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Duan H, Yan W. Visual fatigue a comprehensive review of mechanisms of occurrence, animal model design and nutritional intervention strategies. Crit Rev Food Sci Nutr 2023:1-25. [PMID: 38153314 DOI: 10.1080/10408398.2023.2298789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
When the eyes work intensively, it is easy to have eye discomfort such as blurred vision, soreness, dryness, and tearing, that is, visual fatigue. Visual fatigue not only affects work and study efficiency, but long-term visual fatigue can also easily affect physical and mental health. In recent years, with the popularization of electronic products, although it has brought convenience to the office and study, it has also caused more frequent visual fatigue among people who use electronic devices. Moreover, studies have reported that the number of people with visual fatigue is showing a trend of increasing year by year. The range of people involved is also extensive, especially students, people who have been engaged in computer work and fine instruments (such as microscopes) for a long time, and older adults with aging eye function. More and more studies have proposed that supplementation with the proper nutrients can effectively relieve visual fatigue and promote eye health. This review discusses the physiological mechanisms of visual fatigue and the design ideas of animal experiments from the perspective of modern nutritional science. Functional food ingredients with the ability to alleviate visual fatigue are discussed in detail.
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Affiliation(s)
- Hao Duan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
| | - Wenjie Yan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
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2
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Efron N, Morgan PB, Nichols JJ, Walsh K, Willcox MD, Wolffsohn JS, Jones LW. All soft contact lenses are not created equal. Cont Lens Anterior Eye 2021; 45:101515. [PMID: 34583895 DOI: 10.1016/j.clae.2021.101515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 09/19/2021] [Indexed: 12/13/2022]
Abstract
Soft contact lenses that have been prescribed by eye care practitioners are sometimes substituted for alternative lenses by unqualified, unregulated and sometimes even fully regulated lens suppliers, in the mistaken belief that there is essentially no difference between different soft lens types. This review considers the implications of inappropriately substituting soft contact lens types in terms of (a) lens properties: surface treatment, internal wetting agents, material, total diameter, back optic zone radius, thickness, edge profile, back surface design, optical design, power, colour (tint) and ultraviolet protection; and (b) lens usage: wearing modality (daily versus overnight wear) and replacement frequency. Potential aspects of patient dissatisfaction and adverse events when prescribed soft lenses are substituted for lenses with different properties or intended usage are considered. Substitution of 15 of the 16 lens properties considered (i.e. except for back surface design) was found to be related to at least one - and as many as six - potential sources of patient dissatisfaction and adverse ocular events. Contact lens are medical devices which are prescribed and fitted; they should never be substituted for another lens type in the absence of a new prescription further to a full finalised fitting, for the simple reason that all soft contact lenses are not created equal. A substituted lens may have properties that results in undesirable consequences in respect of vision, ocular health, comfort and cosmetic appearance, and may be incompatible with the lifestyle of the patient.
