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CLEAR - Contact lens complications. Cont Lens Anterior Eye 2021; 44:330-367. [DOI: 10.1016/j.clae.2021.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022]
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Morgan PB, Murphy PJ, Gifford KL, Gifford P, Golebiowski B, Johnson L, Makrynioti D, Moezzi AM, Moody K, Navascues-Cornago M, Schweizer H, Swiderska K, Young G, Willcox M. CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye. Cont Lens Anterior Eye 2021; 44:192-219. [PMID: 33775377 DOI: 10.1016/j.clae.2021.02.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/19/2022]
Abstract
This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia). However, effects on blinking, ptosis, the function of Meibomian glands, fluorescein and lissamine green staining of the conjunctiva and cornea, production of lid-parallel conjunctival folds and lid wiper epitheliopathy have received less research attention. Contact lens wear produces a subclinical inflammatory response manifested by increases in the number of dendritiform cells in the conjunctiva, cornea and limbus. Papillary conjunctivitis is also a complication of all types of contact lenses. Changes to wear schedule (daily disposable from overnight wear) or lens materials (hydrogel from SiHy) can reduce papillary conjunctivitis, but the effect of such changes on dendritic cell migration needs further study. These changes may be associated with decreased comfort but confirmatory studies are needed. Contact lenses can affect the sensitivity of the ocular surface to mechanical stimulation, but whether these changes affect comfort requires further investigation. In conclusion, there have been changes to lens materials, design and wear schedules over the past 20+ years that have improved their safety and seen the development of lenses that can reduce the myopia development. However, several changes to the ocular surface still occur and warrant further research effort in order to optimise the lens wearing experience.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, UK.
| | - Paul J Murphy
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Canada
| | - Kate L Gifford
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Paul Gifford
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | | | - Leah Johnson
- CooperVision Specialty EyeCare, Gilbert, AZ, United States
| | - Dimitra Makrynioti
- School of Health Rehabilitation Sciences, University of Patras (Aigio), Greece
| | - Amir M Moezzi
- Centre for Ocular Research and Education, University of Waterloo, Canada
| | - Kurt Moody
- Johnson & Johnson Vision Care, Jacksonville, FL, United States
| | | | | | - Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, UK
| | | | - Mark Willcox
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Shihab AH, Eliasy A, Lopes BT, Wu R, White L, Jones S, Geraghty B, Joda A, Elsheikh A, Abass A. Compressive behaviour of soft contact lenses and its effect on refractive power on the eye and handling off the eye. PLoS One 2021; 16:e0247194. [PMID: 33606837 PMCID: PMC7895393 DOI: 10.1371/journal.pone.0247194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/02/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the stress-strain behaviour of 9 soft contact lens materials, that are commonly used in the market, under uniaxial compression loading. METHODS Seven types of hydrogel and two types of silicone-hydrogel soft contact lens materials were hydrated in phosphate-buffered saline (PBS) solution then subjected to uniaxial compression loads. The load rate was set to 16.0 N/min starting with two consecutive initial 5.0 N loading cycles followed by three relaxation periods of 4.0 min within which there were two more 5.0 N loading cycles and eventually, a full loading cycle that stopped at a load of 49.0 N. The load and contraction data obtained experimentally were analysed to derive the stress-strain behaviour. Finite Element (FE) analysis was then utilised to evaluate the performance of soft contact lenses on the human eye and handling lenses off the eye. RESULTS Unlike tensile tests, all tested materials showed nonlinear behaviour when tested under compression. When fitted to first-order Ogden hyperelastic model, parameter μ was found to be varying in the range 0.12 to 0.74 MPa and material parameter α was found to be varying in the range 8.2 to 20.326 among the nine tested materials. Compression modulus of elasticity was 2.2 times higher than the tensile modulus of elasticity on average. FE simulation with nonlinear Ogden constitutive model showed a limited change (8%~12%) in the optical performance when compared to other material models, however, it predicted higher stress when the lens was simulated under bending during off-eye handling. CONCLUSIONS Compression tests revealed slightly nonlinear behaviour when materials were strained under compression stress down to 15% ~ 30% of their nominal heights. Considering the physiological compression loading range of 8 mmHg, secant moduli of elasticity were 1.5% to 6.9% higher than the tension moduli of elasticity depending on the material. Tensile-based moduli of elasticity could be used in FE analysis as a step towards simulating the optical performance of soft contact lenses on-eye. However, nonlinear compression-based material models are recommended for FE analysis of soft contact lenses when lens-handling is investigated off-eye.
