Useful Papers

  • Contact Lens Practice

Opportunities and threats to contact lens practice: A global survey perspective

Thite et al.

A study aimed to understand the views of contact lens (CL) practitioners across the globe regarding what they perceive as opportunities and threats in CL practice. A self-administered anonymized questionnaire was distributed through international professional bodies and academic institutions worldwide. The questionnaire included items on demographic characteristics, type of practice, and questions designed to explore practitioners' perspective on the future of their CL practice over the next five years. A total of 2408 valid responses were analyzed. Multifocal CLs for presbyopia, CLs for myopia control, use of daily disposable (DD) CLs for occasional wear, and biocompatible materials to improve comfort were identified as promising areas of opportunities by practitioners (all 8/10). Respondents from North America, and Europe valued DDCLs for occasional wear moderately more favorable (median: 9/10 for all) as compared to colleagues in Asia (median: 8/10, p < 0.001), South America (median: 8/10, p < 0.01), and Africa (median: 8/10p < 0.01). Multifocal CLs for presbyopia was perceived as a better opportunity by practitioners in North America and Europe (median: 9/10 for both), as well as in Australasia (median: 8/10), in comparison to Asia, Africa, and Middle East (for all Median: 6/10, p < 0.001). Practitioners expressed concerns about the availability of CLs and CL prescriptions online without direct professional involvement (both 9/10). Overall, the most appealing opportunities for CL practice growth were identified in occasional use of DD CLs, biocompatible materials to reduce CL discomfort, multifocal CLs for presbyopia correction and management of myopia control with CLs. Lack of regulation in CL sales, especially online, seemed to be a constant threat. The insights from this study can be used to design targeted strategies to enhance CL practice across the globe and in specific geographical areas.

https://pubmed.ncbi.nlm.nih.gov/34426063/


  • Specialty Lenses

Keratoconus: An updated review

Santodomingo-Rubido et al.

Keratoconus is a bilateral and asymmetric disease which results in progressive thinning and steeping of the cornea leading to irregular astigmatism and decreased visual acuity. Traditionally, the condition has been described as a noninflammatory disease; however, more recently it has been associated with ocular inflammation. Keratoconus normally develops in the second and third decades of life and progresses until the fourth decade. The condition affects all ethnicities and both sexes. The prevalence and incidence rates of keratoconus have been estimated to be between 0.2 and 4,790 per 100,000 persons and 1.5 and 25 cases per 100,000 persons/year, respectively, with highest rates typically occurring in 20- to 30-year-olds and Middle Eastern and Asian ethnicities. Progressive stromal thinning, rupture of the anterior limiting membrane, and subsequent ectasia of the central/paracentral cornea are the most commonly observed histopathological findings. A family history of keratoconus, eye rubbing, eczema, asthma, and allergy are risk factors for developing keratoconus. Detecting keratoconus in its earliest stages remains a challenge. Corneal topography is the primary diagnostic tool for keratoconus detection. In incipient cases, however, the use of a single parameter to diagnose keratoconus is insufficient, and in addition to corneal topography, corneal pachymetry and higher order aberration data are now commonly used. Keratoconus severity and progression may be classified based on morphological features and disease evolution, ocular signs, and index-based systems. Keratoconus treatment varies depending on disease severity and progression. Mild cases are typically treated with spectacles, moderate cases with contact lenses, while severe cases that cannot be managed with scleral contact lenses may require corneal surgery. Mild to moderate cases of progressive keratoconus may also be treated surgically, most commonly with corneal cross-linking. A recent publication provides an updated review on the definition, epidemiology, histopathology, aetiology and pathogenesis, clinical features, detection, classification, and management and treatment strategies for keratoconus.

https://pubmed.ncbi.nlm.nih.gov/34991971/


  • Myopia Control

Efficacy and Safety of Different Add Power Soft Contact Lenses on Myopia Progression in Children: A systematic review and meta-analysis

Yu et al.

Soft multifocal contact lenses (SMCLs) are widely used to control myopia progression in children; however, the efficacy and adverse effects to the use of SMCLs of different added powers remains to be explored. A systematic review and meta-analysis evaluated the results from seven independent studies involving 805 children in terms of the weighted mean differences (WMD) in myopic progression, axial length, and odds ratios (ORs) for adverse effects and dropout rates between SMCLs with different added powers and control groups. At 1-year, the WMD in myopia progression between SMCL and control groups was -0.22 diopters (D) (95% CI, -0.56-0.12 D) for low add power SMCLs, 0.09 D (95% CI, 0-0.19 D) for medium add power, and 0.2 D (95% CI. 0.13, 0.27 D) for high add power. At 2-years, the WMD for medium add power was 0.12 D (95% CI, -0.03-0.27 D), and for high add power was 0.25 D (95% CI, 0.14-0.35 D). No differences were detected for adverse effects (p = 0.2) and acceptability (p = 0.74) between different added powers. Additionally, differences in visual performance changes, produced by different added powers, were not detected. The present meta-analysis showed that high add power SMCLs are more effective and stable to control myopia progression, whereas adverse effects and acceptability were not related to the added power.

https://pubmed.ncbi.nlm.nih.gov/35226916/


  • Compliance

Compliance vs. Risk Awareness with Contact Lens Storage Case Hygiene and Replacement

Cardona et al.

