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Ishihara K, Shi X, Fukazawa K, Yamaoka T, Yao G, Wu JY. Biomimetic-Engineered Silicone Hydrogel Contact Lens Materials. ACS APPLIED BIO MATERIALS 2023; 6:3600-3616. [PMID: 37616500 PMCID: PMC10521029 DOI: 10.1021/acsabm.3c00296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Contact lenses are one of the most successful applications of biomaterials. The chemical structure of the polymers used in contact lenses plays an important role in determining the function of contact lenses. Different types of contact lenses have been developed based on the chemical structure of polymers. When designing contact lenses, materials scientists consider factors such as mechanical properties, processing properties, optical properties, histocompatibility, and antifouling properties, to ensure long-term wear with minimal discomfort. Advances in contact lens materials have addressed traditional issues such as oxygen permeability and biocompatibility, improving overall comfort, and duration of use. For example, silicone hydrogel contact lenses with high oxygen permeability were developed to extend the duration of use. In addition, controlling the surface properties of contact lenses in direct contact with the cornea tissue through surface polymer modification mimics the surface morphology of corneal tissue while maintaining the essential properties of the contact lens, a significant improvement for long-term use and reuse of contact lenses. This review presents the material science elements required for advanced contact lenses of the future and summarizes the chemical methods for achieving these goals.
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Affiliation(s)
- Kazuhiko Ishihara
- Division
of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - Xinfeng Shi
- Alcon
Research, LLC, Fort Worth, Texas 76134, United States
| | - Kyoko Fukazawa
- National
Cerebral and Cardiovascular Center Research Institute, Suita, Osaka 564-8565, Japan
| | - Tetsuji Yamaoka
- National
Cerebral and Cardiovascular Center Research Institute, Suita, Osaka 564-8565, Japan
| | - George Yao
- Alcon
Research, LLC, Duluth, Georgia 30097, United States
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2
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Jones L, Efron N, Bandamwar K, Barnett M, Jacobs DS, Jalbert I, Pult H, Rhee MK, Sheardown H, Shovlin JP, Stahl U, Stanila A, Tan J, Tavazzi S, Ucakhan OO, Willcox MDP, Downie LE. TFOS Lifestyle: Impact of contact lenses on the ocular surface. Ocul Surf 2023; 29:175-219. [PMID: 37149139 DOI: 10.1016/j.jtos.2023.04.010] [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: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 05/08/2023]
Abstract
Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviors (e.g., when using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.
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Affiliation(s)
- Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.
| | - Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Kalika Bandamwar
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, USA
| | - Deborah S Jacobs
- Massachusetts Eye & Ear, Harvard Medical School, Boston, MA, USA
| | - Isabelle Jalbert
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Heiko Pult
- Dr Heiko Pult Optometry & Vision Research, Weinheim, Germany
| | | | - Heather Sheardown
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario, Canada
| | | | - Ulli Stahl
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | | | - Jacqueline Tan
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Silvia Tavazzi
- Department of Materials Science, University of Milano-Bicocca, Milan, Italy
| | | | - Mark D P Willcox
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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3
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Martínez-Pérez C, Villa-Collar C, Santodomingo-Rubido J, Shinde L, Thite N, Wolffsohn JS. Opportunities and threats to contact lens practice in Spain. JOURNAL OF OPTOMETRY 2023; 16:116-127. [PMID: 35821106 PMCID: PMC10104793 DOI: 10.1016/j.optom.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/21/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE An international survey evaluated the opportunities and threats related to contact lens practice reported by eye care professionals worldwide. This study reports on the results specifically found in Spain and how these compare with those from other regions of the world. METHODS A questionnaire was distributed to eye care practitioners around the world through professional associations. The questionnaire consisted of 9, 5 and 12 questions about opportunities, interventions, and potential threats related to contact lens practice, respectively. RESULTS A total of 2,408 responses were obtained from practitioners worldwide, of which 436 responses were obtained from Spanish practitioners. Spain was found among the regions with the highest perception of opportunities (median: 6.5/10) along with Australasia, North America, Europe, and South America. Spanish (median: 7.3/10), along with South American practitioners, also reported the highest perception of threats. Continuously updating of knowledge/skills, recommending contact lens wearing options to potential patients, creating an efficient recall system for follow-up examinations and being competent in managing contact lens-related complications were reported as important interventions for contact lens practice growth by Spanish eye care practitioners. CONCLUSIONS Spain is one of the regions in the world with the highest perception of both opportunities and threats regarding future contact lens practice. As such, Spanish practitioners consider it important to continuously update knowledge/skills and to recommend and educate patients on the benefits of contact lens wear. Online sales were found to be one of the most important concerns reported by both Spanish and eye care practitioners worldwide.
