Cont Lens Anterior Eye [JOURNAL]
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200 papers
Prevalence and factors associated with keratoconus among high school students in Trinidad and Tobago: A cross-sectional population-based study.
Ezinne NE, Kwarteng MA, Phagoo S … +3 more , Roopnarinesingh A, Mashige KP, Osuagwu UL
Cont Lens Anterior Eye · 2026 Feb · PMID 41240508 · Publisher ↗
BACKGROUND: This study aimed to determine the prevalence of keratoconus (KC) among high school students in Trinidad and Tobago (T&T) and identify associated factors. METHODS: This cross-sectional study was conducted usin...
BACKGROUND: This study aimed to determine the prevalence of keratoconus (KC) among high school students in Trinidad and Tobago (T&T) and identify associated factors. METHODS: This cross-sectional study was conducted using multi-stratified random sampling. Data on family history, eye rubbing, demographics, and clinical measures (visual acuity, autokeratorefraction, retinoscopy, corneal topography, optical coherence tomography (OCT), and slit-lamp biomicroscopy) were analysed. KC diagnosis was based on clinical signs, topographic and Optical coherence tomography (OCT) findings, and slit-lamp indicators. RESULTS: A total of 2,084 students participated (mean age±SD = 14.0 ± 1.60 years; 58.9 % female). The prevalence of KC was 2.88 % (95 % CI: 2.22-3.69 %). Most cases of KC were stage 1 (78.3 %), and only 3.3 % were previously diagnosed. KC was more common among males (53.3 %), people of East Indian descent (56.7 %), and those residing in the urban areas (36.7 %). Multivariable analysis adjusting for potential covariates revealed that family history of KC (OR 2.56, 95 % CI: 1.11-5.93), rural residency (OR = 2.82, 95 % CI: 1.50-5.31) and grade level (higher odds for Form 1 students OR = 12.34, 95 % CI: 1.64-93.07) were significantly associated with higher odds of KC whereas female sex (OR = 0.56, 95 % CI: 0.33-0.94) was associated with a lower odd of KC. CONCLUSION: The study found that about 3 % of high school students, mostly males, those with an East Indian background and people with a positive family history in T&T had KC. These findings highlight the need for early targeted screening for at-risk individuals and population-based studies to further explore risk factors and inform preventive strategies.
The change of regional relative peripheral refraction after orthokeratology and its correlation with corneal reshaping parameters.
Wang A, Shen L, Zang W … +2 more , Xu X, Yang C
Cont Lens Anterior Eye · 2026 Feb · PMID 41240507 · Publisher ↗
PURPOSE: To assess relative peripheral refraction (RPR) regionally before and after orthokeratology (OK) using the Refraction Topographer (RT) and analyze the relationship between changes in RPR and corneal reshaping par...
PURPOSE: To assess relative peripheral refraction (RPR) regionally before and after orthokeratology (OK) using the Refraction Topographer (RT) and analyze the relationship between changes in RPR and corneal reshaping parameters. METHODS: This is a prospective, non-randomized, controlled study. Subjects chose either OK or single-vision spectacles (SVS) based on preference and were assigned to the OK or SVS group. Regional RPR was measured at baseline (pre-wearing) and 2 months later (post-wearing) in both groups. The increased curvature of high convex zone compared to the treatment zone (ICH) was calculated to quantify the prominence of high convex zone. RESULTS: Forty-one subjects (mean age: 9.93 ± 1.66) were enrolled in the OK group and 20 (mean age: 10.10 ± 1.62) in the SVS group. Only right eyes were included when myopia was bilateral. At baseline, there were no significant differences in age, gender, refractive error or axial length between groups. After 2 months, no significant changes in RPR in any region were found in the SVS group. The OK group showed significant myopic shift in RPR in regions between 15° and 30° visual field (-0.35 ± 0.35D), 30° and 45° (-0.96 ± 0.84D), 45° and 53° (-1.68 ± 1.41D), temporal quadrant (-1.47 ± 1.14D), inferior quadrant (-1.39 ± 1.22D), and superior quadrant (-0.57 ± 0.89D) (all p < 0.05). The shift was more pronounced towards the periphery (p < 0.001) and in the temporal and inferior quadrants (p < 0.01). Additionally, the change in RPR across the whole detection field was significantly correlated with baseline Spherical Equivalent Refractive (r = 0.47, p = 0.002) and ICH (r = -0.51, p = 0.001). CONCLUSIONS: After OK, relative peripheral myopic defocus significantly increased in all regions between 15° and 53° visual field, except the nasal quadrant. The increase was more pronounced in the periphery and in the temporal and inferior quadrants. Additionally, as the degree of myopia increased, the high convex zone became more prominent, leading to a greater increase in relative peripheral myopic defocus.
Identification and quantification of Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS) in myopia control soft contact lenses.
