Cont Lens Anterior Eye [JOURNAL]
Sun
200 papers
Usability of different tear fluid collection methods to analyze ocular surface protein, lipid, and cells.
Assaad JR, Bhattacharya P, Walker MK
Cont Lens Anterior Eye · 2026 Jun · PMID 41825153 · Publisher ↗
BACKGROUND: Tear fluid (TF) collection enables non-invasive ocular surface investigations. Tear wash (TW), microcapillary tube (MC), and Schirmer strip (SS) methods are commonly used; each with its strengths and limitati...
BACKGROUND: Tear fluid (TF) collection enables non-invasive ocular surface investigations. Tear wash (TW), microcapillary tube (MC), and Schirmer strip (SS) methods are commonly used; each with its strengths and limitations. Comparing the outcomes is dependent on the research goals. The purpose of this study is to compare protein and lipid recovery among the three techniques and compare white blood cell (WBC) differentiation between automated and manual methods. METHODS: TF samples were collected from 10 participants using TW, MC, and SS. Total protein and lipid content were determined using infrared spectrometry (Direct Detect, Millipore Sigma). TW samples were collected from 9 other participants and WBC differentiation was compared between automated hematology (DxH 500, Beckmann Coulter), manual hemocytometry (HEMO), and H&E staining. Mixed-effects analysis, Bland-Altman, paired t-tests, or the non-parametric equivalents were used. RESULTS: Total protein content was the greatest for SS samples (471 ± 222 μg) and lowest for MC (88 ± 33 μg), (P = 0.0004) with the TW method (275 ± 215 μg) in between. Total lipid content was highest in TW (2.31 ± 0.56 Absorbance units (AU)) samples compared to MC (0.04 ± 0.02 AU) and SS (0.50 ± 0.19 AU), (P < 0.001). For the second analysis, total WBC count (median; IQR) was greater with the DxH (603 cells/µL; 327, 2365) compared to manual HEMO (475 cells/µL; 265, 2067), (P = 0.004), with a BA bias of -209 ± 209 cells/µL (LOA: -620 to 202 cells/µL). The coefficient of variation was significantly lower for the DxH compared to HEMO, P = 0.02. CONCLUSION: These findings show that TF protein and lipid yields, along with cellular analysis, differ among TF collection methods and should be considered when designing TF studies. SS yielded the most protein and TW allowed cellular analysis. Automated hematology (DxH) provided repeatable total WBC counts.
The potential benefits of periorbital transcutaneous electrical stimulation for the management of dry eye disease.
Donaldson KE, Manor Y
Cont Lens Anterior Eye · 2026 Jun · PMID 41819036 · Publisher ↗
Dry eye disease (DED) is among the most frequent pathologies of the ocular surface (OS). As a multifactorial condition, it is appropriate to manage it with strategies that are customized according to patient signs and sy...
Dry eye disease (DED) is among the most frequent pathologies of the ocular surface (OS). As a multifactorial condition, it is appropriate to manage it with strategies that are customized according to patient signs and symptoms. Recently, several studieshave suggestedthat transcutaneous electrical stimulation (TCES) of the periorbital areainduces various benefits for DED patients, including more efficient eye blinking. This application is particularly novel, as few treatments directly address the effect of inefficient blinking on OS health. In this article, this and other potential benefits of TCES applied in the periorbital area, for a better management of DED, are reviewed. The review starts with a general discussion of the uses of TCES in non-ophthalmic fields of medicine, where merits of this approach are widely recognized, and proposed mechanisms of action (MOAs) are supported by experimental evidence. Results of recent studies which suggest that electrotherapy might be useful for addressing DED as well are then summarized. Finally, the relevance of MOAs proposed in other fields of medicine is examined for DED. It is suggested that TCES enhances blinking and supports OS health through neuromuscular, analgesic, and anti-inflammatory pathways. Given its multifaceted benefits, TCES represents a promising addition to the therapeutic toolkit for ocular surface disease (OSD).
Minor reduction in the back optical zone diameter of orthokeratology lenses delays axial elongation in children with myopia.
Chen Y, Mei L, Fen Y … +3 more , Zhang S, Huang H, Xu J
Cont Lens Anterior Eye · 2026 Jun · PMID 41806505 · Publisher ↗
PURPOSE: To analyze the effect of minor reducing the back optical zone diameter (BOZD) of orthokeratology (OK) lenses on myopia control in Chinese children. METHODS: This retrospective study recruited 35 myopic children...