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Affiliation(s)
- Clara Martínez-Pérez
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - César Villa-Collar
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | | | | | - Nilesh Thite
- International Association of Contact Lens Educators, Pune, India
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4
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Change in Risk Score and Behaviors of Soft Contact Lens Wearers After Targeted Patient Education. Eye Contact Lens 2022; 48:347-354. [PMID: 35580482 DOI: 10.1097/icl.0000000000000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine if targeted education can influence the behaviors and scores of soft contact lens (SCL) wearers via the Contact Lens Risk Survey (CLRS). METHODS This was a multicenter, prospective, case-control study. Cases were symptomatic red eye SCL wearers (age, 18-39 years), and controls were age , sex, and site matched. Participants completed the CLRS and were provided targeted patient education at three time points: baseline, one, and six months. Change in scores and behaviors were analyzed using the Wilcoxon signed rank test. RESULTS Forty-one cases and 71 controls were analyzed. The mean risk score (mean±SE) from baseline to follow-up improved (reduced) for all participants (-1.96±0.73; P=0.01), mostly driven by the improvement among cases (-2.55±1.32; P=0.05). Case subjects reported a decrease in frequency of wearing lenses while showering (-0.32±0.07; P<0.0001), discarding lens solution (-0.13±0.06; P=0.03), and rinsing lenses with tap water (-0.19±0.08; P=0.02) after targeted education. CONCLUSIONS Targeted patient education can influence some behaviors of SCL wearers, especially those who experienced a red eye event. Further study is needed to determine how to improve other risk behaviors and whether these changes are sustained long term.
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Shigeyasu C, Yamada M, Fukuda M, Koh S, Suzuki T, Toshida H, Oie Y, Nejima R, Eguchi H, Kawasaki R, Nishida K. Severe Ocular Complications Associated With Wearing of Contact Lens in Japan. Eye Contact Lens 2022; 48:63-68. [PMID: 34860721 DOI: 10.1097/icl.0000000000000870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the severe ocular complications associated with contact lens wearing in Japan. METHOD A questionnaire was sent to 964 ophthalmologist training facilities inquiring for cases of contact lens-associated complications from April 2016 to March 2018. The inclusion criteria were as follows: (1) corrected distance visual acuity ≤0.1 decimal after treatment for 3 months, (2) corneal perforation observed during follow-up, and (3) requiring surgery. A secondary analysis was conducted, inquiring for further information on the type of contact lens, clinical manifestations, and course of treatment. RESULTS Forty-two patients with infectious keratitis met the inclusion criteria. Eight patients were users of rigid gas-permeable contact lens, and 34 were users of soft contact lens. Microbiological tests were positive in 73.0%. The organisms isolated in microbiological culture were bacteria in 11 patients (Pseudomonas aeruginosa in 9 patients), fungi in 2 patients, and Acanthamoeba in 14 patients. Ten patients were treated with local antibiotics, 11 with a combination of systemic antibiotics, and 21 with a combination of surgical approaches, including 13 with corneal transplantation. CONCLUSIONS The major cause of serious contact lens-associated ocular complications was microbial keratitis, and P. aeruginosa and Acanthamoeba were the major pathogens in Japan.