A study evaluated the level of compliance regarding contact lens (CL) storage case hygiene and replacement, as well as the type of information provided by eye care practitioners regarding lens handling and patients’ risk perception to lens wear compliance. A survey was used to collect demographic and CL wear details, compliance with storage case care, type of received information from practitioners and risk perception (in a 1-to-5 scale). Non-daily disposable wearing participants, with a median age of 24 years (76.9% females), returned 299 completed surveys. Most participants were monthly replacement silicone hydrogel CL wearers who use multipurpose solutions. Self-reported compliance with storage case care was poor, with 19.1% of respondents reporting never cleaning their cases, 68.6% exposing them to tap water, and 26.4% failing to replace them within 6 months of acquisition. Two-thirds of respondents reported receiving specific information on case maintenance from practitioners, mainly in oral form. Perceived risk associated with poor-compliance practices was high (median values of 4 and 5), and increased with educational level (P = .02, regarding hand-washing; P = .03, regarding case hygiene), years of CL wear experience (P < .001, regarding hand-washing) and in those patients provided with specific information on CL case care (P = .01, regarding case replacement). Despite compliance with hygiene and replacement of contact lens storage cases is key to avoid contact lens contamination and anterior ocular surface complications, this study found that compliance with CL storage case hygiene and replacement was generally poor, even in patients with awareness of the risk associated with non-compliance. Strategies must be explored to increase risk awareness through education as this may lead to better compliance practices.

https://pubmed.ncbi.nlm.nih.gov/35165235/


  • Orthokeratology

CLEAR – Orthokeratology

Vincent et al et al.

Orthokeratology (ortho-k) is the process of deliberately reshaping the anterior cornea by utilizing specialty contact lenses to temporarily and reversibly reduce refractive error after lens removal. Modern ortho-k utilizes reverse geometry lens designs, made with highly oxygen permeable rigid materials, worn overnight to reshape the anterior cornea and provide temporary correction of refractive error. More recently, ortho-k has been extensively used to slow the progression of myopia in children. A recent report reviewed the practice of ortho-k, including its history, mechanisms of refractive and ocular changes, current use in the correction of myopia, astigmatism, hyperopia, and presbyopia, and standard of care. Suitable candidates for ortho-k are described, along with the fitting process, factors impacting success, and the potential options for using newer lens designs. Ocular changes associated with ortho-k, such as alterations in corneal thickness, development of microcysts, pigmented arcs, and fibrillary lines are reviewed. The safety of ortho-k is extensively reviewed, along with an overview of non-compliant behaviors and appropriate disinfection regimens. Finally, the role of ortho-k in myopia management for children is discussed in terms of efficacy, safety, and potential mechanisms of myopia control, including the impact of factors such as initial fitting age, baseline refractive error, the role of peripheral defocus, higher order aberrations, pupil size, and treatment zone size.

https://pubmed.ncbi.nlm.nih.gov/33775379/


  • Specialty Lenses

CLEAR - Scleral lenses

Barnett et al.

Scleral lenses were the first type of contact lens, developed in the late nineteenth century to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970's, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This academic report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimize patient outcomes in modern scleral lens practice.

https://pubmed.ncbi.nlm.nih.gov/33775380/


  • Myopia Control

IMI Impact of Myopia

Sankaridurg et al.

