapsing in fewer options in items b, 2b, 3b and item 5 of the original scale. The revised scoring system proved more psychometrically valid and the CLDEQ-8 had good measurement precision, category threshold order, targeting and differential item functioning for gender. Two alternative result indexes are proposed, a symptom intensity index and a symptom frequency index to address dimensionality issues that are evident with the items relating to symptom intensity versus the rest. Results from the CLDEQ-8 correlated with the OSDI total score and the self-reported experience of contact lens use. CONCLUSIONS The Greek version of the CLDEQ-8 is a psychometrically valid and reliable assessment tool for contact lens discomfort in Greek-speaking populations.
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Affiliation(s)
- Ioanna Mylona
- Department of Ophthalmology, General Hospital of Katerini, Katerini, Greece.
| | - Vassilis Aletras
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece
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10
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Zhu Q, Zhang Q, Fu DY, Su G. Polysaccharides in contact lenses: From additives to bulk materials. Carbohydr Polym 2023; 316:121003. [PMID: 37321708 DOI: 10.1016/j.carbpol.2023.121003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 06/17/2023]
Abstract
As the number of applications has increased, so has the demand for contact lenses comfort. Adding polysaccharides to lenses is a popular way to enhance comfort for wearers. However, this may also compromise some lens properties. It is still unclear how to balance the variation of individual lens parameters in the design of contact lenses containing polysaccharides. This review provides a comprehensive overview of how polysaccharide addition impacts lens wear parameters, such as water content, oxygen permeability, surface wettability, protein deposition, and light transmittance. It also examines how various factors, such as polysaccharide type, molecular weight, amount, and mode of incorporation into lenses modulate these effects. Polysaccharide addition can improve some wear parameters while reducing others depending on the specific conditions. The optimal method, type, and amount of added polysaccharides depend on the trade-off between various lens parameters and wear requirements. Simultaneously, polysaccharide-based contact lenses may be a promising option for biodegradable contact lenses as concerns regarding environmental risks associated with contact lens degradation continue to increase. It is hoped that this review will shed light on the rational use of polysaccharides in contact lenses to make personalized lenses more accessible.
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Affiliation(s)
- Qiang Zhu
- School of Pharmacy, Nantong University, Nantong 226001, China
| | - Qiao Zhang
- Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Ding-Yi Fu
- School of Pharmacy, Nantong University, Nantong 226001, China
| | - Gaoxing Su
- School of Pharmacy, Nantong University, Nantong 226001, China.
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Yang Y, Wu Q, Tang Y, Wu H, Luo Z, Gao W, Hu Z, Hou L, Wang M, Yang Z, Li X. Short-term application of diquafosol ophthalmic solution benefits children with dry eye wearing orthokeratology lens. Front Med (Lausanne) 2023; 10:1130117. [PMID: 37521335 PMCID: PMC10374404 DOI: 10.3389/fmed.2023.1130117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This aim of this study was to evaluate the effect of 3% Diquafosol Ophthalmic Solution (DQS) on children with dry eye from wearing overnight orthokeratology (OrthoK) lenses. Methods Myopic children aged 8-18 years with dry eye syndrome were enrolled in this prospective observational study, and they were grouped according to their OrthoK treatment history for at least 1 year. All participants received DQS 4 times per day for 1 month. The following indicators were measured at baseline 1 month after treatment: the Dry Eye Questionnaire-5 (DEQ-5), non-invasive tear meniscus height (TMH), non-invasive tear film break-up time (first and average, NIBUT-F and NIBUT-A), meibomian gland score (MG score), conjunctival hyperemia redness score (R-scan), and blink pattern analysis. Results A total of 104 participants (189 eyes) including 40 OrthoK wearers (72 eyes) and 64 Orthok candidates (117 eyes) completed the study. Of all, after DQS treatment for 1 month, DEQ-5 scores reduced from 5.54 ± 3.25 to 3.85 ± 2.98 (t = -3.36, p = 0.00). TMH increased from 0.20 ± 0.05 mm to 0.21 ± 0.05 mm (t = 2.59, p = 0.01), NIBUT-F and NIBUT-A were prolonged from 6.67 ± 4.71 s to 10.32 ± 6.19 s and from 8.86 ± 5.25 s to 13.30 ± 6.03 s (all p = 0.00), respectively. R-scan decreased from 0.69 ± 0.28 to 0.50 ± 0.25 (t = -9.01, p = 0.00). Upper MG scores decreased from 1.04 ± 0.32 to 0.97 ± 0.36 (t = -2.14, p = 0.03). Lower MG scores, partial blink rate, partial blinks, and total blinks did not change significantly. Both break-up time (BUT) and R-scan improved significantly after DQS treatment for 1 month (all p = 0.00) in OrthoK candidates and OrthoK wearers. Among the OrthoK wearers, TMH and dry eye symptoms increased significantly (all p = 0.00) but did not increase in OrthoK candidates (p > 0.05). There were no adverse events related to DQS. Conclusion Diquafosol Ophthalmic Solution was effective for children wearing overnight orthokeratology in relieving dry eye symptoms and improving ocular surface parameters, which may help improve children's OrthoK wearing tolerance and compliance.
