Contact Lens Dry Eye Questionnaire-8 Research Articles

Validation of the Greek version of the contact lens dry eye questionnaire-8 (CLDEQ-8)

PurposeContact lens discomfort (CLD) has been cited as one of the prime reasons for discontinuing contact lens wear. The CLDEQ-8 was created in 2008 to reflect status of and change in overall opinion of soft contact lenses. The purpose of this study is to examine the validity and reliability of a Greek version of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8), using Rasch statistical analysis. MethodsThis an observational prospective study of 150 consecutive patients who received soft contact lenses and were followed through with a single follow-up appointment up to a year following their initial one. The patients filled in the Greek versions of the CLDEQ-8, the Ocular Surface Disease Index (OSDI) and a self-report item on their experience of contact lens use. The CLDEQ-8 was analyzed with Rasch analytic methodology. ResultsThe original scoring system of the CLDEQ-8 had to be altered regarding the response categories collapsing in fewer options in items b, 2b, 3b and item 5 of the original scale. The revised scoring system proved more psychometrically valid and the CLDEQ-8 had good measurement precision, category threshold order, targeting and differential item functioning for gender. Two alternative result indexes are proposed, a symptom intensity index and a symptom frequency index to address dimensionality issues that are evident with the items relating to symptom intensity versus the rest. Results from the CLDEQ-8 correlated with the OSDI total score and the self-reported experience of contact lens use. ConclusionsThe Greek version of the CLDEQ-8 is a psychometrically valid and reliable assessment tool for contact lens discomfort in Greek-speaking populations.

Italian translation and validation of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8)

PurposeTo translate and validate an Italian version of the CLDEQ-8 (CLDEQ-8_IT). MethodsThe study was carried out in two phases. In the first phase, a cross-cultural adaptation of CLDEQ-8 to Italian was performed by forward and backward translation in sequence. In the second phase, a multi-centre study was conducted for the validation of the questionnaire. Validity CLDEQ-8_IT was evaluated against three gestalt questions: overall opinion of soft contact lenses (CLs), global self-assessments of eye sensitivity and eye dryness. Reliability was evaluated by test–retest assessment in a subgroup of subjects. Finally, the psychometric properties of CLDEQ-8_IT were explored by Rasch analysis. ResultsTwo hundred and forty soft CL wearers, fluent Italian speakers (73 males and 167 females), between 18 and 70 years of age were enrolled. A significant correlation was found between CLDEQ-8_IT and each of the three Gestalt questions. The cutoff score of 12 points demonstrated the best balance between sensitivity and specificity in differentiating wearers grading their CLs as “Excellent/Very good” from those reporting their overall opinion as “Good/Fair/Poor”. The Intraclass Correlation Coefficient between test and retest was 0.88 (95% CI: 0.81–0.92). Finally, infit and outfit statistics using Rasch analysis for the 8 items were in a good range, however Principal Components Analysis revealed a certain degree of multi-dimensionality of the instrument. Also, item 8 analysis could be computed after merging the last two response categories. ConclusionThe CLDEQ-8_IT showed very good validity and reliability in measuring symptoms of CL wearers, comparable to the original English language version. A cut-off of 12 was confirmed as yielding the best balance between sensitivity and specificity in detecting CL wearers who could benefit from clinical management of their CL-related symptoms. Collapsing of the response options 5 and 6 in the last item of questionnaire could optimise its functioning.

Translation and validation of the contact lens dry eye questionnaire 8 (CLDEQ-8) in Canadian French.

To present the process that led to the creation of the French Canadian translated version of the Contact Lens Dry Eye Questionnaire-8 (which allows for an assessment of symptoms while wearing soft contact lenses) as well as the validation data of the f-CLDEQ-8. The CLDEQ-8 went through the process of reverse translation, which was then reviewed and improved by an experts' committee to create a first version of the French questionnaire. Cognitive interviews were conducted to pretest the tool and ensure content validity. After a review of the pretest, the f-CLDEQ-8 was created. A web-based version of this questionnaire was sent to contact lens wearers (CLW) recruited out of a clinical setting for completion at two different endpoints interspaced by 7days. Internal consistency and test-reliability were calculated using Cronbach's alpha and Intra-class Correlation coefficient (ICC), respectively. Convergent validity between the f-CLDEQ-8 score and overall opinion of the contact lenses was evaluated with a correlation. 9 CLW with different socio-economic statuses and education levels went through a cognitive interview with the back-translated version of the f-CLDEQ-8 to improve the questionnaire wording and enhance its comprehension. 63 CLW (34.2±10.1years old and 2/3 of them women) completed the f-CLDEQ-8 twice. An average Cronbach alpha of 0.928 was found and an ICC of 0.944 (CI at 95% 0.905;0.966). A moderately strong correlation of -0.714 (CI at 95% -0.817;-0.566) was found between the overall opinion of the contact lenses and the total score to the f-CLDEQ-8. The French language version (f-CLDEQ-8) generated from the original CLDEQ -8 was shown to be easy to use, reliable and culturally adapted to French spoken in Canada.