Siew L, Jaeger JE, Wilson B … +7 more , Johnstone D, Angell J, Symons R, Lim BXH, Stapleton F, Mehta JS, Lim CHL
Cont Lens Anterior Eye · 2026 Feb · PMID 41232159 · Publisher ↗
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In vitro antibacterial efficacy and antibiofilm activity on contact lenses of a new ophthalmic spray containing Biosecur® citrus extract (Oftasecur®).
Pinna A, Thompson TP, Donadu MG … +5 more , Sacchi M, Serra R, Fruschelli M, Gilmore BF, Dore S
Cont Lens Anterior Eye · 2026 Feb · PMID 41152085 · Publisher ↗
PURPOSE: To investigate the in vitro antimicrobial activity of a new commercial ocular spray containing 0.2% Biosecur® citrus extract (Oftasecur®) against Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas ae...
PURPOSE: To investigate the in vitro antimicrobial activity of a new commercial ocular spray containing 0.2% Biosecur® citrus extract (Oftasecur®) against Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli and test its efficacy in preventing biofilm formation on etafilcon A and senofilcon A contact lenses. METHODS: Antibacterial activity against Staphylococcus epidermidis ATCC 12228, Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa PAO1, and Escherichia coli NCTC 10418 was evaluated by microdilution in Mueller-Hinton broth (MHB). Inocula were standardised to OD600 and MIC/MBC determined across a 50 % to 0.195 % (v/v) dilution range of Oftasecur®. Early biofilm formation on etafilcon A and senofilcon A lenses was assessed over 24 h using alamarBlue™ at 10 % (v/v) with fluorescence recorded (Ex 584 nm, Em 590 nm) every 30 min. Lenses were rinsed in sterile phosphate-buffered saline (PBS; 3 × 5 mL) before use. Data were analysed by assumption-checked parametric/non-parametric tests (one-way ANOVA with Tukey or Kruskal-Wallis with Dunn; α = 0.05). RESULTS: Across species, the MIC was 50 % (v/v) and MBC exceeded 50 % (v/v). On both lens materials, Oftasecur® significantly reduced alamarBlue-measured metabolic activity during early lens-bacteria interactions relative to untreated controls over 24 h (p < 0.05), consistent with inhibition of early biofilm-associated growth. Reductions were observed for all species, with the largest effects for Gram-negative strains. CONCLUSIONS: Oftasecur® demonstrated concentration-dependent antibacterial activity against reference ocular pathogens and suppressed early biofilm-associated metabolism on common contact lens materials. These findings support further ex vivo and clinical studies to determine whether Oftasecur® can help prevent contact lens-related bacterial keratitis.
A survey of contact lens users: Adherence to care guidelines and knowledge of microbial keratitis risk.
AlBalawi E, Salamah RB, Altamimi R … +2 more , AlSarhan R, Alyousef J
Cont Lens Anterior Eye · 2026 Feb · PMID 41130898 · Publisher ↗
BACKGROUND: Contact lenses are widely used for cosmetic and refractive purposes. Proper usage and hygiene are critical to preventing ocular complications like microbial keratitis (MK). This study aims to assess the level...
BACKGROUND: Contact lenses are widely used for cosmetic and refractive purposes. Proper usage and hygiene are critical to preventing ocular complications like microbial keratitis (MK). This study aims to assess the level of awareness and practices regarding contact lens use and hygiene among a sample population. METHODOLOGY: A cross-sectional survey was conducted among 434 contact lens users. Data on demographic factors, reasons for contact lens use, duration and frequency of use, types of lenses, hygiene practices, and awareness of MK were collected and analyzed. Statistical associations between awareness, practices, and various demographic and usage factors were examined using chi-square tests. RESULTS: Most participants were 18-25 years old (248, 57.1 %) and female (393, 90.6 %). The primary reason for contact lens use was cosmetic (216, 49.8 %), followed by refractive purposes (116, 27.4 %). Most participants used soft regular contact lenses (385, 88.7 %) for 5-8 h daily (248, 57.1 %) and had been using them for 1-5 years (163, 37.6 %). Confidence in contact lens care knowledge was high, with (120, 27.6 %) being "Extremely confident." A significant portion (319, 73.5 %) had adequate awareness of MK, with females exhibiting higher awareness levels than males (p = 0.000). Good hygiene practices were reported by (425, 97.9 %) of participants, though gaps in specific practices like rubbing lenses during cleaning (243, 56.0 %) were noted. There was a significant association between high confidence in lens care knowledge and adequate awareness of MK (p = 0.005). CONCLUSION: The study highlights good hygiene practices among contact lens users, though awareness of MK varies. Female users and those with higher confidence in lens care knowledge showed better awareness and practices. Targeted educational initiatives can further enhance awareness and proper practices to prevent MK and other complications associated with contact lens use.
Contact lens discomfort and associated conditions: Definitions and disambiguation relative to dry eye disease.
Papas EB
Cont Lens Anterior Eye · 2026 Feb · PMID 41125520 · Publisher ↗
Terminology used in relation to contact lens discomfort, and its associated conditions has proliferated, leading to confusion and misuse. This short article demonstrates that the lexicon can be reduced to four terms, whi...
