Cont Lens Anterior Eye [JOURNAL]
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200 papers
Impact of lipid degradation and tear film stability on silicone hydrogel contact lens wearers with discomfort.
Itokawa T, Suzuki T, Kakisu K … +1 more , Hori Y
Cont Lens Anterior Eye · 2025 Apr · PMID 41529586 · Publisher ↗
PURPOSE: To investigate the potential impact of lipid degradation deposition and tear film stability on contact lens discomfort in silicone hydrogel soft contact lens (SCL) wearers. METHODS: A total of 38 eyes from 38 SC...
PURPOSE: To investigate the potential impact of lipid degradation deposition and tear film stability on contact lens discomfort in silicone hydrogel soft contact lens (SCL) wearers. METHODS: A total of 38 eyes from 38 SCL wearers were enrolled (mean age, 25.3 ± 4.2 years). Participants used a frequent-replacement silicone hydrogel SCL (Comfilcon A lens). Tear break-up time (BUT), meibomian gland morphology, subjective symptoms, and lipid deposition on SCLs were assessed before and after 2 weeks of SCL wear. Lipid deposition, including the ratio of saturated and unsaturated fatty acids of the same carbon number (C16:0/C16:1 and C18:0/C18:1), was evaluated using gas chromatograph-mass spectrometer. Symptomatic SCL wearers were divided based on the Japanese version of the 8-item contact lens dry eye questionnaire (J-CLDEQ-8) score < 11 points. RESULTS: Symptomatic SCL wearers had a significantly higher fatty acid ratio than asymptomatic wearers (C16: p < 0.05; C18: p < 0.05) and a shorter non-invasive BUT (NIBUT) (p < 0.05) after wearing SCLs for 2 weeks. J-CLDEQ-8 total score significantly correlated with the fatty acid ratio (C16: r = 0.643, p < 0.01; C18: r = 0.507, p < 0.01) and NIBUT (r = - 0.353, p < 0.05). Moreover, before wearing SCLs, fluorescein BUT and upper eyelid MG morphology were significantly shorter (p < 0.05) and worse (p < 0.05) in symptomatic SCL wearers compared with asymptomatic wearers. CONCLUSION: Symptomatic wearers had a higher fatty acid ratio and shorter NIBUT. The fatty acid ratio can be used to effectively identify SCL wearers experiencing discomfort.
Antimicrobial efficacy of multipurpose and oxidative contact lens disinfecting solutions: a systematic review.
Ponce-García V, García-Romera MC, Silva-Viguera MC … +1 more , Bautista-Llamas MJ
Cont Lens Anterior Eye · 2025 Apr · PMID 41520504 · Publisher ↗
PURPOSE: To systematically review the antimicrobial efficacy of multipurpose solutions (MPS) and oxidative systems, hydrogen peroxide (HO) and povidone-iodine (PVP-I), used for contact lens disinfection. METHODS: A syste...
PURPOSE: To systematically review the antimicrobial efficacy of multipurpose solutions (MPS) and oxidative systems, hydrogen peroxide (HO) and povidone-iodine (PVP-I), used for contact lens disinfection. METHODS: A systematic search of PubMed and Scopus was conducted according to PRISMA guidelines. Eligible studies compared commercial disinfecting systems using ISO 14729 reference strains or clinically relevant isolates. Extracted data included disinfectant agents, microorganisms tested, ISO compliance, test methodology, and reported outcomes. RESULTS: Ten studies were included in this systematic review. Oxidative systems (HO and PVP-I) consistently achieved strong antimicrobial effects, often maintaining efficacy in the presence of organic soil, biofilms, or clinical isolates. In contrast, MPS showed variable performance depending on their active biocides with several studies reporting reduced efficacy against fungi and Acanthamoeba cysts. Although all solutions typically met ISO 14729 criteria, several studies showed markedly reduced efficacy under clinically relevant conditions. CONCLUSION: Oxidative systems demonstrated superior antimicrobial efficacy compared to MPS, particularly under challenging conditions and against resistant microorganisms. Given that ISO 14729 does not account for pathogens such as Acanthamoeba spp. or clinically resistant strains, reliance on this standard may overestimate real-world efficacy. Expanding testing requirements to include a broader spectrum of microorganisms would provide a more realistic evaluation of disinfecting systems and ultimately strengthen safety for contact lens wearers.
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".
Erdinest N, Bura N
Cont Lens Anterior Eye · 2025 Apr · PMID 41520503 · Publisher ↗
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Effect of orthokeratology on ocular dominance in Chinese myopic children, a 1-year longitudinal study.
Wu H, Huang J, Tang Y … +6 more , Xu Q, Luo Z, Hu Z, Gao W, Li X, Yang Z
Cont Lens Anterior Eye · 2025 Apr · PMID 41500090 · Publisher ↗
PURPOSE: To investigate the impact of orthokeratology on ocular dominance from both qualitative and quantitative perspectives. METHOD: Thirty-nine myopic children undergoing orthokeratology treatment were enrolled in thi...
