Contact Lens Practitioners Research Articles

CONTACT LENS PRACTITIONER PRACTICES IN RELATION TO PATIENT COMPLIANCE AT LIONS SIGHT FIRST EYE HOSPITAL, KENYA

Background: Contact lens practitioners (CLPs) play a vital role in the fitting of contact lenses (CL) and thus have a great influence on patient compliance. Studies have often focused on investigating levels of compliance and thus limited knowledge of CLP practices. Thus, this study aimed to investigate CLP practices on CL wear and care. Methods: The study employed a cross-sectional research design. Purposive sampling technique was used to select consenting CLP’s working Lions Sight First Eye Hospital (LSFEH). A self-administered questionnaire, containing questions on current Practices, was used to collect information. Once ethical clearance from MMUST IERC, NACOSTI and permission LSFEH were obtained data collection process began. A total of fifteen (15) CLP participated in the study. Results: The mean age of the practitioners was 31± 3.87. Most (67%) of the CLPs had worked for between 5 to 10 years. A majority (73%) of the practitioners had bachelor’s degree. Most (87%) of them specialized in soft lenses. Majority of the CLP use of written appointment card, 53% of the CLP use of manufacturer guidelines and oral communication is the most used form of training patients as said by 60% of the CLP. Conclusion: CLPs at LSFEH had good wear and care practices on patient instruction. For successful CL wear, patients need to follow instructions given by CLPs on CL wear and care. It is, therefore, necessary for CLPs to practice according to the recommended guidelines to avoid patient non-compliance. 
 
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Antibiotic eye drops prescription patterns by orthokeratology practitioners in China and the development of antibiotic usage guidelines

PurposeTo investigate antibiotic eye drops prescribing patterns of contact lens practitioners in Mainland China for orthokeratology (ortho-k) patients and to develop guidelines for their use. MethodsA questionnaire on their antibiotic prescribing habits was administered to eye care practitioners (ECP) involved in ortho-k lens fitting nationwide via an official online account. Multiple logistic regression models were used to assess the relationships between prescribing habits and demographics. ResultsA total of 555 ECP completed the survey, of whom 50.5 % were optometrists (non-medical degree). About 30 % of the respondents routinely prescribed antibiotic eye drops for prophylactic use before and/or after commencement of ortho-k treatment. Forty one percent of the respondents dispensed antibiotics to patients for emergency use without giving written instructions, 48.5 % used antibiotic eye drops to wet fluorescein strips during ortho-k lens fitting, and 44.9 % considered treating corneal infiltrate(s) with antibiotics to be appropriate. A set of guidelines, including when to use antibiotic eye drops during ortho-k lens treatment and their proper use, stratified by different corneal conditions, was developed. ConclusionsInappropriate use of antibiotic eye drops appeared to be common among ortho-k practitioners in Mainland China. Taking into account deficiencies and errors identified from the survey, a set of guidelines based on best practice was developed and can serve to provide advice for proper use of antibiotics in ortho-k practice.

Knowledge, attitudes and practices of contact lens use in a South African adolescent population.

Contact lens usage is becoming increasingly popular amongst young people. Assessing their knowledge, attitudes and practices in relation to contact lens wear is therefore important, so that gaps in understanding or incorrect practices can be rectified to promote continued safety and success of contact lens wear. This study aimed to assess and describe the knowledge, attitudes and practices of contact lens wearers aged 18 to 30 years, in the greater Durban area of South Africa. A semi-structured questionnaire was used to assess the knowledge, attitudes and practice of the participants. Results: Two hundred and forty six participants completed the survey. Young contact lens wearers in this sample generally had poor knowledge with regards to appropriate hygiene and contact lens wear complications. Despite wearers exhibiting a positive attitude with satisfactory hand hygiene and lens cleaning practices, important aspects such as lens case hygiene, storage and lens removal practices were found to be unsatisfactory. Compliance with after-care visits was also unsatisfactory. There is a need for contact lens practitioners to educate young contact lens wearers regarding appropriate contact lens-related care, to promote long term ocular health and contact lens-related safety.

The COVID-19 pandemic: Important considerations for contact lens practitioners

A novel coronavirus (CoV), the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), results in the coronavirus disease 2019 (COVID-19). As information concerning the COVID-19 disease continues to evolve, patients look to their eye care practitioners for accurate eye health guidance. There is currently no evidence to suggest an increased risk of contracting COVID-19 through contact lens (CL) wear compared to spectacle lens wear and no scientific evidence that wearing standard prescription spectacles provides protection against COVID-19 or other viral transmissions.During the pandemic there will potentially be significant changes in access to local eyecare. Thus, it is imperative CL wearers are reminded of the steps they should follow to minimise their risk of complications, to reduce their need to leave isolation and seek care. Management of adverse events should be retained within optometric systems if possible, to minimise the impact on the wider healthcare service, which will be stretched. Optimal CL care behaviours should be the same as those under normal circumstances, which include appropriate hand washing (thoroughly with soap and water) and drying (with paper towels) before both CL application and removal. Daily CL cleaning and correct case care for reusable CL should be followed according to appropriate guidelines, and CL exposure to water must be avoided. Where the availability of local clinical care is restricted, practitioners could consider advising patients to reduce or eliminate sleeping in their CL (where patients have the appropriate knowledge about correct daily care and access to suitable lens-care products) or consider the option of moving patients to daily disposable lenses (where patients have appropriate lens supplies available). Patients should also avoid touching their face, including their eyes, nose and mouth, with unwashed hands and avoid CL wear altogether if unwell (particularly with any cold or flu-like symptoms).

Key considerations for contact lens practitioners during the coronavirus pandemic

Prof Lyndon Jones, Karen Walsh, Prof Mark Willcox, Prof Philip Morgan and Prof Jason Nichols explain the key points from a new review of the evidence concerning the impact of SARS-CoV-2 upon contact lens practice.