Terminology used in relation to contact lens discomfort, and its associated conditions has proliferated, leading to confusion and misuse. This short article demonstrates that the lexicon can be reduced to four terms, which are sufficient to describe the field. These are contact lens discomfort (CLD), contact lens associated dry eye (CLADE), contact lens induced dry eye (CLIDE) and dry eye disease (DED). Definitions for these conditions are clarified and their diagnostic pathways described. Exclusive use of these defined terms is recommended to avoid future misunderstanding, simplify clinical differential diagnosis, maximise treatment efficacy and facilitate the interpretation of research outputs by promoting characterisation of homogenous study groups.
Reply to letter RE "Improved control efficacy of a novel aspherical orthokeratology lens compared with the traditional three-zone spherical lens in a single-blind randomized clinical trial".
Cont Lens Anterior Eye · 2025 Dec · PMID 41125519 · Publisher ↗
Abstract loading — click title to view on PubMed.
Standardized evaluation of orthokeratology lens fitting status assisted by deep learning algorithm.
Song W, Zhang Y, Wan C … +6 more , Liu M, Wang S, Yin H, Xue M, Pan H, Shi L
Cont Lens Anterior Eye · 2026 Feb · PMID 41115819 · Publisher ↗
OBJECTIVE: Aims to develop a standardized evaluation method based on the YOLOv8n object detection algorithm, with the goal of quantitatively assessing the displacement of orthokeratology lenses (OK_lenses) and objectivel...
OBJECTIVE: Aims to develop a standardized evaluation method based on the YOLOv8n object detection algorithm, with the goal of quantitatively assessing the displacement of orthokeratology lenses (OK_lenses) and objectively evaluating their fitting status under fluorescein staining conditions. METHODS: 117 videos documenting of the fluorescein sodium staining fitting process of OK_lenses, were analyzed alongside corresponding ophthalmic examination results. Key frames were extracted from these videos, annotated, and compiled into a local dataset. A YOLOv8n object detection algorithm model was constructed to automatically identify the visible iris and OK_lenses. The lens displacement was calculated based on the distance between the center points of these two targets and the horizontal visible iris diameter (HVID). Model performance was evaluated using Accuracy, Recall, and F1-score metrics, while consistency was assessed via the Kappa consistency test and compared with traditional manual assessment results. RESULTS: Achieved automatic calculation of OK_lens displacement in fluorescein-stained images and analysis of their fitting status through the application of the YOLOv8n object detection algorithm. For iris and lens detection, the model yielded accuracy, recall, and F1-score values of 97.6 %, 98.8 %, 98.2 % and 98.4 %, 98.9 %, 98.6 %, respectively. In terms of fitting status assessment, the accuracy of the three prediction results of this model compared with the gold standard was 88.6 %, 91.4 % and 88.6 % respectively, the average accuracy rate was 89.5 %, and all Kappa values were > 0.80, showing a high consistency with the gold standard. CONCLUSION: The YOLOv8n object detection algorithm model demonstrates strong concordance with the gold standard and high accuracy, validating its robust replication of the gold standard's evaluation logic. By enabling the objective, quantitative analysis of lens displacement in fluorescein-stained images, this highly stable and objective model could serve as a standardized tool to complement traditional manual evaluations. It offers considerable value for improving assessment efficiency of physicians lacking fitting experience and reducing subjective bias during fitting procedures. Notably, this study may not improve efficiency for experienced fitting physicians, as the steps and time required for fitting may not be significantly reduced. To further verify its generalization ability, future studies should expand the sample size and incorporate multi-center data for comprehensive validation to support its transition toward clinical standardization.
The relationship between relative peripheral refraction and axial length elongation in myopic children wearing orthokeratology lenses using a novel wide-angle multispectral refraction topographer.
Mandantuoya, Ao M, Zhang Y
Cont Lens Anterior Eye · 2026 Feb · PMID 41087277 · Publisher ↗
PURPOSE: To investigate the peripheral retinal relative defocus in myopic children wearing orthokeratology (OK) lenses and evaluate its relationship with the efficacy of myopia control. METHODS: Wide-angle (150° field of...
PURPOSE: To investigate the peripheral retinal relative defocus in myopic children wearing orthokeratology (OK) lenses and evaluate its relationship with the efficacy of myopia control. METHODS: Wide-angle (150° field of view) relative peripheral refraction and axial length measurements were conducted in 48 children wearing OK lenses. Key peripheral refraction parameters included minimum defocus distance, defocus ring outer diameter, defocus ring inner diameter, defocus ring width, and retinal relative defocus values (RDVs). Pearson correlation analysis was used to evaluate the associations between axial elongation rate and these parameters. Multiple regression analysis was constructed to predict axial elongation, mainly based on the parameters of peripheral retinal defocus. RESULTS: Peripheral myopic defocus was observed in children wearing OK lenses. Axial elongation rate showed a negative correlation with defocus ring outer diameter (R = -0.388, P < 0.01) and defocus ring width (R = -0.503, P < 0.01), while it was positively correlated with minimum defocus distance (R = 0.383, P < 0.01) and defocus ring inner diameter (R = 0.309, P < 0.01). RDV-53, RDV-45, RDV-(30-45), RDV-(45-53), RDV-N, and RDV-I also showed significant positive correlations with axial elongation rate (P < 0.01). Age, baseline axial length, defocus ring width, minimum defocus distance, and RDV-(45-53) were five predictors in the multivariable prediction model. CONCLUSION: Wearing OK lenses induced peripheral myopic defocus. Larger defocus ring width, closer defocus ring to the macular zone and greater relative peripheral myopic defocus were associated with less axial elongation. Peripheral defocus parameters combined with age and baseline axial length could predict axial elongation to some extent.