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Affiliation(s)
- Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Phillip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Jason J Nichols
- School of Optometry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark D Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Lyndon W Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), Hong Kong
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Yee A, Phan CM, Chan VWY, Heynen M, Jones L. Uptake and Release of a Multipurpose Solution Biocide (MAP-D) From Hydrogel and Silicone Hydrogel Contact Lenses Using a Radiolabel Methodology. Eye Contact Lens 2021; 47:249-255. [PMID: 32604136 DOI: 10.1097/icl.0000000000000724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the uptake and release of radiolabelled myristamidopropyl dimethylamine (MAP-D) on reusable daily wear contact lenses (CLs) over 7 days. METHODS Three silicone hydrogel (SH) CL materials (lotrafilcon B, balafilcon A, senofilcon A) and two conventional hydrogel (CH) materials (etafilcon A, omafilcon A) were tested. A short-term (experiment 1, N=4) and a longer-term (experiment 2, N=3) study was conducted. In experiment 1, the CLs were incubated in 2 mL of phosphate buffered solution (PBS) containing 14C MAP-D (5 μg/mL) for 8 hrs. The release of 14C MAP-D was measured at t=0.25, 0.5, 1, 2, 4, 8, and 24 hr in PBS. In experiment 2, the CLs were incubated in the 14C MAP-D solution for 8 hrs followed by a 16-hr release in PBS. This cycle was repeated daily for 7 days. At the end of both experiments, lenses were extracted to determine the total uptake of MAP-D. The radioactivity was measured using a beta scintillation counter. RESULTS In experiment 1, all three SH lenses sorbed similar amounts of MAP-D (P=0.99), all of which were higher than the two CH materials (P<0.01). However, the CH materials released a greater amount of MAP-D than the SH materials (P<0.01). In experiment 2, the uptake of MAP-D in SH materials increased over 7 days, whereas the amount of MAP-D remained constant in the CH materials (P=0.99). Similar to experiment 1, the CH lenses released more MAP-D than SH lenses after 7 days (P<0.01). CONCLUSION The SH materials absorbed greater amounts of MAP-D compared to CH materials. However, the CH materials released the greatest amount of MAP-D. Radioactive labelling of MAP-D offers a highly sensitive method of assessing the uptake and release profiles of biocides to CL materials.
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Affiliation(s)
- Alan Yee
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
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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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5
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Saccu G, Menchise V, Giordano C, Delli Castelli D, Dastrù W, Pellicano R, Tolosano E, Van Pham P, Altruda F, Fagoonee S. Regenerative Approaches and Future Trends for the Treatment of Corneal Burn Injuries. J Clin Med 2021; 10:jcm10020317. [PMID: 33467167 PMCID: PMC7830803 DOI: 10.3390/jcm10020317] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/13/2022] Open
Abstract
Ocular chemical and thermal burns are frequent causes of hospitalization and require immediate interventions and care. Various surgical and pharmacological treatment strategies are employed according to damage severity. Controlling inflammation and neovascularization while promoting normal ocular surface anatomy and function restoration is the principal aim. In the most severe cases, when epithelial healing is severely affected, reconstruction of the ocular surface may be a valid option, which, however, requires expertise, adequate instruments, and qualified donors. Numerous endogenous and exogenous strategies have been considered for corneal repair. Among these, stem cells and their derivatives have offered numerous attractive possibilities in finding an effective way in stimulating corneal regeneration. Limbal epithelial stem cells and mesenchymal cells from the ocular tissue as well as from various sources have demonstrated their effectiveness in dampening neovascularization, scarring, and inflammation, while promoting epithelialization of the injured cornea. Moreover, a plethora of cytokines and growth factors, and extracellular vesicles, which constitute the secretome of these cells, work in concert to enhance wound healing. In this review, we provide an update on the recent potential therapeutic avenues and clinical applications of stem cells and their products in corneal regeneration after burn injury, as well as current imaging strategies for monitoring therapeutic efficacy and damage resolution.
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Affiliation(s)
- Gabriele Saccu
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, 10126 Turin, Italy; (G.S.); (D.D.C.); (W.D.); (E.T.)
| | - Valeria Menchise
- Institute of Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, 10126 Turin, Italy
- Correspondence: (V.M.); (F.A.); (S.F.); Tel.: +39-0116706423 (S.F.)
| | - Cristina Giordano
- Ophthalmology Veterinary Practice, c.so Galileo Ferraris 121, 10126 Turin, Italy;
| | - Daniela Delli Castelli
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, 10126 Turin, Italy; (G.S.); (D.D.C.); (W.D.); (E.T.)
| | - Walter Dastrù
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, 10126 Turin, Italy; (G.S.); (D.D.C.); (W.D.); (E.T.)
| | | | - Emanuela Tolosano
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, 10126 Turin, Italy; (G.S.); (D.D.C.); (W.D.); (E.T.)
| | - Phuc Van Pham
- Laboratory of Stem Cell Research and Application, and Stem Cell Institute, VNUHCM University of Science, Ho Chi Minh City 08000, Vietnam;
| | - Fiorella Altruda
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, 10126 Turin, Italy; (G.S.); (D.D.C.); (W.D.); (E.T.)