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Affiliation(s)
- Chika Shigeyasu
- Department of Ophthalmology (C.S., M.Y.), Kyorin University School of Medicine, Tokyo, Japan ; Department of Ophthalmology (M.F.), Kindai University Faculty of Medicine, Nara Hospital, Nara, Japan ; Department of Ophthalmology (S.K., Y.O., R.K., K.N.), Osaka University Graduate School of Medicine, Osaka, Japan ; Department of Ophthalmology (T.S.), Toho University School of Medicine, Omori Medical Center, Tokyo, Japan ; Department of Ophthalmology (H.T.), Juntendo University School of Medicine, Shizuoka Hospital, Shizuoka, Japan ; Miyata Eye Hospital (R.N.), Miyazaki, Japan; and Department of Ophthalmology (H.E.), Kindai University Faculty of Medicine, Osakasayama, Japan
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6
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Opportunities and threats to contact lens practice: A global survey perspective. Cont Lens Anterior Eye 2021; 44:101496. [PMID: 34426063 DOI: 10.1016/j.clae.2021.101496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/11/2021] [Accepted: 07/26/2021] [Indexed: 12/14/2022]
Abstract
AIM To understand the views of contact lens (CL) practitioners across the globe regarding what they perceive as opportunities and threats in CL practice. METHODS A self-administered anonymised questionnaire, constructed in English and translated in six more languages, was distributed through reputed international professional bodies and academic institutions worldwide. The questionnaire included items on demographic characteristics, type of practice, and questions designed to explore practitioners' perspective on the future of their CL practice over the next five years. RESULTS A total of 2408 valid responses were analysed. Multifocal CLs for presbyopia, CLs for myopia control, use of daily disposable (DD) CLs for occasional wear, and biocompatible materials to improve comfort were identified as promising areas of opportunities by practitioners (all 8/10). Respondents from North America, and Europe valued DDCLs for occasional wear moderately more favourable (Median: 9/10 for all) as compared to colleagues in Asia (Median: 8/10, p < 0.001), South America (Median: 8/10, p < 0.01), and Africa (Median: 8/10p < 0.01). Multifocal CLs for presbyopia was perceived as a better opportunity by practitioners in North America and Europe (Median: 9/10 for both), as well as in Australasia (Median: 8/10), in comparison to Asia, Africa, and Middle East (for all Median: 6/10, p < 0.001). Practitioners expressed concerns about the availability of CLs and CL prescriptions online without direct professional involvement (both 9/10). CONCLUSIONS Overall, the most appealing opportunities for CL practice growth were identified in occasional use of DD CLs, biocompatible materials to reduce CL discomfort, multifocal CLs for presbyopia correction and management of myopia control with CLs. Lack of regulation in CL sales, especially online, seemed to be a constant threat. The insights from this study can be used to design targeted strategies to enhance CL practice across the globe and in specific geographical areas.
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7
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Characteristics, Behaviors, and Awareness of Contact Lens Wearers Purchasing Lenses Over the Internet. Eye Contact Lens 2021; 46:208-213. [PMID: 32443017 DOI: 10.1097/icl.0000000000000702] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the characteristics and hygiene habits of contact lens (CL) wearers who acquire CLs over the Internet, as well as their awareness of modifiable risk factors (RFs). METHODS A web-based survey was conducted among clients of an online CL sales platform during 6 months. Demographic data, CL hygiene-related awareness, and compliance were collected and analyzed. RESULTS The questionnaire was completed by 1,264 CL wearers: the average age was 40.8 years; most were women (71.1%), had myopia (76.4%), and wore monthly disposable CLs (63.6%). The frequency of eye examination was significantly lower among those buying the CL exclusively online (15.8% vs. 6.6%, P<0.001) and those who had begun CL use on their own (17.5% vs. 8.8%, P<0.001). Initiation to CL wear without the intervention of an eye care practitioner was more frequent in wearers with less experience. Common risk behaviors included water exposure (68.1% in swimming and 64.9% in the shower), use of the case (61.9%) and CL (65.1%) beyond the recommended replacement time, and reuse of the maintenance solution (31.9%). Ignorance of recommended hygiene increased the probability of risky behavior. CONCLUSION There were no differences in compliance or awareness of risks between those purchasing exclusively online and other CL wearers. However, the growing frequency of self-taught initiation in CL wear among less-experienced online customers and online exclusive purchase was associated with a decrease in eye examination frequency and therefore worse compliance and increased risks. This finding underlines the importance of publicizing correct hygiene habits by all possible means so as to increase compliance.
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8
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Efron N, Morgan PB. Rethinking contact lens aftercare. Clin Exp Optom 2021; 100:411-431. [DOI: 10.1111/cxo.12588] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/10/2017] [Accepted: 05/21/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nathan Efron
- School of Optometry and Vision Science,Queensland University of Technology, Kelvin Grove, Queensland, Australia,
| | - Philip B Morgan
- Eurolens Research,The University of Manchester, Manchester, UK,
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Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye 2021; 44:368-397. [PMID: 33775383 DOI: 10.1016/j.clae.2021.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.
