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Gulias-Cañizo R, Rodríguez-Malagón ME, Botello-González L, Belden-Reyes V, Amparo F, Garza-Leon M. Applications of Infrared Thermography in Ophthalmology. Life (Basel) 2023; 13:life13030723. [PMID: 36983878 PMCID: PMC10053626 DOI: 10.3390/life13030723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023] Open
Abstract
Body temperature is one of the key vital signs for determining a disease’s severity, as it reflects the thermal energy generated by an individual’s metabolism. Since the first study on the relationship between body temperature and diseases by Carl Reinhold August Wunderlich at the end of the 19th century, various forms of thermometers have been developed to measure body temperature. Traditionally, methods for measuring temperature can be invasive, semi-invasive, and non-invasive. In recent years, great technological advances have reduced the cost of thermographic cameras, which allowed extending their use. Thermal cameras capture the infrared radiation of the electromagnetic spectrum and process the images to represent the temperature of the object under study through a range of colors, where each color and its hue indicate a previously established temperature. Currently, cameras have a sensitivity that allows them to detect changes in temperature as small as 0.01 °C. Along with its use in other areas of medicine, thermography has been used at the ocular level for more than 50 years. In healthy subjects, the literature reports that the average corneal temperature ranges from 32.9 to 36 °C. One of the possible sources of variability in normal values is age, and other possible sources of variation are gender and external temperature. In addition to the evaluation of healthy subjects, thermography has been used to evaluate its usefulness in various eye diseases, such as Graves’ orbitopathy, and tear duct obstruction for orbital diseases. The ocular surface is the most studied area. Ocular surface temperature is influenced by multiple conditions, one of the most studied being dry eye; other diseases studied include allergic conjunctivitis and pterygium as well as systemic diseases such as carotid artery stenosis. Among the corneal diseases studied are keratoconus, infectious keratitis, corneal graft rejection, the use of scleral or soft contact lenses, and the response to refractive or cataract surgery. Other diseases where thermographic features have been reported are glaucoma, diabetic retinopathy, age-related macular degeneration, retinal vascular occlusions, intraocular tumors as well as scleritis, and other inflammatory eye diseases.
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Affiliation(s)
- Rosario Gulias-Cañizo
- Centro de Investigación en Ciencias de la Salud, Universidad Anahuac México, Naucalpan de Juárez 52786, Mexico
| | - Maria Elisa Rodríguez-Malagón
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Loubette Botello-González
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Valeria Belden-Reyes
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Francisco Amparo
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Manuel Garza-Leon
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
- Correspondence:
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Macedo-de-Araújo RJ, Fadel D, Barnett M. How Can We Best Measure the Performance of Scleral Lenses? Current Insights. CLINICAL OPTOMETRY 2022; 14:47-65. [PMID: 35418790 PMCID: PMC9000539 DOI: 10.2147/opto.s284632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Scleral lenses (SLs) present several unique advantageous characteristics for patients. As these lenses are mainly fitted in severely diseased eyes, a thorough evaluation of the ocular surface before and after SL fitting and the on-eye SL fitting evaluation are essential and help minimize potential physiological complications. This review will explore the current and emerging techniques and instrumentation to best measure SL performance ensuring optimal lens fitting, visual quality, comfort and physiological responses, highlighting some potential complications and follow-up recommendations. A single physician could perform the great majority of evaluations. Still, the authors consider that the assessment of SL fitting should be a collaborative and multidisciplinary job, involving contact lens practitioners, ophthalmologists and the industry. This publication has reviewed the most up-to-date work and listed the most used techniques; however, the authors encourage the development of more evidence-based recommendations for SL clinical practice.