Myopia affected nearly 30% of the world population in 2020 and this number is expected to rise to 50% by 2050. As a result of the latter, the global burden of myopia is also growing. A review from the International Myopia Institute analyzed the impact of myopia on individuals and society; summarizing the evidence for recent research on the prevalence of myopia and high myopia, lifetime pathological manifestations of myopia, direct health expenditure, and indirect costs such as lost productivity and reduced quality of life (QOL). As a result of the rising prevalence of myopia and high myopia, with a disproportionately greater increase in the prevalence of high myopia, this review forecasts a future increase in vision loss due to uncorrected myopia as well as high myopia-related complications such as myopic macular degeneration. Also, QOL has been found to affect those with uncorrected myopia, high myopia, or complications of high myopia. Overall the current global cost related to direct health expenditure and lost productivity has been estimated to be in the billions. Health expenditure is greater in adults, reflecting the added costs due to myopia-related complications. Unless the current trajectory for the rising prevalence of myopia and high myopia change, the costs are expected to grow. The past few decades have seen the emergence of several novel approaches to prevent and slow myopia. Further work is needed to understand the life-long impact of myopia on an individual and the cost-effectiveness of the various novel approaches in reducing the burden.

https://pubmed.ncbi.nlm.nih.gov/33909036/


  • Compliance

Assessment of patient compliance in orthokeratology and analysis of influencing factors: a cross-sectional study

Bian et al.

Patient non-compliance with orthokeratology contact lens wear has been shown to be a major risk factor for contact lens-associated complications. A study conducted in China aimed to investigate the compliance with wear and care behaviors of 238 orthokeratology patients and analyze its influencing factors through the use a questionnaire. The subjects' ages ranged from 7 to 25 (mean ± SD, 11.3 ± 2.5) years. The compliance with wear and care behaviors was 19.7%, and the subjects' self-assessment compliance was 96.6%. The compliance rate of subjects wearing lenses for less than 1 year was higher than that of subjects wearing lenses for more than 1 year (p < 0.001). In the first year, the compliance rates of wearing experiences for less than 1 month, 1 month, 3 months, 6 months, and more than 6 months were 45, 29, 21.6, 20, and 27.6%, respectively; no statistically significant differences in compliance were found among these periods (p = 0.314). No correlation was identified between compliance and age (r = - 0.061, p = 0.527) or sex (r = 0.114, p = 0. 751). There was no correlation between compliance and lens care operator (r = - 0.626, p = 0.151). Overall, this study concluded that compliance with orthokeratology lens wear was poor in the cohort assessed. After wearing orthokeratology lenses for more than 1 year, compliance with wear and care behaviors declined. As such, the authors recommended that measures should be taken in clinical practice to solve these problems and improve the safety of orthokeratology contact lens wear.

https://pubmed.ncbi.nlm.nih.gov/34784895/


  • Myopia Control

Myopia Progression as a Function of Sex, Age, and Ethnicity

Jones-Jordan et al.

A group of researchers in the US aimed to model juvenile-onset myopia progression as a function of race/ethnicity, age, sex, parental history of myopia, and time spent reading or in outdoor/sports activity. The study included 594 children with at least three study visits: one visit with a spherical equivalent (SPHEQ) less myopic/more hyperopic than -0.75 diopter (D), the first visit with a SPHEQ of -0.75 D or more myopia (onset visit), and another after myopia onset. Younger children were found to have faster progression of myopia; for example, the model-estimated 3-year progression in an Asian American child was -1.93 D when onset was at age 7 years compared with -1.43 D when onset was at age 10 years. Annual progression for girls was 0.093 D faster than for boys. Asian American children experienced statistically significantly faster myopia progression compared with Hispanic (estimated 3-year difference of -0.46 D), Black children (-0.88 D), and Native American children (-0.48 D), but with similar progression compared with White children (-0.19 D). Parental history of myopia, time spent reading, and time spent in outdoor/sports activity were not statistically significant factors in multivariate models. In conclusion, younger age, female sex, and racial/ethnic group were the factors associated with faster myopic progression. This model can facilitate the planning of clinical trials for myopia control interventions by informing the prediction of myopia progression rates.

https://pubmed.ncbi.nlm.nih.gov/34463720/


  • Specialty Lenses

Optimizing correction of coma aberration in keratoconus with a novel soft contact lens

Susaki et al.

A group of Japanese researchers reported on the development of a second-generation prototype contact lens (modified lens) with enhanced optics to correct coma aberration in patients with keratoconus (KC). The performance of the modified lens was compared with that of a first-generation prototype contact lens (conventional lens) also optimized to correction coma aberration. Both lenses were designed as a set of standardized soft contact lenses (SCLs) with asymmetric powers along the posterior surface. The modified lens differs from the conventional lens in that the optical zone is decentered superiorly by 0.7 mm. Thirty-four KC eyes were included. Both lenses significantly decreased coma aberration compared to no-lens wear, with the reduction in coma aberration being significantly greater with the modified lens than with the conventional lens. No significant differences in manifest refraction or distance visual acuity were found among the three conditions. Quality of vision was significantly better with the modified lens than with no lens wear, but no differences were found between the SCLs. The on-eye optical center position relative to the pupil was closer to the pupil center using the modified lens than the conventional lens. Optimization of the location of the optical zone in a standardized asymmetric soft contact lens improves correction of coma aberrations and on-eye optical centration.

https://pubmed.ncbi.nlm.nih.gov/33436159/


  • Orthokeratology

Adjunctive effects of orthokeratology and atropine 0.01% eye drops on slowing the progression of myopia

Zhou et al.