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Affiliation(s)
- Yuanfang Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Qinghui Wu
- Changsha Aier Eye Hospital, Changsha, China
| | - Yao Tang
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Haoran Wu
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Wenyu Gao
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Ziqi Hu
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Lijun Hou
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Min Wang
- Shanghai Aier Eye Hospital, Shanghai, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
- Changsha Aier Eye Hospital, Changsha, China
| | - Xiaoning Li
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
- Changsha Aier Eye Hospital, Changsha, China
- Aier College of Ophthalmology and Optometry, Hubei University of Science and Technology, Xianning, China
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12
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Deng M, Li M, Liu L, Shi Y, Sun L, Ma X, Zou J. Proteomic profiling of human corneal stroma from long-term contact lens wearers reveals activation of inflammatory responses. Cont Lens Anterior Eye 2023; 46:101820. [PMID: 36775668 DOI: 10.1016/j.clae.2023.101820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/26/2022] [Accepted: 01/29/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To investigate the association between proteomic changes and potential pathogenesis in the human cornea with respect to the duration of wearing soft contact lenses (SCLs). METHODS A total of 96 corneal stroma samples, obtained via small incision lenticule extraction (SMILE), were equally grouped according to the duration of wearing SCL: 0Y, did not wear SCL; 5Y, wore SCL for<5 years; 5-10Y, wore SCL for 5-10 years; O10Y, wore SCL for>10 years. Liquid chromatography-tandem mass spectrometry was used to identify and quantify protein profiles in the corneal stroma. Expression levels of CO1A1, CO4A1, NFKB1, and IL6RB were determined using western blot and immunohistochemistry analysis. RESULTS This study quantified a total of 5,668 proteins across samples and identified 2,379 differentially expressed proteins (DEPs) with significantly increased abundance in the three SCL-wearing groups compared with that in the non-SCL-wearing group. Compared with those in the 0Y group, the molecular functions of DEPs in the 5Y, 5-10Y, and O10Y groups were mainly related to translation regulator activity, antigen binding, peptidase inhibitor activity, participation in extracellular matrix (ECM) production, complement activation, and inflammatory responses. Pathway enrichment analysis of DEPs showed that the sphingolipid, phosphatidylinositol 3-kinase-protein kinase B, and hypoxia-inducible factor-1 signaling pathways were activated in the human corneal stroma after long-term SCL use. CONCLUSIONS Inflammation-related proteomic components in human corneal stroma increased after long-term use of SCL and may act as an essential factor in the molecular pathogenesis of corneal stroma damage.