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Affiliation(s)
- Rute J Macedo-de-Araújo
- Clinical & Experimental Optometry Research Laboratory (CEORLab), Physics Centre of Minho and Porto Universities (CF-UM-UP), University of Minho, Braga, Portugal
| | | | - Melissa Barnett
- Davis Eye Center, University of California, Sacramento, CA, USA
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Anatomical and physiological considerations in scleral lens wear: Eyelids and tear film. Cont Lens Anterior Eye 2021; 44:101407. [PMID: 33468392 DOI: 10.1016/j.clae.2021.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022]
Abstract
Scleral lenses can affect a range of anterior segment structures including the eyelids and the tears. The eyelids, consisting of the outer skin layer, the middle tarsal plate, and the posterior palpebral conjunctiva, provide physical protection and house the meibomian glands and cilia which have important and unique functions. Tears consist of a mix of aqueous, mucus, and lipidomic components that serve vital functions of lubricity, protection, and nourishment to the ocular surface. Both the eyelids and the tear film interact directly with scleral lenses on the eye and can affect but also be impacted by scleral lens wear. The purpose of this paper is to review the anatomy and physiology of the eyelids and tear film, discuss the effects and impacts of the scleral lenses on these structures, and identify areas that require further research.
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Randomised controlled trial of corneal vs. scleral rigid gas permeable contact lenses for keratoconus and other ectatic corneal disorders. Cont Lens Anterior Eye 2020; 43:543-552. [DOI: 10.1016/j.clae.2019.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/07/2019] [Accepted: 12/07/2019] [Indexed: 11/23/2022]
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Anterior Corneal Curvature and Aberration Changes After Scleral Lens Wear in Keratoconus Patients With and Without Ring Segments. Eye Contact Lens 2019; 45:141-148. [PMID: 30005055 DOI: 10.1097/icl.0000000000000534] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate changes in the anterior corneal curvature and aberrometry after scleral contact lens wear in keratoconus (KC) subjects with and without intracorneal ring segments (ICRS). METHODS Twenty-six subjects diagnosed with keratoconus were selected to participate in the study. Subjects were divided into 2 groups, those with ICRS (KC-ICRS group) and those without ICRS (KC group). Subjects were instructed to wear 16.5-mm scleral lenses for 8 hours. Topographic and aberrometric parameters were evaluated before lens wear and immediately after lens removal. Anterior corneal curvature was evaluated at corneal diameters of 2, 4, 6, and 8 mm, and corneal aberrations were measured at 4-, 6-, and 8-mm pupil diameters. RESULTS The mean age of subjects was 36.95±8.95 years. In KC group, there was a statistically significant flattening of the central corneal curvature, from 6.98 to 7.09 mm (P<0.05). No changes were found in the central corneal curvature in the KC-ICRS group. The KC group showed anterior corneal curvature flattening, mainly in the nasal quadrant. The KC-ICRS group showed flattening primarily in the inferior hemisphere. In the KC group, spherical aberration for 6-mm pupil increased significantly. In the KC-ICRS group, changes in aberrations were significant for high-order root mean square at 4- and 6-mm pupil diameters (P<0.05), for oblique astigmatism for 4 mm and 6 mm, and for vertical coma for 4-mm pupil (P<0.05). CONCLUSION Short-term scleral lens wear showed flattening of the anterior corneal surface in all subjects. In the KC group, the flattening was more pronounced in the nasal quadrant while changes were more pronounced inferiorly in KC-ICRS group.
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Practitioner Learning Curve in Fitting Scleral Lenses in Irregular and Regular Corneas Using a Fitting Trial. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5737124. [PMID: 30834269 PMCID: PMC6369499 DOI: 10.1155/2019/5737124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/06/2019] [Indexed: 11/17/2022]
Abstract
Purpose To assess the learning curve of a novel practitioner with minor previous experience with scleral lenses (SL) fitting in the initial 156 consecutive fittings in irregular and regular corneas using a fitting trial. Methods Prospective dispensing case series involving a total of 85 subjects (156 eyes), 122 eyes with irregular corneas (IC Group) and 34 eyes with regular corneas (RC Group). All lenses were fitted by the same practitioner with minimal previous knowledge and practice on SL fitting. The first 156 consecutive fits were studied to estimate the number of trial lenses required to achieve the optimal fit and the number of reorders required. The results were divided into 8 chronological groups of 20 fittings (eyes) each. Results There was a decrease in the number of trial lenses required to achieve the optimal fit from 2.35±0.18 lenses in the first 20 fittings to 1.56±0.13 in the last fittings (p<0.05, Wilcoxon). There were no statistically significant differences between IC and RC groups. Regarding the number of reorders, there was also a decrease from 0.95±0.17 in the first fittings to 0.25±0.11 in the last fittings (p<0.05, Wilcoxon). Thought not statistically significant, there was an increase in the use of toric designs with increasing experience. Conclusions Practitioner fitting experience reduced both the number of trial lenses required to achieve the best fit and the number of reorders with time. After the first 60 cases, there was a significant reduction in the trial lenses and reorders necessity.