PURPOSE: To analyze the effect of minor reducing the back optical zone diameter (BOZD) of orthokeratology (OK) lenses on myopia control in Chinese children. METHODS: This retrospective study recruited 35 myopic children corrected with conventional OK lenses who switched to a smaller BOZD design (ΔBOZD ≥ 0.4 mm). Corneal treatment zone area (TZA), decentration, maximum relative corneal refractive power (RCRP) and its distance from the pupil center (X) were calculated from the tangential difference map using MATLAB. The 12-month axial elongations (AE) before and after switching were assessed and compared with that of children continuing conventional BOZD lenses over the same two-year period. Associations between the changes in AE changes and these topographic parameters before and after treatment with smaller BOZD lenses were analyzed. RESULTS: Smaller BOZD lenses significantly reduced 12-month AE by 0.08 mm in the second year versus unchanged BOZD (F = 5.58, P = 0.02). In the BOZD-altered group, smaller BOZD lenses (5.68 ± 0.12 mm vs. 6.17 ± 0.07 mm) retarded myopia progression (0.26 ± 0.11 mm vs. 0.16 ± 0.12 mm, t = 4.24, p < 0.001) and yielded a smaller corneal treatment zone (8.69 ± 1.91 mm vs. 7.42 ± 1.30 mm, t = 4.41, p < 0.001). No significant differences were observed in decentration (0.47 ± 0.23 mm vs. 0.48 ± 0.22 mm, t = -0.16, p = 0.88), RCRP (11.71 ± 6.27 D vs. 12.05 ± 5.38 D, t = -0.36, p = 0.72), or X (2.54 ± 0.61 mm vs. 2.38 ± 0.60 mm, t = 1.02, p = 0.31) between different BOZD lenses treatments. When switching to smaller BOZD lenses, the change in 12-month AE was negatively correlated with the change in X (β = - 0.059, P = 0.032) but not with other topographic parameters (all p > 0.05). CONCLUSION: Reducing the BOZD of OK lenses by approximately 0.5 mm from the conventional design slowed second-year axial elongation by more than one-third and minimally affected visual acuity (2-letter decrease), without impacting lens centration. This approach may be considered as an initial option for children using OK lenses for myopia control.
A deep learning-based method for evaluating the fitting states of orthokeratology lenses using fluorescein staining videos.
Lu R, He Z, Niu K … +1 more , Song H
Cont Lens Anterior Eye · 2026 Jun · PMID 41794006 · Publisher ↗
PURPOSE: To develop and validate an automated deep learning-based tool for evaluating the fitting states of orthokeratology lenses using a dual-stream architecture based on ResNet-50 and a temporal attention module, comp...
PURPOSE: To develop and validate an automated deep learning-based tool for evaluating the fitting states of orthokeratology lenses using a dual-stream architecture based on ResNet-50 and a temporal attention module, compare its performance to the manual annotation results of experienced optometrists and assess the effectiveness of the methods used in the model. METHODS: The dataset comprises 143 video recordings of fluorescein staining examinations conducted under slit-lamp microscopy. Five experienced optometrists independently evaluated these videos, classifying lens fitting states into three categories: loose-fitting, well-fitting, and tight-fitting. The consensus assessment of these optometrists was adopted as the gold standard. The ResNet-50 network was utilized to process intra-frame images and extract lens morphological features, while a temporal attention module was employed to analyze successive inter-frame images and capture lens movement features. To enhance the capture of spatial characteristics of lens fitting, an edge detection method was used as a form of data augmentation. After independent feature extraction, the outputs from the two branches were aggregated through concatenation, with the fused result being used for the final classification task. RESULTS: By incorporating annotations from experienced optometrists, the proposed model demonstrates strong performance in classifying orthokeratology (Ortho-K) lens fitting states, achieving an overall accuracy of 92.3%, a macro sensitivity of 92.6%, and a macro specificity of 96.2%. The approach outperforms individual TimeSformer and ViViT models, with the integration of the proposed module into these models resulting in a significant enhancement in evaluation accuracy. CONCLUSION: The study demonstrated the effectiveness of the proposed model, which could automatically and accurately evaluate the fitting states of orthokeratology lenses. This approach offers a reliable and objective evaluation method, significantly aiding in the clinical assessment of orthokeratology lens fitting.
Reply to Letter to the Editor concerning: "Effects of ambient illuminance and mobile phone screen brightness on tear film stability, visual fatigue, and blink patterns during reading".
Cont Lens Anterior Eye · 2025 Apr · PMID 41775136 · Publisher ↗
Abstract loading — click title to view on PubMed.
Global prevalence of dry Eye: A systematic review and meta-analysis.
Xiao K, Li L, Zhang X … +10 more , Ye Y, Yao Y, Liu Y, Chen W, Wang X, Gu C, He M, Liang L, Liu YC, Zhu Z
Cont Lens Anterior Eye · 2025 Apr · PMID 41734553 · Publisher ↗
OBJECTIVE: Dry eye significantly impacts global quality of life and productivity, yet existing epidemiological data remain fragmented and outdated, hindering effective prevention and management strategies. This study aim...
