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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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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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Efron N. Catchy titles. Clin Exp Optom 2023; 106:1-3. [PMID: 36628600 DOI: 10.1080/08164622.2022.2146485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Australia
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Wirta D, McLaurin E, Ousler G, Liu J, Kacmaz RO, Grieco J. Repository Corticotropin Injection (Acthar ® Gel) for Refractory Severe Noninfectious Keratitis: Efficacy and Safety from a Phase 4, Multicenter, Open-Label Study. Ophthalmol Ther 2021; 10:1077-1092. [PMID: 34669183 PMCID: PMC8589919 DOI: 10.1007/s40123-021-00400-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/20/2021] [Indexed: 02/08/2023] Open
Abstract
Introduction Noninfectious keratitis is a painful corneal inflammation treated with topical cyclosporine and other immunosuppressants. Additional treatment options are needed for keratitis that does not improve with standard therapies. Repository corticotropin injection (RCI; Acthar® Gel) is approved to treat severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa, including keratitis. This phase 4, multicenter, open-label study assessed the efficacy and safety of RCI for refractory severe noninfectious keratitis. Methods Patients were ≥ 18 years old with persistent severe keratitis despite treatment with topical immunosuppressants. Patients received 80 U of RCI subcutaneously twice weekly for 12 weeks followed by a 4-week taper. Assessments included all domains of the Impact of Dry Eye on Everyday Life (IDEEL) Questionnaire, Ocular Discomfort and 4-Symptom Questionnaire, and Visual Analog Scale (VAS). Corneal fluorescein and conjunctival lissamine green staining, Conjunctival Redness Scale, tear production (Schirmer’s test), visual acuity, slit lamp examination, and intraocular pressure were also assessed. Safety was evaluated via treatment-emergent adverse events. Analyses were performed using the modified intent-to-treat (mITT) population (patients who received ≥ 1 dose of RCI and contributed any post-baseline efficacy data). Results In the mITT population (N = 35), 50.0% (95% confidence interval, 33.2% to 66.8%) of patients experienced clinically important improvements in the symptom bother domain of the IDEEL Questionnaire at week 12 of RCI therapy. All domains of the IDEEL and the Ocular Discomfort and 4-Symptom Questionnaire showed improvements at week 12 of RCI treatment. The most pronounced improvements in the VAS at week 12 were for eye dryness and eye discomfort. Corneal staining, conjunctival staining, conjunctival redness, and tear production showed early improvements that were sustained through week 12. No new safety signals for RCI were identified. Conclusions RCI is safe and effective for refractory severe noninfectious keratitis that has not improved with other approved therapies. Trial registration number ClinicalTrials.gov NCT04169061. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-021-00400-y.
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Affiliation(s)
- David Wirta
- Eye Research Foundation, 520 Superior Ave. #235, Newport Beach, CA, 92663, USA.
| | | | | | - Jingyu Liu
- Mallinckrodt Pharmaceuticals, Hampton, NJ, USA
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Fujimoto H, Ochi S, Yamashita T, Inoue Y, Kiryu J. Role of the Water Gradient Structure in Inhibiting Thin Aqueous Layer Break in Silicone Hydrogel-Soft Contact Lens. Transl Vis Sci Technol 2021; 10:5. [PMID: 34473222 PMCID: PMC8419878 DOI: 10.1167/tvst.10.11.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Purpose Soft contact lenses (SCLs) are effective for refractive error correction, but prolonged wear triggers discomfort and discontinuation. This study investigates whether water gradient technology of delefilcon A-based SCLs improve tear film dynamics. Methods This retrospective observational study included 50 asymptomatic delefilcon A or narafilcon A users. Data on thin aqueous layer break (TALB; %), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH; mm), subjective dryness, and higher-order aberrations (HOAs) were collected. Measurements of the bare eye, the SCL-worn eye after 15 minutes (visit 1 [v1]) and 30 ± 5 days after v1 after SCL was worn for ≥5 hours (visit 2 [v2]) were recorded. Results TALB was significantly reduced in the delefilcon A group compared to the narafilcon A group (33.3% vs. 85.5% at v1; P < 0.0001 and 31.7% vs. 80.4% at v2; P < 0.0001). The NIBUT was also significantly higher in the former (4.2 ± 2.1 seconds vs. 2.9 ± 1.5 at v1; P < 0.01 and 4.1 ± 2.3 seconds vs. 2.7 ± 1.6 seconds at v2; P < 0.01) across both visits. The TMH was significantly reduced in the former in both v1 and v2. The total ocular HOAs were significantly lower in the former at v1 (P < 0.001) and v2 (P < 0.05) compared to the bare eye. Conclusions The water gradient technology of delefilcon A reduces TALB and increases NIBUT. Translational Relevance The use of water gradient technology improves tear film dynamics and alleviate pathological break-up pattern, improving lens performance.