- Correspondence: (V.M.); (F.A.); (S.F.); Tel.: +39-0116706423 (S.F.)
| | - Sharmila Fagoonee
- Institute of Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, 10126 Turin, Italy
- Correspondence: (V.M.); (F.A.); (S.F.); Tel.: +39-0116706423 (S.F.)
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Walsh K, Jones L. The use of preservatives in dry eye drops. Clin Ophthalmol 2019; 13:1409-1425. [PMID: 31447543 PMCID: PMC6682755 DOI: 10.2147/opth.s211611] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/03/2019] [Indexed: 12/14/2022] Open
Abstract
Topical ocular preparations are widely recommended by health care professionals, or chosen by patients, to help manage dry eye disease (DED). The chronic and progressive nature of DED may result in the administration of topical products several times a day, over a period of many years. Given DED is a condition that by definition affects the ocular surface, it is important to understand how the repeated use of eye drops may impact the ocular surface, influence clinical signs, affect symptoms, and impact the overall disease process of dry eye. The component in topical preparations with the greatest potential to adversely affect the ocular surface is the preservative. This paper reviews the literature in relation to the use of preservatives in formulations for dry eye. The ocular effects of benzalkonium chloride (BAK) are summarised and compared to the performance of alternative preservatives and preservative-free formulations. Use of preserved and preservative-free drops in relation to the management of varying stages of DED is discussed.
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Affiliation(s)
- Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, N2L 3G1, Canada
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, N2L 3G1, Canada
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7
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Lid wiper epitheliopathy: The influence of multiple lid eversions and exposure time. Cont Lens Anterior Eye 2019; 42:304-310. [DOI: 10.1016/j.clae.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/20/2018] [Accepted: 09/13/2018] [Indexed: 12/24/2022]
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8
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9
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Taylor M, Ousler G, Torkildsen G, Walshe C, Fyfe MCT, Rowley A, Webber S, Sheppard JD, Duggal A. A phase 2 randomized, double-masked, placebo-controlled study of novel nonsystemic kinase inhibitor TOP1630 for the treatment of dry eye disease. Clin Ophthalmol 2019; 13:261-275. [PMID: 30858682 PMCID: PMC6387610 DOI: 10.2147/opth.s189039] [Citation(s) in RCA: 4] [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 safety and efficacy of topical TOP1630, a novel nonsystemic kinase inhibitor, in dry eye disease (DED). Patients and methods A randomized, double-masked, parallel-group trial of 0.1% TOP1630 ophthalmic solution TID or placebo (vehicle without active drug) was conducted in DED subjects (n=61). Key eligibility criteria consistent with enrolling a moderate to severe DED population included >6 months DED history; OSDI© score ≥18; Schirmer’s test score ≤10 and ≥1 mm/5 minutes; tear film break-up time >1 and <7 seconds; and dry eye exacerbation in corneal staining and ocular discomfort in a Controlled Adverse Environment (CAE®). After a 7-day run-in period with placebo TID, eligible subjects were randomized to TOP1630 or placebo for 28 days. No supplemental artificial tears or rescue medication were allowed. Results TOP1630 was safe, well-tolerated, and efficacious in treating DED symptoms and signs. No serious adverse events (AEs) or withdrawals due to treatment emergent AEs occurred. Drop comfort scores showed TOP1630 to be comfortable and comparable with placebo. Significant symptom improvements were seen for TOP1630 vs placebo for ocular discomfort (P=0.02 post-CAE), grittiness/foreign body sensation (on four independent assessment scales, each P<0.05), worst DED symptom (diary, P=0.06), and ocular pain (VAS, P=0.03). Sign improvements were seen for total ocular surface (all regions), corneal sum, and conjunctival sum staining with TOP1630 compared with placebo (each P<0.05). Conclusion TOP1630 had placebo-like tolerability and produced improvements in multiple symptom and sign endpoints in both environmental and challenge settings. The emergent TOP1630 benefit–risk profile for DED treatment is highly favorable and supports further development.