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Affiliation(s)
| | - Kathy Dumbleton
- School of Optometry, University of California, Berkeley, CA, USA
| | - Byki Huntjens
- Division of Optometry and Visual Sciences at City, University of London, London, UK
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Japan
| | | | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Cambridge, UK
| | - Heiko Pult
- Optometry and Vision Research, Weinheim, Germany
| | | | - Marta Vianya-Estopa
- Department of Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Karen Walsh
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Stephanie Wong
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Steele KR, Wagner H, Lai N, Zimmerman AB. Gas-Permeable Contact Lenses and Water Exposure: Practices and Perceptions. Optom Vis Sci 2021; 98:258-265. [PMID: 33771955 DOI: 10.1097/opx.0000000000001660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study provides insight into the current recommendations, clinical behaviors, and risk assessments of eye care professionals on the topic of rigid contact lens exposure to tap water. This knowledge may motivate professional organizations to develop initiatives to educate eye care professionals on the dangers of contact lens exposure to water. PURPOSE The purpose of this study was to investigate the practice patterns and risk perceptions of eye care professionals regarding gas-permeable contact lens exposure to tap water. METHODS A branched-logic survey was started by 320 clinicians, vision scientists, and industry personnel and was fully completed by 272 participants. The survey queried participants about their current practices, recommendations, and perceptions of risk regarding exposure of gas-permeable contact lenses to tap water. RESULTS Of those who prescribe gas-permeable contact lenses, 57.4% reported rinsing lenses with tap water, whereas only 32.7% reported engaging in this same behavior in front of patients. Of those who reported never rinsing lenses with tap water, 85.6% indicated that rinsing lenses with water increases infection risk, whereas 52.1% of those who rinse lenses with water reported the same perceived risk (P < .001). Of all participants, 60% indicated that wearing contact lenses while showering increases infection risk, and 50.2% of all participants advised patients to avoid this behavior. CONCLUSIONS A discrepancy exists between perceptions of risk concerning exposure of contact lenses to water and both clinical practices and patient education provided by professionals.
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Affiliation(s)
| | - Heidi Wagner
- The Ohio State University, College of Optometry, Columbus, Ohio
| | - Nicky Lai
- The Ohio State University, College of Optometry, Columbus, Ohio
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Woods J, Jones D, Jones L, Jones S, Hunt C, Chamberlain P, McNally J. Ocular health of children wearing daily disposable contact lenses over a 6-year period. Cont Lens Anterior Eye 2021; 44:101391. [DOI: 10.1016/j.clae.2020.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/29/2020] [Accepted: 11/22/2020] [Indexed: 12/26/2022]
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Mickles CV, Kinoshita BT, Lam D, Wagner H, Zimmerman AB, Sorbara L, Mitchell GL, Rosner B, Richdale K. The contact Lens risk survey to assess risk of soft contact lens-related inflammatory events. Cont Lens Anterior Eye 2020; 44:35-41. [PMID: 33288409 DOI: 10.1016/j.clae.2020.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/03/2020] [Accepted: 11/25/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To test the Contact Lens Assessment in Youth Contact Lens Risk Survey (CLRS) scoring algorithm in soft contact lens (SCL) wearers presenting with SCL-related adverse events and healthy matched controls. METHODS This prospective case-control study compared CLRS responses in SCL wearers presenting with symptomatic red eyes (Cases) with age-, sex- and site-matched healthy SCL wearers (Controls) at six locations across North America. Responses to individual questions from Cases and Controls were analyzed using either the Pearson, Mantel-Haenszel chi-square, or Fisher's exact test. Differences in the CLRS scores were compared using t-tests. RESULTS A total of 171 SCL wearers were enrolled (n = 57 Cases, 114 Controls). Cases were adjudicated to consensus and classified as contact lens-related serious and significant (S&S) or non-serious events. S&S Cases scored significantly higher on the CLRS (56.1 ± 11.1) than either their matched Controls (44.3 ± 11.1) (P < 0.001) or the non-Serious Cases (44.8± 12.8 P = 0.002). Scores of non-serious Cases were not significantly different than scores of their Controls (43.4 ± 10.7, P = 0.33) CONCLUSIONS: The CLRS scoring algorithm discriminated between SCL wearers presenting with S&S CL-related adverse events from healthy SCL wearers and those with non-serious events. This survey and scoring system could help practitioners identify patients at greatest risk for CL-related adverse events and support targeted interventions aimed at reducing risk behaviors.
