Eye & Contact Lens-Science and Clinical Practice最新文献

Objectives: As face mask wear can result in the redirection of nasal and oral exhalation toward the ocular region, this study investigated the impact of face mask wear on the conjunctiva, eyelid margin, and contact lens (CL) surface microbiome.

Methods: In this prospective, cross-over study, experienced CL wearers (N=20) were randomized to wear a face mask for 6 hr/day (minimum) for a week or no mask for a week. The conjunctiva, eyelid, and CLs were then sampled. After a 1-week washout period, participants were crossed over into the alternate treatment for 1 week and sampling was repeated. Sampling was bilateral and randomly assigned to be processed for culturing or 16S ribosomal(r) RNA gene sequencing.

Results: Culturing showed no effect of mask wear on the average number of bacterial colonies isolated on the conjunctiva, eyelid, or CL, but there was increased isolation of Staphylococcus capitis on CL samples with mask wear ( P =0.040). Culture-independent sequencing found differences in the taxonomic complexity and bacterial composition between the three sites ( P <0.001), but there was no effect of bacterial diversity within and between sites. Mask wear did not impact dry eye or CL discomfort, but increased ocular surface staining was reported ( P =0.035).

Conclusions: Mask wear did not substantially alter the microbiome of the conjunctiva, eyelid margin, or CL surfaces in uncompromised healthy eyes.

Abstract: We report a case of corneal epithelial hyperplasia associated with chronic eye rubbing mimicking keratoconus. A 32-year-old man was presented with a 3-year history of suboptimal vision and astigmatism in his left eye. His history was significant for chronic left eye rubbing. The anterior corneal curvature map showed inferior steepening in the left eye; however, other features of ectasia were absent. Corneal epithelium thickness mapping with optical coherence tomography was significant for corresponding epithelial thickening. His corneal imaging remained stable at a 6-month follow-up examination. At month 15-and after cessation of eye rubbing behavior-the vision symptoms, refraction, and corneal imaging had normalized. In conclusion, chronic eye rubbing may cause reversible corneal epithelial hypertrophy. Eye rubbing should be considered in the evaluation of patients presenting with unexplained vision symptoms and changes in astigmatism that are not consistent with ectasia on corneal imaging.

Objectives: The aim of this study was to evaluate the impact of wearing center-near (CN) and center-distance (CD) multifocal contact lenses (MFCLs) on spherical aberrations and visual acuity in patients with early presbyopia.

Methods: Fifty participants with early presbyopia wore CN-MFCLs and CD-MFCLs for 1 week. The average corrected refractive power was -2.65±1.67 D. Spherical aberration was measured using an auto-refractor after 1 week of lens use.

Results: No significant difference in overall visual acuity was observed when using either lens. Participants favored CD-MFCLs for distance vision and CN-MFCLs for near vision. This study highlighted variations in aberration and satisfaction based on age, refractive errors, and individual responses. Patients with positive spherical aberrations tended to benefit from CN-MFCLs, which improved both distance and near vision, although additional correction was required for clear distance vision. Patients with early presbyopia generally preferred CN-MFCLs when positive aberration was prevalent, whereas those with negative aberration reported greater satisfaction with distance vision when wearing CD-MFCLs.

Conclusions: This study confirmed that wearing MFCLs leads to changes in spherical aberration and visual acuity in patients with early presbyopia, particularly when positive aberration prevails. Future research should investigate these effects across different stages of presbyopia.

Abstract: Stevens-Johnson syndrome often results in a significant reduction in vision, dryness, and photophobia based on severity. Scleral lenses are well-considered visual interventions that enhance vision and comfort, resulting in an increased quality of life for patients. This case report describes the enhancement of comfort, cosmesis, and reduction of photophobia using a piggyback system (scleral contact lenses over a prosthetic contact lens), whereas the other modalities were unsatisfactory.

Objectives: To investigate the referral and management patterns of patients with keratoconus among primary eye care practitioners in Ghana and Nigeria.

Methods: A questionnaire adapted from previous studies was modified and created using Google Forms. The online survey was distributed to prospective participants using e-mails and other social media platforms. Data were analyzed using the Statistical Product and Service Solutions software (version 25.0; IBM Corp, Armonk, NY; Released 2017).