The Effects of Reading on Tear Stability in Soft Contact Lens Wearer

This study aimed to determine the effects of reading on non-invasive tear break-up time (NIBUT) in soft contact lens wearers and establish the correlation between the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and the NIBUT before and after reading. The demographic questionnaire, Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8), were completed by 18 soft contact lens wearer (36 eyes; 17 females and 1 male). The NIBUT was measured as a baseline using modified bowl perimetry before reading. The subjects were then instructed to read silently for 20 minutes a validated hard copy text. The NIBUT test was administered again following the reading task. This study enrolled a total of 18 contact lens wearers (36 eyes). The mean age of the participants was 22.89 ± 1.687 years, and the mean refractive power of their contact lenses ranged from Plano to -5.75D (1.44 ± 0.504D). Twenty-five eyes (55.6%) of contact lens wearers wore lenses less than -3.00D, while sixteen eyes (44.4%) wore lenses greater than -3.00D. The mean of pre-NIBUT and post-NIBUT were 6.43 secs (SD;1.250) and 3.22 secs (SD;0.964) respectively. The paired t-test revealed a significant difference between pre and post-NIBUT; p< 0.001. CLDEQ-8 had a negative poor correlation with pre-NIBUT (r = -0.266) and post-NIBUT (r = -0.150). The values of NIBUT decreased in soft contact lens wearers after a 20-minute near-reading task. Sustained 20 minutes of reading affects the tear stability, resulting in disruption of the tear film layer, which results in tear film instability as measured by CLDEQ-8 and NIBUT before and after reading. There was little correlation between CLDEQ-8 and NIBUT scores before and after reading.

Comparison of the Pre-Lens Tear Film Stability and Visual Performance of a Novel and Two Other Daily Disposable Contact Lenses in Healthcare Professionals Wearing Facial Masks for Prolonged Time.

ObjectiveTo compare a novel daily disposable contact lens (DDCL) verofilcon A with other DDCL materials in terms of pre-lens tear film (PLTF) stabilization and visual performance for prolonged use in healthcare professionals with the use of masks.MethodsSubjects aged 20–40 years old were prospectively randomized into three study groups. Group 1: verofilcon A, group 2: nesofilcon A and group 3: senofilcon A. The subjects were evaluated at baseline with best corrected visual acuity (BCVA), non-invasive tear break up time (NIBUT) of pre-lens tear film, and high order aberrations (HoAs). After 28 days of CL use, NIBUT at 1, 4, 8, and 12 h, HoAs, contrast sensitivity (CS) with CVS100-E and contact lens dry eye questionnaire-8 (CLDEQ-8) were evaluated.ResultsBetween August and September 2021, 147 eyes of 77 subjects were included in the three study groups. At day 28, the CS scores at 18 cycles per degree, spatial frequencies, and the mean NIBUT scores at 4, 8, and 12 h were higher in the verofilcon A group compared to the nesofilcon A and at 12 h were higher compared to the senofilcon A (p < 0.05). The mean HoAs and CLDEQ-8 test scores were higher in the nesofilcon A group (p < 0.001).ConclusionThe results of this study suggest the superiority of the PLTF stabilization ability of verofilcon A in healthcare professionals with prolonged use of mask. The improved CS and NIBUT scores of this lens could be explained by a new and unique surface technology with greater than 80% water content.

A New Contact Lens Sensor System for Continuous Intraocular Pressure Monitoring: Evaluation of Safety and Tolerability.