PURPOSE: To investigate the impact of orthokeratology on ocular dominance from both qualitative and quantitative perspectives. METHOD: Thirty-nine myopic children undergoing orthokeratology treatment were enrolled in this 1-year prospective longitudinal study. The hole-in-the-card method, convergence near-point method, and the Gabor-based psychophysical method were employed to determine ocular sighting, motor, and sensory dominance, respectively. Refractive error and axial length were measured and analyzed. Pairwise agreements between ocular dominance tests were compared, and the variation in the ocular dominance index (ODI) before and after orthokeratology wear were assessed. RESULT: The mean age of participants was 10.92 ± 2.21 years (range 8-16 years), with 19 (49 %) being boys. All ocular dominance tests showed poor consistency with each other at the baseline measurement. After 1 year, changes in sighting, motor, and sensory dominance occurred in 5 %, 31 %, and 46 % of subjects, respectively. No significant difference was found in the absolute value of ODI before (1.20 ± 0.54) and after (1.55 ± 0.91) orthokeratology wear (p = 0.23) in the group with no clear dominant eye at baseline. But for those who had a clear dominant eye at baseline, this value significantly decreased after one year of orthokeratology (p = 0.002). CONCLUSION: Orthokeratology treatment induced dynamic changes in ocular dominance, especially in sensory dominance, among Chinese myopic children.
Assessment of dry eye disease and retinal nerve fiber layer thickness in chronic smokers.
Wanees Nakhla MT, El Din Shalash AB, Edris NA … +1 more , ElSheikha OZ
Cont Lens Anterior Eye · 2025 Apr · PMID 41483742 · Publisher ↗
BACKGROUND: Dry eye disease (DED) and retinal nerve fiber layer (RNFL) changes have been independently associated with smoking, but their relationship in chronic smokers remains unclear. This study investigated the impac...
BACKGROUND: Dry eye disease (DED) and retinal nerve fiber layer (RNFL) changes have been independently associated with smoking, but their relationship in chronic smokers remains unclear. This study investigated the impact of long-term smoking on dry eye indicators and RNFL thickness. METHODS: This observational case-control study incorporated 100 eyes from 50 individuals aged 30-60 yearsdivided equally into two groups: group A: non-smokers and group B: chronic smokers (≥1 pack/day for ≥10 years). Comprehensive ophthalmic examination included Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear film breakup time (NIBUT), tear meniscus height (TMH), lipid layer thickness, and RNFL thickness measurements using Fourier-domain OCT Optovue RTVue. RESULTS: Smokers demonstrated significantly higher OSDI scores (27.2 ± 16 vs 5.5 ± 3.3, p < 0.001), reduced NIBUT, and thinner lipid layers than non-smokers. RNFL thickness was considerably reduced in smokers in superior temporal (129.1 ± 17.7 vs 136 ± 12.2 μm, p = 0.032), inferior temporal, temporal upper, and nasal upper regions, with lower average thickness (99.1 ± 12.1 vs 105.5 ± 7 μm, p = 0.003). Smoking duration and pack-years positively correlated with OSDI scores (r = 0.74, r = 0.71; p < 0.001) and negatively correlated with temporal upper RNFL thickness (r = -0.29, p < 0.05). CONCLUSIONS: Chronic smoking significantly impacts ocular surface health and RNFL thickness, particularly affecting tear film stability and specific retinal regions. These findings suggest increased risk for both DED and optic nerve degeneration in chronic smokers.
Dropout rates among optical interventions for myopia control: a systematic review.
Santodomingo-Rubido J, Martínez-Pérez C, Villa-Collar C
Cont Lens Anterior Eye · 2025 Apr · PMID 41481944 · Publisher ↗
BACKGROUND: Understanding adherence and discontinuation is essential for evaluating the real-world feasibility of myopia-control strategies. Although dropout is recognised as a concern in adult contact lens wear, its pre...