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10
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Zhong L, Braun RJ, Begley CG, King-Smith PE. Dynamics of Fluorescent Imaging for Rapid Tear Thinning. Bull Math Biol 2019; 81:39-80. [PMID: 30324271 PMCID: PMC6781631 DOI: 10.1007/s11538-018-0517-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/27/2018] [Indexed: 12/26/2022]
Abstract
A previous mathematical model has successfully simulated the rapid tear thinning caused by glob (thicker lipid) in the lipid layer. It captured a fast spreading of polar lipid and a corresponding strong tangential flow in the aqueous layer. With the simulated strong tangential flow, we now extend the model by adding equations for conservation of solutes, for osmolarity and fluorescein, in order to study their dynamics. We then compare our computed results for the resulting intensity distribution with fluorescence experiments on the tear film. We conclude that in rapid thinning, the fluorescent intensity can linearly approximate the tear film thickness well, when the initial fluorescein concentration is small. Thus, a dilute fluorescein is recommended for visualizing the rapid tear thinning during fluorescent imaging.
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Affiliation(s)
- L Zhong
- Department of Mathematical Sciences, University of Delaware, Newark, DE, 19716, USA.
| | - R J Braun
- Department of Mathematical Sciences, University of Delaware, Newark, DE, 19716, USA
| | - C G Begley
- School of Optometry, Indiana University, Bloomington, IN, 47405, USA
| | - P E King-Smith
- College of Optometry, The Ohio State University, Columbus, OH, 43218, USA
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11
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Abstract
The purpose of this article is to provide a review of existing literature describing complications with contemporary contact lenses and their management. It is envisioned that this will serve as a useful summary of noninfectious and infectious complications associated with contact lens wear.
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12
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Abstract
The assessment of corneal staining is a commonly conducted procedure in both clinical practice and as part of various research studies. Different grading scales are employed by many clinicians and researchers to undertake this procedure for corneal staining comparisons between eyes, products and over time. This paper describes the development and use of a grading scale for corneal staining undertaken at an academic research site. The scale involves assessment of three factors across five corneal zones: type, area and depth. Staining type and area are graded on a 0–100 scale, and depth is graded on a 0–4 scale. These factors can be combined to create a three- or two-factor staining grade, or the factors may be reported individually. An additional benefit of this scale is that the staining scores may be reported by zone as “zone staining scores” or the scores of zones may be combined to provide an overall corneal “global staining score”.
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Affiliation(s)
- Jill Woods
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada,
| | - Jalaiah Varikooty
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada,
| | - Desmond Fonn
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada,
| | - Lyndon W Jones
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada,
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13
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Contact Lens Solutions and Contact Lens Discomfort: Examining the Correlations Between Solution Components, Keratitis, and Contact Lens Discomfort. Eye Contact Lens 2018; 44:355-366. [DOI: 10.1097/icl.0000000000000458] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Cellular fluorescein hyperfluorescence is dynamin-dependent and increased by Tetronic 1107 treatment. Int J Biochem Cell Biol 2018; 101:54-63. [PMID: 29800726 DOI: 10.1016/j.biocel.2018.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/04/2018] [Accepted: 05/21/2018] [Indexed: 11/22/2022]
Abstract
Sodium fluorescein ('fluorescein') staining of the ocular surface is frequently an indicator of compromised ocular health, and increases in the presence of certain contact lens multi-purpose solutions (MPS), a phenomenon known as solution induced corneal staining (SICS). The mechanism(s) underpinning fluorescein hyperfluorescence are uncertain, though may reflect increased cellular uptake of fluorescein by corneal epithelial cells. We have developed an in vitro model to study fluorescein uptake in both 'generic' mammalian cells (murine fibroblasts) and human corneal cells. Fluorescein hyperfluorescence increased after treatment with two MPS associated with clinical corneal fluorescein staining, yet there was no cellular hyperfluorescence for two MPS that do not cause this staining. Increased fluorescein uptake did not correlate with presence of a necrotic or an apoptotic marker (propidium iodide and caspase-3 respectively). Incubation of MPS-treated cells with dynasore (an inhibitor of dynamin, implicated in endocytic pathways) reduced fluorescein uptake irrespective of MPS treatment. The non-ionic surfactant Tetronic 1107 (present in both MPS associated with corneal fluorescein staining) increased uptake of fluorescein for both cell types, whereas an unrelated surfactant (Triton X-100) did not. We conclude that the clinical hyperfluorescence profile observed after exposure to four MPS can be reproduced using a simple model of cellular fluorescein uptake, suggesting this is the biological basis for SICS. Fluorescein entry does not correlate with necrosis or apoptosis, but instead involves a dynamin-dependent active process. Moreover the surfactant Tetronic 1107 appears to be a key MPS constituent triggering increased fluorescein entry, and may be the major factor responsible for SICS.