To assess the safety and tolerability of a new contact lens sensor (CLS) system for continuous 3- and 24-hr intraocular pressure (IOP) monitoring in human eyes. Twenty-five subjects were recruited for 3-hr IOP measurement by CLS. Corneal fluorescein staining (CFS) scores were evaluated before and after measurement. Then, 30 participants (10 normal subjects and 20 glaucoma patients) were recruited for 24-hr IOP monitoring. Ocular surface disease index (OSDI) was assessed before and one day after measurement. Contact lens dry eye questionnaire-8 was assessed immediately after measurement. Visual analog scale of discomfort was measured before, immediately after, and one day after measurement. Best-corrected visual acuity (BCVA), tear break-up time (TBUT), and CFS were assessed before, immediately after, and 1 day after measurement. All participants completed 3- or 24-hr IOP measurement by CLS. Corneal fluorescein staining increased from 0.6±0.7 to 2.4±1.5 after 3-hr IOP measurement ( P <0.001). For participants undergoing 24-hr IOP monitoring, OSDI increased from 9.1±9.7 to 18.0±12.4 ( P =0.001). CLDEQ-8 score was 11.6±5.8. Visual analog scale increased from 11.1±14.2 to 35.2±21.8 after measurement ( P <0.001) and decreased to 26.7±18.4 one day later ( P <0.001 compared with baseline). BCVA decreased from 1.0±0.01 to 0.8±0.1 ( P <0.001) and returned to 0.9±0.1 after one day ( P <0.001 compared with baseline). TBUT decreased from 5.1±3.9 to 2.6±1.5 s ( P =0.001) and returned to 4.8±2.5 s ( P =0.465 compared with baseline). Corneal fluorescein staining increased from 0.7±0.9 to 4.3±0.8 ( P <0.001) and dropped to 0.8±0.7 ( P =0.599 compared with baseline). No significant difference was found for all variations of indicators between normal subjects and glaucoma patients ( P >0.1 for all comparisons). The CLS shows a great potential for a safe and tolerable 24-hr IOP monitoring in normal subjects and glaucoma patients. Clinical attention to the worsening signs and symptoms after measurement is required.

Kısa gözyaşı kırılma zamanı olan hastalarda etafilcon A ve nesofilcon A’nın oküler konfor seviyeleri açısından kıyaslanması: prospektif karşılaştırmalı çalışma

Aim: The aim of the study was to compare the two different hydrogel daily disposable contact lenses (HyDDCLs) satisfaction levels in patients with meibomian gland disfunction (MGD) and allergic conjunctivitis accompanied with short noninvasive tear break-up time (NIBUT). Material and Methods: Fifty patients who had no history of contact lens and had short NIBUT were included to the study into two groups: allergic conjunctivitis findings (group 1) and MGD findings (group 2). All patients used both etafilcon A and nesofilcon A, respectively. The OSDI (Ocular Surface Disease Index) and CLDEQ-8 (Contact Lens Dry Eye Questionnaire- 8) tests were performed by the patients for each lens and the mean scores were compared. In addition, the decisions of all patients regarding the continued use of each lens were questioned. Results: The mean of total scores of OSDI and CLDEQ-8 were statistically lower in nesofilcon A, significantly. The mean scores of the all OSDI subscales and the CLDEQ-8 subscales of dryness, discomfort, blurred vision and closing eyes were lower in nesofilcon A. Four patients (8%) were not satisfied by any of the lenses. 36 (72%) patients preferred nesofilcon A and remaining 10 (20%) patients preferred etafilcon A to continue. Conclusion: Due to the hydrophilic structure and low modulus of the HyDDCLs, the satisfaction rate was found to be higher in the study group (92%). HyDDCLs could be a suitable option in cases where ocular surface diseases are accompanied. Hydrogel material with higher water content offers better comfort levels at the end of the day.