Influence of baseline characteristics on subjective improvement of dry eye after intense pulsed light therapy.
Carrillo-Pulido M, Ortiz-Peregrina S, López Pérez MD … +2 more , Cano-Ortiz A, González-Cruces T
Cont Lens Anterior Eye · 2026 Feb · PMID 41062344 · Publisher ↗
PURPOSE: To identify baseline clinical signs and symptoms associated with response to intense pulsed light (IPL) combined with meibomian gland expression in dry eye disease (DED), and to develop machine learning (ML) mod...
PURPOSE: To identify baseline clinical signs and symptoms associated with response to intense pulsed light (IPL) combined with meibomian gland expression in dry eye disease (DED), and to develop machine learning (ML) models for individualized outcome prediction. METHODS: This retrospective study analyzed 100 eyes from 100 DED patients (aged 58.6 ± 13.4 years) treated with IPL and meibomian gland expression. Baseline parameters assessed with the Antares system included meibomian gland loss (MGL), tear meniscus height (TMH), non-invasive tear break-up time (NIBUT), conjunctival hyperemia, and Ocular Surface Disease Index (OSDI). Patients were stratified by change in OSDI after treatment (ΔOSDI): Class 1 (no improvement), Class 2 (mild improvement), and Class 3 (clear improvement). Several ML models were trained to predict ΔOSDI from baseline parameters. RESULTS: IPL significantly improved both symptoms and signs. OSDI decreased from 44.65 ± 18.3 to 28.47 ± 19.3 (p < 0.001), NIBUT increased from 4.5 ± 3.2 to 7.5 ± 6.5 s (p < 0.001), and TMH and conjunctival hyperemia also improved (p < 0.001), while MGL and BCVA remained stable. Greater improvement was observed in patients with higher baseline OSDI (p = 0.001). The XGBoost algorithm achieved the highest predictive performance (AUC-ROC = 0.77), with OSDI and NIBUT as the strongest predictors based on SHAP analysis. CONCLUSIONS: IPL combined with meibomian gland expression improves symptoms and signs in DED, particularly in patients with more severe baseline symptoms. Baseline OSDI and NIBUT were the strongest predictors of response. ML models demonstrated moderate accuracy, supporting their potential role in personalized DED treatment strategies.
Effects of ambient illuminance and mobile phone screen brightness on tear film stability, visual fatigue, and blink patterns during reading.
Lin M, Zheng X, He C … +3 more , Li M, Lu F, Hu L
Cont Lens Anterior Eye · 2026 Feb · PMID 41058350 · Publisher ↗
PURPOSE: This study aimed to investigate the impacts of different ambient illuminance and screen brightness conditions on tear film stability, visual fatigue, and blink patterns during mobile phone reading. METHODS: This...
PURPOSE: This study aimed to investigate the impacts of different ambient illuminance and screen brightness conditions on tear film stability, visual fatigue, and blink patterns during mobile phone reading. METHODS: This prospective study involved 30 young subjects who completed 4 experiments based on ambient illuminance and screen brightness: Group 1: bright room, bright screen; Group 2: dark room, dark screen; Group 3: bright room, dark screen; Group 4: dark room, bright screen. Participants completed a 30-minute mobile phone reading task in each experiment. Tear film stability indicators, including fluorescein tear break-up time (FTBUT), noninvasive tear breakup time, tear meniscus height, and lipid layer thickness, were measured before and after reading. During reading, an infrared camera recorded blink-related parameters. Subjective questionnaires assessed comfort and visual fatigue. RESULTS: After the reading task, the FTBUT of each group significantly decreased (all P < 0.05). Notably, all tear film stability indicators significantly changed in Group 4. The incomplete blink rate in all the groups tended to increase over time (all P < 0.05). Among the four groups, Group 4 had a significantly greater incomplete blink rate and partial blink ratio (P < 0.05), along with a greater subjective fatigue score, than did Group 1 (P < 0.01). The frequency of incomplete blinks (r = 0.29, P = 0.03) was positively correlated with the visual fatigue score. CONCLUSIONS: Reading in a dark environment with a bright screen led to the most significant instability of the tear film, visual fatigue, and changes in blink patterns. Therefore, it is advisable to avoid reading under such conditions.