OBJECTIVE: Dry eye significantly impacts global quality of life and productivity, yet existing epidemiological data remain fragmented and outdated, hindering effective prevention and management strategies. This study aimed to estimate the global prevalence of dry eye and examine variations across regions, demographics, diagnostic criteria, study settings, and the COVID-19 pandemic. METHODS: A systematic search of PubMed, Web of Science, Embase, and Cochrane Library identified 119 cohort or cross-sectional studies involving 15,251,528 participants. Two reviewers independently screened records, extracted data, and assessed study quality using the Joanna Briggs Institute checklist. A random-effects model pooled prevalence estimates, with subgroup analyses exploring heterogeneity. RESULTS: The global pooled prevalence of dry eye was 34.6% (95% CI: 30.2%-39.4%). Regional disparities were pronounced, with the highest prevalence in Africa 43.9% (95% CI: 31.5%-57.2%) and the lowest in North America 20.9% (95% CI: 8.2%-43.8%). Higher rates were observed in females 39.1% (95% CI: 32.8%-45.8%) vs. males 30.8% (95% CI: 24.8%-37.7%), individuals aged > 40 years 37.0% (95% CI: 29.1%-45.7%) vs. ≤ 40 years 35.0% (95% CI: 25.4%-46.0%), institutional settings 45.2% (95% CI: 36.2%-54.5%), and during COVID-19 44.5% (95% CI: 28.0%-62.2%). Diagnostic criteria significantly influenced estimates, ranging from 6.9% (95% CI: 1.9%-21.7%) (ICD-9-based) to 53.8% (95% CI: 46.7%-60.8%) (OSDI ≥ 13). CONCLUSIONS: Dry eye represents a major global public health challenge, with prevalence shaped by geographic, demographic, environmental, and methodological factors. The pandemic exacerbated dry eye burden, underscoring the urgency for standardized diagnostic protocols and targeted interventions to mitigate its growing impact.
Academic malpractice in publishing - painting the mice.
Naroo SA
Cont Lens Anterior Eye · 2025 Apr · PMID 41713087 · Publisher ↗
Abstract loading — click title to view on PubMed.
Long-term outcomes of myopia control strategies in intermittent exotropia: A real-world study of myopia control spectacles and orthokeratology.
Han M, Wang X, Li Z … +11 more , Jiang J, Sun Q, Wang M, Vincent SJ, Yan J, Zhang X, Chen W, Lin X, Hu Y, Yu X, Yang X
Cont Lens Anterior Eye · 2025 Apr · PMID 41679075 · Publisher ↗
PURPOSE: This real-world study evaluated the effectiveness of myopia control spectacles (MCS) and orthokeratology (Ortho-k) in slowing myopia progression and supporting binocular function in children with intermittent ex...
PURPOSE: This real-world study evaluated the effectiveness of myopia control spectacles (MCS) and orthokeratology (Ortho-k) in slowing myopia progression and supporting binocular function in children with intermittent exotropia (IXT), highlighting treatment outcomes from routine clinical practice. METHODS: Clinical data were obtained from myopic children with IXT who completed at least two years of follow-up. After applying inclusion and exclusion criteria, 70 children were assigned to the MCS group. Using PSM, 82 and 76 children were included in the single-vision (SV) and orthokeratology Ortho-K groups, respectively. RESULTS: After two years, both the MCS and Ortho-k groups demonstrated significantly less axial elongation and myopia progression compared to the SV group (both, P < 0.0001), with no significant difference between MCS and Ortho-k groups (P > 0.05). The MCS group also exhibited better preservation of distance and near stereoacuity than the Ortho-k (both P < 0.0001) and SV groups (P = 0.01 and P < 0.001, respectively). For distance exodeviation, the MCS group showed a smaller increase than the Ortho-k and SV groups (P < 0.01 and P < 0.0001, respectively), and the Ortho-k group displayed less increase than the SV group (P = 0.01). A similar pattern was observed for near exodeviation, and the difference between the MCS and Ortho-k groups approached significance (P = 0.05). CONCLUSIONS: MCS and Ortho-K effectively slowed myopia progression in children with basic-type IXT. In this high-risk population, MCS may additionally help preserve binocular function. These findings provide a foundation for future studies extending to broader IXT populations.
Analysis of tear inflammatory proteins following Low-Level light therapy in dry eye disease patients.
Antwi A, Redfern R, Ritchey ER
Cont Lens Anterior Eye · 2025 Apr · PMID 41667355 · Publisher ↗
PURPOSE: Low-level light therapy (LLLT) in combination with intense pulsed light (IPL) has been shown to improve clinical signs and symptoms of dry eye disease (DED), as well as tear inflammatory protein levels. However,...