Evaluation of daily disposable senofilcon A contact lenses in a symptomatic population

PurposeTo evaluate the comfort performance of ACUVUE OASYS® 1-Day with HydraLuxe™ Technology among symptomatic contact lens wearers by using Contact Lens User Experience (CLUE) comfort scores and Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8) discomfort and dryness scores. MethodsThree clinical trials evaluated comfort and dryness when refitting symptomatic contact lens wearers to ACUVUE OASYS® 1-Day with HydraLuxe™ lenses. This analysis combined the CLUE comfort and CLDEQ-8 scores obtained at baseline and 2-week follow-up and compared average scores between visits. Subjects were grouped by habitual lens modality (daily disposable or daily wear reusable) and habitual lens material (silicone hydrogel or hydrogel). The analysis included data from 107 subjects. ResultsSignificant increases in mean CLUE comfort scores between baseline and 2–week follow-up occurred in all subject groups across habitual lens modality and material, indicating an improvement in overall comfort. CLUE comfort score improved clinically (≥5-point increase) among 75.7% of subjects (81/107). Similarly, significant decrease in mean CLDEQ-8 scores between baseline and 2-week follow-up occurred in all subject groups, indicating a decrease in the prevalence of dryness and discomfort symptoms. CLDEQ-8 score improved clinically (≥3-point reduction) among 82.2% of subjects (88/107). A majority of subjects (57.0%) became asymptomatic (CLDEQ-8 score ≤ 11 points) after 2 weeks of bilateral wear. ConclusionRefitting symptomatic contact lens patients to ACUVUE OASYS® 1-Day with HydraLuxe™ can improve overall comfort and reduce symptoms of dryness and discomfort, irrespective of the previous lens modality or habitual lens material.

Assessment of Dry Eye Syndrome Among Contact Lens Users in Asir Region, Saudi Arabia.

BackgroundPatients with contact lens-associated dry eye (CLADE) disease had different symptoms, such as dryness, foreign body sensation, eye strain, and blurred vision. In addition, CLADE is characterized by end-of-day pain. The degradation of the ocular surface as a result of extended dryness or employment with a visual display terminal (VDT) causes these symptoms. Because these symptoms worsen as the day progresses, practitioners should evaluate contact lens wearers at the end of the day to identify symptomatic patients.AimTo assess dry eye syndrome among contact lens users in the Asir region, Saudi Arabia.MethodologyA descriptive cross-sectional study was used, targeting all accessible contact lens users in the Asir region, South of Saudi Arabia. A total of 250 individuals received the study survey. Data were collected from participants using an online pre-structured questionnaire. The authors initiated the study tool with the help of a comprehensive review of similar articles in the literature and consulting specialized experts, including an ophthalmologist and Arabic translator, to ensure the accuracy of the questionnaire's translation process. The questionnaire covered the following data: participants' socio-demographic data, contact lens use and frequency of use, dry eyes symptoms (DESs) questions, Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8), and Ocular Surface Disease Index (OSDI).ResultsOut of 405 respondents, only 201 contact lens users in the Asir region were included in the study, with a participation rate of 80.4%. Respondents' ages ranged from 18 to 50 years with a mean age of 24.3 ± 12.8 years old. A total of 122 (60.7%) contact lens users had eye disease, including myopia among 94 (77%), hyperopia among 8 (6.6%), and 20 (16.4%) had other eye diseases. A total of 91% of the study participants felt dry eyes two weeks before study time, 88.1% experienced burning sensation, and 82.6% complained of red-eye. A total of 131 (65.2%) contact lens users had non-dry eyes, 41 (20.4%) had mild dry eyes, 20 (10%) had moderate dry eyes, and 9 (4.5%) had severe dry eyes. A total of 48.8% of those who used lenses daily had dry eyes compared to 25% of those who used lenses annually (P = 0.049).ConclusionsIn conclusion, the current study showed that nearly one out of three contact lens users in the Asir region experienced contact lens-related dry eye syndrome mainly with a moderate degree. A higher dry eye syndrome rate is estimated among those who reported a higher frequency of contact lens use and others with a history of eye diseases.

Associations between Binocular Vision Disorders and Contact Lens Dissatisfaction.