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Affiliation(s)
- Chandra V Mickles
- Nova Southeastern University, College of Optometry, Ft. Lauderdale, FL, USA.
| | | | - Dawn Lam
- Marshall B. Ketchum University, College of Optometry, Fullerton, CA, USA
| | - Heidi Wagner
- The Ohio State University, College of Optometry, Columbus OH, USA
| | | | - Luigina Sorbara
- University of Waterloo, School of Optometry, Waterloo, Ontario, Canada
| | - G Lynn Mitchell
- The Ohio State University, College of Optometry, Columbus OH, USA
| | - Bernard Rosner
- Harvard University, T. H Chan School of Public Health, Boston, MA, USA
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Mitchell GL, Richdale K, Lam D, Wagner H, Kinoshita BT, Zimmerman AB, Sorbara L, Rosner B. Development of a contact Lens risk survey. Cont Lens Anterior Eye 2020; 44:101383. [PMID: 33281075 DOI: 10.1016/j.clae.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe the development and report psychometric properties of the Contact Lens Risk Survey (CLRS) to identify patients at risk for soft contact lens-related complications. METHODS Psychometric properties of the CLRS, a web-based survey with branching logic, were determined using data from 5 multi-site fieldings (n = 1059), including re-fielding to sub groups. Responses from participants with and without an active red eye were used to identify risk factors of a red eye event and calculate an overall risk score. A 6th fielding of the CLRS (n = 171) was used to assess discriminate validity. RESULTS Participants needed 11-12 min to complete the survey with a negligible difference by age. Internal consistency was excellent (Cronbach's α ≥ 0.70) for 3 of the 5 constructs identified by factor analysis. Twelve of the 17 survey items exhibited excellent within-subject repeatability (Kappa ≥ 0.61). Between-subject agreement, assessed in 18-25 year olds, was high for the majority of items, suggesting good generalizability across different populations of SCL wearers. The ability of the model using individual items of the CLRS to discriminate Controls and participants with a red eye was good with an area under the curve of 0.779. CONCLUSION The CLRS tool is a repeatable and valid instrument to standardize documentation of demographic, behavior, and exposure factors which appear to drive the greatest risk of a contact lens related red eye event.
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Affiliation(s)
- G Lynn Mitchell
- Ohio State University, College of Optometry, Columbus, OH, United States.
| | - Kathryn Richdale
- University of Houston, College of Optometry, Houston, TX, United States
| | - Dawn Lam
- Marshall B. Ketchum University, College of Optometry, Fullerton, CA, United States
| | - Heidi Wagner
- Ohio State University, College of Optometry, Columbus, OH, United States
| | - Beth T Kinoshita
- Pacific University, College of Optometry, Forest Grove, OR, United States
| | - Aaron B Zimmerman
- Ohio State University, College of Optometry, Columbus, OH, United States
| | - Luigina Sorbara
- University of Waterloo, School of Optometry, Waterloo, ON, Canada
| | - Bernard Rosner
- Harvard University, T. H Chan School of Public Health, Boston, MA, United States
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14
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Value of routine evaluation in asymptomatic soft contact lens wearers. Cont Lens Anterior Eye 2020; 43:484-488. [DOI: 10.1016/j.clae.2020.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/12/2020] [Accepted: 02/25/2020] [Indexed: 11/20/2022]
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15
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Pucker AD, Jones-Jordan LA, Marx S, Powell DR, Kwan JT, Srinivasan S, Sickenberger W, Jones L. Clinical factors associated with contact lens dropout. Cont Lens Anterior Eye 2019; 42:318-324. [DOI: 10.1016/j.clae.2018.12.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/19/2018] [Accepted: 12/01/2018] [Indexed: 02/01/2023]
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16
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Chao C, Akileswaran L, Cooke Bailey JN, Willcox M, Van Gelder R, Lakkis C, Stapleton F, Richdale K. Potential Role of Ocular Microbiome, Host Genotype, Tear Cytokines, and Environmental Factors in Corneal Infiltrative Events in Contact Lens Wearers. Invest Ophthalmol Vis Sci 2019; 59:5752-5761. [PMID: 30516819 PMCID: PMC6281277 DOI: 10.1167/iovs.18-24845] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose The purpose of this study was to explore differences in genotype, ocular surface microbiome, tear inflammatory markers, and environmental and behavioral exposures in soft contact lens (SCL) wearers with and without a history of corneal infiltrative events (CIEs). Methods Nine SCL wearers with a recent CIE and nine age-, sex-, and SCL material- and modality-matched