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Affiliation(s)
- Manli Deng
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Min Li
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Lin Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yuehui Shi
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Lina Sun
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xiaoyun Ma
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
| | - Jun Zou
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Ophthalmology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
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Wróbel-Dudzińska D, Osial N, Stępień PW, Gorecka A, Żarnowski T. Prevalence of Dry Eye Symptoms and Associated Risk Factors among University Students in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1313. [PMID: 36674068 PMCID: PMC9859544 DOI: 10.3390/ijerph20021313] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Aim: The aim of the study was to demonstrate the prevalence and risk factors of dry eye symptoms (DES) among university students in Poland. Material and methods: A cross-sectional study survey was conducted among 312 Polish university students. The questionnaire consisted of the Ocular Surface Disease Index (OSDI), the 5-Item Dry Eye Questionnaire (DEQ-5) and questions regarding medical history and risk factors. Results: According to the OSDI, more than half of respondents (57.1%) have symptoms of ocular surface disease. Time spent using electronic devices is correlated with scores gathered in both OSDI and DEQ-5 (p < 0.001). There is a statistically significant dependence between psychotropics (p = 0.002), glucocorticosteroids usage (p = 0.026), the presence of depression (p < 0.001), diabetes (p = 0.01) or allergy (p = 0.008) and dry eye symptoms proved in both questionnaires. Respondents with refractive errors and those living in metropolitan areas have a statistically higher symptom intensity(p < 0.022). Stress felt by students is associated with higher DES risk. No correlation between DES and smoking habits was observed. The history of SARS-CoV-2 infection was associated with the severity of DES (p = 0.036). Conclusion: Pathogenesis of DES is multifactorial and its severity depends on several factors, both genetic and environmental. Its prevalence among the young population is underestimated. Determining risk factors will enable the implementation of appropriate prophylaxis and early diagnosis.
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Affiliation(s)
- Dominika Wróbel-Dudzińska
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland
| | - Natalia Osial
- Faculty of Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | | | - Adrianna Gorecka
- Faculty of Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Tomasz Żarnowski
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland
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Huang R, Su C, Fang L, Lu J, Chen J, Ding Y. Dry eye syndrome: comprehensive etiologies and recent clinical trials. Int Ophthalmol 2022; 42:3253-3272. [PMID: 35678897 PMCID: PMC9178318 DOI: 10.1007/s10792-022-02320-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/18/2022] [Indexed: 12/07/2023]
Abstract
Dry eye syndrome (DES) is multifactorial and likely to be a cause of concern more so than ever given the rapid pace of modernization, which is directly associated with many of the extrinsic causative factors. Additionally, recent studies have also postulated novel etiologies that may provide the basis for alternative treatment methods clinically. Such insights are especially important given that current approaches to tackle DES remains suboptimal. This review will primarily cover a comprehensive list of causes that lead to DES, summarize all the upcoming and ongoing clinical trials that focuses on treating this disease as well as discuss future potential treatments that can improve inclusivity.
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Affiliation(s)
- Ruojing Huang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Caiying Su
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Lvjie Fang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiaqi Lu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiansu Chen
- Institute of Ophthalmology, Medical College, Jinan University, Huangpu Avenue West 601, Tianhe District, Guangzhou, 510632, China.
| | - Yong Ding
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China.