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Affiliation(s)
- Hisataka Fujimoto
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | | | | | | | - Junichi Kiryu
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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Efron N. Contact lens wear is intrinsically inflammatory. Clin Exp Optom 2021; 100:3-19. [DOI: 10.1111/cxo.12487] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 05/07/2016] [Accepted: 06/09/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nathan Efron
- Institute of Health and Biomedical Innovation and School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia,
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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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Sweeney D, Holden B, Evans K, Ng V, Cho P. Best practice contact lens care: A review of the Asia Pacific Contact Lens Care Summit. Clin Exp Optom 2021; 92:78-89. [DOI: 10.1111/j.1444-0938.2009.00353.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Deborah Sweeney
- Vision CRC, University of New South Wales, Sydney, Australia
- Institute for Eye Research, University of New South Wales, Sydney, Australia
| | - Brien Holden
- Vision CRC, University of New South Wales, Sydney, Australia
- Institute for Eye Research, University of New South Wales, Sydney, Australia
| | - Kylie Evans
- Vision CRC, University of New South Wales, Sydney, Australia
- Institute for Eye Research, University of New South Wales, Sydney, Australia
| | | | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
E‐mail:
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Konda N, Kaur I, Garg P, Chakrabarti S, Willcox MDP. Toll-like receptor gene polymorphisms in patients with keratitis. Cont Lens Anterior Eye 2020; 44:101352. [PMID: 32723620 DOI: 10.1016/j.clae.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate differences in SNPs in TLR genes between people who had keratitis and controls in an Indian population. METHODS 145 cases of keratitis and 189 matched controls were recruited. DNA was extracted from peripheral blood. Single nucleotide polymorphisms (SNP) in TLR2 (n = 6), TLR4 (n = 15), TLR5 (n = 13) and TLR9 (n = 10) were analysed. The risk of developing keratitis was assessed based on allele, genotype and haplotype associations. RESULTS For all cases of keratitis, the TLR4 SNP rs4986791 TC genotype frequency was significantly higher in cases (p = 0.006, OR = 1.96, 95 % CI 1.19-3.2). Including cases of only microbial keratitis (MK) revealed that genotypes in TLR2 SNP rs5743706 TA (p = 0.0001; OR = 8.61; 95 % CI 2.59-28.56)), TLR4 SNP s4986791 TC (p = 0.002; OR = 2.65; 95 % CI 1.39-5.07) were significantly more common for MK, whereas the TLR5 SNP rs2241096 A allele (p = 0.00316, OR = 0.42, 95 % CI 0.2-0.9286) and GA genotype (p = 0.016; OR = 0.45; 95 % CI 0.23-0.86) was significantly less common in MK cases. The TLR2 SNP rs5743706 genotype TA was significantly less common in the sterile keratitis (SK) group (p = 0.004, OR = 0.43, 95 %CI 0.24-0.77). Haplotype analysis of MK compared to controls showed that TLR2 AT was more common in controls (p = 0.003); TLR4 ACAC was more common in cases (p = 0.004); TLR5 TGGCA was more common in controls (p = 0.001). CONCLUSION The present study revealed multiple associations between variants across TLR genes, which may have implications for understanding the underlying host factors, risk of developing keratitis and molecular pathogenesis in keratitis.
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Affiliation(s)
- Nagaraju Konda
- School of Optometry and Vision Science, University of New South Wales, Australia; Brien Holden Vision Institute, Sydney, Australia; School of Medical Sciences, University of Hyderabad, Hyderabad, Telangana, India
| | - Inderjeet Kaur
- Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Prashant Garg
- The Cornea Institute, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Subhabrata Chakrabarti
- Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Australia.