Comparison of different methods to image the tear film before and during contact lens wear.
Dumpati S, Kumar M, Vijay AK … +2 more , Tan J, Willcox M
Cont Lens Anterior Eye · 2026 Feb · PMID 40973601 · Publisher ↗
PURPOSE: To evaluate the repeatability and compare non-invasive tear breakup time (NIBUT) and tear film lipid layer thickness (TFLLT) measurements obtained using subjective (Keeler Tearscope-Plus) and objective (Oculus K...
PURPOSE: To evaluate the repeatability and compare non-invasive tear breakup time (NIBUT) and tear film lipid layer thickness (TFLLT) measurements obtained using subjective (Keeler Tearscope-Plus) and objective (Oculus Keratograph 5M and LipiView II Interferometer) instruments before and during soft contact lens (CL) wear. METHODS: This prospective, randomised, double-masked, crossover study involved ten healthy participants who wore two types of daily disposable soft CLs: hydrogel and silicone hydrogel. NIBUT and TFLLT were assessed under pre cornea (before lens insertion) and pre lens (over the lens) conditions. NIBUT was measured using Tearscope-Plus and the Oculus Keratograph 5M, while TFLLT was assessed with Tearscope-Plus and the LifpiView II Interferometer. Repeatability was evaluated using repeated-measures ANOVA within-subject standard deviation (Sw), coefficient of repeatability (CR), and intraclass correlation coefficient (ICC). Correlation between instruments was assessed using Spearman coefficients, while agreement was evaluated using Bland-Altman analysis. RESULTS: NIBUT measured with the Tearscope-Plus demonstrated good to excellent repeatability (ICC: 0.84-0.96). TFLLT measured with the LipiView II Interferometer showed excellent repeatability (ICC: 0.92-0.96). The Oculus Keratograph 5M showed moderate to good repeatability for NIBUT (ICC: 0.67-0.85). No significant correlations were observed between NIBUT measurements from the Tearscope-Plus and Oculus Keratograph 5M (r range: 0.02-0.30; p > 0.05). In contrast, strong correlations were observed between TFLLT measurements from the Tearscope-Plus and LipiView II Interferometer in pre cornea (r = 0.72, p < 0.01) and pre hydrogel (r = 0.74, p = 0.02) conditions, with a moderate, non-significant correlation in the pre silicone hydrogel condition (r = 0.51, p = 0.13). Bland-Altman analysis revealed wide limits of agreement between instruments, indicating substantial measurements variability. CONCLUSION: Tearscope-Plus and LipiView II Interferometer demonstrated high repeatability for NIBUT and TFLLT, respectively. However, the Tearscope-Plus overestimated both NIBUT and TFLLT values compared to objective instruments, indicating that these instruments should not be used interchangeably in clinical practice or research.
IMI-global trends in myopia management attitudes and strategies in clinical practice - A nine-year review.
Whayeb Y, Wolffsohn JS, Logan NS … +2 more , Santodomingo-Rubido J, International Myopia Institute Ambassador Group
Cont Lens Anterior Eye · 2026 Feb · PMID 40967974 · Publisher ↗
PURPOSE: Surveys in 2015, 2019, and 2022 identified a high level of eye care practitioner activity and concern about pediatric myopia, reflected by an uptake of appropriate control techniques. This research provided upda...
PURPOSE: Surveys in 2015, 2019, and 2022 identified a high level of eye care practitioner activity and concern about pediatric myopia, reflected by an uptake of appropriate control techniques. This research provided updated information, examining global trends from 2015 to 2024. METHODS: A self-administered, internet-based questionnaire was distributed in 18 languages to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy, prescribing of available strategies and barriers to adoption. Responses were compared with data from previous surveys. RESULTS: A total of 2,993 practitioners responded in 2024. From 2015 to 2024, practitioner concern had increased in all continents besides Australasia (all p < 0.05), being consistently highest in Asia (8.4 ± 1.8 to 8.6 ± 1.9, respectively). Practitioner activity level had increased markedly in every continent (all p < 0.001), with the greatest change in North America (4.7 ± 3.0 to 7.1 ± 2.6, respectively). Perceived efficacy of soft contact lenses approved for myopia control more than doubled since 2015 (24.4 ± 25.0 % to 52.2 ± 24.0 %, p < 0.001). Combination therapy and orthokeratology were perceived to be the most efficacious interventions, yet single vision spectacles were the most prescribed option. However, the frequency of prescribing single vision spectacles had decreased since 2015 (by -11.1 %, p < 0.001). Globally, cost to the patient remained practitioners' primary reason for not prescribing myopia interventions. CONCLUSIONS: More practitioners are prescribing appropriate control methods to children with lower degrees of myopia than identified previously. However, consistent hindrances need addressing, namely increased affordability and accessibility of effective control options.
Randomized contralateral eye study of myopia control between aspheric multifocal soft contact lens and orthokeratology in children.
