Antimicrobial nanocoatings and films for contact lenses: progress and promise.

Invited comment:

An estimated 45 million U.S. residents enjoy the benefits of contact lens wear, but many of them might be at increased risk for complications stemming from improper wear and care behaviors (1). One of the most serious complications of contact lens wear is a corneal infection known as microbial keratitis, which can sometimes result in reduced vision or blindness (2). In 2014, 50% of contact lens wearers reported ever sleeping in contact lenses, and 55% reported topping off* their contact lens solutions (3), which put them at greater risk for a contact lens-related eye infection (2,4). Data on communication between eye care providers and contact lens wearers on contact lens wear and care recommendations are limited. Two surveys were conducted to better understand and assess contact lens education about nine recommendations: the first assessed contact lens wearer experiences regarding recommendations received from eye care providers during their most recent appointment; the second evaluated provider-reported practices for communicating contact lens wear and care recommendations to their patients. One third (32.9%) of contact lens wearers aged ≥18 years recalled never hearing any lens wear and care recommendations. Fewer than half (47.9%) recalled hearing their provider recommend not sleeping in lenses at their last visit, and 19.8% recalled being told to avoid topping off their contact lens solution. A majority of providers reported sharing recommendations always or most of the time at initial visits, regular checkups, and complication-related visits. Providers reported sharing nearly all recommendations more frequently at initial and complication-related visits than at regular checkups. Of the nine recommendations for safe contact lens wear and care, eye care providers at regular checkups most often recommend complying with the recommended lens replacement schedules (85% of regular visits), not sleeping in lenses (79.0% of regular visits), and not topping off solutions (64.4% of regular visits). Eye care providers play an important role in the health of their contact lens-wearing patients and can share health communication messages with their patients to help educate them about healthy wear and care habits. These findings can assist in the creation of health communication messages to help encourage eye care providers to communicate more effectively with their patients.

Antimicrobial peptides (AMPs) are essential components of the innate immune response. They have direct killing ability as well as immunomodulatory functions. Here, we describe techniques to identify specific AMPs involved in the protection against microbial keratitis, a vision threatening infection of the cornea of the eye which is the most serious complication of contact lens wear. Specifically we detail the use of siRNA technology to temporarily knockdown AMP expression at the murine ocular surface in vivo and then describe ex vivo assays to determine the level of bacteria, relative number of neutrophils, and levels of cytokines, chemokines, and AMPs in infected corneas.

ObjectiveMicrobial keratitis is a sight-threatening complication of contact lens wear, which affects thousands of patients and causes a significant burden on healthcare services. This study aims to identify compliance with...

To solicit parents' knowledge on myopia control strategies available; to investigate their attitudes toward the use of orthokeratology (ortho-k), daily wear soft lenses, and spectacles for myopia control, assuming all three optical strategies were equally effective for myopia control; and to collect their opinion on the age at which children can commence contact lens wear for vision correction. Telephone interviews were conducted on parents who responded to the advertisement for two myopia control studies, one on ortho-k and one on soft lenses. Most of the 196 respondents (ortho-k group, 56%; soft lens group, 44%) were mothers, aged 36 to 45 years. Ortho-k was the most commonly known myopia control strategy (86%). Parents in the ortho-k group selected ortho-k (49%) and spectacles (45%) (p < 0.001) as their preferred myopia control strategy, whereas parents in the soft lens group had no preference (p = 0.57). Decision was affected by prior knowledge of myopia control strategy. Major considerations were convenience and safety among parents selecting contact lenses and spectacles, respectively, as their preferred options. Overall, because of the lack of confidence in safety in contact lens wear, most parents (75%) were of the opinion that contact lenses for vision correction were only for children older than 14 years (53%) and not indicated for children younger than 8 years. Parents in Hong Kong were open to the use of contact lenses for myopia control in young children and they appeared to regard myopia control contact lenses as "treatment" and not as visual aids. They were more conservative in the use of contact lenses for vision correction in children. Parents' decision in selecting a myopia control strategy, assuming all three strategies to be equally effective, was affected by an individual's concerns of safety and additional benefits as well as influenced by positive evidence on myopia control effects.

Contact lenses are a successful and popular means to correct refractive error and are worn by just under 700,000 Australians1 and approximately 125 million people worldwide. The most serious complication of contact lens wear is microbial keratitis, a potentially sight-threatening corneal infection most often caused by bacteria. Gram-negative bacteria, in particular pseudomonas species, account for the majority of severe bacterial infections. Pathogens such as fungi or amoebae, which feature less often, are associated with significant morbidity. These unusual pathogens have come into the spotlight in recent times with an apparent association with specific lens cleaning solutions...

