Optical causes of experimental myopia

Experiments in which chicks are reared wearing a translucent goggle, or some similar device designed to degrade the retinal image, usually result in the induction of a significant degree of myopia. The induced myopia is due to enlargement of the vitreous chamber of the eye. Despite extensive change in the size, shape and refractive index distribution of the crystalline lens, its refractive power is static in the embryonic and early chick eye. The contribution to myopia of the cornea is uncertain; some studies have indicated either an increase or a decrease in corneal radius of curvature while others found no change. The fact that experimental myopia can be produced in chicks even when the optic nerve has been cut or when the degraded retinal image is restricted to one sector of the eye suggests that accommodation is not involved. Nevertheless, when the retinal image is degraded by being defocused with convex or concave lenses, myopia (concave lenses) or hyperopia (convex lenses) results. Chicks wearing concave or convex soft contact lenses from the day of hatching develop refractive states equal to the lens power (+8 and -10 diopters) within one week. The ability of the eye to vary its refractive development according to the sign of defocus suggests a role for accommodation. However, study of the ciliary muscle and accommodative apparatus of myopic and emmetropic chick eyes does not reveal any morphological differences that might indicate that the myopic eye had experienced an increased level of accommodation.

Afocal magnification does not influence chick eye development

In defocus-induced ametropia experiments, retinal blur circles are a likely source of information as to the magnitude but not the sign of the defocus. However, magnification (and minification) produced by the lenses may be a cue. In this study, 1-day-old broiler chicks (N = 13) were treated monocularly for 7 days with special goggles containing approximately afocal iseikonic lenses which were designed to produce 10% retinal image magnification. This is a little less than the magnification produced by +10 D defocusing lenses used to produce about 10 D of hyperopia in earlier work. Intraocular dimensions of both eyes were measured by A-scan ultrasonography on the first and last day. Refractive states of both eyes were measured daily with a retinoscope and trial lenses. After the birds were sacrificed, the eyes were enucleated, weighed, and measured with calipers. Before the treatment there was no difference in the refractive state or dimensions of the right and left eyes. After 1 week of goggle wear there was still no significant difference between the eyes in spite of the magnification produced by the goggles. These data suggest that factors other than magnification are responsible for the ability of the eye to respond to the sign of defocus.

Induced refractive anomalies affect chick orbital bone structure

Experiments have shown that it is possible to induce ametropias (myopia and hyperopia) in the eyes of young animals by distorting early visual experience through the use of negative and positive defocussing lenses mounted over the eye. Defocus lenses (+15 and -15 diopters) were mounted unilaterally over one eye of day old broiler chicks using a contact lens-goggle and velcro combination. Refractive states and ocular dimensions were measured by retinoscopy and ultrasound during the experiment. On the seventh day the birds were killed after which the eyes were removed, weighed and measured with calipers. The remaining heads were cleaned of all soft tissue to leave only the bones of the skull. Axial and equatorial orbital dimensions were then measured with vernier calipers. The frontal bone was prepared for histological analysis and sections were used to determine the relative proportions of formed bone to primitive mesenchymal cells. Prior to treatment there were no differences in refractive states or dimensions of the two eyes. After one week of defocus, the treated eyes were longer or shorter as well as more myopic or hyperopic than the contralateral eye by amounts close to the powers of the defocussing lenses (-12.3 and +11.8 diopters). Orbital sizes varied substantially. Orbital axes of myopic eyes were significantly (P < or = 0.05) longer (on average 0.77 +/- 0.23 mm) than the contralateral control orbits. The orbital axes associated with the hyperopic eyes were significantly (P < or = 0.05) shorter (on average 0.69 +/- 0.18 mm) than the contralateral control orbits. Similarly, significant differences (P < or = 0.05) were recorded for a variety of equatorial measures (naso-temporal, superior inferior, oblique (nasal-superior, temporal-superior). Histological analysis reveals that the frontal bone of the myopic chick is in a more mature state of development compared to the frontal bone of the hyperopic chick. The eyes and orbits of chicks with induced ametropias that were allowed to the recover were not significantly different from the control eyes and orbits. This study clearly shows that, in chicks, ocular refractive development is associated with orbital development and that experiments related to growth factors and retinal processing of defocus information should also consider growth and development of tissue beyond the ocular globe.