These data demonstrate that binocular vision disorders (BVDs) contribute to contact lens (CL) dissatisfaction independently of CL discomfort (CLD) in myopic, pre-presbyopic, adult, single-vision CL wearers. This study aimed to determine whether BVDs contribute to CL dissatisfaction and whether this contribution is independent of CLD. Participants attended one clinical visit while wearing their habitual CLs. Symptoms from CLD and BVDs were measured with the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and Convergence Insufficiency Syndrome Survey (CISS), respectively. A comprehensive binocular vision (BV) assessment was performed. The Ocular Surface Disease Index (OSDI) was used to measure CL dissatisfaction from CLD and BVDs based on reported correlations between the CLDEQ-8 and the CISS with the OSDI. Participants were categorized according to their CL comfort status (CLD [≥12 on CLDEQ-8] or non-CLD [<12 on CLDEQ-8]) and BV status (BVD or non-BVD). Seventy-six participants completed the trial, and 19 (25%) were diagnosed with BVD. Those diagnosed with BVD scored higher than did those diagnosed with non-BVD for the OSDI (25.1 ± 12.7 vs. 10.7 ± 7.3, P < .001) and CISS (18.7 ± 7.7 vs. 11.9 ± 5.9, P = .001), but not the CLDEQ-8 (P = .25). Those categorized as having CLD scored higher than did those categorized as having non-CLD for the OSDI (19.0 ± 12.3 vs. 9.3 ± 5.9, P = .003) and CISS (16.1 ± 6.8 vs. 11.0 ± 6.2, P = .001). There were no significant interactions between BV status and CL comfort status for any questionnaire (P > .08). Higher scores for OSDI in those with CLD or BVD indicate that both conditions contribute to CL dissatisfaction. Higher scores for the CISS in those with CLD suggest a degree of overlap for some BVD symptoms. Nonsignificant differences between BVD and non-BVD for the CLDEQ-8 suggest that BVDs contribute to CL dissatisfaction independently of CLD.

Contact Lens- and Patient-related Factors Associated with Contact Lens Discomfort among Contact Lens Wearers in an African Cohort.

No information is available on contact lens discomfort in any African population. Such information may be helpful in developing the scope and priorities for intervention. The purpose of the study was to examine contact lens- and patient-related factors associated with contact lens discomfort among wearers in Ghana. In this multicenter cross-sectional study, contact lens wearers 18 years and older were recruited. The Contact Lens Dry Eye Questionnaire-8 and a standardized scripted interview were administered to 72 contact lens wearers at five clinical sites, and 40 participants' lens storage cases were collected and cultured. A variety of patient- and contact lens-related factors were examined. Univariate and multivariate logistic regression modeling were used to assess risk factors associated with contact lens discomfort. Seventy-two contact lens wearers aged 18 to 45 years completed the study. The mean age was 27.5 ± 6.4 years, 65.3% of them were females, 86.1% wore soft contact lens, and 13.9% wore rigid gas-permeable lens. Contact lens discomfort was reported by 66.7% of the subjects. Most frequent lens storage cases isolates were Bacillus species (40%) and fungi (31.1%). Significant association was found between disinfecting with tap water (5.98; 95% confidence interval [CI], 1.22 to 29.27; P = .03), heavy visual display terminal use (3.39; 95% CI, 1.01 to 11.34; P = .05), high water content (1.16; 95% CI, 1.02 to 1.33; P = .03), and contact lens discomfort. Demographic factors, wear modality, and care solutions were not significant (all P > .05). In considering the use of contact lenses for refractive correction in this population, strategies for preventing contact lens discomfort that should be targeted include use of low-water-content lenses, disinfecting with multipurpose solutions, and reducing the time spent daily on visual display terminal use.

Usefulness of a global rating change scale for contact lens discomfort evaluation

ObjectivesTo evaluate the usefulness of a global rate of change scale (GRCS) to detect variations in contact lens discomfort (CLD). MethodsSymptomatic contact lens (CL) wearers were recruited according to the ‘Contact Lens Dry Eye Questionnaire-8’ (CLDEQ-8). At the baseline visit, subjects scored their comfort following insertion of their habitual CL using a 0–100 visual analogue scale (VAS). After 4–10 h of CL wear, comfort was again self-evaluated with the VAS and with a GRCS (range, −50 to +50). Then, a daily disposable CL (DDCL) was fitted. After one month of DDCL wear, a follow-up visit was conducted where the same evaluations as the baseline visit were performed. Changes in comfort were estimated using a Student's t-test for normal variables and the Friedman test for multiple comparisons of non-parametric variables. Internal responsiveness was measured by calculating the standardised response mean. Agreement between scales was estimated by the intraclass correlation coefficient (ICC). ResultsTwenty-nine (22 females and 7 males) CL wearers with a mean age of 23.4 ± 5.4 years participated in the study. There was a significant decrease in comfort at both visits detected by the GRCS (baseline = −13.58 ± 17.48, p < 0.001; follow up = −6.86 ± 12.69, p = 0.007). However, the VAS did not detect that change, either at baseline (insertion = 64.28 ± 18.72 vs removal = 52.89 ± 17.64, p = 1.000) or follow-up visit (insertion = 81.97 ± 12.91 vs removal = 76.48 ± 16.02, p = 1.000). Comfort at insertion and removal times was significantly higher with the DDCL (p = 0.008 at insertion and p = 0.004 at removal). The standardised response mean was greater with the GRCS than the VAS at baseline (0.78 vs 0.63) and follow-up (0.54 vs 0.37) visits. Agreement between both scales was moderate and significant (p < 0.001) for both visits, ICC: 0.674 (95 % confidence interval (CI):0.411–0.833) (baseline) and 0.652 (95 % CI:0.377–0.821) (follow-up visit). ConclusionsThe GRCS can detect slight changes in CL wear comfort and shows higher responsiveness than the VAS. This subjective scale can allow detection of changes in comfort in a simple and quick way.