controls were enrolled. The Contact Lens Risk Survey, slit-lamp examination data, basal tears, conjunctival microbial cultures, and peripheral blood samples were collected. Tear inflammatory mediator concentrations, genomic DNA from swabs, and whole exome sequencing of blood samples were quantified. Results There were no marked differences in SCL wear behaviors or exposures between case and control subjects. Predominant organisms detected among case and control subjects were Staphylococcus, Propionibacterium, Streptococcus, and Corynebacterium. Marginally higher levels of Neisseria were found in three of nine cases but zero of nine control samples (P = 0.056). A potentially deleterious missense single nucleotide polymorphism (SNP) variant in IL-6 Signal Transducer (IL6ST) was found in seven of eight cases and zero of nine controls (rs2228046; P = 0.03). The concentration of tear IL-6 was significantly higher in cases (4.5 [range, 2.1 to 6.2] pg/mL) versus controls (3.5 [range, 2.5 to 6.6] Pg/mL; = 0.02). Conclusions Tear IL-6 concentration was higher, and SNP variants were detected in subjects with a history of CIEs compared with healthy controls. The synthesis, signaling, and ocular surface cytokine concentration of IL-6 may be related to susceptibility to CIE. A larger study population is required to further explore relationships between genetic variations, the ocular surface microbiome, inflammatory mediators, and environmental exposures.
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Affiliation(s)
- Cecilia Chao
- Tufts Medical Center, Center for Translational Ocular Immunology, Boston, Massachusetts, United States.,University of New South Wales School of Optometry and Vision Science, Kensington, New South Wales, Australia
| | - Lakshmi Akileswaran
- Department of Ophthalmology, University of Washington Medical School, Seattle, Washington, United States
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Institute for Computational Biology, Cleveland, Ohio, United States
| | - Mark Willcox
- University of New South Wales School of Optometry and Vision Science, Kensington, New South Wales, Australia
| | - Russell Van Gelder
- Department of Ophthalmology, University of Washington Medical School, Seattle, Washington, United States
| | - Carol Lakkis
- Johnson & Johnson Vision Care, Inc., Jacksonville, Florida, United States
| | - Fiona Stapleton
- University of New South Wales School of Optometry and Vision Science, Kensington, New South Wales, Australia
| | - Kathryn Richdale
- University of Houston College of Optometry, Houston, Texas, United States
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Dong Z, Ding X, Li Y, Gan Y, Wang Y, Xu L, Wang Y, Zhou Y, Li J. Short-Term Deposition of PM 2.5 Particles on Contact Lens Surfaces: Effect on Oxygen Permeability and Refractive Index. Curr Eye Res 2018; 43:1102-1107. [PMID: 29787322 DOI: 10.1080/02713683.2018.1476552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSES To identify the deposition of fine (≤2.5 μm diameter) particulate matter (PM) particles (PM2.5) on contact lens surfaces and to investigate the effects of such deposition on the oxygen permeability (OP) and refractive index (RI) of contact lenses. METHODS A total of 36 contact lenses, including rigid gas permeable (RGP) lens and soft contact lens (SCL), were investigated. RGP lens (n=12) and SCL (n=12) (experimental group) were incubated in a PM2.5 solution for 24 h, after which PM2.5-treated RGP lens (n=6) and SCL (n=6) were further washed for 1 h in phosphate-buffered saline (PBS). All lenses were examined by field emission scanning electron microscopy. OP and RI of all lenses were measured. RESULTS Average-sized PM2.5 particles deposited on RGP contact lens and SCL surfaces after immersion in the PM2.5 solution were 3.192 ± 1.637 and 2.158 ± 1.187/100 μm2, respectively. On RGP lens surfaces, we observed both large (≥2.5 µm diameter) and small (PM2.5) particles. PM2.5 particles were deposited in diffuse patterns, primarily along the honeycomb structural border of SCL, while no PM2.5 particles were found in the honeycomb hole of SCL surfaces. Washing in PBS removed the larger PM particles from RGP lens surfaces, but left copious amounts of PM2.5 particles. In contrast, nearly all PM particles were removed from SCL surfaces after PBS washing. OP values of RGP lens and SCL appeared to be unchanged by PM2.5 deposition. RI values increased in both RGP lens and SCL groups after PM2.5 deposition. However, these increases were not statistically significant, suggesting that PM2.5 deposition itself does not cause fluctuations in contact lens RI. CONCLUSIONS Deposition of PM2.5 particles on contact lens surfaces varies according to lens material. PM2.5 particles deposited on SCL, but only large particles on RGP surfaces were able to be removed by washing in PBS and did not appear to alter OP and RI of either lens type.