Effects of continuous light on experimental refractive errors in chicks

It is possible to induce ametropias in young chicks either by depriving the developing eye of clear form vision with a translucent goggle or by defocusing the retinal image with convex or concave lenses. The refractive properties of the developing chick eye are also altered by raising young birds in a continuous light environment. The effects of superimposing form deprivation or defocus treatments on chicks raised in continuous light are unclear. Newly hatched (n = 31) chicks were raised for 2 weeks under continuous light while wearing either translucent goggles or + 10 or -10 diopter (D) lenses over one eye. Refractive states, corneal curvature and intraocular dimensions were measured periodically by retinoscopy, keratometry and A-scan ultrasound. The birds were sacrificed after 2 weeks and the eyes removed and measured with calipers. Under continuous light, all eyes treated with translucent goggle and -10 D lens developed moderate myopia (-2.6 +/- 0.5 D and -1.4 +/- 0.3 D, respectively) by day 4. The eyes treated with a + 10 D lens developed moderate hyperopia (+ 4.8 +/- 0.5 D) at day 4. Corneal curvatures of all treated eyes were slightly, but significantly, larger than contralateral control eyes by day 4. After 2 weeks of goggle or lens application, all the treated eyes were hyperopic due to corneal flattening. But the eyes treated with a goggle or a -10 D lens still showed relative myopia compared to the fellow eyes (treated minus untreated = -3.8 +/- 0.4 D and -2.8 +/- 0.4 D, respectively), and the eyes treated with a + 10 D lens showed more hyperopia than fellow eyes (treated minus untreated = + 5.1 +/- 0.6 D). Compared with the control eyes, the axial length (mainly vitreous chamber depth) was slightly, but significantly, increased in the eyes treated with a goggle or a -10 D lens, and the axial length decreased slightly in the eyes treated with + 10 D lens. The results suggest that form deprivation and retinal defocus (induced by +/- 10 D lenses) could still induce experimental refractive errors (myopia and hyperopia) in chicks kept under continuous light, but the effects of form deprivation and retinal defocus were partially suppressed by continuous light.

Chick eye optics: zero to fourteen days

Ocular dimensions and refractive state data for chicks 0 to 14 days of age were obtained from 234 untreated control eyes of birds treated unilaterally in previous work involving various defocussing lenses and/or translucent goggles. Refractive state and corneal curvatures were measured in vivo by retinoscopy and ophthalmometry respectively. Intraocular dimensions were measured by A-scan ultrasonography, after which the eyes were removed, weighed and measured. In some cases (n = 52) intraocular dimensions and lens curvatures were obtained from frozen sections of enucleated eyes. The hyperopia of hatchling chicks (+6.5 +/- 4.0 D) initially decreases rapidly and then more gradually to +2.0 +/- 0.5 D by 16 days. The distribution of refractive errors is very broad at Day 0, but becomes leptokurtotic, with a slight myopic skew, by Day 14. Corneal radius is constant for the first four days, possible as a result of pre-hatching lid pressure, and then increases linearly, as do all lens dimensions, axial diameter and equatorial diameter. Schematic eyes were developed for Days 0, 7, and 14.

The absence of a photopic influence on the refractive development of the embryonic eye of the clearnose skate (Raja eglanteria)

The clearnose skate (Raja eglanteria) develops in an almost opaque eggcase and lays its eggs in pairs. One sibling from each of eight pairs of skates was removed from its eggcase during embryonic development, while the other sibling developed inside the eggcase. The refractive development of the eyes at hatching was examined to see if ambient light exposure during embryonic development could influence the refractive states of hatchlings. Measurements included refractive states, ocular dimensions and lens focal properties. The differences in measurements between the two groups were not significant, which would indicate that environmental light does not influence the refractive development of the embryonic skate eye.

