Contact Lens Discomfort Research Articles

Contact Lens Discomfort and Dropout. What is it? Epidemiology

Growing number of contact lens discomfort (CLD) and CL dropout incidence rate afflict the development of CL industry. This article analyzes literatures of past 5 years’ on studies of CLD. It reviews the epidemiology and mechanism of CLD, analyzes different characteristics of CLD resulting from CL material, contact lens care system, and wearers. It sketches the relationship between CLD and ocular surface microenvironment, pointing out that CLD is an incompatible status between CL and the ocular surface microenvironment. Literature analysis also reveals that while high-quality optical effect of rigid lens came at the price of unwelcome initial discomfort, soft lens wearing continuously changes the balance of ocular surface microenvironment, leading to time-dependent discomfort. Different components or formulas of contact lens care systems could be transited by CL into ocular surface and induce CLD. Personal features of wearers such as age, gender, race, and psychological state also could be considered as potential CLD risks.

Categorising contact lens discomfort and the relationship to comfortable wearing time

Purpose: Categorising contact lens discomfort (CLD) and investigating its relationship to comfortable wearing time of soft contact lenses (SCL).

Evidence of Lipid Degradation During Overnight Contact Lens Wear: Gas Chromatography Mass Spectrometry as the Diagnostic Tool

We investigated structural differences in the fatty acid profiles of lipids extracted from ex vivo contact lenses by using gas chromatography mass spectrometry (GCMS). Two lens materials (balafilcon A or lotrafilcon A) were worn on a daily or continuous wear schedule for 30 and 7 days. Lipids from subject-worn lenses were extracted using 1:1 chloroform: methanol and transmethylated using 5% sulfuric acid in methanol. Fatty acid methyl esters (FAMEs) were collected using hexane and water, and analyzed by GCMS (Varian 3800 GC, Saturn 2000 MS). The gas chromatograms of lens extracts that were worn on a continuous wear schedule showed two predominant peaks, C16:0 and C18:0, both of which are saturated fatty acids. This was the case for balafilcon A and lotrafilcon A lenses. However, the gas chromatograms of lens extracts that were worn on a daily wear schedule showed saturated (C16:0, C18:0) and unsaturated (C16:1 and C18:1) fatty acids. Unsaturated fatty acids are degraded during sleep in contact lenses. Degradation occurred independently of lens material or subject-to-subject variability in lipid deposition. The consequences of lipid degradation are the production of oxidative products, which may be linked to contact lens discomfort.

KEYNOTE ADDRESS: Through my aching eyes - reflections on the perennial problem of contact lens discomfort

The pained, red eyed, weeping contact lens wearer is a stereotypical image that has permeated popular culture. Happily for the overwhelming majority of contemporary users, the reality is much more pleasant. Nevertheless, discomfort and dryness remain the most important reasons for dropouts to occur and substantial numbers experience problems, particularly towards the end of their wearing day. The systems responsible for these sensations involve biological, mechanical and psychological processes and understanding how these interact with the contact lens is critical to developing an effective solution.

The TFOS International Workshop on Contact Lens Discomfort: Report of the Subcommittee on Clinical Trial Design and Outcomes

The goal of this report is to review previously published clinical trials addressing contact lens discomfort (CLD) to identify appropriate trial design and outcome parameters to guide future clinical research that will characterize and investigate possible causes of CLD. A further goal is to identify possible confounding features of clinical trial design and performance in order to reduce bias in conduct of future trials or analysis of data from those trials.

The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Materials, Design, and Care Subcommittee

Jones, L., Brennan, N. A., Gonzalez-Meijome, J., Lally, J., Maldonado-Codina, C., Schmidt, T. A., … Nichols, J. J. (2013). The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Materials, Design, and Care Subcommittee. Investigative Opthalmology & Visual Science, 54(11), TFOS37. https://doi.org/10.1167/iovs.13-13215

The TFOS International Workshop on Contact Lens Discomfort: Report of the Definition and Classification Subcommittee

The TFOS International Workshop on Contact Lens Discomfort: Report of the Definition and Classification Subcommittee

The TFOS International Workshop on Contact Lens Discomfort: Report of the Management and Therapy Subcommittee

Erratum in Invest Ophthalmol Vis Sci. 2014 Sep;55(9):5588. Miller, William S [coorected to Miller, William L].

The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Interactions With the Ocular Surface and Adnexa Subcommittee

Efron, N., Jones, L., Bron, A. J., Knop, E., Arita, R., Barabino, S., … Markoulli, M. (2013). The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Interactions With the Ocular Surface and Adnexa Subcommittee. Investigative Opthalmology & Visual Science, 54(11), TFOS98. https://doi.org/10.1167/iovs.13-13187

The TFOS International Workshop on Contact Lens Discomfort: Report of the Subcommittee on Neurobiology

The TFOS International Workshop on Contact Lens Discomfort: Report of the Subcommittee on Neurobiology