BACKGROUND: Understanding adherence and discontinuation is essential for evaluating the real-world feasibility of myopia-control strategies. Although dropout is recognised as a concern in adult contact lens wear, its prevalence and causes in paediatric optical myopia-control interventions remain poorly characterised. This study systematically quantified dropout rates and examined reasons for discontinuation across optical modalities used for myopia control in children. METHODS: A systematic review was conducted in accordance with PRISMA and registered in PROSPERO (CRD420251177073). PubMed, Scopus, and Web of Science were searched through April 2025, supplemented by reference screening. Randomised and non-randomised clinical trials enrolling children and adolescents (≤18 years) and reporting discontinuations during optical myopia-control treatment were included. Data on study design, subject characteristics, dropout counts, subject-years, and reasons for discontinuation were extracted. Poisson regression with log-link and offset for subject-years estimated dropout rates with 95 % confidence intervals; Bonferroni-adjusted pairwise contrasts compared modalities. RESULTS: Fifty-seven trials met inclusion criteria (22 spectacles, 20 soft contact lenses, 17 orthokeratology), representing > 7,000 subject-years. Dropout ranged from 6 % to 21 % per year across modalities (p < 0.001), lowest for spectacles and highest for soft contact lenses. Reasons for dropout also differed significantly between modalities (p < 0.001). Spectacles showed markedly lower discontinuation due to "symptoms, vision, appearance, fitting/handling issues" and "unknown" reasons (both p < 0.05) but higher dropout for administrative/logistical "other" reasons versus contact lenses (p < 0.03). Soft contact lenses had lower discontinuation for "ocular adverse events" than orthokeratology but substantially higher discontinuation for "unknown" reasons (p < 0.001). No significant differences were found between modalities for treatment/compliance or non-ocular health reasons (p > 0.05). CONCLUSIONS: Dropout in paediatric optical myopia-control interventions is modality-dependent, reflecting differences in handling burden, ocular tolerance, and follow-up demands. Standardised reporting of discontinuation reasons and structured adherence-support strategies are required to improve comparability across studies, enhance patient retention, and optimise real-world myopia-control outcomes.
A non-invasive Schirmer strip-based analysis of tear cotinine and MMP-9 levels in chronic smokers.
Güven S, Arıkan S, Uysal ME … +1 more , Cakır I
Cont Lens Anterior Eye · 2025 Apr · PMID 41477937 · Publisher ↗
PURPOSE: This study aimed to objectively investigate the impact of chronic cigarette smoking on ocular surface inflammation by analyzing the correlation between tear levels of cotinine, a biomarker of active smoke exposu...
PURPOSE: This study aimed to objectively investigate the impact of chronic cigarette smoking on ocular surface inflammation by analyzing the correlation between tear levels of cotinine, a biomarker of active smoke exposure, and matrix metalloproteinase-9 (MMP-9), a key inflammatory mediator. DESIGN: Prospective, cross-sectional study. METHODS: In this cross-sectional study, tear fluid samples were collected from 35 chronic smokers and 50 never-smoked controls. Tear concentrations of cotinine and MMP-9 were quantified using enzyme-linked immunosorbent assay (ELISA). All participants underwent comprehensive ophthalmologic examination, including corneal topography with Pentacam HR. Statistical analyses were performed to compare biomarker levels between groups and assess their correlation and diagnostic utility. RESULTS: Tear cotinine and MMP-9 levels were significantly elevated in smokers compared to controls (p < 0.0001 and p = 0.002, respectively). A strong positive correlation was found between cotinine and MMP-9 levels in the smoking group (Spearman's ρ = 0.786, p < 0.0001). Receiver operating characteristic (ROC) curve analysis indicated that both biomarkers significantly discriminated smokers from non-smokers. No significant differences were found in corneal topography parameters between the groups. CONCLUSION: Chronic smoking significantly elevates tear MMP-9 levels, indicating subclinical ocular surface inflammation even in the absence of clinical disease. This study is the first to report a strong objective correlation between tear cotinine and MMP-9, establishing tear cotinine as a reliable biomarker for active smoking. Future studies on ocular surface inflammation must account for smoking status as a major confounding variable.
Eyes on the Journal: how curiosity shaped a career in clinical research.
Huntjens B
Cont Lens Anterior Eye · 2026 Feb · PMID 41456538 · Publisher ↗
Abstract loading — click title to view on PubMed.
Lacrimal gland Ga-68 PSMA-11 PET/CT radiomic profile: a potential novel imaging biomarker in dry eye disease.
Köylüce N, Arslan ME
Cont Lens Anterior Eye · 2026 Feb · PMID 41455293 · Publisher ↗
PURPOSE: This study aimed to investigate the relationship between texture analysis parameters of lacrimal gland activity and dry eye disease (DED) in participants undergoing Gallium-68 labelled Prostate-Specific Membrane...