Inducing ametropias in hatchling chicks by defocus--aperture effects and cylindrical lenses

Light-weight translucent plastic goggles with convex or concave rigid contact lens inserts were applied unilaterally to the eyes of young chicks. Convex and concave cylindrical lenses produced astigmatic refractive errors. The magnitude of the induced astigmatism was less than that of the inducing lens and varied with axis orientation. Decreased aperture size or interruption of the defocus resulted in a decreased response to refractive defocus. Slit apertures and spherical defocus produced variable amounts of myopia, hyperopia and astigmatism. Choroidal changes (increased thickness) were observed only in birds developing hyperopia or recovering from myopia.

Retinal dopamine and lens-induced refractive errors in chicks

This study investigated the relationship between retinal dopamine and lens induced refractive errors in chicks by high performance liquid chromatography with ultraviolet detection (HPLC-UV). After two weeks of lens wear, the chick eyes treated with +10D lenses were hyperopic (+8.29 +/- 0.43D), while the eyes treated with -10D lenses were myopic (-11.69 +/- 0.74D). At the same time, in myopic eyes the level of retinal dopamine and its metabolite 3,4-dihydroxy-phenylacetic acid (DOPAC) were reduced compared to control eyes, while in hyperopic eyes the level of retinal dopamine and DOPAC were increased as compared with control eyes. Therefore, retinal dopamine may participate in the development of lens induced refractive errors in chicks.

Accuracy of Javal's rule in the determination of spectacle astigmatism

Javal's rule and Grosvenor's simplification of it are commonly used formulas for predicting spectacle astigmatism from keratometric measurements. We assessed the accuracy of these two rules. Spectacle astigmatism was estimated using both rules from measurements of corneal astigmatism on 100 eyes of 100 subjects. These estimates were then compared to the subjectively determined spectacle astigmatism. Grosvenor's simplification of Javal's rule gave slightly more accurate assessments than the original rule. However, only 66% of results gave estimates within 0.50 D, and 7% differed by more than 1.00 D. This can be compared to previous reports on the accuracy of autorefractors, where approximately 95% of cylinder results were within 0.50 D of the spectacle astigmatism. These results indicate that using Javal's rule or Grosvenor's simplification of it to determine spectacle astigmatism from corneal cylinder readings is of limited clinical value.

Refractive plasticity of the developing chick eye

We have developed a lightweight plastic goggle with rigid contact lens inserts that can be applied to the eyes of newly hatched chicks to explore the range and accuracy of the developmental mechanism that responds to retinal defocus. Convex and concave lenses of 5, 10, 15, 20 and +30 D were applied to one eye on the day of hatching. The chick eye responds accurately to defocus between -10 and +15 D, although hyperopia develops more rapidly than myopia. Beyond this range there is first a levelling off of the response and then a decrease. The resulting refractive errors are caused mainly by increases and decreases in axial length, although high levels of hyperopia are associated with corneal flattening. If +/- 10 D defocusing lenses are applied nine days after hatching the resulting myopia and hyperopia are equal to about 80% of the inducing power. After one week of inducing myopia and hyperopia with +/- 10 D lenses, the inducing lenses were reversed. In this case, the refractive error did not reach the power of the second lens after another week of wear. Instead, astigmatism in varying amounts (0-12 D) was produced, being greater when reversal was from plus to minus. Finally, astigmatism can also be produced by applying 9 D toric inducing lenses on the day of hatching. The astigmatism produced varies from 2 to 6 D, and the most myopic meridian coincides with the power meridian of the inducing lens. This astigmatism appears to be primarily due to corneal toricity.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of storage time with different lens care systems on in-office hydrogel trial lens disinfection efficacy: a multi-center study