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15
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Li L, Braun RJ, Henshaw WD, King-Smith PE. Computed flow and fluorescence over the ocular surface. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2018; 35:51-85. [PMID: 29036609 DOI: 10.1093/imammb/dqx011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 08/21/2017] [Indexed: 11/14/2022]
Abstract
Fluorescein is perhaps the most commonly used substance to visualize tear film thickness and dynamics; better understanding of this process aids understanding of dry eye syndrome which afflicts millions of people. We study a mathematical model for tear film flow, evaporation, solutal transport and fluorescence over the exposed ocular surface during the interblink. Transport of the fluorescein ion by fluid flow in the tear film affects the intensity of fluorescence via changes in concentration and tear film thickness. Evaporation causes increased osmolarity and potential irritation over the ocular surface; it also alters fluorescein concentration and thus fluorescence. Using thinning rates from in vivo measurements together with thin film equations for flow and transport of multiple solutes, we compute dynamic results for tear film quantities of interest. We compare our computed fluorescent intensity distributions with in vivo observations. A number of experimental features are recovered by the model.
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Affiliation(s)
- Longfei Li
- Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy NY, 12180, USA
| | - R J Braun
- Department of Mathematical Sciences, University of Delaware, Newark, DE 19711, USA
| | - W D Henshaw
- Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy NY, 12180, USA
| | - P E King-Smith
- College of Optometry, The Ohio State University, Columbus, OH 43218, USA
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Downie LE, Craig JP. Tear film evaluation and management in soft contact lens wear: a systematic approach. Clin Exp Optom 2018; 100:438-458. [PMID: 28940531 DOI: 10.1111/cxo.12597] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/09/2017] [Accepted: 07/05/2017] [Indexed: 12/13/2022] Open
Abstract
The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear.
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Affiliation(s)
- Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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18
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Reply. Am J Ophthalmol 2016; 168:294-295. [PMID: 27292530 DOI: 10.1016/j.ajo.2016.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 11/22/2022]
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Pilot Study to Determine the Effect of Lens and Eye Rinsing on Solution-Induced Corneal Staining (SICS). Optom Vis Sci 2016; 93:1218-27. [PMID: 27441740 DOI: 10.1097/opx.0000000000000933] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The main purpose of this study was to determine whether two interventions (rinsing the lens before lens insertion and rinsing the ocular surface post-lens removal) had any impact on solution-induced corneal staining (SICS). In addition, the presence of hyper-reflective epithelial cells in the presence of SICS was investigated. METHODS Twenty subjects wore new balafilcon A lenses, which had been soaked overnight in a multipurpose care product containing polyhexamethylene biguanide for 2 hours. The study was conducted across three phases. In phase 1 (investigator and subject masked, randomized eye), one lens was rinsed with nonpreserved saline before lens insertion. In phase 2 (investigator masked, randomized eye), one eye was rinsed with nonpreserved saline after lens removal, before staining assessment. Corneal staining was recorded as the percentage area of the cornea exhibiting superficial punctate staining. In both phases, ocular comfort and presence of specific symptoms were captured. In phase 3, there was no randomized treatment; confocal images of the epithelium were obtained after 2 hours of wear. RESULTS In phase 1 (lens-rinse), there was no significant difference in staining between the treated and untreated eyes (84 vs. 92%, respectively; p = 0.06). In phase 2 (eye-rinse), there was also no significant difference between the treated and untreated eye (86 vs. 86%, p = 0.92). Most subjects were asymptomatic. In phase 3, images of hyper-reflective cells were captured in 97% of the eyes imaged. CONCLUSIONS The two rinsing procedures did not affect the level of the SICS response. Hyper-reflective epithelial cells were found to be present in a significant number of eyes exhibiting SICS, and their presence warrants further investigation.