PURPOSE: Low-level light therapy (LLLT) in combination with intense pulsed light (IPL) has been shown to improve clinical signs and symptoms of dry eye disease (DED), as well as tear inflammatory protein levels. However, the therapeutic mechanism of LLLT as a stand-alone treatment remains unclear. This single-arm pilot study aimed to determine the impact of LLLT alone on tear protein levels in patients with DED. METHODS: Study participants received a 15-minute LLLT session once a week for three weeks using the Eye-light® EPI-C Plus device. Clinical measures of DED were assessed, including first and average non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH), tear film lipid layer thickness (TFLLT), and Schirmer's test. Tear samples were collected with Schirmer's strips at baseline and after the final treatment. Tear fluid was extracted by eluting the strips in PBS, and the concentrations of ten inflammatory proteins were quantified using a Luminex bead-based multiplex assay. RESULTS: Thirty participants (mean age ± SD: 31.1 ± 9.5 years; 16 females) with mild to moderate DED completed the study. Compared to baseline, there was a statistically significant fold change in clinical outcome measures after the last LLLT treatment including first and average NIKBUT (mean FC (SD): 1.6 (0.9), 1.4 (0.7)), TMH (1.2 (0.3)), TFLLT (1.3 (0.4)) and Schirmer's test (0.9 (0.5)), (all p < 0.05). There was a significant reduction in MMP-9 levels post-LLLT treatment (mean Log2FC (SD): -0.7 (1.5), p = 0.005). No significant differences were observed in the remaining analytes, and no correlations were observed between the Log2FC of MMP-9 and clinical measures (all p > 0.05). CONCLUSION: Findings from this single-arm pilot study suggest that LLLT is associated with improved tear film stability and reduced MMP9 levels in patients with mild to moderate DED.
Translation and validation of the Italian version of the Neuropathic Pain Symptom Inventory-Eye (NPSI-Eye) questionnaire for evaluation of ocular neuropathic pain.
Ferrini E, Posarelli C, Bacchetti C … +2 more , Figus M, Gabbriellini G
Cont Lens Anterior Eye · 2025 Apr · PMID 41655474 · Publisher ↗
PURPOSE: The aim of the study was to translate the Neuropathic Pain Symptom Inventory - Eye (NPSI-Eye) questionnaire into the Italian language and to validate its psychometric properties for assessing the neuropathic com...
PURPOSE: The aim of the study was to translate the Neuropathic Pain Symptom Inventory - Eye (NPSI-Eye) questionnaire into the Italian language and to validate its psychometric properties for assessing the neuropathic component of ocular pain in chronic eye pain patients. METHODOLOGY: The translation and validation process were conducted according to standardized methods for cross-cultural adaptation of psychometric tools. Patients presenting to the Ophthalmology Unit complaining of chronic ocular pain were enrolled and completed the questionnaire. Objective assessment of ocular surface dysfunction was performed. Internal consistency and test-retest reliability were determined. Validity was assessed as face validity, construct validity (convergent and divergent validity) and criterion validity. Factor analysis was performed using Exploratory Factor Analysis. RESULTS: The Italian version of the NPSI-Eye questionnaire showed optimal internal consistency (Cronbach's alpha = 0.889, p < 0.001) and test-retest reliability (ICC = 0.991, p < 0.001). Five of the ten symptom items were endorsed by at least 60%. There were moderate-to-high correlations between NPSI-Eye score and comparison pain questionnaires, and lower correlations with dry eye questionnaire scores, demonstrating good convergent and divergent validity. Concerning criterion validity, the questionnaire score showed significant positive correlation with dry eye discordance score (Spearman ρ = 0.530, p < 0.001), and the mean NPSI-Eye score was significantly higher in patients reporting no or partial analgesic response to anesthetic drop instillation (p < 0.001). CONCLUSIONS: The Italian version of the NPSI-Eye questionnaire proved to be a valid and reliable tool to measure neuropathic component of ocular pain. It demonstrated psychometric properties comparable to those of the original English instrument in a demographically and clinically distinct population. The NPSI-Eye can be used to assess and quantify distinct dimensions of ocular neuropathic pain across diverse patient groups, offering a standardized means of assessing this complex and often underrecognized pain phenotype.
Intervention with cyclosporine A stabilizes tear film and relieves asthenopia in mild dry eye with short fluorescein tear break-up time : A randomized controlled trial.
Mu C, Sun Y, Zhuoruo X … +2 more , Qin Z, Jin X
Cont Lens Anterior Eye · 2025 Apr · PMID 41628505 · Publisher ↗
BACKGROUND: This study aims to compare therapeutic effects of 0.1% sodium hyaluronate (SH) and 0.05% cyclosporine A (CsA) eye drops on dry eye and asthenopia in patients with mild dry eye combined with short fluorescein...