PURPOSE: This study aimed to investigate the relationship between texture analysis parameters of lacrimal gland activity and dry eye disease (DED) in participants undergoing Gallium-68 labelled Prostate-Specific Membrane Antigen ligand Positron Emission Tomography / Computed Tomography ([68 Ga]Ga-PSMA-11 PET/CT) imaging for prostate cancer (PCa). METHODS: A prospective cohort of 56 male patients who underwent [68 Ga]Ga-PSMA-11 PET/CT for PCa at the Department of Nuclear Medicine, Kayseri City Hospital (October 2024-June 2025) were included. Lacrimal gland regions of interest were delineated using LIFEx software with a 40 % maximum standard uptake value (SUVmax) threshold. Texture features (morphological, intensity-based, intensity-histogram) were extracted. An ophthalmological evaluation focused on dry-eye parameters was conducted, which included the Ocular Surface Disease Index (OSDI) scoring, in addition to Schirmer and tear break-up time (TBUT) test. Statistical analyses included Spearman correlation, univariate binary logistic regression, and ROC analysis; p < 0.05 was considered significant. RESULTS: Thirty-two participants (57 %) met the criteria for DED. Several intensity-based and histogram parameters were significantly lower in DED participants. SUVmax (cut-off 7.65) demonstrated limited but statistically significant diagnostic potential (AUC = 0.669, p = 0.031; sensitivity 75 %, specificity 50 %). Higher intensity measures correlated with higher TBUT and Schirmer scores and lower OSDI scores. CONCLUSIONS: Texture analysis of lacrimal gland activity on [68 Ga]Ga-PSMA-11 PET/CT provides potential, non-invasive quantitative biomarkers for DED. Intensity-based metrics (SUVmean, SUVmax) may reflect functional impairment of the lacrimal gland. Further multicenter validation is warranted.
Comprehensive assessment of tear film dynamics in pediatric vernal keratoconjunctivitis using a novel non-invasive device (MYAH).
Gülcü A, Erdur SK, Altınbaş M
Cont Lens Anterior Eye · 2026 Feb · PMID 41455292 · Publisher ↗
PURPOSE: To objectively evaluate tear film parameters in children diagnosed with vernal keratoconjunctivitis (VKC) using the MYAH device, and to compare the findings with those of healthy controls. METHODS: This cross-se...
PURPOSE: To objectively evaluate tear film parameters in children diagnosed with vernal keratoconjunctivitis (VKC) using the MYAH device, and to compare the findings with those of healthy controls. METHODS: This cross-sectional, case-control study included 45 children with clinically diagnosed VKC and 45 age- and sex-matched healthy controls. All participants underwent non-invasive ocular surface assessment using the MYAH system. The evaluated parameters included non-invasive tear break-up time (NI-TBUT), tear meniscus height (TMH), blink rate, and ocular protection index (OPI). Correlations between tear film parameters and VKC severity scores were analyzed using Spearman's rank correlation coefficient. RESULTS: Compared to the control group, the VKC group showed significantly lower values in NI-TBUT (5.2 ± 2.1 s vs. 12.8 ± 3.6 s, p < 0.001), TMH (0.18 ± 0.07 mm vs. 0.28 ± 0.05 mm, p < 0.001), blink rate (11 ± 5 vs. 17 ± 4 blinks/min, p = 0.002), and OPI (2.1 ± 1.4 vs. 6.8 ± 2.0, p < 0.001). NI-TBUT and TMH demonstrated moderate negative correlations with clinical severity scores (r = -0.62, p < 0.001 and r = -0.58, p < 0.001, respectively). CONCLUSION: Children with VKC exhibit significant alterations in tear film dynamics, even in the absence of visual acuity loss. The MYAH device offers a non-invasive, and pediatric-friendly approach for objectively assessing tear film stability and blink behavior. These parameters may serve as useful biomarkers for disease severity and monitoring in pediatric VKC.
Corrigendum to "Scleral lens landing zone toricity and tear exchange" [Contact Lens Anterior Eye 49(1) (2025) 102571].
Iqbal A, Fisher D, Alonso-Caneiro D … +2 more , Collins MJ, Vincent SJ
Cont Lens Anterior Eye · 2026 Feb · PMID 41435584 · Publisher ↗
Abstract loading — click title to view on PubMed.
Tendency to obtain written informed consent in clinical applications of contact lenses.
Furundaoturan O, Korkmaz I, Selver OB
Cont Lens Anterior Eye · 2026 Feb · PMID 41380345 · Publisher ↗
AIM: Notwithstanding contact lenses extensive clinical application, complications particularly in the absence of adequate hygiene and education remain a concern. The objective of this study was to evaluate physicians' pr...
AIM: Notwithstanding contact lenses extensive clinical application, complications particularly in the absence of adequate hygiene and education remain a concern. The objective of this study was to evaluate physicians' propensity to obtain written informed consent prior to the prescription of contact lenses, and to investigate the factors associated with this practice. METHODS: A cross-sectional survey was distributed to physicians authorized to prescribe contact lenses. The questionnaire collected data on demographics, prescription habits, patient education practices, and consent behaviors of clinicians. Associations between demographic factors and consent behaviors were analyzed using chi-square tests. A power analysis determined a minimum sample size of 370 participants. The survey was created using the Google Forms Platform. The results were recorded anonymously and stored securely using a password-protected system. RESULTS: A total of 390 physicians participated in the study(mean age:33.7 years;54.1 % female). The majority of these professionals were employed in university or tertiary hospitals(76.4 %), and most of their prescriptions were for contact lenses for refractive(97.4 %) and therapeutic(65.1 %) reasons. Pre-usage education was provided by 88.7 % of physicians, and 95.7 % of these informed patients about potential complications. However, only 4.3 % of participants obtained written informed consent, 12.2 % obtained verbal consent, and 36.5 % obtained no consent. Among the remaining respondents, 41.8 % were unaware of the necessity for informed consent, while 5.2 % believed it was unnecessary. A statistically significant variation in consent practices was observed according to professional rank(p < 0.05). The highest rates of written consent were recorded among professors (11.1 %). CONCLUSION: This study underscores a critical paucity of awareness and consistency in obtaining informed consent prior to contact lens utilization, a particular concern among early-career physicians. Although patient education was commonly provided, formal documentation of consent was rare. Establishing standardized consent guidelines will reduce variability in obtaining written informed consent, enhance medicolegal safety, and guide future clinical practice in contact lens prescription.