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Affiliation(s)
- Ahmad H. Shihab
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom
- Department of Engineering and Technology, School of Physics, Engineering & Computer Science, University of Hertfordshire, Hatfield, United Kingdom
| | - Ashkan Eliasy
- Department of Civil Engineering and Industrial Design, School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Bernardo T. Lopes
- Department of Civil Engineering and Industrial Design, School of Engineering, University of Liverpool, Liverpool, United Kingdom
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Richard Wu
- Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Lynn White
- R&D Department, UltraVision CLPL, Leighton Buzzard, United Kingdom
| | - Steve Jones
- Department of Civil Engineering and Industrial Design, School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Brendan Geraghty
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Akram Joda
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom
- Faculty of Engineering, Higher Colleges of Technology, Dubai, UAE
| | - Ahmed Elsheikh
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom
- School of Biological Science and Biomedical Engineering, Beihang University, Beijing, China
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Ahmed Abass
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom
- Department of Production Engineering and Mechanical Design, Faculty of Engineering, Port Said University, Port Said, Egypt
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Abstract
PURPOSE The observation of lid-parallel conjunctival folds (LIPCOF) is reported to be useful in dry eye diagnoses. Around 70% of the European clinicians use this test in a dry eye clinic. This study investigated the sensitivity and specificity of LIPCOF to predict dry eye. METHODS Ocular Surface Disease Index (OSDI) outcome, noninvasive break-up time (NIKBUT) using the Keratograph (Oculus, Wetzlar, Germany), and LIPCOF of 148 randomized selected patient reports (88 females; mean age=37.0±12.9 years) from 3 different sites were analyzed. Subjects were divided into dry eye and non-dry eye groups by OSDI only, named symptomatic dry eye (OSDI scores ≥15) and by a composite score (OSDI scores ≥15 and NIKBUTaverage of ≤9 sec). RESULTS Lid-parallel conjunctival folds (temporal, nasal, Sum [=temporal+nasal]) were significantly correlated to OSDI and to NIKBUTaverage (Spearman; r>-0.185, P<0.013). NIKBUTaverage (r=-0.322; P<0.001) was significantly correlated to OSDI scores. Based on the OSDI questionnaire, 37.2% of the subjects were symptomatic and 14.7% were positive for dry eye based on the composite score. Lid-parallel conjunctival folds were a significant discriminator between healthy and dry eye subjects (P≤0.001). The areas under the receiver operating characteristic curve for temporal LIPCOF, nasal LIPCOF, and LIPCOF Sum were 0.716, 0.737, and 0.771, respectively, for the symptomatic dry eye group and 0.771, 0.719, and 0.798, respectively, for the composite dry eye group. CONCLUSIONS As LIPCOF demonstrated high predictive ability of dry eye; it appears to be a promising test in the diagnoses of dry eye.
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Abstract
PURPOSE This study evaluated relationships between meibomian gland loss (MGL) and age, sex, and dry eye. METHODS Dry eye and MGL of the lower eyelid was evaluated from 112 randomly selected subjects (66 women; mean age 62.8; SD ±15.7; and age range: 19-89 years) from Horst Riede GmbH, Weinheim, Germany. In addition, subjects were grouped into dry eye and non-dry eye by the Ocular Surface Disease Index (OSDI) score, lid-parallel conjunctival folds and non-invasive break-up time. Symptoms were evaluated by the OSDI. Meibography of the lower eyelid was performed using a Cobra camera (bon Optic, Lübeck, Germany), and images were analyzed by its digital grading tool. Data were analyzed by backward, multiple regression analyses and Pearson correlation. RESULTS Analyzing all subjects, multiple regression analyses detected that age and dry eye status (dry eye diagnosis or OSDI) but not sex were significantly related to MGL. In both, non-dry eye (n=66) and dry eye subjects (n=46), dry eye status (OSDI) but not age or sex was significantly related to MGL. Ocular Surface Disease Index scores were significantly correlated with MGL, but this correlation was stronger among all subjects (Pearson correlation; r=0.536, P<0.001) and dry eye group subjects (r=0.520, P<0.001) than in non-dry eye group subjects (r=0.275, P=0.014). CONCLUSIONS Dry eye group subjects showed significantly increased MGL of the lower eyelid. Age and dry eye status were related to MGL of the lower eyelid, but sex was not; dry eye status was the dominant factor.