A group of Chinese researchers investigated the adjunctive effects of using both orthokeratology and 0.01% atropine eye drops for controlling the progression of myopia in children aged 8 to 13 years and with spherical equivalent refraction (SER) ranging from -2.00 to -5.00 D. Participants were allocated into a combination group (i.e., orthokeratology and 0.01% atropine) or atropine group (0.01% atropine). Axial length and spherical equivalent refraction were measured at baseline and then every three months post-treatment for two years. Following two years of treatment, the average SER change was 0.88 ± 0.31 D and 1.14 ± 0.63 D in the combination and atropine groups, respectively, with an average increment in axial length of 0.50 ± 0.17 mm and 0.61 ± 0.21 mm, respectively. In conclusion, orthokeratology and 0.01% atropine eye drops combination therapy was found to be more effective in reducing both myopia progression and the axial elongation of the eye than atropine monotherapy.

https://pubmed.ncbi.nlm.nih.gov/34228946/


  • Lens Care

Antiviral effect of multipurpose contact lens disinfecting solutions against coronavirus

Yasir et al.

A study evaluated the antiviral potential against coronavirus of five multipurpose disinfecting solutions, including Biotrue, renu Advanced [Bausch and Lomb], ACUVUE RevitaLens [Johnson and Johnson Vision], cleadew [Ophtecs corp.] or AOSept Plus [Alcon]). Solutions were mixed with coronavirus and surviving viruses from each sample were quantified. The three multipurpose disinfecting solutions Biotrue, renu Advanced and ACUVUE RevitaLens did not kill the coronavirus at the manufacturers recommended disinfection time in the stand-alone test. In contrast, AOSept Plus (hydrogen peroxide) and cleadew (povidone iodine) significantly reduced the numbers of coronaviruses to below the detection limit. This study shows that oxidative contact lens disinfecting solutions (i.e. those containing povidone-iodine or hydrogen peroxide) provide superior antiviral activity against a coronavirus.

https://pubmed.ncbi.nlm.nih.gov/34465537/


  • Myopia Control

The Risks and Benefits of Myopia Control

Bullimore et al.

The potential benefits of myopia control have been reported to outweigh the risks as it has been recently estimated that between 4 and 7 patients with a mean age of 12 years need to receive myopia control treatment with contact lenses to prevent 5 years of visual impairment (assuming a mean life expectancy of 82 years), while fewer than 1 in 38 will experience a loss of vision as a result of suffering from microbial keratitis due to myopia control contact lens wear.

https://pubmed.ncbi.nlm.nih.gov/33961969/


  • Orthokeratology

Pediatric Microbial Keratitis With Overnight Orthokeratology in Russia

Bullimore et al.

A recent study estimated the incidence of microbial keratitis in children wearing overnight orthokeratology lenses in Moscow, Russia. The number of children wearing orthokeratology lenses was estimated based on the review of over 1,300 patient records from 13 Doctors Lens clinics between 2010 and 2018. To identify cases of microbial keratitis, all episodes of infiltrative keratitis from Morozovskaya City Children's Clinical Hospital in 2018 were recorded and adjudicated by three experienced ophthalmologists. Incidence was calculated as the number of cases divided by the estimated number of wearers. Based on a 7% or 10% annual discontinuation rate, the estimated number of children wearing lenses in 2018 was 10,307 or 9,422, respectively. During 2018, 5 cases of microbial keratitis were found attributed to orthokeratology lens wear. The annual incidence of microbial keratitis associated with orthokeratology lens wear was estimated between 4.9 (95% confidence interval[CI]: 2.1-11.4) and 5.3 (95% CI: 2.3-12.4) per 10,000 patient years assuming a 7% or 10% discontinuation rate, respectively. Such estimated rates of microbial keratitis in children wearing overnight orthokeratology in Moscow is lower than a previous United States study and similar to rates associated with use of daily wear soft contact lenses.

https://pubmed.ncbi.nlm.nih.gov/34050085/


  • Lens Care

Factors Affecting Microbial Contamination on the Back Surface of Worn Soft Contact Lenses

Tan et al.