Vision-related quality of life in highly myopic children undergoing orthokeratology treatment.
Yang Y, Vincent SJ, Cheung SW … +2 more , Cho P, Chan HHL
Cont Lens Anterior Eye · 2026 Feb · PMID 41353876 · Publisher ↗
PURPOSE: To compare the vision-related quality of life (VRQoL) of highly myopic children before and after one-year orthokeratology (ortho-k) treatment, and between full and partial correction ortho-k groups. METHODS: Chi...
PURPOSE: To compare the vision-related quality of life (VRQoL) of highly myopic children before and after one-year orthokeratology (ortho-k) treatment, and between full and partial correction ortho-k groups. METHODS: Chinese children aged 7 to 13 years, with myopia no less than -5.00 D and astigmatism no more than -2.00 D, were fitted with either a conventional ortho-k lens design targeted for -4.00 D or a dual RC design targeted for full correction. Participants were required to wear spectacles during the day if their residual spherical refraction was no less than -1.25 D or monocular unaided visual acuity was worse than 0.18 logMAR. VRQoL was evaluated before and after one-year ortho-k treatment using the traditional Chinese Paediatric Refractive Error Profile (PREP) questionnaire along with four additional questions regarding symptoms and their frequency after treatment. Participants were retrospectively classified into full and partial correction groups, based on their spectacle dependence at the one-year follow-up visit. The overall PREP score, calculated from the mean of 10 subscales, and the 10 subscales themselves, were compared pre- and post-ortho-k treatment, and between the full and partial correction groups. RESULTS: Thirty-eight participants (full correction: 17, partial correction: 21) completed the study. At baseline, the partial correction group exhibited significantly greater spherical refraction and SER than the full correction group (p < 0.001), while unaided monocular visual acuity was comparable between the groups (p = 0.41). At the one-year follow-up, the full correction group had significantly lower residual spherical refraction and SER, and better unaided monocular visual acuity than the partial correction group (p < 0.001). No significant Group by Visit interactions were observed for any PREP subscales (p ≥ 0.13), indicating similar patterns of change over time in both groups. A significant improvement in the "Activities" subscale was found with ortho-k treatment compared to spectacle wear in both groups (main effect of Visit, p = 0.001). For the "Handling" subscale, when averaging across both time points, the full correction group reported consistently higher scores than the partial correction group (spectacle wear: 83 ± 3 vs 78 ± 3) and the one-year follow-up (ortho-k wear: 85 ± 2 vs 75 ± 3) (main effect of Group, p = 0.03). Although an improving trend in the "Appearance" subscale was noted in the full correction group following ortho-k (57 ± 6 vs 72 ± 4), compared to stable scores in the partial correction group (62 ± 5 vs 63 ± 3), this difference was not significant (Group by Visit interaction, p = 0.13). Regarding symptoms experienced during nighttime ortho-k lens wear, the most reported symptoms (∼18%) were "ocular discomfort" and "itchy/burning/dryness", with ≤ 10% of participants reporting any symptom more than twice per week. No significant differences in ocular symptoms were found between the full and partial correction groups. CONCLUSION: After one year of ortho-k treatment, VRQoL in the "Activities" subscale significantly improved compared to baseline spectacle wear, for both full and partial correction. The full correction group demonstrated a trend towards improved "Appearance" scores over spectacles and achieved significantly higher overall scores in the "Handling" subscale than the partial correction group. Both correction strategies were well-tolerated with a comparable, low frequency of mild ocular symptoms.
Clinical efficacy of induced epiphora by punctal plugging on refractory dry eye disease with ocular surface Damage: Randomized sham-controlled trial.
Ahn H, Chung JL, Jun I … +2 more , Kim TI, Seo KY
Cont Lens Anterior Eye · 2026 Feb · PMID 41330011 · Publisher ↗
PURPOSE: To evaluate the efficacy of induced epiphora by punctal plug on refractory dry eye disease (DED) with ocular surface damage. METHODS: A 24-week, patient-masked, randomized, sham-controlled trial was conducted. P...