Application of systane complete for the treatment of contact lens discomfort

PurposeTo understand the safety of treating contact lens (CL) discomfort with a new artificial tear when it is directly applied to a CL-wearing eye. MethodsThis was a two-week, two-visit, double-masked study that randomized participants with CL discomfort to use Systane Complete (artificial tear), Sensitive Eyes (rewetting drop), or no treatment. Drops were applied before, twice during, and after CL use each day. Corneal staining served as the primary safety metric. Conjunctival staining, tear break-up time, Schirmer’s test, CL comfort (Contact Lens Dry Eye Questionnaire-8 [CLDEQ-8]), and dry eye symptoms (Standardized Patient Evaluation of Eye Dryness [SPEED]) were also evaluated. ResultsThis study recruited 73 participants with a mean age of 30.3 ± 11.5 years; 18 % of the participants were male. There were no significant changes in ocular surface signs from baseline or between the artificial tear and rewetting drop groups after two weeks (p ≥ 0.05). Participants in the artificial tear and rewetting drop groups had significant improvements in CLDEQ-8 scores after two weeks of treatment compared with baseline (p < 0.0001), though scores for this test were not significantly different between these groups after two weeks (p = 0.94). CLDEQ-8 scores were significantly better in the artificial tear and rewetting drop groups compared with no treatment after two weeks (p < 0.0001). ConclusionsBoth drops were found to be safe for use with CLs while also significantly improving ocular symptoms compared to no treatment after two weeks of use.

A randomised clinical trial of multifocal contact lenses and contact lens discomfort.

To determine how multifocal contact lenses affect contact lens discomfort. This randomised, participant-masked, crossover clinical trial fitted 84 uncomfortable soft contact lens wearers (30-40years old) with single vision and multifocal contact lenses. Contact lens discomfort was assessed using the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). There was no difference between multifocal and single vision survey scores (p=0.08). There was an interaction between lens type and age group (p=0.05). CLDEQ-8 scores with the single vision lens were less symptomatic than multifocal scores in participants <35years old (p=0.01). Single vision and multifocal scores for the older age group were not different. Subjectively, those in the <35year-old age group preferred the single vision lens for intermediate (p=0.02), distance (p=0.003), and overall vision (p=0.002). In the ≥35year-old age group, no lens was significantly preferred for vision. Participants in the younger age group had more favourable wearing experiences with the single vision lens compared to the multifocal lens. The older age group, however, had similar wearing experiences with both lens types. While younger contact lens wearers may prefer the wearing experience with single vision lenses, some uncomfortable contact lens wearers approaching 40years old may benefit from wearing a multifocal contact lens sooner in life than is typically practised.

Validation and reliability of the Turkish version of Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8)