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Characterization of Soft Contact Lens Edge Fitting during Daily Wear Using Ultrahigh-Resolution Optical Coherence Tomography. J Ophthalmol 2018; 2018:3463595. [PMID: 29862064 PMCID: PMC5971333 DOI: 10.1155/2018/3463595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/19/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine conjunctival overlap over the edge of soft contact lens and to visualize the peripheral postlens tear film (PoLTF) underneath soft contact lenses using ultrahigh-resolution optical coherence tomography (UHR-OCT). Methods Twenty participants (4 males and 16 females, 23.0 ± 3.7 years) were fitted with two different types of soft contact lenses randomly. The limbus with lens was imaged with the UHR-OCT at the horizontal meridian every two hours up to 6 hours during lens wear. The conjunctival overlap was ranked as the percentage of the edge covered by the conjunctiva. The frequency of occurrence for visualized peripheral PoLTF was determined. Results The average conjunctival overlaps at insertion were 49% and 73% for galyfilcon A and balafilcon A lenses and increased significantly to 84% and 90% by 6 hours of lens wear (P < 0.001). Lenses with rounded edges had more conjunctival overlap than the lenses with angled edges (P=0.014). There were significant decreases for PoLTF on the conjunctiva (P=0.014) and peripheral cornea (P=0.004) over the study period compared to insertion. The percentage of subjects with PoLTF on the conjunctiva (32.5%) and peripheral cornea (36%) were greater in subjects wearing balafilcon A lenses (P=0.017). Conclusions Increased conjunctival overlap over the lens edges and reduced PoLTF underneath the peripheral region of soft contact lenses were shown during lens daily wear. The lens edge configuration may play a role in conjunctival response and peripheral PoLTF.
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TFOS DEWS II Diagnostic Methodology report. Ocul Surf 2017; 15:539-574. [DOI: 10.1016/j.jtos.2017.05.001] [Citation(s) in RCA: 836] [Impact Index Per Article: 119.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 05/01/2017] [Indexed: 01/09/2023]
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Gavara R, Compañ V. Oxygen, water, and sodium chloride transport in soft contact lenses materials. J Biomed Mater Res B Appl Biomater 2016; 105:2218-2231. [DOI: 10.1002/jbm.b.33762] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/22/2016] [Accepted: 07/11/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Rafael Gavara
- Packaging Group, Instituto de Agroquímica y Tecnología de Alimentos; Consejo Superior de Investigaciones Científicas (IATA-CSIC), Avda, Agustín Escardino; 46980 Paterna Spain
| | - Vicente Compañ
- Escuela Técnica Superior de Ingenieros Industriales, Departamento de Termodinámica Aplicada; Universidad Politécnica de Valencia, Camino de vera s/n; 46020 Valencia Spain
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Adverse events in allergy sufferers wearing contact lenses. Postepy Dermatol Alergol 2015; 32:204-9. [PMID: 26161062 PMCID: PMC4495118 DOI: 10.5114/pdia.2015.48071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/20/2014] [Accepted: 11/27/2014] [Indexed: 11/29/2022] Open
Abstract
Allergy is the fifth leading chronic condition in industrialized countries among all ages, and the third most common chronic disease among children under 18 years old. Many of allergic patients also have problems with vision and want to improve their quality of life by wearing contact lenses. They are most frequently young and active individuals, for whom contact lenses provide greater convenience and more satisfying vision correction than spectacles. However, application of high quality and immunologically neutral products do not protect from allergic side reactions. Nowadays, eye-related allergy and contact lens wear concern larger and larger populations worldwide. The purpose of this review is to summarize the studies on ocular complications associated with wearing contact lenses. The article presents indications for allergic patients especially on the care system and wear schedule.