PURPOSE: To evaluate the efficacy of induced epiphora by punctal plug on refractory dry eye disease (DED) with ocular surface damage. METHODS: A 24-week, patient-masked, randomized, sham-controlled trial was conducted. Participants (n = 66) with refractory DED were randomized into treatment and control groups. The treatment group received silicone punctal plugs in both upper and lower eyelids and induced an overflow of tears, while the control group underwent a sham procedure. Efficacy was assessed through changes in Ocular Surface Disease Index (OSDI), SICCA corneal staining score (CSS) over time. Repeated measures ANOVA was performed to test the significance. RESULTS: At baseline, the mean OSDI of the overall participants was 34.1 ± 11.7, the mean CSS were 1.5 ± 0.7. The treatment group showed significant improvement in OSDI scores and reduction in CSS compared to the control group, starting as early as 3 weeks and increasing over the study period (all p < 0.05). At the 12- and 24-week follow-ups, 70 % achieved mild or lower OSDI scores. Complications of the treatment included plug dislodgement (39.4 %) and skin irritation (33.3 %). Over 90 % of participants reported being satisfied with the induced epiphora. CONCLUSION: Induced epiphora by punctal plugging showed improvement in both subjective and objective outcomes in patients with refractory DED with ocular surface damage. This approach may serve as a potential adjunctive option for patients unresponsive to standard treatments, warranting careful application and longer-term evaluation.
Exploring the potential for microbial transfer from exhaled breath to the ocular surface: a comparative analysis of respiratory and ocular microbiota.
Majzoub M, Thomas T, Willcox M … +2 more , Coroneo M, Ozkan J
Cont Lens Anterior Eye · 2026 Feb · PMID 41314088 · Publisher ↗
PURPOSE: Respiratory microbes typically enter the body via the nose and mouth, but transmission through the ocular surface-nasolacrimal duct route remains poorly understood. This study investigated the microbiota of exha...
PURPOSE: Respiratory microbes typically enter the body via the nose and mouth, but transmission through the ocular surface-nasolacrimal duct route remains poorly understood. This study investigated the microbiota of exhaled breath, conjunctiva, and anterior nares in healthy individuals to assess the potential for microbial transfer from exhalations to the ocular surface. DESIGN: Cross-sectional, single-center observational study. METHODS: Exhalation, conjunctival, and nasal samples were collected from 20 participants. Exhaled breath samples were obtained by having participants read a standardized script for three minutes in front of a sterile agar plate positioned 15 cm from the mouth. Sterile phosphate-buffered saline was applied to the agar surface and a sterile cell scraper was used to collect the sample. Conjunctival and nasal samples were collected using sterile flocked swabs. All samples were stored at - 80 °C. Microbial DNA was extracted, followed by PCR amplification and paired-end 16S rRNA gene sequencing on the Illumina MiSeq platform. RESULTS: The cohort included 20 participants (8 female, 12 male; mean age 41.9 ± 9.2 years). Significant differences were found in microbial richness (P < 0.0001), evenness (P < 0.01), and bacterial community structure (P < 0.001) across sites. While 9 % of amplicon sequencing variants (ASVs) were shared across all sites, only 1 % were shared between exhalations and the conjunctiva. The anterior nares shared more ASVs with both the conjunctiva (8 %) and exhalations (20 %). CONCLUSIONS: Minimal microbial overlap between exhaled breath and the conjunctiva suggests that in healthy adults, under specific low-intensity conditions tested, direct transmission to the ocular surface appears minimal.
Higher order aberrations and visual outcomes of scleral lenses for ocular surface disease.
Balakrishnan M, Iqbal A, Iyer G … +4 more , Srinivasan B, Dutta R, Goppalakrishnan VA, Vincent SJ
Cont Lens Anterior Eye · 2026 Feb · PMID 41314087 · Publisher ↗
PURPOSE: To evaluate the impact of scleral lenses on higher-order aberrations (HOAs), visual function, and symptomatology in eyes with ocular surface disease (OSD). METHODS: Nineteen eyes with OSD were fitted with sclera...