Microbial contamination of contact lenses has been associated with sight-threatening ocular complications. Proposed strategies to reduce lens contamination include improved hand hygiene before handling contact lenses and disposing of lenses after each wear to minimize potential effects of lens storage case contamination. A study investigated the effect of lens packaging type, chelating agent, and finger contamination on microbial contamination on the back surface of worn soft contact lenses. Twenty-five subjects completed each contralateral lens wear comparison in a randomized order: Smart Touch Technology versus conventional blister packaging for (1) silicone hydrogel lenses with ethylenediaminetetraacetic acid (EDTA) and (2) hydrogel lenses without EDTA in the packaging, and (3) silicone hydrogel lenses without EDTA versus hydrogel lenses with EDTA both in Smart Touch Technology packaging. Smart Touch Technology packaging was found effective in reducing the proportion of contaminated lenses. Although silicone hydrogel lenses were more likely to be contaminated, the presence of EDTA ameliorated this effect. Finger contamination was not associated with lens contamination. The results of this study highlight that Menicon’s Smart Touch Technology is effective in reducing contact lens contamination and thus it is likely to contribute to safer contact lens wear.

https://pubmed.ncbi.nlm.nih.gov/33973914/


  • Contact lenses for Keratokonus

Contact lenses are the primary form of visual correction for patients with keratoconus

Laura Downie and Richard Lindsay

Contact lenses are the primary form of visual correction for patients with keratoconus. Contemporary advances in contact lens designs and materials have significantly expanded the available fitting options for patients with corneal ectasia. Furthermore, imaging technology, such as corneal topography and anterior segment optical coherence tomography, can be applied to both gain insight into corneal microstructural changes and to guide contact lens fitting. A review paper from Downie and Lindsay
provides a comprehensive summarize of the range of contact lens modalities, including soft lenses, hybrid designs, rigid lenses, piggyback configurations, corneo-scleral, mini-scleral and scleral lenses currently available for the optical management of keratoconus.

https://pubmed.ncbi.nlm.nih.gov/26104589/


  • Myopia Control

The Scientific Bureau of World Society of Paediatric Ophthalmology and Strabismus recommends treatment options for myopia control

Seo Wei Leo

In a review paper, Seo Wei Leo from the Scientific Bureau of World Society of Paediatric Ophthalmology and Strabismus concluded that controlling the onset of myopia is now possible through increasing time outdoors whereas slowing the progression of myopia can be successfully achieved with interventions like atropine and orthokeratology.

https://pubmed.ncbi.nlm.nih.gov/28212157/


  • Compliance

Hand washing essential for safe and effective contact lens wear

Desmond Fonn and Lyndon Jones

Lack of or inadequate hand washing is a risk factor in the development of contact lens related microbial keratitis and corneal inflammatory events. There is compelling evidence that proper hand washing with soap can save lives, which it is now of outmost importance during the covid pandemic. Contact lens wearers are also guilty of poor hand washing behavior but there is scant evidence that education of hand washing procedures of lens wearers alters patient non-compliance. Adequate patient education with regards to hand hashing is critical for safe and effective contact lens wear

https://pubmed.ncbi.nlm.nih.gov/30413375/


  • Myopia Control

The International Myopia Institute has synthesed the research evidence to date on the most important and relevant aspects related to myopia, including recommended guidelines for myopia control

International Myopia Institute

With the growing prevalence of myopia, already at epidemic levels in some countries, there is an urgent need for new management approaches. However, with the increasing number of research publications on the topic of myopia control, there is also a clear necessity for agreement and guidance on key issues, including on how myopia should be defined and how interventions should be appropriately and ethically applied. The International Myopia Institute, with help from more than 85 multidisciplinary experts in the field, recently published seven critical reviews that syntheses the research evidence to date on the most important and relevant aspects related to myopia. These reports form the basis for recommended guidelines for eye care practitioners.

https://www.myopiainstitute.org/imi-white-papers.html


  • Contact lenses for Children

The Safety of Soft Contact Lenses in Children

Mark A Bullimore

There is increasing interest in fitting children with soft contact lenses. A review collated data from a range of studies to estimate the incidence of complications, specifically corneal infiltrative events and microbial keratitis, in patients under the age of 18 years.
Nine prospective studies representing 1800 patient years of wear in 7- to 19-year-olds included safety outcomes. In three large prospective studies representing between 159 and 723 patient years of soft contact lens wear in patients 8 to 14 years, the incidence of corneal infiltrative events is up to 136 per 10,000 years. Data from a large retrospective study show similar rates of corneal infiltrative events: 97 per 10,000 years in 8- to 12-year-olds and 335 per 10,000 years in 13- to 17-year-olds. None of the prospective studies report any cases of microbial keratitis. One retrospective study found no cases of microbial keratitis occurred in 8- to 12-year-olds and an incidence of 15 per 10,000 patient years in 13- to 17-year-olds -no higher than the incidence of microbial keratitis in adults wearing soft contact lenses on an overnight basis. This review concluded that the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest age range of 8 to 11 years, it may be markedly lower.

https://pubmed.ncbi.nlm.nih.gov/28514244/


  • Myopia Management

Global trends in myopia management attitudes and strategies in clinical practice - 2019 Update

Wolffsohn et al.