BACKGROUND: This study aims to compare therapeutic effects of 0.1% sodium hyaluronate (SH) and 0.05% cyclosporine A (CsA) eye drops on dry eye and asthenopia in patients with mild dry eye combined with short fluorescein tear break-up time (FBUT). METHODS: 60 eligible subjects were recruited and ultimately 55 subjects completed all four visits throughout the entire process. Patients with mild dry eye and short FBUT (2-5 s) were randomly, assigned to either a sodium hyaluronate group (Group A) or a cyclosporine A group (Group B) and received eye drop treatment for 8 weeks. Dry eye symptoms were assessed using OSDI, Schirmer test, FBUT, TMH, NIBUT, and bulbar redness. Asthenopia was evaluated using ASQ-17 and high-frequency components (HFC) of accommodative microfluctuations. Measurements were taken at baseline and after 1, 4, and 8 weeks of treatment. RESULTS: Both CsA and SH improved OSDI and FBUT. Compared to SH, CsA showed a more sustained FBUT improvement from week 4 to week 8 (95%CI [0.90,2.52], P < 0.001). Asthenopia, assessed by HFC and ASQ-17, was also more significantly reduced in Group B at week 8 from baseline (HFC 95%CI [-4.10,-0.76], P = 0.002; ASQ-17 95%Cl [-13.52,-6.13], P < 0.001). FBUT improvement was significantly correlated with HFC reduction (Standardized coefficients = -0.39,P = 0.01). CONCLUSIONS: CsA and SH can both improve the symptoms and signs of patients with mild dry eye syndrome. However, the therapeutic effect of CsA on such patients is more lasting, and it has an alleviating effect on asthenopia. The mechanism may be to increase the FBUT and thereby stabilize the tear film.
Corneal nerve axonal characteristics in chronic whiplash-associated disorder: An in vivo confocal microscopy case series.
Hoffmann M, Farrell SF, Colorado LH … +2 more , Sterling M, Edwards K
Cont Lens Anterior Eye · 2025 Apr · PMID 41604728 · Publisher ↗
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Tear meniscus height in the Beijing Adult Dry Eye Cohort study (ADEC).
Hao Y, Cao K, Zhang Q … +3 more , Tong L, Tian L, Jie Y
Cont Lens Anterior Eye · 2025 Apr · PMID 41592417 · Publisher ↗
PURPOSE: To investigate the potential associations of the tear meniscus height (TMH) in terms of demographic features, environmental factors, lifestyle factors, and health conditions in adults in Beijing. DESIGN: A popul...
PURPOSE: To investigate the potential associations of the tear meniscus height (TMH) in terms of demographic features, environmental factors, lifestyle factors, and health conditions in adults in Beijing. DESIGN: A population-based cross-sectional study. SUBJECTS: Data from 2272 eyes of 1136 patients from three streets were utilized. METHODS: The Beijing Adult Dry Eye Cohort (ADEC) was performed from July to August 2023. Adults (n = 1136) were randomly selected from 15 communities in Beijing, China, and 91.5 % responded. Dry eye clinical signs and Ocular Surface Disease Index (OSDI) were elicited. MAIN OUTCOME MEASURES: Parameters related to demographics, environment, lifestyle and general health were recorded. RESULTS: The median (interquartile range) of TMH was 0.17 (0.14,0.21) mm [minimum: 0.03 mm, maximum: 0.95 mm]. Lower TMH was significantly associated with age ≥ 45 (P < 0.0001), female sex (P < 0.0001), long-term exposure to dust (P = 0.0146), frequent use of electronic devices (P < 0.0001), seldom intake of Vitamin A, vegetable and fruit (P = 0.0022, P < 0.0001, P = 0.0016), smoke and alcohol consumption (P = 0.0255, P = 0.0028), hyperlipidemia (P = 0.0031), coronary heart disease (P = 0.0096), rheumatism (P = 0.0168), ocular and systemic medication (P < 0.0001, P = 0.0322), ocular irritation symptom(P < 0.0001) and systemic dryness (P < 0.0001). Long-term exposure to dusty environment (P = 0.004), frequent fruit consumption (P = 0.034), myopia (P = 0.040), frequent ocular medication (P = 0.041), coronary heart disease (P = 0.030) and systemic dryness symptoms (P = 0.039) could contribute to lower TMH. CONCLUSIONS: This study identified multiple factors associated with lower tear meniscus height in Beijing adults, including demographic characteristics, lifestyle habits, environmental exposure, and health conditions. These findings highlight the complexity of tear meniscus height variation and may provide insights for targeted interventions to improve ocular health in the population.
Evaluating the visual benefits of toric soft contact lenses using a novel pupil-controlled vision testing system.
Read M, Morgan P, Maldonado-Codina C … +3 more , Orsborn G, Vega J, Navascues-Cornago M
Cont Lens Anterior Eye · 2025 Apr · PMID 41579512 · Publisher ↗
PURPOSE: This study investigated the clinical astigmatism threshold at which toric soft contact lenses (CLs) provide superior visual acuity (VA) compared with spherical CLs, and how pupil size affects this. A novel pupil...