PURPOSE: To evaluate the impact of scleral lenses on higher-order aberrations (HOAs), visual function, and symptomatology in eyes with ocular surface disease (OSD). METHODS: Nineteen eyes with OSD were fitted with scleral lenses. Corrected distance visual acuity (CDVA), contrast sensitivity (CS), and HOAs were measured at baseline prior to scleral lens (SL) wear, immediately after application (Day 1), and after one month of lens wear. An i-Trace aberrometer was used to measure HOAs over a 4.5 mm pupil diameter and subjective symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. RESULTS: Significant improvements in CDVA and CS (both p < 0.001) were observed following scleral lens application on Day 1, and CDVA continued to improve up to 1 month with an additional gain of 0.1 logMAR (p = 0.03). Significant reductions in HOAs were observed between baseline and the Day 1 SL measurement for: RMS HOA 1.56 to 0.20 µm (p < 0.001), coma 0.71 to 0.12 µm (p < 0.001), secondary astigmatism 0.17 to 0.06 µm (p < 0.05), and trefoil 0.50 to 0.11 µm (p < 0.001). Spherical aberration showed a modest but statistically significant reduction from baseline 0.16 µm to 0.03 µm by 1 month (p = 0.03). No significant differences were observed between the initial and 1-month SL visits for any aberration parameter (p > 0.05). OSDI scores improved significantly from 47 ± 19 to 17 ± 9 (p < 0.001), indicating notable symptom relief. CONCLUSION: Scleral lenses significantly improved visual function and reduced HOAs in eyes with OSD, while also offering sustained symptomatic relief. These findings support the dual optical and therapeutic role of scleral lenses in the management of OSD.
Scleral lens landing zone toricity and tear exchange.
Iqbal A, Fisher D, Alonso-Caneiro D … +2 more , Collins MJ, Vincent SJ
Cont Lens Anterior Eye · 2026 Feb · PMID 41308327 · Publisher ↗
PURPOSE: To quantify the effect of landing zone toricity on tear exchange during short-term scleral lens wear using a profilometry based method. METHODS: Nine healthy participants wore scleral lenses (KATT™, Capricornia)...
PURPOSE: To quantify the effect of landing zone toricity on tear exchange during short-term scleral lens wear using a profilometry based method. METHODS: Nine healthy participants wore scleral lenses (KATT™, Capricornia) with a spherical and 150 μm toric landing zone in a randomised order on separate days, with other lens parameters held constant. Following the instillation of 10 µl of 2 % sodium fluorescein, Eye Surface Profiler images were captured over 100 min of lens wear. A second dose of 10 µl of 2 % sodium fluorescein was instilled after 90 min of lens wear. Fluorescence intensity data were extracted and analysed over central (5 mm diameter, coincident with the centre of the horizontal visible iris diameter [HVID]) and peripheral regions (1 mm annulus, with the HVID as the outer border). RESULTS: Fluorescence intensity varied throughout lens wear, with the toric lens design displaying greater fluorescence intensity than the spherical design at 0, 60, and 100 min (all p < 0.05), when averaged across both regions. The ingress of sodium fluorescein was evident with the toric lens design in both central and peripheral regions during the first 30 min of wear, followed by a gradual decline, while the spherical design stabilised after 5-10 min. The toric lens design displayed tear exchange following the reapplication of sodium fluorescein after 90 min of lens wear, while the spherical design did not. CONCLUSIONS: Scleral lenses with a toric landing zone facilitated greater central and peripheral tear exchange than a spherical lens design. Alterations to the scleral landing zone which enhance tear exchange may have clinical implications for reducing peripheral corneal oedema during lens wear.
Tear molecule concentrations as potential biomarkers of digital eye strain.
Redondo B, Lara-Vázquez PM, Vera J … +1 more , Rosenfield M
Cont Lens Anterior Eye · 2026 Feb · PMID 41289657 · Publisher ↗
PURPOSE: The objective of this study was to investigate differences in tear inflammatory molecules after digital and paper-based reading, examine the influence of cognitive load and explore their relationship with digita...
PURPOSE: The objective of this study was to investigate differences in tear inflammatory molecules after digital and paper-based reading, examine the influence of cognitive load and explore their relationship with digital eye strain (DES) symptoms. METHODS: Twenty-four young adults completed four 30-minute reading tasks, each varying in cognitive demands (high vs. low) and reading media (digital vs. paper). After each task, unstimulated tear samples were collected and analyzed using multiplex bead assays to quantify the concentrations of 12 tear molecules. Participants also completed a questionnaire to assess visual symptomatology. RESULTS: Reading from a digital screen significantly increased tear concentrations of IL-1α (P = 0.02), IL-6 (P = 0.03), IL-8 (P = 0.004), TGF-α (P = 0.02), and TNF-β (P = 0.01) compared to reading printed text. High cognitive load was also associated with elevated IL-8 (P = 0.002) and TNF-β (P = 0.02) levels. Participants reported higher visual discomfort when using digital screens, with higher cognitive demand exacerbating these symptoms. Correlation analyses revealed moderate positive relationships between the changes induced by the display type on IL-1α and DES symptoms (P = 0.02), and between IL and 6 (P = 0.02), TGF-α (P = 0.04) and TNF-β (P = 0.05) with cognitive load-induced discomfort. A subgroup analysis based on dry eye symptomatology revealed that individuals with fewer symptoms exhibited higher cytokine concentrations for IL-1α (P = 0.05) and TGF-α (P = 0.02). CONCLUSIONS: Tear biomarkers could serve as objective tools for evaluating DES, offering a deeper understanding of the physiological mechanisms involved in the condition.