A self-administrated, internet-based questionnaire was distributed in eight languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy of available strategies and adoption levels of such strategies, and reasons for not adopting specific strategies. Over 1300 eye care practitioners from the 5 different continents responded to the questionnaire. Concern was highest in Asia and lowest in Australasia. Practitioners from Asia also considered their clinical practice of myopia control to be the most active, the North American practitioners being the least active. Orthokeratology was perceived to be the most effective method of myopia control, followed by pharmaceutical approaches and approved myopia control soft contact lenses. Most practitioners did not consider single-vision distance under-correction to be an effective strategy for attenuating myopia progression, but prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost and inadequate information. While practitioner concern about myopia and the reported level of activity have increased in recent years, the vast majority of eye care clinicians still prescribe single vision interventions to young myopes.

https://pubmed.ncbi.nlm.nih.gov/31761738/


  • Compliance

Soft contact lens wearers' compliance during the COVID-19 pandemic

Vianya-Estopa et al.

An online survey distributed in the UK and Ireland explored contact lens wearers' compliance behaviors, attitudes and concerns during the COVID-19 pandemic. Two hundred and forty-seven responses were received (34.3 ± 11.7 years old, 79% female). Seventy nine percent of participants reported that they were self-isolating or rigorously following social distance advice. Fifty-six percent of participants reported using their lenses less during the pandemic. Eighty-seven percent of respondents reported following the recommended 20-second rule most times/every time and 96% used soap and water during handwashing. Eleven percent of respondents admitted not following recommendations regarding disposal of lenses and 18% would not consider ceasing lens wear if unwell (with flu/cold) during the pandemic. In summary, respondents reported wearing their contact lenses less than usual. In summary, although good compliance with handwashing was observed during the COVID-19 pandemic, soft reusable lens wearers showed a statistically significant lower compliance with lens wear and care compared to daily disposable lens wearers.

https://pubmed.ncbi.nlm.nih.gov/32839091/


  • Contact Lens Care

Subjective Comfort and Physiology with Modern Contact Lens Care Products

Berntsen et al

A study compared subjective comfort and ocular physiology with three multipurpose solutions (MPSs) to that of a peroxide-based system with three different soft contact lens materials in 236 habitual soft contact lens wearers. Subjects were randomly assigned to one of three lens types, including one hydrogel and two silicone hydrogel contact lenses. A new lens of the assigned type was worn for 10 to 14 days each while using one of four MPSs. After using each care solution, biomicroscopy was performed and subjective comfort and comfortable wear time (CWT) were assessed and compared to that of the peroxide solution. Comfort score across all lens types with each MPS was not significantly different than with the peroxide solution. There were no differences in CWT between each MPS and the peroxide solution for any lens. Six MPS/material combinations had no clinically meaningful change in corneal staining versus peroxide. Staining was < grade 1 for all combinations. In conclusion, comparable levels of comfort were found between the latest generation of MPSs compared to peroxide disinfection indicating that the current lens care systems investigated in this study are generally appropriate for use with the contact lenses tested.

https://pubmed.ncbi.nlm.nih.gov/27309523/


  • α Ortho-K

α Ortho-K Results of a Three-Year Clinical Trial on Treatment of Myopia in Children

CHANG Yong, XIE Pei-ying, WANG De-chen, CHI Hui, XHOU Jian-lan
Beijing Internet Eyecare Optometry & Ophthalmology Clinic

To evaluate the effect and safety of long-term wearing high precision ORTHO-K contact lens for myopic
children and adolescents.

Design
Retrospective case series.

Participants
150 myopic children and adolescents.