Chen R, Chen T, Lu W … +8 more , Li Y, Li J, Li T, Lian H, Chen S, McAlinden C, Wang X, Huang J
Cont Lens Anterior Eye · 2025 Dec · PMID 40962628 · Publisher ↗
BACKGROUND: This study aimed to compare myopia progression in children wearing an aspheric multifocal contact lens and an orthokeratology (OrthoK) lens. METHODS: A total of 65 participants, aged 9.70 ± 1.31 years, were f...
BACKGROUND: This study aimed to compare myopia progression in children wearing an aspheric multifocal contact lens and an orthokeratology (OrthoK) lens. METHODS: A total of 65 participants, aged 9.70 ± 1.31 years, were fitted with an OrthoK lens in one randomly assigned eye and a multifocal soft contact lens in the contralateral eye for the first 6 months (period 1). Following this, contact lens wear was discontinued in both eyes for 1 month, after which the two lens-wearing methods were swapped between eyes and continued for another 6 months (period 2). Axial length (AL), spherical equivalent refraction (SER), central corneal thickness (CCT), and central choroidal thickness (CChT) were measured at the 0-, 6-, 7-, 13-, and 14-month visits. AL and SER were the primary outcome measures. RESULTS: For the OrthoK and multifocal soft lens, AL elongation was 0.14 ± 0.11 mm and 0.23 ± 0.12 mm, respectively, after period 1. AL elongation for the OrthoK and multifocal lens was 0.12 ± 0.19 mm and 0.20 ± 0.13 mm, respectively, after period 2. The SER change for the OrthoK and multifocal lens was -0.20 ± 0.27 D and -0.33 ± 0.30 D after period 1 and -0.26 ± 0.40 D and -0.36 ± 0.46 D after period 2, respectively. No significant differences were observed between the two treatment groups (all P > 0.05). CONCLUSIONS: During the 14-month observation period, no statistically significant differences in myopia progression were found between the aspheric multifocal contact lens and the OrthoK lens. Further longitudinal observation is necessary to characterize the disparities in long-term myopia-control efficacy between the two intervention strategies. TRIAL REGISTRATION: ChiCTR, ChiCTR2000041520. Registered 27 December 2020, https://www.chictr.org.cn/ChiCTR2000041520. Retrospectively registered.
Scleral shell prostheses in patient care: A survey of eyecare clinicians in New Zealand.
Yeoman JP, Sloan BH, Pine KR … +2 more , Jacobs RJ, Misra SL
Cont Lens Anterior Eye · 2026 Feb · PMID 40962627 · Publisher ↗
PURPOSE: Research to guide scleral shell practice is sparse with minimal evidence-based information available about indications and contraindications for shell wear, or the ideal wear and maintenance regimes. New Zealand...
PURPOSE: Research to guide scleral shell practice is sparse with minimal evidence-based information available about indications and contraindications for shell wear, or the ideal wear and maintenance regimes. New Zealand optometrists, ophthalmologists and ocular prosthetists were surveyed to gauge current understanding. METHODS: Topics queried included practitioner specialisation, judgements on the suitability and success of shells for different presentations of non-functional disfigured eyes, shell wear and maintenance protocols, and management of complications. RESULTS: Responses from 140 optometrists, 50 ophthalmologists and 8 ocular prosthetists were collected. Optometrists and ophthalmologists observed that patients with non-functional disfigured eyes had an ocular prosthesis significantly less often than anophthalmic patients (∼30 % vs >90 %). Judgements from optometrists and ophthalmologists about shell suitability for different clinical presentations were wide ranging and inconsistent. Judgements from ocular prosthetists highlighted globe volume, corneal sensitivity and corneal integrity as key factors determining shell wear success. Keratitis and discomfort with shell wear were of high concern to both optometrists and ophthalmologists. Optometrists and ocular prosthetists most frequently reported that shells should be disinfected daily with no overnight wear, while ophthalmologists provided heterogeneous recommendations. CONCLUSIONS: There are significant inconsistencies among and between ophthalmologists and optometrists in the provision, care and maintenance of scleral shells. Ocular prosthetists in New Zealand do not have the necessary scope of practice to care for patients' eye health once they have fabricated and fitted a scleral shell. The consequence of these combined factors is that people with blind disfigured eyes in New Zealand are sub-optimally managed. This survey provides a foundation for developing interdisciplinary consensus guidelines on scleral shell provision and maintenance in New Zealand.
Diagnostic accuracy in dry eye: Insights into clinical and artificial intelligence limitations: Limitations of diagnostic accuracy in dry eye.
Mejía-Salgado G, Rojas-Carabali W, Cifuentes-González C … +9 more , Bernal-Valencia MA, Saboya-Galindo P, Soto-Ariño J, Dumar-Kerguelen V, Marroquín-Gómez G, Moreno-Pardo ML, Tirado-Ángel J, Galor A, de-la-Torre A
Cont Lens Anterior Eye · 2026 Feb · PMID 40954005 · Publisher ↗
PURPOSE: To evaluate the agreement and performance of four large language models (LLMs)-ChatGPT-3.5, ChatGPT-4.0, Leny-ai, and MediSearch-in diagnosing and classifying Dry Eye Disease (DED), compared to clinician judgmen...