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Efron N, Brennan NA, Morgan PB, Wilson T. Lid wiper epitheliopathy. Prog Retin Eye Res 2016; 53:140-174. [PMID: 27094372 DOI: 10.1016/j.preteyeres.2016.04.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/05/2016] [Accepted: 04/12/2016] [Indexed: 01/12/2023]
Abstract
Some recent research has resulted in a hypothesis that there is a common 'lid wiper' region that is apposite to the ocular surface or anterior lens surface (where contact lenses are worn), responsible for spreading tears during blinking. In the upper eyelid, it extends about 0.6 mm from the crest of the sharp posterior (inner) lid border (i.e. the mucocutaneous junction, or line of Marx) to the subtarsal fold superiorly and from the medial upper punctum to the lateral canthus horizontally. Histologically, it is seen as an epithelial elevation comprising of stratified epithelium with a transitional conjunctival structure of (moving posteriorly) squamous cells then cuboidal cells, with some parakeratinised cells and goblet cells. Lid wiper epitheliopathy (LWE) denotes staining of the lid wiper observed after instillation of dyes such as fluorescein, rose bengal or lissamine green. There have been some reports of higher rates of LWE in dry eye patients and contact lens wearers, but others have failed to find such associations. The primary cause of LWE is thought to be increased friction between the lid wiper and ocular or anterior contact lens surface due to inadequate lubrication, which could be caused by dry eye and may be exacerbated by factors such as abnormal blinking patterns, poor contact lens surface lubricity and adverse environmental influences. Recent evidence suggests that LWE is associated with sub-clinical inflammation. LWE has the potential to provide the missing mechanistic link between clinical observation and symptoms associated with dry eye and contact lens wear. Clinical and fundamental research into LWE is still in its infancy and in many instances equivocal; however, it is an idea that provides a potentially important new avenue for further investigation of anterior eye discomfort associated with ocular dryness and contact lens wear.
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Affiliation(s)
- Nathan Efron
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland 4059, Australia.
| | - Noel A Brennan
- Johnson & Johnson Vision Care, Inc., 7500 Centurion Parkway, Jacksonville, FL 32256, USA
| | - Philip B Morgan
- Eurolens Research, The University of Manchester, Dover Street, Manchester, M13 9PL, UK
| | - Tawnya Wilson
- Johnson & Johnson Vision Care, Inc., 7500 Centurion Parkway, Jacksonville, FL 32256, USA
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Varikooty J, Srinivasan S, Subbaraman L, Woods CA, Fonn D, Simpson TL, Jones LW. Variations in observable lid wiper epitheliopathy (LWE) staining patterns in wearers of silicone hydrogel lenses. Cont Lens Anterior Eye 2015; 38:471-6. [DOI: 10.1016/j.clae.2015.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/30/2015] [Accepted: 05/12/2015] [Indexed: 01/04/2023]
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Bron A, Argüeso P, Irkec M, Bright F. Clinical staining of the ocular surface: Mechanisms and interpretations. Prog Retin Eye Res 2015; 44:36-61. [DOI: 10.1016/j.preteyeres.2014.10.001] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
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Shaheen BS, Bakir M, Jain S. Corneal nerves in health and disease. Surv Ophthalmol 2014; 59:263-85. [PMID: 24461367 PMCID: PMC4004679 DOI: 10.1016/j.survophthal.2013.09.002] [Citation(s) in RCA: 305] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 08/23/2013] [Accepted: 09/03/2013] [Indexed: 12/14/2022]
Abstract