Methods
We examined 150 patients (300 eyes) who wore ORTHO-K lens for 3 years in Beijing Internet Eyecare Optometry & Ophthalmology Clinic. Following examinations had been performed for baseline and all annual follow-up visits: slit lamp exam, uncorrected visual acuity (UCVA), and tear secretion, eye axial length, corneal thickness, corneal endothelial cell density, percentage of hexagon and corneal curvature values. We also selected 66 eyes switching to ORTHO-K from other brands for evaluation of comfort, clarity and cleanliness.

https://image.menicon.com/files/file1_path5ff54dab3cbff.pdf


  • COVID-19

The COVID-19 pandemic: Important considerations for contact lens practitioners

Lyndon Jones et al

A novel coronavirus (CoV), the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), results in the coronavirus disease 2019 (COVID-19). As information concerning the COVID-19 disease continues to evolve, patients look to their eye care practitioners for accurate eye health guidance. There is currently no evidence to suggest an increased risk of contracting COVID-19 through contact lens (CL) wear compared to spectacle lens wear and no scientific evidence that wearing standard prescription spectacles provides protection against COVID-19 or other viral transmissions.

https://www.contactlensjournal.com/article/S1367-0484(20)30055-2/fulltext


  • COVID-19

Could telehealth help eye care practitioners adapt contact lens services during the COVID-19 pandemic?

Manbir Nagra et al

The COVID-19 pandemic has necessitated government-imposed restrictions on social interactions and travel. For many, the guidance has led to new ways of working, most notably a shift towards working remotely. While eye care practitioners (ECPs) may continue to provide urgent or emergency eye care, in many cases the travel restrictions present a unique challenge by preventing conventional face-to-face examination. Telephone triage provides a useful starting point for establishing at-risk and emergency patients. Approaches to teleoptometry in contact lens practice primarily includes smartphone based ocular imaging and assessment of visual acuity. However, the absence of a comprehensive evidence base for teleoptometry limits ECPs, particularly during a pandemic. Advances in the field, such as ocular self-imaging, could help move this field forwards.

https://www.contactlensjournal.com/article/S1367-0484(20)30075-8/fulltext


  • Care solution

Antimicrobial properties of new rigid gas-permeable contact lens multipurpose solution formulated with polylysine as disinfecting agent

Osamu Mori and Megumi Toyohara

A study presented at a recent conference of the British Contact Lens Association compared the antimicrobial properties of a new rigid gas-permeable (RGP) contact lens multipurpose solution (MPS) formulated with Polylysine as disinfecting agent against other commercially available MPS formulated with other disinfecting agents. Four commercially available RGP-MPS were compared according to ISO14729 stand-alone disinfection test: MPS-A (polylysine), MPS-B (PHMB + chlorhexidine), MPS-C (PHMB), MPS-D (Oxychlorite + hydrogen peroxide) and MPS-E (Polyquad). Antimicrobial properties were assessed with/without artificial tear as organic load for time (5–360 min) and temperature-dependence (10–32 ºC). MPS-A, MPS-B and MPS-E showed sufficient efficacy under all test conditions. MPS-C showed insufficient efficacy against fungi and decreased efficacy at low temperature and with organic load. MPS-D barely showed efficacy against all microorganisms tested. The new RGP-MPS formulated with Polylysine represents a safe and effective care solution for use with rigid gas-permeable contact lenses.

https://www.sciencedirect.com/science/article/pii/S1367048414001453


  • Myopia control

Overnight orthokeratology

Mark A Bullimore and Leah A. Johnson

A recent publication in the Contact Lens & Anterior Eye provided an interesting review of the current status of the use of overnight orthokeratology contact lenses. Overnight orthokeratology lenses are currently approved in countries all over the world for the temporary reduction in myopia, and recently, one lens design has received regulatory approval for myopia control in Europe. The modern orthokeratology lens has a substantial history from its origins of attempting to flatten the corneal curvature with a spherical rigid contact lens to sophisticated gas permeable lenses, designed to reshape the cornea. Currently, these lenses are predominantly prescribed for children to slow myopia progression and limit axial elongation of the eye. The article reviews the peer-reviewed literature on the efficacy of orthokeratology for myopia control, sustainability after treatment is discontinued, and the safety concerns of overnight contact lens wear.

https://www.contactlensjournal.com/article/S1367-0484(20)30061-8/fulltext


  • Myopia control

Short-term and long-term changes in corneal power are not correlated with axial elongation of the eye induced by orthokeratology in children

Jacinto Santodomingo-Rubido et al

In this study, it was assessed the relationship between short-term and long-term changes in power at different corneal locations relative to the change in central corneal power and the 2-year change in axial elongation relative to baseline in white European children wearing orthokeratology contact lenses (Ortho-K).
The result showed the reduction in central corneal power and relative increase in paracentral and pericentral power induced by OK over 2 years were not significantly correlated with concurrent changes in axial length of white European children.

https://insights.ovid.com/pubmed?pmid=27763910


  • Myopia control

Short- and Long-Term Changes in Corneal Aberrations and Axial Length Induced by Orthokeratology in Children Are Not Correlated

Jacinto Santodomingo-Rubido et al.