Overview of factors that affect comfort with modern soft contact lenses

The past few years have been dynamic in the soft contact lens (SCL) field, resulting in a number of new research tools and new products to successfully fit and manage SCL wearers. In particular, the field has recently seen important developments that were designed to improve the SCL comfort in the quest for the “ultimate contact lens”. This comfort topic remains very timely and complex. Contact lens discomfort remains the primary reason for discontinuation of wear [ 1 Dumbleton K. Woods C.A. Jones L.W. Fonn D. The impact of contemporary contact lenses on contact lens discontinuation. Eye Contact Lens. 2013; 39: 93-99 Crossref PubMed Scopus (7) Google Scholar , 2 Richdale K. Sinnott L.T. Skadahl E. Nichols J.J. Frequency of and factors associated with contact lens dissatisfaction and discontinuation. Cornea. 2007; 26: 168-174 Crossref PubMed Scopus (62) Google Scholar ] and the number of discontinuations approximates the number of new fits annually, creating a significant drain on overall growth of the wearer base [ [3] Fonn D. Targeting contact lens induced dryness and discomfort: what properties will make lenses more comfortable. Optom Vis Sci. 2007; 84: 279-285 Crossref PubMed Scopus (51) Google Scholar ]. In the future, if novel applications of SCLs are to be successful, such as lenses to retard the development of myopia or to monitor diabetes, patients must be able to maintain years of comfortable use in order to receive the benefit from these innovations.

Lenses and lids—I get by with eyelid help from my friends

The important role of the lids is often overlooked when considering the ocular compatibility of contact lenses. The eyelids are crucially influential in controlling the fit of toric soft and rigid lenses and govern movement and centration in spherical lenses. The eyelids not only produce some of the components of the tear film but also ensure that these are circulated and structured in a way that maintains hydration, lubrication and optical clarity. The upper lid margins are probably more significant in contact lens discomfort and dryness than any of the other ocular tissues.

Historical overview of imaging the meibomian glands

Growing knowledge of the role of the meibomian glands in dry eye disease and contact lens discomfort has resulted in a surge of interest in visualizing these glands within the eyelids. This manuscript provides an overview of the many different visualization methods that have evolved over the past 30–40 years. Some of the visualization methods covered in this review include lid transillumination, video and non-contact meibography, and imaging methods employing confocal microscopy, optical coherence tomography and ultrasound. This review has also highlighted all the studies to date that have employed meibography as part of their methods. An overview of the available meibography dropout grading systems will also be provided.

Function of lipids – their fate in contact lens wear: An interpretive review

Lipids play a vital role in the body at many interfaces. Examples include the lubrication of articulating joints by synovial fluid, the coating of the lung by pulmonary surfactant and the functions of the tear film in the protection of the anterior eye. The role of the lipids is similar at each site - acting as boundary lubricants and reducing surface and interfacial tension. This review focuses on how and why contact lens wear can disrupt the normal function of lipids within the tear film and explains how the otherwise advantageous presence and function of tear lipids can become disadvantageous, causing problems for the wearer. Because the contact lens is some ten times thicker than the tear film, lipids deposited on the anterior surface become immobilised, reducing lipid turnover and thus leading to prolonged exposure to oxygen and light with consequent generation of degradation products. These degraded lipids reduce lens wettability and have additionally been linked to problems of contact lens discomfort and intolerance. Lipid problems are influenced by the thickness of the lens, the material, surface modification, mode of wear and ultimately the subject. The most influential of these variables is frequently the subject.

The effect of degree of refractive error on hydrogel contact lens-induced complications and patient self-management behaviors.

Although many aspects of hydrogel lens wear have been explored over the last 20 years, little attention has been paid to the role of refractive error magnitude in determining patients' ocular responses or associated contact lens behaviors. A cross-sectional study was conducted in 32 optometric and ophthalmologic practices. We enrolled 2161 spherical soft contact lens-wearing patients. High ametropes were defined as those with at least +/- 5.00 D spherical equivalent refractive error in the right eye. Data on current contact lenses, prescribed care regimens, and slit lamp biomicroscopic signs were provided by the eye care practitioners, and information on actual lens care behaviors and attitudes toward contact lens wear were gathered by survey directly from the patients. All differences between high and low ametropes were compared using the chi-square test. Compared with low ametropes, high ametropes were more satisfied with their vision with contact lenses (p < 0.001). More high ametropes wore their lenses on an extended-wear schedule (p = 0.015). Both groups of patients reported a similar degree of lens awareness and lens-associated pain, but fewer high ametropes reported foreign body sensation (p = 0.002). In managing contact lens discomfort, high ametropes were more likely to use an old spare lens (p = 0.01) and more likely to continue wearing their lenses (p = 0.016)--indicators of a propensity for self-management. In response to a damaged lens, high ametropes were less likely to remove both of their lenses (p = 0.002). High ametropes showed more conjunctival staining (p = 0.001) and more corneal scars (p = 0.033). High ametropes also presented with more corneal fluorescein staining (p = 0.001) and more corneal vascularization (p < 0.001). These relations between the degree of ametropia and slit lamp signs of contact lens wear were not significantly affected by daily- vs. extended-wear status. In summary, practitioners should consider the implications of the patient's degree of ametropia when prescribing contact lenses. These results indicate the need for closer observation and specific advice concerning management of contact lens-related problems when caring for patients with high refractive errors.