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Turhan SA, Toker E. Optical coherence tomography to evaluate the interaction of different edge designs of four different silicone hydrogel lenses with the ocular surface. Clin Ophthalmol 2015; 9:935-42. [PMID: 26045658 PMCID: PMC4448929 DOI: 10.2147/opth.s83798] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the lens edge interaction with the ocular surface with different edge designs using optical coherence tomography and to examine the effect of lens power on the lens edge interactions. Methods Four types of silicone hydrogel lenses with different edge designs (round-, semi-round-, chisel-, and knife-edged) at six different powers (+5.0, +3.0, +1.0, −1.0, −3.0, and −5.0 diopters) were fitted to both eyes of 20 healthy volunteers. Optical coherence tomography images were taken at the corneal center and at the limbus within 15–30 minutes after insertion. The images were evaluated with respect to two parameters: conjunctival indentation exerted by the lens edge; and the tear film gaps between the posterior surface of the lens and the ocular surface. The amount of conjunctival indentation was measured with the distortion angle of the conjunctiva at the lens edge. Results The degree of conjunctival indentation was highest with the chisel-edged design followed by the semi-round design (P<0.0001). Knife- and round-edged lenses exerted similar levels of conjunctival indentation that was significantly lower compared to chisel-edged lens (P<0.001). For each one of the tested lens edge designs, no significant difference was observed in the conjunctival indentation with respect to lens power. The chisel-edged lens produced the highest amount of conjunctival indentation for each one of the six lens powers (P<0.0001). Post-lens tear film gaps at the limbus were observed at most in the round-edge design (P=0.001). Conclusion The fitting properties of contact lenses may be influenced by their edge design but not by their lens power.
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Affiliation(s)
- Semra Akkaya Turhan
- Department of Ophthalmology, School of Medicine, University of Marmara, Istanbul, Turkey
| | - Ebru Toker
- Department of Ophthalmology, School of Medicine, University of Marmara, Istanbul, Turkey
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Sorbara L, Simpson TL, Maram J, Song ES, Bizheva K, Hutchings N. Optical edge effects create conjunctival indentation thickness artefacts. Ophthalmic Physiol Opt 2015; 35:283-92. [DOI: 10.1111/opo.12196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 12/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Luigina Sorbara
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
- Centre for Contact Lens Research; University of Waterloo; Waterloo Canada
| | - Trefford L. Simpson
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
| | - Jyotsna Maram
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
- Centre for Contact Lens Research; University of Waterloo; Waterloo Canada
| | - Eun Sun Song
- Department of Physics & Astronomy; University of Waterloo; Waterloo Canada
| | - Kostadinka Bizheva
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
- Department of Physics & Astronomy; University of Waterloo; Waterloo Canada
| | - Natalie Hutchings
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
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Abstract
PURPOSE To investigate the relationship between blink action, dry eye symptoms, and lid-parallel conjunctival folds (LIPCOF). METHODS In 30 subjects (14 were women; mean [standard deviation {SD}] age, 42.4 [±12.3] years), spontaneous blinks were recorded from a temporal-inferior view (high-speed video), and the blink extent (incomplete [IC], almost complete [AC], and complete [CC]) was evaluated. Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI), and nasal and temporal LIPCOF grades were noted. Correlations between groups were calculated with Pearson correlation (or Spearman rank in nonparametric data), and differences between groups were calculated with an unpaired t-test (or U-test Mann-Whitney in nonparametric data). RESULTS Blink rate was significantly higher in females (22.0% [±16.8]) than in males (8.6% [±7.2]; unpaired t-test: p = 0.007). The percentage of AC of all blinks (AC%) was significantly correlated to LIPCOF sum (nasal + temporal) and OSDI scores (r > 0.570, p < 0.001). The percentage of IC was significantly correlated to LIPCOF sum (r = -0.541, p < 0.001) but not to OSDI. CONCLUSIONS The frequency and type of blinking may have an effect on dry eye symptoms and LIPCOF severity since almost all complete blinks were significantly related to both factors.