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Affiliation(s)
- Zhizhang Dong
- b Department of Ophthalmology , The Seconnd affiliated hospital & Yuying Children's hospital of Wenzhou Medical University , Wenzhou , China
| | - Xiaoyan Ding
- c Department of Ophthalmology , Xi'an No.3 Hospital, Xi'an , Shaanxi Province , China
| | - Yong Li
- a Department of Ophthalmology , Shaanxi Ophthalmic Medical Center, Xi'an No.4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University , Xi'an , China
| | - Yifeng Gan
- b Department of Ophthalmology , The Seconnd affiliated hospital & Yuying Children's hospital of Wenzhou Medical University , Wenzhou , China
| | - Yanhui Wang
- d Shaanxi Medical Device Testing , Xi'an , China
| | - Libin Xu
- d Shaanxi Medical Device Testing , Xi'an , China
| | - Yahong Wang
- e Environmental Monitoring Station of Xi'an , Xi'an , China
| | - Ying Zhou
- f Department of Ophthalmology , The First Affiliated hospital of University of south China , Hengyang , China
| | - Juan Li
- a Department of Ophthalmology , Shaanxi Ophthalmic Medical Center, Xi'an No.4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University , Xi'an , China
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Abstract
PURPOSE To understand soft contact lens (SCL) and gas-permeable (GP) lens wearers' behaviors and knowledge regarding exposure of lenses to water. METHODS The Contact Lens Risk Survey (CLRS) and health behavior questions were completed online by a convenience sample of 1056 SCL and 85 GP lens wearers aged 20 to 76 years. Participants were asked about exposing their lenses to water and their understanding of risks associated with these behaviors. Chi-square analyses examined relationships between patient behaviors and perceptions. RESULTS GP lens wearers were more likely than SCL wearers to ever rinse or store lenses in water (rinsing: 91% GP, 31% SCL, P < 0.001; storing: 33% GP, 15% SCL P < 0.001). Among SCL wearers, men were more likely to store (24% vs. 13%, P = 0.003) or rinse (41% vs. 29%, P = 0.012) their lenses in water. Showering while wearing lenses was more common in SCL wearers (86%) than GP lens wearers (67%) (P < 0.0001). Swimming while wearing lenses was reported by 62% of SCL wearers and 48% of GP lens wearers (P = 0.027). Wearers who rinsed (SCL; P < 0.0001, GP; P = 0.11) or stored lenses in water (SCL; P < 0.0001, GP P = 0.007) reported that this behavior had little or no effect on their infection risk, compared with those who did not. Both SCL (P < 0.0001) and GP lens wearers (P < 0.0001) perceived that distilled water was safer than tap water for storing or rinsing lenses. CONCLUSIONS Despite previously published evidence of Acanthamoeba keratitis' association with water exposure, most SCL, and nearly all GP lens wearers, regularly expose their lenses to water, with many unaware of the risk.
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Steele KR, Szczotka-Flynn L. Epidemiology of contact lens-induced infiltrates: an updated review. Clin Exp Optom 2017; 100:473-481. [PMID: 28868803 DOI: 10.1111/cxo.12598] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 11/29/2022] Open
Abstract
Corneal infiltrative events (CIEs) are well established as a risk associated with soft contact lens wear. The incidence of symptomatic CIEs during extended soft lens wear ranges from 2.5 to six per cent; when asymptomatic CIEs are included, the incidence can be as high as 20-25 per cent. In daily soft lens wear, the annual incidence of symptomatic CIEs is about three per cent. There are various accepted methods of categorising CIEs, and a scoring system based on clinical signs and symptoms is a good approach to grade severity. Lens-related risk factors include extended wear, silicone hydrogel material, the use of multipurpose solutions, bacterial bioburden and reusable lenses. Recent studies report that daily disposable lenses reduce the risk of CIEs.
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Affiliation(s)
- Kelsy R Steele
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | - Loretta Szczotka-Flynn
- University Hospitals Eye Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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