PurposeContact lens dry eye questionnaire-8 (CLDEQ-8) quantifies the disturbing symptoms with the aim of assessing the satisfaction and overall opinion of contact lens wearers. The aim of this study was to develop Turkish version and to evaluate the validity and reliability of the questionnaire. MethodsCLDEQ-8 was translated into Turkish language, using the back translation methods. In a sample of 10 individuals, validation of translation was checked as pre-test evaluation. Turkish version of CLDEQ-8 questionnaire was conducted in 100 soft contact lens wearers. Validity was investigated using Rasch analysis and reliability by Cronbach’s alpha (α) and person separation index (PSI). ResultsThe participants were healthy other than refractive errors. Their mean age was 25.19 ± 7.03 years and male to female ratio was 14/86. All of them were silicone-hydrogel soft contact lens wearers. Their contact lens history was 3.13 ± 3.77 years and mean refraction error was -2.69 ± 1.64 diopters.The whole 8 items were consistent with the Rasch model (p > 0.05) and unidimensional (paired t test, p = 0.1). Both Cronbach’s alpha and PSI values were higher than 0.7 (α = 0.873, PSI = 0.867). There were not functional differences in questionnaire items regarding overall age groups (Andersen LR test, p = 0.518). ConclusionTurkish version of the CLDEQ-8 conforms to the Rasch model and provides the one dimensional assumption. The questionnaire has internal consistency, is valid and reliable in Turkish contact lens wearers.

The Effect of Microblepharon Exfoliation on Clinical Correlates of Contact Lens Discomfort.

Microblepharon exfoliation improved eyelid signs and tear film characteristics after a single in-office treatment in symptomatic contact lens wearers. The purpose of this study was to assess the effect of two eyelid hygiene treatments-microblepharon exfoliation and a hypoallergenic foam cleanser (LidHygenix)-on clinical signs of the eyelids, meibomian glands, and tear film in contact lens discomfort. A randomized, interventional, unmasked, crossover trial was conducted on 30 experienced daily-wear soft contact lens wearers. Assessment of clinical signs of the eyelid margin, meibomian gland morphology and secretion, and tear film biophysical properties was performed (baseline 1), and participants were randomly assigned to receive one of the two treatments (microblepharon exfoliation or foam cleansing using LidHygenix) as a single in-office procedure. Symptoms were evaluated using the Contact Lens Dry Eye Questionnaire-8 immediately after treatment, and assessment of all the study variables was repeated at the follow-up visit 7 to 10 days after treatment. After 28 to 30 days of washout, participants returned for reassessment of the study variables (baseline 2) and were crossed over to receive the alternate treatment. Follow-up was repeated 7 to 10 days after the second treatment. Seven to 10 days after treatment with microblepharon exfoliation, symptomatic wearers showed significant improvement in anterior blepharitis (mean difference, 0.60; P = .04), lid wiper staining (0.50; P = .06), and lid-parallel conjunctival folds (0.68, P = .02) along with orifice capping (median difference, 0.65; P < .001), foam (0.90; P < .001), secretion volume (0.69; P < .001), quality (0.74; P < .001), and expressibility (0.49; P = .002), which were also clinically significant changes. However, in tear properties, significant improvements were observed in tear volume (LidHygenix, -1.25 mm; microblepharon exfoliation, -1.62 mm), break-up time (-0.14 seconds; -0.14 seconds), tear evaporation rate without contact lenses (21.52 g m h; 45.43 g m h), and lipid layer thickness (-20.61 nm; -25.13 nm) after both treatments but in symptomatic lens wearers only (P < .05). Microblepharon exfoliation improved eyelid signs and tear film characteristics in symptomatic contact lens wearers after a single in-office treatment.

Lotrafilcon B with HydraGlyde moisture matrix or Samfilcon A: Contralateral comparison study for comfort.

PURPOSE:The purpose of this study was to compare two new silicone hydrogel contact lens (CL) models of lotrafilcon B with HydraGlyde moisture matrix (Air Optix plus HydraGlyde®) and samfilcon A (Bausch and Lomb Ultra®) using the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) test.METHODS:This prospective study included 30 patients between the ages of 19 and 35 years. Lotrafilcon B with HydraGlyde moisture matrix (Air Optix plus HydraGlyde®) and samfilcon A (Bausch and Lomb Ultra®) CLs were fitted on the right and the left eye of the patients, respectively. All of the patients have not used any CLs before. After 4 weeks, the CLs were compared by asking the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) test.RESULTS:The mean scores of CLDEQ-8, frequency and intense of discomfort, dryness, blurry vision, frequency of needing to blink eye, and removal of the CL were assessed. There was no statistically significant difference between two groups (P > 0.05).CONCLUSION:The main reasons for CL discontinuation are dryness and discomfort. These two new CLs used new advanced technology have a good compliance among the first-time CL users.