PURPOSE: To evaluate the agreement and performance of four large language models (LLMs)-ChatGPT-3.5, ChatGPT-4.0, Leny-ai, and MediSearch-in diagnosing and classifying Dry Eye Disease (DED), compared to clinician judgment and Dry Eye Workshop-II (DEWS-II) criteria. METHODS: A standardized prompt incorporating retrospective clinical and symptomatic data from patients with suspected DED referred to a dry eye clinic was developed. LLMs were evaluated for diagnosis (DED vs. no DED) and classification (aqueous-deficient, evaporative, mixed-component). Agreement was assessed using Cohen's-kappa (Cκ) and Fleiss'-kappa (Fκ). Balanced accuracy, sensitivity, specificity, and F1 score were calculated. RESULTS: Among 338 patients (78.6 % female, mean age 53.2 years), clinicians diagnosed DED in 300, and DEWS-II criteria identified 234. LLMs showed high agreement with clinicians for DED diagnosis (93 %-99 %, Cκ: 0.81-0.86). Subtype agreement was lower (aqueous-deficient: 0 %-18 %, evaporative: 4 %-80 %, mixed-component: 22 %-92 %; Fκ: -0.20 to -0.10). Diagnostic balanced accuracy was 48 %-56 %, with high sensitivity (93 %-99 %) but low specificity (0 %-16 %). Subtype balanced accuracy and F1 score ranged from 33 %-81 % 0 %-71 %, respectively. Compared to DEWS-II, agreement for DED diagnosis remained high (96 %-99 %) but with weaker Cκ (0.52-0.58). Subtype agreement was again low (aqueous-deficient: 0 %-20 %, evaporative: 9 %-68 %, mixed-component: 16 %-75 %; Fκ: -0.09 to -0.02). Diagnostic balanced accuracy was 49 %-56 %, sensitivity 97 %-99 %, and specificity 5 %-16 %. Subtype balanced accuracy ranged from 43 % to 56 %, F1 score 0-68. CONCLUSION: LLMs showed strong agreement and high sensitivity for DED diagnosis but limited specificity and poor subtype classification, mirroring clinical challenges and highlighting risks of overdiagnosis.
Reliability and readability of online patient information for contact lens wearers.
Cardona G, Vega C
Cont Lens Anterior Eye · 2026 Feb · PMID 40947365 · Publisher ↗
PURPOSE: This study aimed to assess the reliability and readability of online patient information regarding contact lens (CL) wear and maintenance, given that many users may employ these resources to supplement or replac...
PURPOSE: This study aimed to assess the reliability and readability of online patient information regarding contact lens (CL) wear and maintenance, given that many users may employ these resources to supplement or replace professional advice. METHODS: Ten frequently asked questions (FAQs) concerning CL wear and maintenance were formulated based on clinical experience and literature search. Each FAQ was used to query Google, and the first 20 eligible websites were analysed, yielding a final sample of 200 websites. Reliability was assessed using the short version of the Ensuring Quality Information for Patients (EQIP) tool, while readability was evaluated through the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL) tests. Websites were classified by country of origin and source type. Non-parametric group contrast and variable correlation analyses were conducted. RESULTS: The median EQIP score was 68.0 % (range 29.0 %-90.0 %), with 30.0 % of websites providing high-quality content (≥75 %). Websites from encyclopaedias and medical centres/hospitals scored higher in reliability compared to commercial and practitioner sources (p < 0.05). Readability was generally poor, with mean FRES and FKGL values of 55.8 ± 11.3 and 9.9 ± 2.3, respectively, exceeding recommended reading levels. Unexplained technical jargon was found in 59.5 % of websites. Encyclopaedias demonstrated better readability scores than news centres (p = 0.036). A weak but significant inverse correlation was found between EQIP and FRES scores (rho = -0.215; p = 0.002), indicating that higher reliability was associated with slightly better readability. CONCLUSION: Overall, online patient information regarding CL wear and maintenance evidenced moderately high reliability but insufficient readability. Contact lens wearers may find this information difficult to understand, leading to poor compliance and potential ocular complications. Given the critical role of online resources in patient education, eye care professionals should guide patients towards reliable, comprehensible websites and consider modern communication strategies to enhance compliance and safety in CL wear.
Dehydration kinetics of soft contact lenses: The hidden impact of early wear.
Tavazzi S, Galli A, Maspero F … +3 more , Rizzo GC, Zeri F, Ponzini E
Cont Lens Anterior Eye · 2026 Feb · PMID 40947364 · Publisher ↗
In contact lens (CL) wear, maintaining adequate CL hydration is essential to prevent ocular dryness and associated discomfort. In this context, dehydration of worn Etafilcon A and Kalifilcon A CLs hydrated by natural tea...