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Konieczka K, Schoetzau A, Koch S, Hauenstein D, Flammer J. Cornea Thermography: Optimal Evaluation of the Outcome and the Resulting Reproducibility. Transl Vis Sci Technol 2018; 7:14. [PMID: 29888112 PMCID: PMC5991773 DOI: 10.1167/tvst.7.3.14] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/05/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of the study was to establish a standardized quantitative evaluation of corneal temperature (CT) that includes anchoring reference points in the topography and minimization of artifacts. We further investigated the distribution and the short- and long-term reproducibility of the CT values, as well as the influence of the core temperatures. Methods The CT values in both eyes of 40 healthy subjects were measured through thermography. These examinations took place over the course of four visits within 2 consecutive weeks. At each visit, the CTs were measured twice in both eyes with intervals of 15 minutes between measurements. Results CT values were not significantly different between the right and left eyes and their distribution was nearly normal. The CTs increased slightly when measured twice over the 15-minute intervals (short-term reproducibility) but remained stable over a period of 2 weeks (long-term reproducibility). In addition, the CT values depended on the core temperatures. Conclusions Ocular surface thermography is a fast and noninvasive examination. The methods of optimized and standardized evaluation of the CT values facilitate comparisons and follow-ups. Translational Relevance Thermography can be used clinically and scientifically only if both the measurement and its evaluation are efficient and standardized and if the outcomes are highly reproducible.
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Affiliation(s)
- Katarzyna Konieczka
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Andreas Schoetzau
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Simone Koch
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Daniela Hauenstein
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Josef Flammer
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
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Serramito M, Carpena-Torres C, Carballo J, Piñero D, Lipson M, Carracedo G. Posterior cornea and thickness changes after scleral lens wear in keratoconus patients. Cont Lens Anterior Eye 2018; 42:85-91. [PMID: 29728290 DOI: 10.1016/j.clae.2018.04.200] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the changes in the corneal thickness, anterior chamber depth and posterior corneal curvature and aberrations after scleral lens wear in keratoconus patients with and without intrastromal corneal ring segments (ICRS). METHODS Twenty-six keratoconus subjects (36.95 ± 8.95 years) were evaluated after 8 h of scleral lens wear. The subjects were divided into two groups: those with ICRS (ICRS group) and without ICRS (KC group). The study variables evaluated before and immediately after scleral lens wear included corneal thickness evaluated in different quadrants, posterior corneal curvature at 2, 4, 6 and 8 mm of corneal diameter, posterior corneal aberrations for 4, 6 and 8 mm of pupil size and anterior chamber depth. RESULTS There was a statistically significant corneal thinning (p < 0.05) in the inferior region of the KC group and in the superior region of the ICRS group. No change (p > 0.05) in the anterior chamber depth was found. The KC group showed a steepening (p < 0.05) in the temporal quadrant and a flattening that mainly affected to the superior-nasal quadrant. The ICRS group showed a steepening (p < 0.05) that mainly affected to the superior-nasal quadrant. Regarding posterior corneal aberrations, only changes (p < 0.05) in Z4 for 8 mm and Z8 for 4 mm were found in the KC group. CONCLUSIONS Short-term scleral lens wear showed a thinning of the cornea and changes in the posterior corneal curvature affects different regions in keratoconus patients with and without ICRS.
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Affiliation(s)
- Maria Serramito
- Department of Optics II (Optometry and Vision), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Carlos Carpena-Torres
- Department of Optics II (Optometry and Vision), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Jesús Carballo
- Department of Optics II (Optometry and Vision), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - David Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain; Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain
| | - Michael Lipson
- Department of Ophthalmology and Visual Science, University of Michigan, Northville, MI, USA
| | - Gonzalo Carracedo
- Department of Optics II (Optometry and Vision), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain; Ocupharm Group Research, Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain.
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