Randomized crossover trial of silicone hydrogel contact lenses

PurposeThe aim of the current study is to assess, using new technologies, the interaction of four monthly silicone hydrogel contact lenses on the ocular surface and the comfort over 15 days of use. MethodsProspective cross-over, randomized and double-masked study including four materials (lotrafilcon-B, samfilcon-A , comfilcon-A and filcom-V3). Clinical examination was performed in the following order: tear meniscus height, first break-up of the tear film, the average time of all tear film breakup incidents, bulbar redness, limbal redness (Keratograph 5M ,Oculus, Germany); central corneal thickness (Pentacam, Oculus, Germany), thermography values (FLIR A325; FLIR Systems Inc., USA), and slit-lamp evaluations, including ocular surface staining. Finally, subjective comfort was obtained from Contact Lens Dry Eye Questionnaire-8. ResultsThe impact of contact lens wear on the ocular surface didn’t show statistically significant changes over time except for corneal and conjunctival staining grades on day 15 compared to day 1 for the comfilcon A group (P = .003 and P = .01, respectively). Contact lens stability and impact on the ocular surface during contact lens wear didn’t show statistically significant changes over time except in the case of the comfilcon A material with respect to the irritation item (P = .01). ConclusionsThese results suggest that the impact of monthly silicone hydrogel contact lens materials on the ocular surface after and during contact lens wear, contact lens stability over time, and subjective comfort did not reveal any significant changes over 15 days of use for any of the materials.

Translation and validation of the contact lens dry eye questionnaire-8 (CLDEQ-8) to the Spanish language.

To present the process of cultural and psychometric adaptation, and clinical validation of a new version in the Spanish language of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). The translation-retro-translation method was applied to the CLDEQ-8 questionnaire. Two independent native Spanish-speaking translators adapted the questionnaire from English to Spanish, and then a committee of experienced clinicians (CE) evaluated the semantic equivalence and designed a Spanish version of the CLDEQ-8 questionnaire. The resulting translated version was tested conducting a pilot study in contact lens users and assessing their perception and overall understanding of the terminology. The results were analyzed and a final version was designed. The final version was retro-translated to English by a native English-speaking translator and compared with the original CLDEQ-8 version to confirm there were no meaningful differences. To clinically validate the new instrument, a prospective study was conducted to apply the new Spanish CLDEQ-8 to 50 contact lens users. Fifty patients were studied with an average age of 21.50 ± 1.66 years. The average CLDEQ-8 score was 13.28 ± 6.81 points (range 1-31). The internal consistency (Cronbach's alpha) was 0.89, with a corrected index of homogeneity >0.50 for all evaluated items. The process of trans-cultural adaptation of the questionnaire CLDEQ-8 resulted in the elaboration of a reliable and much needed instrument capable of measuring frequency and intensity of dry eye symptoms in Spanish-speaking contact lens users.

Psychometric Analysis of the SPEED Questionnaire and CLDEQ-8

PurposeThis study reports on the ability of the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire to detect dry eye (DE) symptoms in contact lens (CL) and non-CL wearers.MethodsThe SPEED questionnaire was administered to all subjects while the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) was only administered to CL wearers. Tear meniscus heights (TMH) were measured, and the phenol red thread (PRT) test was conducted. These tests along with self-reported DE were used to identify subjects with dry eye disease (DED). Rasch analysis was performed to evaluate the questionnaires for measurement precision and unidimensionality, and the scores from these Rasch analyses were used to understand their ability to predict measures of DED.ResultsWe enrolled 284 subjects (150 CL and 134 non-CL wearers). Mean subject age was 39.4 ± 14.2 years. Rasch analysis yielded a multidimensional short form of the SPEED questionnaire (8-items) and a unidimensional short form of the CLDEQ-8 (4-item). Scores from both questionnaires were significantly associated with self-reported DE in CL and non-CL wearers. Scores of the 8-item SPEED questionnaire were associated with DED status in non-CL wearers but not in CL wearers while 4-item CLDEQ scores were associated with DED status in CL wearers. TMH or PRT were not associated with either questionnaire in CL or non-CL wearers.ConclusionsThe 8-item SPEED questionnaire demonstrated adequate measurement precision with evidence of quantifying multiple symptoms categories while the 4-item CLDEQ-8 primarily quantified DE symptoms. Questionnaire scores were associated with self-reported DE, which suggests that they may have utility in both populations analyzed.