Results: One hundred and sixty-nine optometrists responded to the survey (61.54% from Nigeria and 38.46% from Ghana). Most (88.6%) practiced without corneal topographers. Most respondents (77.7%, n=136) reported not fitting rigid gas-permeable (RGP) contact lenses in a year and 68% were willing to refer for contact lens fitting to another practitioner. The major barriers to RGP fitting were lack of experience (44.4%, n=72), cost to practice (15.4%, n=25), and other reasons (12.4%), whereas 27.8% (n=45) preferred not to answer. Seventy-six percent of respondents (n=133) were willing to fit RGPs if the respondents received the training to do so. About half of the respondents (53.8%) reported progression of cornea signs as the reason for referral to an ophthalmologist. Half of the respondents (n=51.4%) did not have a cornea surgeon in the area the respondents practiced, and 76.3% reported not comanaging patients at all with ophthalmologists.

Conclusion: This study highlights the current standard of care of patients with keratoconus in West Africa. The findings from this study suggest that clinical guidelines and further training of eye care practitioners in West Africa are needed to better manage patients with keratoconus.

Objective: This study was developed with the goal of exploring the efficacy of orthokeratology (OK) as an approach to controlling axial length (AL) growth and identifying factors predictive of the long-term efficacy of this approach.

Methods: This was a retrospective study that enrolled 157 myopic children 7 to 15 years of age undergoing OK correction for over 3 years. The short- and long-term effectiveness of this approach at 1 and 3 years post-OK correction, respectively, was assessed. All participants were classified into two groups based on whether they exhibited good or poor long-term efficacy outcomes. Measurements of changes in AL were made at baseline and at 1 and 3 years post-OK. Univariate analyses and binary logistic regression approaches were used to evaluate baseline age, baseline spherical equivalent refraction, baseline keratometry (K) values of flat and steep meridians, and short-term effectiveness with the goal of identifying predictors of long-term efficacy.

Results: Univariate analyses led to the identification of significant differences in baseline age, baseline spherical equivalent refraction, baseline AL, and short-term efficacy between these two groups (P<0.05), whereas gender, baseline flat K, and baseline steep K did not differ significantly (P>0.05). In binary logistic regression analyses, baseline AL (P=0.017) and short-term efficacy (P<0.001) were both found to significantly influence long-term efficacy. Receiver operating characteristic curves demonstrated that short-term efficacy offered an area under the curve value >0.8, consistent with its highly accurate performance as a predictor of long-term efficacy.

Conclusion: These results suggest that short-term efficacy outcomes can feasibly be used to predict the long-term effectiveness of OK correction in children. In patients exhibiting poor short-term efficacy, timely replacement or the incorporation of additional treatment modalities may aid efforts to better control the progression of myopia.

Abstract: The corneal epithelium, supplied by thousands of nerve endings, plays a substantial role in absorbing and distributing nutrients along the ocular surface. Many studies have explored the influence of various modalities in regulating tear production to manage corneal disorders and dry eye disease. These findings have highlighted the advantages of enhancing corneal nerve function and regeneration through neurostimulation, neural signaling, immunomodulation, topical medication application, and surgical reconstruction. The purpose of this narrative review article was to provide an overview of the current state of knowledge on this topic based on a PubMed database literature search for relevant animal and human studies investigating the modification of the trigeminal pathway to restore corneal nerve function and improve overall ocular health. Further investigation into this area of research is important to help guide new therapeutic targets for the prevention and development of treatments of corneal degeneration.

Objectives: Beginning in January 2023, numerous eye drops were recalled following reports of contamination. To investigate hesitancy in topical therapies for dry eye disease (DED), we analyzed trends in Internet search traffic for alternative DED therapies and eye drop safety concerns following initial recalls.

Methods: Google Trends (GT) was used to measure the popularity of specific search terms during a given time period. The main GT output metric for gauging interest in a search term is the Search Volume Index (SVI). We collected worldwide SVI data for terms "dry eye vitamin," "are eye drops safe," "stop eye drops," "lipiflow," "ilux treatment," "dry eye mask," "dry eye warm compress," "omega-3 for dry eyes," "dry eye plugs," "dry eye humidifier," "itear," and "IPL dry eye" from April 24, 2022, to October 29, 2023. Statistical analysis was performed with Microsoft Excel v.16.77.1, and comparisons between groups were performed using paired t tests.

Results: A significant increase in SVI was observed for most keywords. When comparing the 40-week period before and after the initial recall, 7/10 alternative DED therapies demonstrated a statistically significant surge in Internet search traffic after recall (P < 0.05). Furthermore, 2/2 keywords pertaining to eye drop safety concerns demonstrated an increase in SVI (P < 0.0001).

Conclusions: We identified a significant surge in Internet search activity for eye drop safety and alternative DED therapies following eye drop recalls. Public health agencies and physicians may find this information valuable while attempting to address safety concerns and navigating noncompliance of routine eye drop therapy.