The study was conducted to assess the correlation between changes in corneal aberrations and the 2-year change in axial length in children fitted with orthokeratology contact lenses (ortho-K).
It was found short-term and long-term ortho-K lens wear induces significant changes in corneal aberrations that are not significantly correlated with changes in axial elongation after 2-years.

https://insights.ovid.com/crossref?an=00140068-201711000-00005


  • Myopia control

Long-term Efficacy of Orthokeratology Contact Lens Wear in Controlling the Progression of Childhood Myopia

Jacinto Santodomingo-Rubido, César Villa-Collar, Bernard Gilmartin, Ramón, Gutiérrez-Ortega & Keiji Sugimoto

The study was conducted over 7 years to compare the axial length growth of white European myopic children from 6 to12 years old wearing orthokeratology contact lenses (ortho-K) to a control group over a 7-year period. The axial length growth of ortho-K group was 33% slower than the on

https://www.tandfonline.com/doi/full/10.1080/02713683.2016.1221979?scroll=top&needAccess=true


  • Myopia control

The effects of entrance pupil centration and coma aberrations on myopic progression following orthokeratology

Jacinto Santodomingo Rubido et al.

The study was conducted in Spain to assess the potential association between entrance pupil location relative to the coaxially sighted corneal light reflex (CSCLR) and the progression of myopia in children fitted with orthokeratology (OK) and to investigate whether coma aberration induced by decentration of the entrance pupil centre relative to the CSCLR, as well as following OK treatment, is correlated with the progression of myopia. A significant increase in vertical coma was found with OK lens wear compared to baseline (p < 0.001) but total root mean square (RMS) coma was not associated with the change in axial length (all p > 0.05). Entrance pupil location relative to the CSCLR was not significantly affected by either OK lens wear or an increase in axial length. Greater magnitude coma aberrations found at the entrance pupil centre in comparison to the CSCLR might be attributed to centration of orthokeratological treatments at the CSCLR.

https://onlinelibrary.wiley.com/doi/full/10.1111/cxo.12297


  • Myopia control

Effect of low-addition soft contact lenses with decentered optical design on myopia progression in children: a pilot study

Takashi Fujikado et al.

The pilot study was conducted to evaluate the effect of decentered optical design low-addition soft contact lenses for controlling myopia progression over 2 years. Control group wore monofocal soft contact lenses. As a result of this study, it was observed that the decentered optical design low-addition soft contact lenses was effective to suppress the axial elongation compared to control group, however, we did not find significant difference on refractive error.
The reduction of the progression of myopia by low-addition soft CLs warrants further investigations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181743/


  • Myopia control

Factors Preventing Myopia Progression With Orthokeratology Correction

Jacinto Santodomingo-Rubido et al

The study was conducted in Spain to examine which baseline measurements constitute predictive factors for axial length growth over 2 years in children wearing orthokeratology contact lenses (ortho-k) and single-vision spectacles (SV). Orthokeratology is a successful treatment option in controlling axial elongation compared to SV in children of older age, had earlier onset of myopia, were female, had lower rate of myopia progression before baseline, had lower myopia at baseline, had longer anterior chamber depth, had greater corneal power, had more prolate corneal shape, had larger iris and pupil diameters, and had lower levels of parental myopia.

https://journals.lww.com/optvissci/pages/articleviewer.aspx?year=2013&issue=11000&article=00012&type=abstract


  • Myopia control

Myopia Control with Orthokeratology Contact Lenses in Spain (MCOS): Refractive and Biometric Changes

Jacinto Santodomingo-Rubido et al

The study was conducted for 2 years in Spain, for the purpose of comparing axial length growth between white children with myopia wearing orthokeratology contact lenses (ortho-k) and distance single-vision spectacles (SV). The axial length growth was observed with both groups, however, that of SV group was significantly greater than ortho-k group. This result showed the ortho-k lowered the axial length growth and might be effective to control the myopia progression.
Open Access https://iovs.arvojournals.org/article.aspx?articleid=2168338

https://iovs.arvojournals.org/article.aspx?articleid=2168338


  • Myopia control

Retardation of Myopia in Orthokeratology (ROMIO) Study: A 2-Year Randomized Clinical Trial

Pauline Cho; Sin-Wan Cheung

The study was conducted for 2 years in Hong Kong, for the purpose to evaluate the effectiveness of orthokeratology contact lenses (ortho-k), which is thought to be one of the means for the myopia progression control. One group was assigned to wear ortho-k, and the other to wear single-vision glasses as a control. As a result of measuring the axial length, the axial length elongation of ortho-k group was 43% slower than of the control group, so that the ortho-k might be effective to control the myopia progression.

https://iovs.arvojournals.org/article.aspx?articleid=2127470

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