PURPOSE: This study investigated the clinical astigmatism threshold at which toric soft contact lenses (CLs) provide superior visual acuity (VA) compared with spherical CLs, and how pupil size affects this. A novel pupil-controlled vision testing system (PUCS) was developed to assess VA across different pupil sizes by dynamically adjusting lighting conditions. METHODS: A randomised, crossover, partially participant-masked clinical study was conducted with 53 habitual soft CL wearers (84 eyes; ages 20-40). Eyes were categorised into seven astigmatism groups (0.00 to -1.50 DC in 0.25 DC steps). Each eye was tested with three corrections: spherical soft CLs, custom toric soft CLs, and full-correction spectacles. VA was assessed using PUCS at five pupil diameters (2.5 mm, 4.0 mm, 5.5 mm, maximum, and minimum). The primary outcome was the between-correction difference in PUCS logMAR visual acuity, assessed at each pupil diameter. Secondary measures included conventional VA, subjective ratings, and lens preference. RESULTS: PUCS VA decreased significantly with increasing pupil diameter across all corrections (p< 0.0001). Toric CLs provided significantly better PUCS VA than spherical CLs for astigmatism of -0.75 DC and greater, regardless of pupil diameter (p< 0.001). The mean toric-spherical difference was approximately 0.06 logMAR (≈3 letters) at -0.75 DC and 0.12 logMAR (≈6 letters) at -1.50 DC. Toric CL performance was comparable to spectacle correction across all cylinder groups. Participants favoured toric CLs over spherical lenses from -0.75 DC upwards, with no participants preferring spherical CLs at -1.25 DC or greater (p< 0.001). Toric CLs demonstrated excellent rotational stability. CONCLUSIONS: The PUCS system provided robust evidence that toric CLs offer significant visual benefits at -0.75 DC or greater (within the tested range up to -1.50 DC), irrespective of pupil diameter. These findings support routine soft toric CL prescribing for astigmatism correction at or above this threshold to optimise visual performance and patient satisfaction. CLINICAL TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov (Identifier: NCT04613882).
Corneal surface temperature dynamics with lipid vs non-lipid artificial tears during sustained eye opening: a crossover study.
Atalay E, Çalışkan ME, Aydın MT … +3 more , Özalp O, Bilgeç MD, Eroğlu S
Cont Lens Anterior Eye · 2025 Apr · PMID 41576856 · Publisher ↗
PURPOSE: To evaluate the impact of lipid-containing versus lipid-deficient artificial tears on dynamic corneal surface temperature (CST) decline during sustained eye opening. METHODS: Fifteen healthy volunteers aged 20-4...
PURPOSE: To evaluate the impact of lipid-containing versus lipid-deficient artificial tears on dynamic corneal surface temperature (CST) decline during sustained eye opening. METHODS: Fifteen healthy volunteers aged 20-40 years were examined under standardized room conditions (22-24 °C, 45-50 % humidity). Two hyaluronic acid (HA)-based tear supplements-Thealoz Duo (TD; 3 % trehalose, 0.15 % HA) and Artelac Advanced (AA; 0.2 % HA)-and their lipid-containing counterparts-Thealipid (TL) and Artelac Complete (AC)-were instilled in right eyes on four separate visits after an initial 5-minute acclimatization. Following eyedrop instillation, subjects underwent a second round of 5-minute acclimatization period, after which they were instructed to maintain sustained eye opening for 15 s during thermal image acquisition. CST was recorded within the 3 mm central cornea using a high-sensitivity infrared camera (FLIR A8200sc). Changes were compared with contralateral control eyes using analysis of covariance, with Schirmer and tear break-up time (TBUT) included as covariates. RESULTS: Lipid-deficient formulations accelerated CST decline, with slope differences of -0.06 °C/15 s for AA and -0.12 °C/15 s for TD (both p < 0.001). In contrast, lipid-containing formulations better preserved CST, with minimal changes (0.05 °C/15 s for TL; -0.03 °C/15 s for AC, both p < 0.001). Time-segmented analyses showed the steepest CST drop occurred within the first 5 s post-blink, particularly with AA and TD (p < 0.001), whereas TL maintained stable CST relative to controls. Neither Schirmer nor TBUT influenced CST dynamics. CONCLUSION: Lipid-containing artificial tears maintained CST stability better than lipid-deficient formulations. The decline in CST during interblink periods may be more pronounced in dry eye disease, particularly with meibomian gland dysfunction, and during prolonged screen use where evaporation is increased.
Corneal sensitivity in new silicone hydrogel contact lens wearers.
Seghetti M, Nosch DS, Albon J
Cont Lens Anterior Eye · 2025 Apr · PMID 41558082 · Publisher ↗
PURPOSE: To explore the influence of silicone-hydrogel contact lens (CL) neophyte wear on corneal sensitivity and its correlation with CL comfort. METHODS: In this prospective longitudinal clinical study 42 participants...