The number of contact lens wearers has steadily increased over the past 10 years. Convenience, efficiency and availability of different types of lenses have made them popular. The rise in the use of contact lenses has increased the number of people at risk of contact lens-related complications. Studies have highlighted the consequences of poor contact lens care. Acanthamoeba keratitis is one of the most devastating complications of contact lens wear and can be avoided by adhering to the recommended contact lens regimen. This article reviews the literature on the complications of contact lens wear and stresses the need to educate the wearer. It examines the nurse's role in relation to health promotion and the basic principles for successful long-term contact lens wear. This information is relevant to all nurses caring for people with contact lenses and will be of particular interest to the nurse who wears contact lenses.

International survey of contact lens fitting for myopia control in children

Antimicrobial films and coatings for inactivation of Listeria innocua on ready-to-eat deli turkey meat

Corneal Infections Associated With Sleeping in Contact Lenses—Six Cases, United States, 2016-2018

Recent progress and strategies to develop antimicrobial contact lenses and lens cases for different types of microbial keratitis

Direct microbial corneal infection is one of the most serious known complications of contact lens wear. Pseudomonasspp. and Staphylococcus spp. are the most commonly isolated microbes from corneal infections during cosmetic contact lens wearl-y (Table l) , followed by protozoa (for example, Acanthamoeba spp.) l o and rarely, fungi. Viral corneal infections, especially herpetic and adenoviral, occur but do not seem to be specific complications of contact lens wear. We have reviewed the pertinent literature regarding contact lenses and our purpose is to suggest a direction for future research based on current findings.

Non-compliance to hygienic practices in contact lens wear is regarded as a significant risk factor for contact lens-related complications. Non-compliant behaviour continues to prevent efforts to improve contact lens safety despite advancements in lens materials and care solutions. The objective of this study was to identify the association between knowledge, compliance and complications of contact lens wear. A cross-sectional design was used and contact lens users among medical faculty students were identified and recruited via convenience sampling throughout October 2013 to March 2014. A total of 36 close-ended questions that focused on knowledge level, compliance to standard contact lens practice, and experience of complications were administered. A total of 188 respondents, majority of females (89.4%; n=168) participated in this study. Although majority had good knowledge level (68.1%; n=128) on care and usage of contact lens while only a small number having moderate knowledge (26.6%; n=50) and poor knowledge (5.3%; n=10), most of them were partially compliant (74.5%; n=140) to the recommended contact lens practices. However, a small group was found to be fully compliant (24.4%; n=46) and the rest being non-compliant (1.1%; n=2). There was a significant association between knowledge on contact lens usage and compliance level to standard practices (p=0.0003). In addition, a significant association also existed between compliance level to recommended practices and risk of complications from contact lens usage (p=0.023). Findings of this study showed the positive association between knowledge of contact lens usage and compliance to recommended practices and negative association between knowledge of contact lens usage and complications experienced by contact lens users. By providing basic knowledge on contact lens care and usage via education, improvement on compliance and enhancement of safety of contact lens wear could invariably be achieved.

To investigate the clinical presentation, isolated organism, treatment, and morbidity of contact lens-associated microbial keratitis needing hospitalization. This retrospective study included all consecutive patients with contact lens-associated microbial keratitis hospitalized in the Rotterdam Eye Hospital from January 1, 2005, to December 31, 2009. All data regarding epidemiological characteristics, clinical presentation, isolated organism, and treatment were collected from medical records. There were 109 cases (108 patients) of contact lens-associated microbial keratitis hospitalized during the study period. Mean age was 33.3 ± 15.4 (SD) years. Pseudomonas aeruginosa was the most frequently isolated microorganism (68.8%), with minor resistance to gentamicin (2.7%) and ofloxacin (1.3%). At time of presentation, best corrected visual acuity (BCVA) was very poor, with the largest proportion of patients (65.1%) seeing worse than 0.05 Snellen. After intensive treatment, the visual outcome improved considerably, with the largest proportion (67.0%) achieving a BCVA ≥ 0.7 Snellen. Low BCVA at admission was significantly associated with a worse final BCVA. A total of 22 patients (20.2%) required corneal transplantation (three emergency cases). Larger size of stromal infiltrate was significantly associated with the need for corneal transplantation. Microbial keratitis is a serious complication of contact lens wear, with approximately one out of five hospitalized cases requiring corneal transplantation. Ofloxacin, or a combination of gentamicin and cephazolin, still appear to be excellent first-choice therapies in the Netherlands, as little resistance has developed to these antibiotics.

Hybrid nanocoatings of self-assembled organic-inorganic amphiphiles for prevention of implant infections