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15
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Xu L, Wu Y, Song Y, Zhang Q, Qin G, Yang L, Ma J, Palme C, Moore JE, Pazo EE, He W. Comparison Between Heated Eye Mask and Intense Pulsed Light Treatment for Contact Lens-Related Dry Eye. Photobiomodul Photomed Laser Surg 2022; 40:189-197. [PMID: 35298282 DOI: 10.1089/photob.2021.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Contact lens-related dry eye (CLDE) is common in contact lens (CL) wearers and can lead to ocular pain, decreased visual quality, and reduced quality of life. Objective: The purpose of this prospective, randomized, examiner masked study was to compare the effectiveness of intense pulsed light (IPL) and heated eye mask (HEM) for relieving CLDE. Methods: The final analysis included 60 patients (30 in the IPL group and 30 in the HEM group) who were using CL and had been suffering contact lens discomfort for more than a year. The IPL treatment group had two IPL treatments spaced 3 weeks apart, whereas the HEM group received HEM daily for 6 weeks (42 days). Non-invasive tear break-up time (NITBUT), tear-film lipid layer (TFLL), conjunctival fluorescein staining, meibum gland quality and expression, conjunctival redness score, ocular surface disease index (OSDI), best-corrected visual acuity, endothelial cell count, and intraocular pressure were assessed at baseline: first visit (V1), second visit (V2), and third visit (V3). Results: The mean age of the IPL group was 28.6 ± 4.3 years (16 females, 53%) and that of the HEM group was 28.6 ± 4.2 years (16 females, 53%). Mean NITBUT for the IPL group at V2 was 5.53 ± 0.77 sec (p < 0.001) and at V3 was 7.72 ± 0.88 sec (p < 0.001); the IPL group demonstrated a clinically and statistically significant improvement in mean NITBUT. In addition, the HEM group showed a clinically and statistically significant improvement in mean NITBUT at V3 (5.86 ± 0.76 sec, p < 0.001). At V3, the C-OSDI, TFLL score, and meibum gland quality and expressibility all increased considerably (p < 0.05) in both groups. Conclusions: Our results imply that IPL or HEM treatment of CLDE can be safely used to relieve symptoms of CLDE. In addition, IPL treatment is more effective in improving the general stability of the tear-film and decreasing the need for artificial tears in CLDE.
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Affiliation(s)
- Ling Xu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Yi Wu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yilin Song
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qing Zhang
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guanghao Qin
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lanting Yang
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jinfei Ma
- Breast Cancer, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, China
| | - Christoph Palme
- Department of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Austria
| | - Jonathan E Moore
- Cathedral Eye Clinic, Belfast, United Kingdom.,Aston University, Birmingham, United Kingdom
| | - Emmanuel Eric Pazo
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Wei He
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
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Alamri A, Amer KA, Aldosari AA, Al-Muhsin SD, Al-Maalwi RS, Al Hamdan SA, Al-Tarish LM. Assessment of Dry Eye Syndrome Among Contact Lens Users in Asir Region, Saudi Arabia. Cureus 2022; 14:e21526. [PMID: 35223301 PMCID: PMC8863558 DOI: 10.7759/cureus.21526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2022] [Indexed: 11/12/2022] Open
Abstract
Background Patients with contact lens-associated dry eye (CLADE) disease had different symptoms, such as dryness, foreign body sensation, eye strain, and blurred vision. In addition, CLADE is characterized by end-of-day pain. The degradation of the ocular surface as a result of extended dryness or employment with a visual display terminal (VDT) causes these symptoms. Because these symptoms worsen as the day progresses, practitioners should evaluate contact lens wearers at the end of the day to identify symptomatic patients. Aim To assess dry eye syndrome among contact lens users in the Asir region, Saudi Arabia. Methodology A descriptive cross-sectional study was used, targeting all accessible contact lens users in the Asir region, South of Saudi Arabia. A total of 250 individuals received the study survey. Data were collected from participants using an online pre-structured questionnaire. The authors initiated the study tool with the help of a comprehensive review of similar articles in the literature and consulting specialized experts, including an ophthalmologist and Arabic translator, to ensure the accuracy of the questionnaire's translation process. The questionnaire covered the following data: participants' socio-demographic data, contact lens use and frequency of use, dry eyes symptoms (DESs) questions, Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8), and Ocular Surface Disease Index (OSDI). Results Out of 405 respondents, only 201 contact lens users in the Asir region were included in the study, with a participation rate of 80.4%. Respondents' ages ranged from 18 to 50 years with a mean age of 24.3 ± 12.8 years old. A total of 122 (60.7%) contact lens users had eye disease, including myopia among 94 (77%), hyperopia among 8 (6.6%), and 20 (16.4%) had other eye diseases. A total of 91% of the study participants felt dry eyes two weeks before study time, 88.1% experienced burning sensation, and 82.6% complained of red-eye. A total of 131 (65.2%) contact lens users had non-dry eyes, 41 (20.4%) had mild dry eyes, 20 (10%) had moderate dry eyes, and 9 (4.5%) had severe dry eyes. A total of 48.8% of those who used lenses daily had dry eyes compared to 25% of those who used lenses annually (P = 0.049). Conclusions In conclusion, the current study showed that nearly one out of three contact lens users in the Asir region experienced contact lens-related dry eye syndrome mainly with a moderate degree. A higher dry eye syndrome rate is estimated among those who reported a higher frequency of contact lens use and others with a history of eye diseases.