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Efron N. Twenty years of silicone hydrogel contact lenses: a personal perspective. Clin Exp Optom 2020; 103:251-253. [PMID: 32335960 DOI: 10.1111/cxo.13062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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11
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Efron N, Brennan NA, Chalmers RL, Jones L, Lau C, Morgan PB, Nichols JJ, Szczotka-Flynn LB, Willcox MD. Thirty years of 'quiet eye' with etafilcon A contact lenses. Cont Lens Anterior Eye 2020; 43:285-297. [PMID: 32278644 DOI: 10.1016/j.clae.2020.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 11/17/2022]
Abstract
Frequent replacement contact lenses made from the etafilcon A hydrogel lens material were introduced onto the market over 30 years ago, and etafilcon A remains the most widely used hydrogel lens material today. Although the prescribing of silicone hydrogel lenses is increasing, millions of lens wearers globally have been wearing hydrogel lenses for many years and exhibit a physiologically-stable 'quiet eye', with a low profile of adverse events. Hydrogel lenses are demonstrated to maintain a low inflammatory response and infection risk profile during daily wear, which in the case of etafilcon A, may be related to its low modulus, and the naturally-protective, anti-microbial, non-denatured lysozyme absorbed into the lens from the tear fluid. Although improved corneal physiology from decreased hypoxia with silicone hydrogel lenses is well accepted, equivalent levels of corneal oxygenation are maintained during daily wear of low to medium powered hydrogel lenses, which do not impede the daily corneal de-swelling process, and do not induce clinically significant changes in ocular health. Therefore, hydrogel lenses remain an important alternative for daily wear in modern contact lens practice.
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Affiliation(s)
- Nathan Efron
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Australia.
| | | | | | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Charis Lau
- Johnson & Johnson Vision, Inc, Jacksonville, FL, USA
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, UK
| | - Jason J Nichols
- The University of Alabama at Birmingham, School of Optometry, Birmingham, AL, USA
| | - Loretta B Szczotka-Flynn
- University Hospitals Eye Institute, University Hospitals Cleveland Medical Center, Department of Ophthalmology & Visual Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Mark D Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Makrynioti D, Zagoriti Z, Koutsojannis C, Morgan PB, Lagoumintzis G. Ocular conditions and dry eye due to traditional and new forms of smoking: A review. Cont Lens Anterior Eye 2020; 43:277-284. [PMID: 32111452 DOI: 10.1016/j.clae.2020.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/24/2020] [Accepted: 02/16/2020] [Indexed: 12/26/2022]
Abstract
Addiction to cigarette smoking has high prevalence rates recorded worldwide. Smoking has been linked to several life-threatening systemic conditions such as cancer, heart attack and stroke, in addition to a range of ocular pathologies. In recent years, electronic cigarettes (EC) have emerged as alternatives to smoking. ECs are nicotine delivery devices which produce an aerosol by heating, rather than combusting, a liquid which contains nicotine, flavours and preservatives. This review focuses on the association of traditional and new forms of smoking with dry eye disease, contact lens wear and four other common ocular diseases: cataract, age-related macular degeneration, glaucoma and Graves' ophthalmopathy. It is concluded that smoking and vaping appear as a risk factor for the aforementioned ocular conditions. An evidence-based, clear link between cigarette smoking, or EC vaping and ocular problems is yet to be discovered.
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Affiliation(s)
- Dimitra Makrynioti
- School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece.
| | - Zoi Zagoriti
- Department of Pharmacy, Laboratory of Molecular Biology and Immunology, University of Patras, University Campus, GR26504, Patras, Greece.
| | - Constantinos Koutsojannis
- Department of Physiotherapy, Laboratory of Health Physics and Computational Intelligence, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece.
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Carys Bannister Building, Dover Street, Manchester, M13 9PL, United Kingdom.
| | - George Lagoumintzis
- School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece; Department of Pharmacy, Laboratory of Molecular Biology and Immunology, University of Patras, University Campus, GR26504, Patras, Greece.