Incidence of keratoconus following allergic conjunctivitis: a multicenter retrospective cohort study using a U.S. healthcare network database.
Lishinsky-Fischer N, Erdinest N, Buhbut O … +1 more , Gur Z
Cont Lens Anterior Eye · 2026 Feb · PMID 41252778 · Publisher ↗
OBJECTIVE: To evaluate the risk of keratoconus and related corneal complications in patients with allergic conjunctivitis, using a large, multicenter real-world dataset. METHODS: A retrospective cohort study was conducte...
OBJECTIVE: To evaluate the risk of keratoconus and related corneal complications in patients with allergic conjunctivitis, using a large, multicenter real-world dataset. METHODS: A retrospective cohort study was conducted utilizing the TriNetX US Collaborative Network. Patients aged 5-25 years with allergic conjunctivitis were matched to patients with non-allergic conjunctivitis using 1:1 propensity score matching. The primary outcome was incident keratoconus. Secondary outcomes included corneal topography, advanced corneal diagnostic procedures (e.g., pachymetry and scanning computerized ophthalmic imaging), keratoconus-specific contact lens fitting, corneal cross-linking, keratoplasty, recurrent corneal erosion, and acute corneal hydrops. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards models. RESULTS: After matching, 174,443 patients were included in each cohort. Allergic conjunctivitis was associated with a significantly increased risk of keratoconus (HR 1.6; 95 % CI, 1.18-2.18; p = 0.0024), with 118 patients developing the condition versus 62 in the control group. Corneal erosion was significantly associated with allergic conjunctivitis as well with HR of 1.87 (95 % CI 1.05-3.34; p = 0.0305). Corneal topography and advanced corneal diagnostic procedures were also more frequent in the allergic group with HRs of 1.94 (95 % CI 1.58-2.38; p < 0.0001) and 2.05 (95 % CI 1.74-2.4; p < 0.0001), respectively. CONCLUSIONS: Allergic conjunctivitis is associated with an elevated risk of keratoconus and an increased need for corneal diagnostic evaluation in children and young adults. These findings support the implementation of enhanced screening and proactive allergy management in this population.
Clinical impact of varying the molecular weight of hyaluronic acid in artificial tears - A randomised controlled crossover trial.
Semp DA, Dutta D, Wolffsohn JS
Cont Lens Anterior Eye · 2026 Feb · PMID 41242004 · Publisher ↗
PURPOSE: To assess the impact of molecular weight of hyaluronic acid, of the same concentration, in artificial tears. METHODS: A size exclusion high-performance liquid chromatography system with ultraviolet detection was...
PURPOSE: To assess the impact of molecular weight of hyaluronic acid, of the same concentration, in artificial tears. METHODS: A size exclusion high-performance liquid chromatography system with ultraviolet detection was used to measure hyaluronic acid content and establish a relative molecular weight, based on standardised hyaluronic acid samples. The rheology of HydraMed®, Evolve® and Hylo-Forte® eye drops, which all report containing 0.2 % hyaluronic acid as the principal constituent, was assessed at shear rates of relevance to blink conditions in-vitro, using a research rheometer fitted with a 60 mm aluminium flat plate measuring system at 31 °C. Twenty-five participants (aged 23.6 ± 9.2 years) meeting the TFOS DEWS II criteria for a diagnosis of dry eye disease were randomised to receive one double-masked application of each drop, on separate days. Dry eye symptom severity, non-invasive breakup time, tear meniscus height and ocular redness were assessed at baseline and 5, 15, 30, 45, 60 and 90 min after application. RESULTS: Rheology demonstrated Hylo-Forte (2.5 M Da, 0.16 % hyaluronic acid) had a more non-linear (non-Newtonian) relationship between viscosity and sheer force (r = 0.295) compared to HydraMed (0.8 M Da, 0.26 % hyaluronic acid; r = 0.485) and Evolve (1.3 M Da, 0.24 % hyaluronic acid; r = 0.521). Dry eye symptoms rapidly reduced and tear stability improved with drop instillation and the effect slowly declined with time (p < 0.001), with all drops following a similar profile (p > 0.05). Hylo-Forte demonstrated the greatest reduction in dry eye symptoms and sustained improvement in tear stability. Tear meniscus height increased with drop instillation and then declined with time (F = 18.643, p < 0.001), with Evolve having a reduced initial effect compared to HydraMed and Hylo-Forte (F = 4.045, p < 0.001). Average bulbar redness was low (0.63 ± 0.44 Efron grade) and did not change with drop application (F = 1.721, p = 0.120). CONCLUSIONS: Artificial tear formulation impacts its rheology, leading to differences in clinical effectiveness, even from a single application. Higher molecular weight hyaluronic acid in Hylo-Forte demonstrated more non-Newtonian behaviour, which is more aligned with the rheology of the natural tear film.
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