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Tong L, Lim L, Tan D, Heng WJ, Lim J, Chan C, Arundhati A, Tan A. Assessment and Management of Dry Eye Disease and Meibomian Gland Dysfunction: Providing a Singapore Framework. Asia Pac J Ophthalmol (Phila) 2021; 10:530-541. [PMID: 34759232 PMCID: PMC8673856 DOI: 10.1097/apo.0000000000000417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/04/2021] [Indexed: 01/10/2023] Open
Abstract
ABSTRACT The purpose of this article is to provide a framework for general ophthalmologists in Singapore to manage dry eye. This framework considers the evidence in the literature as well as recommendations from expert panels such as the Tear Film & Ocular Surface Society Dry Eye Workshop II and the Asia Cornea Society Workgroup.This article covers the assessment of patient medical history and ask triage questions to identify local and systemic causes of dry eye disease (DED), excluding other possible causes, as well as the risk factors for DED and ocular surface inflammation. Evaluation of clinical signs to establish the diagnosis of DED and differentiation from other causes of irritable, red eyes are described. Tests for understanding the underlying disease processes and severity of DED are also presented.Management of dry eye should involve patient education and engagement. Information about the natural history and chronic nature of DED should be provided to improve long-term management of the disease and enhance compliance. Aggravating factors should be removed or lessened.We provide a guide to determine the most appropriate treatment (or combination of treatments) based on the severity and cause(s) of the disease, as well as the patient's needs and preferences. The aim of the management is to relieve ocular discomfort and prevent worsening of symptoms and signs, as well as to optimize visual function and minimize structural ocular damage. We also discuss the systematic follow-up and assessment of treatment response, as well as monitoring side effects of treatment, bearing in mind continuous support and reassurance to patients.
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Affiliation(s)
- Louis Tong
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore
- Eye Academic Clinical Program, Duke-National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore
| | - Li Lim
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore
- Eye Academic Clinical Program, Duke-National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore
| | - Donald Tan
- Yong Loo Lin School of Medicine, Singapore
- Eye Retina Surgeon, Singapore
| | - Wee Jin Heng
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | | | | | - Anshu Arundhati
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore
- Eye Academic Clinical Program, Duke-National University of Singapore, Singapore
| | - Anna Tan
- Department of Ophthalmology, National University Hospital, Singapore
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Bickford M, Rocha K. Impact of the COVID-19 Pandemic on Refractive Surgery. CURRENT OPHTHALMOLOGY REPORTS 2021; 9:127-132. [PMID: 34721950 PMCID: PMC8532571 DOI: 10.1007/s40135-021-00280-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
Purpose of Review In this article, we review the impact of the COVID-19 pandemic on refractive surgery. Recent Findings COVID-19 infection frequently causes eye symptoms, most commonly conjunctivitis or mild irritation. While virus can be detected in tears of symptomatic patients, the risk of transmission via this route appears low. Summary Refractive surgery consultations were significantly reduced during the pandemic; however, volume is rebounding quickly likely due to a number of lifestyle, health, and financial factors. Laser refractive and intraocular surgery likely confer a low risk of virus spread, especially in asymptomatic patients. Screening prior to the refractive consultation and surface disinfection in the clinic and operating room can help reduce transmission risk further.
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20
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Jeng BH, Belin MW. New Consideration for Old Conditions. Asia Pac J Ophthalmol (Phila) 2020; 9:479-480. [PMID: 33323703 DOI: 10.1097/apo.0000000000000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Bennie H Jeng
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD
| | - Michael W Belin
- Department of Ophthalmology and Vision Science, University of Arizona, Tuscon, AZ
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