In contact lens (CL) wear, maintaining adequate CL hydration is essential to prevent ocular dryness and associated discomfort. In this context, dehydration of worn Etafilcon A and Kalifilcon A CLs hydrated by natural tears was monitored using an in-vitro gravimetric method. A kinetic model was applied to derive the water kinetics coefficient, which emerged as a reliable indicator of the on-eye hydration state and water diffusion mechanisms. A significant reduction in water content and a tendency from a polymer-hindered water diffusion toward free diffusion were observed after just five minutes of wear, suggesting a rapid initial adaptation to the ocular environment that alters the material resistance to water evaporation. After two hours of wear, a similar effect was evident in approximately half of the samples investigated, indicating that a new hydration equilibrium may eventually be reached over time.
Proteomic analysis of tear fluid: Comparative short-term effects of scleral lenses and rigid corneal lenses wear in ametropic healthy adults.
Zhang Z, Zeng L, Le Q … +6 more , Yu Y, Zhou J, Xue F, Zhou X, Hong J, Chen Z
Cont Lens Anterior Eye · 2025 Dec · PMID 40935694 · Publisher ↗
PURPOSE: The aim of this study was to evaluate the effect of scleral lenses (SLs) on the ocular surface of healthy individuals and explore potential molecular changes in the tear fluid reservoir associated with this form...
PURPOSE: The aim of this study was to evaluate the effect of scleral lenses (SLs) on the ocular surface of healthy individuals and explore potential molecular changes in the tear fluid reservoir associated with this form of contact lens. METHODS: Forty-one healthy Chinese subjects were enrolled in the prospective study and assigned to wear SLs or rigid corneal lenses (RCL), and their ocular surface was evaluated at various time points over one month period. Hyperemia, tear film stability, and molecular changes in tear fluid were assessed. Tandem mass tagging proteomics analysis was used to identify differentially expressed proteins in tears after wearing different lenses. RESULTS: There were no statistically significant differences observed in in the hyperemia index of the nasal and temporal ciliary vessel areas, as well as the nasal and temporal conjunctival vessel areas between groups. The difference in tear film stability between the two groups was not statistically significant. However, proteomic analysis of tear samples revealed 397 differentially expressed proteins in the SLs group, including pro-inflammatory markers such as interleukins. Pathway analysis identified upregulation of inflammation-related pathways. CONCLUSIONS: SLs wear does not significantly impact hyperemia and tear film stability compared to RCL. Nevertheless, at the molecular level, there is evidence showing an underlying inflammatory response. These findings require continued research to elucidate the clinical implications of these molecular changes and to guide SLs fitting.
Impact of orthokeratology lens decentration on axial length growth in Chinese myopic children: A meta-analysis.
Guo YM, Wang J, Bi J … +4 more , Huang J, Wei J, Han Y, Ye L
Cont Lens Anterior Eye · 2026 Feb · PMID 40930925 · Publisher ↗
BACKGROUND: Orthokeratology (OK) lenses have become a prevalent intervention for myopia control. However, lens decentration, a frequent complication, may influence the efficacy of myopia control. The aim of this study wa...
BACKGROUND: Orthokeratology (OK) lenses have become a prevalent intervention for myopia control. However, lens decentration, a frequent complication, may influence the efficacy of myopia control. The aim of this study was to systematically assess the impact of OK lens decentration on axial length growth (ALG) in Chinese myopic children through a meta-analysis. METHODS: We conducted a meta-analysis to evaluate the effect of OK lens decentration on ALG in myopic children. Relevant studies were identified through comprehensive searches in databases, including PubMed, Embase, and the Cochrane Library, for publications from 2000 to 2024. The primary outcome was the standardized mean difference (SMD) in ALG between the centered and decentered lens groups. Heterogeneity was assessed using the Cochrane Q test and I statistics, while publication bias was examined using funnel plots and visual inspection. RESULTS: A total of nine retrospective studies, encompassing 1503 participants aged 8-15 years, met the inclusion criteria. Six studies with 12-month data were included in the primary analysis, showing a significant reduction in ALG in the decentered group (SMD = -0.45, 95 % CI: -0.66 to -0.24, p < 0.0001), with moderate heterogeneity (I = 59.1 %). Subgroup analyses by publication year and sample size revealed temporal and methodological variations, with studies from earlier years showing more pronounced reductions in ALG. Sensitivity analysis confirmed the robustness of the results, with slight variations in the pooled effect size. At 24 months, three studies demonstrated a significant reduction in ALG (SMD = -0.46, 95 % CI: -0.68 to -0.24, p < 0.0001), with negligible heterogeneity (I = 0 %). Potential publication bias was suggested by the funnel plot, particularly due to one outlier study. CONCLUSION: OK lens decentration significantly reduces ALG in myopic children, indicating its potential efficacy in myopia control. However, moderate heterogeneity was observed, which may be attributed to variations in study designs and sample characteristics. Further research with larger sample sizes and extended follow-up periods is necessary to validate these findings.
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