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Shu X, Wang J, Hu L. A review of functional slit lamp biomicroscopy. EYE AND VISION 2019; 6:15. [PMID: 31139665 PMCID: PMC6528339 DOI: 10.1186/s40662-019-0140-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/16/2019] [Indexed: 12/24/2022]
Abstract
Functional slit lamp biomicroscopy (FSLB) is a novel device which consists of a traditional slit-lamp and a digital camera. It can quantitatively assess vessel diameter, blood flow velocity, and blood flow rate and can create noninvasive microvascular perfusion maps (nMPMs). At present, FSLB is mainly used in contact lens (CL) and dry eye disease (DED) studies to advance our understanding of ocular surface microcirculation. FSLB-derived blood flow and vessel density measures are significantly altered in CL wearers and DED patients compared to normal people. These subtle changes in the ocular surface microcirculation may contribute to the monitoring of potential diseases of the body and provide a new way to diagnose dry eye disease. Therefore, this may also indicate that FSLB can be more widely applied in the study of other diseases to reveal the relationship between changes in ocular surface microcirculation and systemic diseases. The purpose of this paper is to summarize the functions of FSLB and the related studies especially in CL and DED.
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Affiliation(s)
- Xupeng Shu
- 1School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 China
| | - Jianhua Wang
- 2Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Liang Hu
- 1School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 China
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Wang J, Hu L, Shi C, Jiang H. Inter-visit measurement variability of conjunctival vasculature and circulation in habitual contact lens wearers and non-lens wearers. EYE AND VISION 2019; 6:10. [PMID: 30984795 PMCID: PMC6442401 DOI: 10.1186/s40662-019-0135-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 03/11/2019] [Indexed: 01/06/2023]
Abstract
Background The inter-visit variation of measuring bulbar conjunctival microvasculature and microcirculation needs to be considered when the results from multiple visits are interpreted. This study examined the inter-visit variability of measuring conjunctival microvasculature and microcirculation in habitual contact lens (HCL) wearers and non-contact lens (NCL) wearers. Methods Twenty-eight subjects were recruited including 13 HCL wearers (10 females and 3 males; mean age ± standard deviation, 25.8 ± 4.6 years) who had worn contact lenses on a daily basis for at least 3 years and 15 NCL wearers (10 females and 5 males, age 25.5 ± 4.0 years) were recruited. The temporal bulbar conjunctiva was imaged using a functional slit-lamp bio-microscope (FSLB) imaging system. FSLB imaging was performed in the morning when the HCL wearers did not wear their lenses. The measurements included conjunctival vessel diameter, vessel density, blood flow velocity and flow volume. In addition, conjunctival microvasculature was analyzed using monofractal (Dbox, representing vessel density) and multifractal (D0 representing vessel complexity) analyses. The repeated measurement was conducted at least one week after the first visit and both eyes of each participant were imaged. The coefficient of variation (CV) was calculated as the standard deviation of the differences between test and re-test then divided by the mean of the measurements. The intra-class correlation coefficient (ICC) was also calculated. Results No significant differences of all vascular measurements in both the right and left eyes were found between two groups (P > 0.05). Between two measurements on two different visits, the CV was from 2.4% (vessel density D0) to 63.5% (blood flow volume Q) in HCL wearers and from 3.4% (D0) to 40.6% (blood flow volume) in NCL wearers. The ICC was from 0.60 (vessel diameter) to 0.81 (axial blood flow velocity VA) in HCL wearers and from 0.44 (Q) to 0.68 (cross-sectional blood flow velocity VS) in NCL wearers. Conclusions The measurement variability of the vessel density of the bulbar conjunctiva appeared to have the smallest inter-visit variation. The measurement variability of the vasculature and circulation in HCL wearers were similar to that in NCL wearers.
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Affiliation(s)
- Jianhua Wang
- 1Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
| | - Liang Hu
- 1Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA.,2School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ce Shi
- 1Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA.,2School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hong Jiang
- 1Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
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Shi Y, Hu L, Chen W, Qu D, Jiang H, Wang J. Evaluated Conjunctival Blood Flow Velocity in Daily Contact Lens Wearers. Eye Contact Lens 2018; 44 Suppl 1:S238-S243. [PMID: 28410281 PMCID: PMC5640452 DOI: 10.1097/icl.0000000000000389] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study examined conjunctival microvasculature development in long-term habitual contact lens (HCL) wearers after a night of sleep. METHODS Twenty HCL wearers (15 women and 5 men, aged 28.6±6.9 years, mean age±standard deviation) who had worn contact lenses on a daily basis for at least 3 years and 40 noncontact lens (NCL) wearers (23 women and 17 men, aged 36.5±6.6 years, mean age±standard deviation) participated in the study. A functional slitlamp biomicroscopy imaging system was used to image the temporal bulbar conjunctiva. Imaging was performed in the morning while the contact lens wearers were not wearing their lenses after a night of sleep. The conjunctival vessel diameters, blood flow velocities, and flow rates were measured. In addition, fractal analyses were performed to obtain the vessel network density (Dbox) and complexity (D0). RESULTS The average blood flow velocity in HCL wearers after a night of sleep was 0.59±0.19 mm/s, which was significantly higher than that in NCL wearers (0.48±0.17 mm/s, P<0.05). The microvessel network density and complexity levels (Dbox=1.64±0.05 and D0=1.71±0.05, respectively) in the HCL wearers were significantly higher than those in NCL wearers (Dbox=1.61±0.05 and D0=1.69±0.04, both P<0.05). The blood flow velocity was positively correlated with the duration of contact lens wear (r=0.46, P<0.05) and with the daily number of lens-wearing hours (r=0.49, P<0.05) in HCL wearers. CONCLUSIONS This study identified microvascular alterations in the conjunctiva in response to daily contact lens wear after a night of sleep in long-term daily contact lens wearers. The unrecovered changes may indicate that para-inflammation occurs on ocular surfaces because of contact lens wear and that overnight sleeping with no lenses may not sufficiently restore the ocular surface to an intact state.