PURPOSE: To explore the influence of silicone-hydrogel contact lens (CL) neophyte wear on corneal sensitivity and its correlation with CL comfort. METHODS: In this prospective longitudinal clinical study 42 participants new to CL wear were recruited for three visits over a period of six weeks with Visit 2 being 7 ± 2 days after Visit 1, and Visit 3 being six weeks ±2 days after Visit 1. Corneal sensitivity was measured in the right eye at each visit, using the Swiss Liquid Jet Aesthesiometer for Corneal Sensitivity (SLACS). Participants completed the Contact Lens Dry Eye Questionnaire (CLDEQ-8©) during the second and third visits to assess CL comfort. RESULTS: 38 participants (mean age: 26.55 ± 5.7 years; 26 females and 12 males aged: 25.23 ± 5.3 years and 29.42 ± 5.8 years respectively) completed the study. No significant difference in the corneal sensory threshold was noted between the three visits (p = 0.175, ηp = 0.044, ANOVA repeated measures). However, a difference in corneal sensory threshold between visit was dependent on gender (visit*gender p = 0.004, ηp = 0.214); with a decreasing trend in corneal sensitivity observed in females compared to an increasing trend in males. No significant correlations were obtained between corneal sensitivity and CL comfort after one week (Spearman correlation coefficient r = -0.138, p = 0.409) or six weeks (Spearman correlation coefficient r = -0.073, p = 0.662). CONCLUSIONS: The adaptation of silicone hydrogel CLs to new wearers did not cause any change in corneal sensitivity during the first six weeks of CL wear. However, the effect of gender and its influence on corneal sensitivity requires further investigation.
Corneal inflammatory events during orthokeratology: analysis of 600 cases over two decades.
Tapasztó B, Németh J, Kovács I … +1 more , Nagy ZZ
Cont Lens Anterior Eye · 2025 Apr · PMID 41547134 · Publisher ↗
PURPOSE: To investigate the occurrence of corneal inflammatory events during orthokeratology (ortho-k) treatment in patients over a 20-year period, and to identify risk factors related to the most common type of inflamma...
PURPOSE: To investigate the occurrence of corneal inflammatory events during orthokeratology (ortho-k) treatment in patients over a 20-year period, and to identify risk factors related to the most common type of inflammatory complication. METHODS: Retrospective analysis was conducted on 600 patients (mean age: 13.2 years; range: 7-50 years) who were fitted with ortho-K lenses between 2005 and 2024. All cases of keratitis, including both infectious and non-infectious (inflammatory) forms, were recorded. The mean follow-up time was 4.2 years (range: 0.5-19 years). Logistic regression analysis was performed to investigate associations between keratitis occurrence and potential risk factors, including age, sex, spherical equivalent (SE), corneal thickness, meibomian gland dysfunction (MGD), history of ocular allergy, and participation in water sports. RESULTS: Among 600 patients (1193 eyes), no cases of microbial keratitis were observed, while infiltrative keratitis (IK) occurred in 20.2 % of patients predominantly within the first two years of lens wear. Participation in water sports (p < 0.001), presence of meibomian gland dysfunction (p < 0.001), and higher baseline spherical equivalent (p = 0.002) were significantly associated with increased risk of IK. No significant association was found between IK and age, sex, baseline pachymetry, or history of allergy. CONCLUSIONS: Infiltrative keratitis was a relatively common inflammatory complication during ortho-K wear. Water sports participation, MGD, and higher myopic refractive error were significant risk factors for IK. Regular follow-up, especially during the first two years, careful management of ocular surface health, and consideration of preservative-free cleaning systems are recommended to reduce IK incidence in ortho-K patients.
Hygiene practices in orthokeratology lens use: A survey among adolescents in Xi'an, China.
An N, Li J, Liu X … +3 more , Wei W, Wang Y, Xiao X
Cont Lens Anterior Eye · 2025 Apr · PMID 41544543 · Publisher ↗
PURPOSE: This study aimed to investigate the hygiene practices of adolescent orthokeratology (ortho-k) lens wearers and their parents in Xi'an, China. By surveying hygiene habits and testing for microbial contamination i...