A combined prospective and retrospective study was conducted to evaluate the efficacy of in-office disinfection methods for hydrogel trial contact lenses. Two hundred and twenty-one trial contact lenses, disinfected by four different disinfection methods, were collected from seven Study Centers and cultured for microbial contamination after various storage periods. Negative and positive control lenses were included as an additional Center in this double-masked study. There was a significant difference in the incidence of microbial contamination among the Centers for all storage times (chi 2 p < 0.001). Contamination of trial lenses in Centers using thermal disinfection with preserved saline (SoftWear Saline) was negative and thermal disinfection with nonpreserved saline (LensPlus Saline) was 8.7%. Lens contamination in Centers using chemical disinfection was 13.6% with ReNu and 40.7% with OptiFree. The degree of contamination ranged from 90 colony forming units (CFU)/ml to over 10 million CFU/ml. Among the microorganisms isolated after the different disinfection methods were Alcaligenes xylosoxidans, Serratia marcescens, Moraxella phenylpyruvica, Enterobacter agglomerans, Pseudomonas stutzeri, and various gram-positive organisms. This study suggests that practitioners should redisinfect all inventory trial lenses at least once a month to minimize the risk of patient infection.

Inducing myopia, hyperopia, and astigmatism in chicks

Myopia and hyperopia have been produced in chicks by applying specially designed convex and concave soft contact lenses to the eyes of newly hatched birds. After 2 weeks of wear, the eyes develop refractive states equivalent in sign and amount (+8 and -10 D) to the lens used. However, the lenses produce an artificial hyperopic shift during the first week of wear due to corneal flattening. We have developed a new approach involving the use of goggles with hard convex and concave contact lens inserts placed between the frontal and lateral visual fields. Myopia and hyperopia (+10 and -10 D) can be produced within days (4 days for hyperopia and 7 days for myopia) if the defocus is applied from the day of hatching. We can also produce significant amounts of astigmatism (1 to 5 D) axis at 90 degrees and 180 degrees by using cylindrical contact lens inserts. Although these last results are preliminary, they suggest that accommodation is not likely involved at this stage of refractive development because we do not believe that the accommodative mechanism can cope with cylindrical defocus. All spherical refractive errors produced using the goggle system appear to result from alterations in vitreous chamber depth.

Antimicrobial effectiveness of some soft contact lens care systems

A study of the antimicrobial effectiveness of three soft contact lens care systems, In-A-Wink, Oxysept, and Hydrocare revealed that viable microorganisms are less likely to be present in the storage solution of the Hydrocare system than in either the Oxysept or In-A-Wink systems after lenses are removed by patients. The limited antimicrobial activity of sorbic acid in the In-A-Wink neutralizing solution could be attributed to the pH of the formulation. It is recommended that the neutralizing solution be discarded after the lenses are removed from the case, as microorganisms transferred by the hands to the solution in the case could remain viable, thus increasing the risk of eye contamination.

Bacterial flora of the eye and contact lens. Cases during hydrogel lens wear

Bacteriological comparisons between the tear fluids of soft contact lens wearers and noncontact lens wearers indicate that there is an increase in the bacterial population in contact lens wearers but not a significant change in the varieties present. Differences between groups of contact lens wearers appear to depend on the method of disinfection used.

A subjective method of monitoring corneal scattering

Border-enhancement spread is a new criterion for assessing the quality of the retinal image. In one study, it was found that the width of the enhanced region increases with the steepness of a contact lens fit, and this increase was attributed to scattering accompanying corneal edema arising from tight-fitting lenses. The present study tested this hypothesis. Corneal thickness and border-enhancement spread were measured concurrently at regular intervals during and after contact lens wear. It was found that border-enhancement spread generally follows changes in corneal thickness. Since scattering increases with corneal swelling, the findings generally support the hypothesis. However, it was also found that variables not originating in the cornea sometimes modify the retinal-image quality and thus mask the scattering effects. Future applications of the methods are discussed.