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Affiliation(s)
- Yingying Shi
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, Guangdong, China
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Liang Hu
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
- School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, China
| | - Wan Chen
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, Guangdong, China
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Dongyi Qu
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
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Zhu Q, Yang B, Deng N, Li Y, Wang T, Qi H, Liu L. The use of contact lenses among university students in Chengdu: Knowledge and practice of contact lens wearers. Cont Lens Anterior Eye 2017; 41:229-233. [PMID: 29221709 DOI: 10.1016/j.clae.2017.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 11/02/2017] [Accepted: 12/01/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE To assess the prevalence and general knowledge of contact lens wearers among college students in Chengdu, a metroplolitan of Chinaand find out the routine habits of use and hygienic conditions when wearing contact lenses. METHOD The questionnaire was distributed to 1,600 ametropic participants who were from 8 different universities. Data about demographics, general contact lens handling habits, personal attitudes, hygiene behaviors and eye health conditions were collected. We made the analysis ofthe demographics and wearing of contact lenses. Possible reasons for behaviors related to the care of contact lenses were analyzed. RESULTS The prevalence of contact lens use was 19.80%. Most users (82.15%) were females. An aesthetic effect was cited as the first reason for using (57.91%). The comfort of eyes was the first consideration (75.76%) when buying. To keep clean and use safe, 86.20% subjects washed hands before handling and 83.50% cleaned the lens carefully after removing. There was significant difference between males and females regarding the replacement of the solution (p=0.014). 32.66% wears knew the removal of protein deposits. A total of 54.88% were not informed of the potential complications of contact lens. The incidence of ocular discomfort was 44.78%. Only 3.03% of the students paid regular visits to ophthalmic clinics. CONCLUSION The prevalence of contact lenses was relatively low in Chengdu. The wears had limited knowledge about using and careof contact lens. More education on standard lens wear and care should be provided to wearers.
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Affiliation(s)
- Qiurong Zhu
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China
| | - Bi Yang
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China
| | - Nan Deng
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China
| | - Yifan Li
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China
| | - Tingwei Wang
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China
| | - Huang Qi
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China
| | - Longqian Liu
- The Department of Optometry and Visual Science, West China Hospital, Sichuan University, People's Republic of China.
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Clinical Presentation and Antibiotic Susceptibility of Contact Lens Associated Microbial Keratitis. J Pathog 2016; 2015:152767. [PMID: 26770828 PMCID: PMC4681797 DOI: 10.1155/2015/152767] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction. In recent years, the number of contact lens wearers has dramatically increased in Iran, particularly in youngsters. The purpose of current study was to assess the clinical presentation and antibiotic susceptibility of contact lens related microbial keratitis in Ahvaz, southwest of Iran. Methodology. A cross-sectional investigation of 26 patients (33 eyes) with contact lens induced corneal ulcers who were admitted to Imam Khomeini Hospital, Ahwaz City, from June 2012 to June 2013 was done. In order to study microbial culture and susceptibility of corneal ulcers, all of them were scraped. Results. Eight samples were reported as sterile. Pseudomonas aeruginosa (80%) in positive cultures was the most widely recognized causative organism isolated. This is followed by Staphylococcus aureus 12% and Enterobacter 8%. The results showed that 84% of the microorganism cases were sensitive to ciprofloxacin, while imipenem, meropenem, and ceftazidime were the second most effective antibiotics (76%). Conclusion. Results of current study show the importance of referring all contact lens wearers with suspected corneal infection to ophthalmologists for more cure. The corneal scraping culture and contact lens solution should be performed to guide antibiotic therapy.