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Morphology of contact lens-induced conjunctival epithelial flaps: a pilot study. Cont Lens Anterior Eye 2012; 35:185-8. [PMID: 22503643 DOI: 10.1016/j.clae.2012.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 03/15/2012] [Accepted: 03/19/2012] [Indexed: 11/22/2022]
Abstract
PURPOSE Conjunctival epithelial flap (CEF) is a conjunctival condition most commonly seen in silicone hydrogel contact lens wearers. This study utilized impression cytology to investigate the cellular composition and health of CEFs. METHODS Nine (9) subjects were enrolled - 3 non-lens wearers, 3 contact lens wearers without CEF, and 3 contact lens wearers with CEFs wearing 8.4/13.8 lotrafilcon A lenses. Impression cytology samples were collected from the flap or similar locations, if CEF was absent, using rectangular 5 mm × 2 mm Millipore HAWP02500 membrane filters. The filters were gently pressed onto the conjunctiva, subsequently fixed in 95% alcohol, stained with hematoxylin-eosin and evaluated under an Olympus IX70 microscope. Measurements of the longest cell and nucleus dimensions were measured on 40 cells from each filter by utilizing NIH Image 1.63. RESULTS CEF consisted of multilayers of epithelial and goblet cells and were devoid of inflammatory cells, basement membrane material and stromal tissue. The cytoplasmic and nuclear dimensions were similar within the groups and the cytoplasm-to-nucleus ratio was not different between the flap group and the non-lens wearing group. CONCLUSION The CEF appeared to be formed by healthy epithelial and goblet cells that have been dislocated from their normal location along the conjunctival surface by the lens edge. No inflammatory cells were present in this contact lens induced condition, which is reported to be associated most commonly with the silicone hydrogel material.
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Contact Lens–Induced Circumlimbal Staining in Silicone Hydrogel Contact Lenses Worn on a Daily Wear Basis. Eye Contact Lens 2012; 38:16-26. [DOI: 10.1097/icl.0b013e31823bad46] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A Histopathological Study of Bulbar Conjunctival Flaps Occurring in 2 Contact Lens Wearers. Cornea 2011; 30:1037-41. [DOI: 10.1097/ico.0b013e318207ec82] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pult H, Purslow C, Murphy PJ. The relationship between clinical signs and dry eye symptoms. Eye (Lond) 2011; 25:502-10. [PMID: 21252949 PMCID: PMC3171239 DOI: 10.1038/eye.2010.228] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 12/02/2010] [Accepted: 12/02/2010] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate (i) the relationship between traditional and new clinical tests (lid-wiper epitheliopathy (LWE), lid-parallel conjunctival folds (LIPCOF)) and dry eye symptoms in non-contact lens wearers, and (ii) that a combination of these tests can improve predictive ability for the development of dry eye symptoms. METHODS Tear meniscus height (TMH), non-invasive break-up time (NIBUT), ocular hyperaemia, LIPCOF, phenol red thread test (PRTT), corneal and conjunctival staining, and LWE grades were observed in a cohort of 47 healthy, non-lens wearers (male=17, female=30, median age=35 years, range=19-70). Symptoms were assessed using the Ocular Surface Disease Index (OSDI). RESULTS LWE was significantly correlated to both temporal and nasal LIPCOF (0.537 -0.248, P < 0.001). Significant correlations were found between NIBUT and TMH (r=0.461, P=0.001) and PRTT (r = 0.640, P < 0.001). OSDI scores were significant correlated to NIBUT, TMH, PRTT, LIPCOF, and LWE (r>∣0.31∣; P<0.05). Significant discriminators of OSDI+/- were NIBUT (area under the receiver operative characteristic curve (AUC)=0.895), TMH (0.715), PRTT (0.781), LIPCOF (temporal/nasal/Sum 0.748/0.828/0.816), and LWE (0.749). Best predictive ability was achieved by combining NIBUT with nasal LIPCOF (AUC=0.944). CONCLUSIONS The individual tests NIBUT, TMH, PRTT, LIPCOF, and LWE were significantly, but moderately, related to OSDI scores. The strongest relationship appeared by combining NIBUT with nasal LIPCOF.
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Affiliation(s)
- H Pult
- Optometry and Vision Research, Weinheim, Germany.
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