Corneal nerves are responsible for the sensations of touch, pain, and temperature and play an important role in the blink reflex, wound healing, and tear production and secretion. Corneal nerve dysfunction is a frequent feature of diseases that cause opacities and result in corneal blindness. Corneal opacities rank as the second most frequent cause of blindness. Technological advances in in vivo corneal nerve imaging, such as optical coherence tomography and confocal scanning, have generated new knowledge regarding the phenomenological events that occur during reinnervation of the cornea following disease, injury, or surgery. The recent availability of transgenic neurofluorescent murine models has stimulated the search for molecular modulators of corneal nerve regeneration. New evidence suggests that neuroregenerative and inflammatory pathways in the cornea are intertwined. Evidence-based treatment of neurotrophic corneal diseases includes using neuroregenerative (blood component-based and neurotrophic factors), neuroprotective, and ensconcing (bandage contact lens and amniotic membrane) strategies and avoiding anti-inflammatory therapies, such as cyclosporine and corticosteroids.
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Affiliation(s)
- Brittany Simmons Shaheen
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - May Bakir
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Sandeep Jain
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois.
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Doughty MJ. Rose bengal staining as an assessment of ocular surface damage and recovery in dry eye disease—A review. Cont Lens Anterior Eye 2013; 36:272-80. [DOI: 10.1016/j.clae.2013.07.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/15/2013] [Accepted: 07/10/2013] [Indexed: 11/26/2022]
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Gorbet M, Peterson R, McCanna D, Woods C, Jones L, Fonn D. Human Corneal Epithelial Cell Shedding and Fluorescein Staining in Response to Silicone Hydrogel Lenses and Contact Lens Disinfecting Solutions. Curr Eye Res 2013; 39:245-56. [DOI: 10.3109/02713683.2013.841255] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Efron N. Response to re: putting vital stains in context. Clin Exp Optom 2013; 96:508-9. [PMID: 23992360 DOI: 10.1111/cxo.12062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tran N, Graham AD, Lin MC. Ethnic differences in dry eye symptoms: effects of corneal staining and length of contact lens wear. Cont Lens Anterior Eye 2013; 36:281-8. [PMID: 23850062 DOI: 10.1016/j.clae.2013.06.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 05/15/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To explore the relationships among length of contact lens (CL) wear, degree of corneal staining and severity of dryness symptoms, and to determine whether these relationships differ between Asians and non-Asians. METHODS Adapted soft CL wearers (n=395; 180 Asian, 215 non-Asian) were required to discontinue CL wear for at least 24h and report to the University of California, Berkeley Clinical Research Center (UCB-CRC). Fluorescein corneal staining was graded according to Brien Holden Vision Institute scales. Length of CL wear was reported by subjects and subjective dryness ratings were collected using the UCB-CRC Dry Eye Flow Chart (DEFC). RESULTS More Asian CL wearers exhibited corneal staining compared to non-Asians, and Asian CL wearers had a higher mean grade of corneal staining (p<0.001), as well as a higher mean DEFC classification (p<0.001). The difference between Asians and non-Asians in grades of corneal staining extent and depth were significant (p<0.001). Among non-Asian CL wearers, dryness symptoms decreased with more years of CL wear and increased in the presence of corneal staining, which was not the case for Asian CL wearers. CONCLUSIONS Asian soft CL wearers reported more severe dryness symptoms and demonstrated more severe corneal staining overall compared to non-Asians. Among non-Asians, dryness symptoms were less severe on average with increased years of CL wear and more severe in the presence of corneal staining. Dryness severity does not appear to be related to years of CL wear or corneal staining among Asians.
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Affiliation(s)
- Nina Tran
- Clinical Research Center, School of Optometry, University of California at Berkeley, United States
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