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Khan MH, Mubeen SM, Chaudhry TA, Khan SA. Contact lens use and its compliance for care among healthcare workers in Pakistan. Indian J Ophthalmol 2014; 61:334-7. [PMID: 23552347 PMCID: PMC3759103 DOI: 10.4103/0301-4738.97552] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Poor care and hygiene of contact lens (CL) results in eye problems and infections. Healthcare workers have an important role in advocating correct lens care. Objectives: To determine the practices of CL care and the adverse consequences of poor CL care among healthcare workers. Setting and Design: A cross-sectional study in one public and three private sector hospitals in Karachi, Pakistan, in 2009–2010. Materials and Methods: We questioned 500 healthcare workers of all ages and both sexes, who wore CL, about compliance with advice on care and any complications due to improper hygiene practices. Ethical approval was obtained. Chi-square tests were used to determine significance and p-value less than 0.05 was considered statistically significant. Results: Of the total CL users, 385 (77%) were females. Most (75%) respondents wore CL to correct myopia, whereas 54% wore CL only occasionally. Surprisingly, only 24% knew the CL cleaning protocol. Lens solution was changed daily by 33% of users and after more than 2 weeks by 42%. Although 412 (82%) participants practised reasonable hand hygiene before inserting CL, 88 (18%) did not. Infection and eye dryness were statistically significantly (P < 0.01) associated with sex, hand-washing, and frequency of CL use. Conclusion: Noncompliance with the CL protocol was common among healthcare workers in our society. This behavior calls for targeted health education and awareness programs for healthcare workers.
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Affiliation(s)
- Muhammed Hamza Khan
- Department of Community Health Sciences, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan
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McGlinchey SM, McCoy CP, Gorman SP, Jones DS. Key biological issues in contact lens development. Expert Rev Med Devices 2014; 5:581-90. [DOI: 10.1586/17434440.5.5.581] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Narayanan S, Redfern RL, Miller WL, Nichols KK, McDermott AM. Dry eye disease and microbial keratitis: is there a connection? Ocul Surf 2013; 11:75-92. [PMID: 23583043 DOI: 10.1016/j.jtos.2012.12.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 02/07/2023]
Abstract
Dry eye is a common ocular surface disease of multifactorial etiology characterized by elevated tear osmolality and inflammation leading to a disrupted ocular surface. The latter is a risk factor for ocular surface infection, yet overt infection is not commonly seen clinically in the typical dry eye patient. This suggests that important innate mechanisms operate to protect the dry eye from invading pathogens. This article reviews the current literature on epidemiology of ocular surface infection in dry eye patients and laboratory-based studies on innate immune mechanisms operating at the ocular surface and their alterations in human dry eye and animal models. The review highlights current understanding of innate immunity in dry eye and identifies gaps in our knowledge to help direct future studies to further unravel the complexities of dry eye disease and its sequelae.