PURPOSE: This study aimed to investigate the hygiene practices of adolescent orthokeratology (ortho-k) lens wearers and their parents in Xi'an, China. By surveying hygiene habits and testing for microbial contamination in lens case solutions, this study provides valuable insights for future health education on ortho-k lenses. METHODS: A 17-item questionnaire was developed to evaluate the hygiene habits of ortho-k lens wearers. The survey covered topics such as wearing habits, hand hygiene, lens cleaning, and case cleaning. Additionally, lens case solution samples were collected for microbiological testing via culture and quantitative polymerase chain reaction (qPCR). The chi-square test and ordinal logistic regression were used to analyze the effects of the parameters on microbial contamination of the case solution. RESULTS: A total of 283 valid questionnaire responses were collected for the survey. Of those respondents, 247 provided lens cases for microbial testing. Among those samples, 57 (23.1 %) tested positive for bacteria, fungi, or Acanthamoeba. The predominant bacterial contaminants found in the case solution were Pandoraea sputorum, Achromobacter sp., Serratia marcescens, and Staphylococcus spp.. A chi-square test revealed significant associations between age (10-17 years old) and overnight wear duration with microbial positivity. CONCLUSION: Compared with those in earlier reports from other Chinese cities, the hygiene practices of adolescent ortho-k lens wearers and their parents in recent years in Xi'an have been generally satisfactory. Although overall lens hygiene is largely adequate, deficiencies remain in lens case hygiene as well as hand washing duration and thoroughness indicating a need for targeted improvements.
Peripheral scleral lens modifications and tear exchange.
Iqbal A, Fisher D, Alonso-Caneiro D … +2 more , Collins MJ, Vincent SJ
Cont Lens Anterior Eye · 2025 Apr · PMID 41534439 · Publisher ↗
PURPOSE: To quantify the effect of landing zone modifications on tear exchange during short-term scleral lens wear. METHODS: Nine healthy adults with normal corneas wore scleral lenses with three different landing zone m...
PURPOSE: To quantify the effect of landing zone modifications on tear exchange during short-term scleral lens wear. METHODS: Nine healthy adults with normal corneas wore scleral lenses with three different landing zone modifications (toric landing zone (control condition), peripheral notches, or channels) in a randomised order. Following the application of 10 µl of 2 % sodium fluorescein, Eye Surface Profiler (ESP) images were captured over a period of 100 min. Sodium fluorescein was reapplied at 90 min to assess tear exchange following lens settling. Central and peripheral fluorescent intensity data (quantified in arbitrary units, AU) were extracted from the ESP and analysed using customised software in MATLAB. RESULTS: Fluorescent intensity varied significantly with lens design, time, and corneal location (p < 0.001). Averaged across all time points, the channel design displayed a higher level of fluorescent intensity (22 ± 2 AU) compared to the toric control (19 ± 1 AU) (p < 0.01) and notch designs (18 ± 1 AU) (p < 0.001). Following the reapplication of sodium fluorescein after 90 min of lens wear, the channel design also displayed a greater increase in fluorescent intensity ten minutes later (15 ± 3 AU increase) compared to the toric (10 ± 5 AU increase) and notch design (12 ± 5 AU increase) averaged across both central and peripheral locations (groove > toric and notch, both p < 0.05). CONCLUSIONS: Landing zone modifications influence tear dynamics during short-term scleral lens wear. The channel design provided a consistent increase in tear ingress, mainly in the periphery. These findings provide quantitative evidence that channel modifications can enhance tear exchange in the short-term and may inform future innovations in scleral lens customisation.
Corneal biomechanical response in orthokeratology: A finite element model based on squeeze-film force.
Peng E, Chen QO, Ning G
Cont Lens Anterior Eye · 2025 Apr · PMID 41534438 · Publisher ↗
PURPOSE: This study aimed to elucidate the biomechanical mechanisms of orthokeratology (Ortho-K) by examining the effects of key lens design parameters - back optic zone diameter (BOZD) and target diopter reduction (TDR)...
PURPOSE: This study aimed to elucidate the biomechanical mechanisms of orthokeratology (Ortho-K) by examining the effects of key lens design parameters - back optic zone diameter (BOZD) and target diopter reduction (TDR) - on corneal responses. METHODS: A finite element model incorporating squeeze-film force theory was established to simulate corneal biomechanics under varying corneal curvatures (39.5D, 43D, and 46D) and Ortho-K lens designs targeting myopic corrections of -2D, -3D, and -4D, with BOZD values of 5mm and 6mm. Displacement fields, von Mises stress distributions, and corneal refractive power changes were quantitatively analyzed and statistically compared to assess the biomechanical response. RESULTS: Simulation results showed that BOZD broadened the treatment zone and shifted peak stress locations peripherally, whereas TDR primarily elevated the magnitude of corneal deformation (p<0.001). Notably, central displacement (U) was governed by BOZD due to the spatial shift of squeeze-film tension, presenting an exception to the general pattern. Furthermore, both parameters significantly influenced central (D) and cumulative (RCRP) refractive power changes. CONCLUSION: This study provides biomechanical evidence that BOZD primarily regulates the spatial extent and central deformation direction of corneal reshaping, while TDR controls its intensity. The inclusion of squeeze-film force modeling offers a more physiologically accurate framework for simulating Ortho-K treatment. These findings enhance the understanding of Ortho-K's therapeutic mechanisms and support the development of more personalized and effective lens designs for myopia control.
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