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Affiliation(s)
- Srihari Narayanan
- University of the Incarnate Word, Rosenberg School of Optometry, San Antonio, TX, USA
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Incidence and Epidemiologic Associations of Corneal Infiltrates With Silicone Hydrogel Contact Lenses. Eye Contact Lens 2013; 39:49-52. [DOI: 10.1097/icl.0b013e318271d3dc] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Estimating the Annual Economic Burden of Illness Caused by Contact Lens–Associated Corneal Infiltrative Events in the United States. Eye Contact Lens 2012; 38:164-70. [DOI: 10.1097/icl.0b013e31824ccaa1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Contact Lens Complications in an Urgent-Care Population: The University of California, Los Angeles, Contact Lens Study. Eye Contact Lens 2012; 38:49-52. [DOI: 10.1097/icl.0b013e31823ff20e] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Guimera A, Gabriel G, Plata-Cordero M, Montero L, Maldonado M, Villa R. A non-invasive method for an in vivo assessment of corneal epithelium permeability through tetrapolar impedance measurements. Biosens Bioelectron 2012; 31:55-61. [DOI: 10.1016/j.bios.2011.09.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 09/20/2011] [Accepted: 09/23/2011] [Indexed: 10/24/2022]
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Morgan PB, Efron N, Toshida H, Nichols JJ. An international analysis of contact lens compliance. Cont Lens Anterior Eye 2011; 34:223-8. [DOI: 10.1016/j.clae.2011.08.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 07/30/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
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Postmarket Surveillance of Menicon Z Rigid Gas-Permeable Contact Lenses for up to 30 Days Continuous Wear in the United States. Eye Contact Lens 2010; 36:241-4. [DOI: 10.1097/icl.0b013e3181efa61b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pseudomonas Keratitis Associated With Daily Wear of Silicone Hydrogel Contact Lenses. Eye Contact Lens 2008; 34:124-8. [DOI: 10.1097/icl.0b013e318126c0ee] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Are inflammatory events a marker for an increased risk of microbial keratitis? Eye Contact Lens 2008; 33:383-7; discussion 399-400. [PMID: 17975427 DOI: 10.1097/icl.0b013e318157d86b] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To consider whether inflammatory events, such as contact lens-induced peripheral ulcers, contact lens-induced acute red eye, and infiltrative keratitis are a marker for an increased risk for the occurrence of microbial keratitis. METHODS A review of relevant studies was undertaken with the view to answering two questions: 1) Do inflammatory events associated with contact lens wear progress to infection or microbial keratitis; and 2) Do episodes of inflammatory events predispose a patient to having an event of microbial keratitis? RESULTS The large body of laboratory work, along with the epidemiologic data on incidence rates and clinical data with regard to differences between the nature of inflammatory events and infection, supports the supposition that inflammatory events are not a marker for increased risk of microbial keratitis. CONCLUSIONS Inflammatory events are not a marker for increased risk of microbial keratitis, nor will they progress to infection because they are separate disease entities.
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Efron N, Morgan PB, Makrynioti D. Chronic morbidity of corneal infiltrative events associated with contact lens wear. Cornea 2007; 26:793-9. [PMID: 17667611 DOI: 10.1097/ico.0b013e31806c79dc] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the chronic morbidity of corneal infiltrative events (CIEs) associated with contact lens wear. METHODS The central corneas of both eyes of 13 subjects who had suffered a CIE 27 +/- 4 months previously were examined by using slit-lamp biomicroscopy, confocal microscopy, and ultrasound pachometry. Snellen visual acuity was recorded in both eyes. A questionnaire was administered to ascertain the type and extent of changes in contact lens wear and care since suffering from the CIE. RESULTS Slit-lamp biomicroscopy revealed the presence of a circular scar, approximately 1.5 mm in diameter, in the central cornea of the right eye of the patient who had suffered the most clinically severe CIE; no residual scar, or any other abnormality, was detected in any of the other 12 patients. No significant difference between the 2 eyes was found with respect to basal epithelial cell density; anterior or posterior keratocyte density; endothelial cell density, polymegethism, or pleomorphism; corneal thickness; or visual acuity. Anecdotally, however, markedly reduced pan-corneal cell counts, increased endothelial polymegethism, and reduced corneal thickness were observed in the affected eye of the patient who had suffered the most clinically severe CIE. After having suffered from a CIE, many patients changed lens type or brand, ceased to routinely sleep in lenses, or wore lenses less often. CONCLUSIONS In general, contact lens-associated CIEs do not compromise the long-term integrity of the cornea. Changes in lens-related behaviors of patients who have suffered from a CIE seem to be aimed at reducing the risk of a further occurrence. Anecdotally, more severe CIEs may be associated with chronic tissue morbidity.
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Affiliation(s)
- Nathan Efron
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Australia.
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Abstract
With estimated numbers of contact lens wearers worldwide exceeding 140 million, even complications with a low incidence will affect a significant number of individuals. Although contact lenses clearly have many advantages for wearers, certain risks have been associated with their use. Differences in risk for different types of contact lenses and wearing patterns have been demonstrated for both rare and common lens related complications. This review particularly focuses on the incidence and etiology of contact lens related corneal infection and inflammation. An understanding of the risks and contributory factors to these conditions is important for practitioners and will enable an informed choice of safer lens wear modalities, wear schedules, and hygiene regimes to be made.
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Affiliation(s)
- Fiona Stapleton
- Vision Cooperative Research Centre, University of New South Wales, Sydney, Australia.
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