International Association of Contact Lens Educators: Exceptional education-Exponential impact.

The International Association of Contact Lens Educators (IACLE) is the leading provider of educational and information resources essential to contact lens educators worldwide. The New IACLE Contact Lens Course is its most important resource, used by members around the world to teach their students, the contact lens practitioners of the future. In 2019, IACLE celebrated the 40th Anniversary of its founding meeting. In this article, we trace the early years of the organization and describes its impact on contact lens education in India.

Ochrona przed infekcją w gabinecie kontaktologicznym – przygotowanie do stanu po zakończeniu epidemii COVID-19

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Kropacz-Sobkowiak S, Michalski A. Protection against infection in contact lens practice – preparation for the post-COVID-19 epidemic period. Klinika Oczna / Acta Ophthalmologica Polonica. 2020;122(2):43-48. doi:10.5114/ko.2020.96136. APA Kropacz-Sobkowiak, S., & Michalski, A. (2020). Protection against infection in contact lens practice – preparation for the post-COVID-19 epidemic period. Klinika Oczna / Acta Ophthalmologica Polonica, 122(2), 43-48. https://doi.org/10.5114/ko.2020.96136 Chicago Kropacz-Sobkowiak, Sylwia, and Andrzej Michalski. 2020. "Protection against infection in contact lens practice – preparation for the post-COVID-19 epidemic period". Klinika Oczna / Acta Ophthalmologica Polonica 122 (2): 43-48. doi:10.5114/ko.2020.96136. Harvard Kropacz-Sobkowiak, S., and Michalski, A. (2020). Protection against infection in contact lens practice – preparation for the post-COVID-19 epidemic period. Klinika Oczna / Acta Ophthalmologica Polonica, 122(2), pp.43-48. https://doi.org/10.5114/ko.2020.96136 MLA Kropacz-Sobkowiak, Sylwia et al. "Protection against infection in contact lens practice – preparation for the post-COVID-19 epidemic period." Klinika Oczna / Acta Ophthalmologica Polonica, vol. 122, no. 2, 2020, pp. 43-48. doi:10.5114/ko.2020.96136. Vancouver Kropacz-Sobkowiak S, Michalski A. Protection against infection in contact lens practice – preparation for the post-COVID-19 epidemic period. Klinika Oczna / Acta Ophthalmologica Polonica. 2020;122(2):43-48. doi:10.5114/ko.2020.96136.

Is the Internet Era affecting the relations between Ametropes and Contact Lens Practitioners? An Italian Survey

Purpose: To assess if internet behaviour in terms of contact lens (CL) on-line purchasing and time spent on social media can affect the relationship between ametropes and CL practitioners (CLP).

Tear Stability, Corneal Staining and Dry Eye Symptoms in Contact Lens Wearers

The aim of this study was to examine tear stability of contact lens wearers (CLW) in young Malay adults aged 18 and above and to compare the results with non-contact lens wearers (NCLW). Corneal staining and McMonnies Dry Eye Questionnaires (MDEQ) scores between habitual soft CLW and NCLW were also compared. It also aimed to find correlation between tear stability and MDEQ scores. Quasi-experimental and case control study was conducted among 53 participants (53 right eyes) at UiTM Vision Care, UiTM Puncak Alam Campus. Twenty six participants were habitual soft CLW and twenty seven were NCLW. Tear stability was measured using non-invasive tear break-up time (NIBUT) and invasive tear break-up time (TBUT). Corneal staining was measured using Efron Grading Scale and dry eye symptoms evaluated using MDEQ. Mean scores of NIBUT and TBUT for CLW were 5.23 ± 7.3 sec and 2.19 ± 2.41 sec respectively; for NCLW were 8.71 ± 4.33 sec and 3.00 ± 1.69 sec respectively. There were significant differences in NIBUT (Mann-Whitney U, p=0.0001) and TBUT (Mann-Whitney U, p=0.001) between the CLW and NCLW. There was also significant difference in percentage of corneal staining found between the CLW (22.6%) and NCLW (7.5%), (Chi-square, p=0.013). However no significant difference was found in MDEQ scores between the CLW (7.54 ± 3.62) and the NCLW (8.15 ± 3.38) group, (Mann-Whitney U, p=0.42). There were also no correlations found between tear stability and MDEQ scores in the two groups. The results of this study showed NIBUT and TBUT values were significantly higher in NCLW than in CLW and corneal staining was more extensive in CLW. Contact lens practitioners need to be aware of changes in tear stability as results of contact lens wear and take the necessary action to improve on the management of their patients during aftercare consultation. DOI : http://dx.doi.org./10.17576/JSKM-2019-1702-04

Analysis from a year of increased cases of Acanthamoeba Keratitis in a large teaching hospital in the UK

Purpose of the studyTo report an observational study of Acanthamoeba Keratitis (AK) in University Hospital Coventry & Warwickshire (UHCW), Coventry, UK and determine risk factors, outcomes as well as incidence rates. MethodsA retrospective analysis was done of consecutive patients who were treated for AK by the corneal service at UHCW from January 2017 to January 2018. Cases were identified from 2 sources; the department of microbiology and the hospital pharmacy. Patient data was collected by 3 of the authors using both paper and electronic medical records. Information was also gathered over the telephone using a predefined questionnaire. The primary endpoint used for assessing duration of disease was time to resolution after the initial diagnosis. Results9 eyes were identified over the 12-month period, a drastic increase from previous years. All were contact lens (CL) wearers and 3 used daily disposable CL’s. 8 out of 9 patients had an improvement in best corrected visual acuity (BCVA) which was consistent with their baseline levels pre-infection. The average length of treatment was 107.25 days for the 8 resolved cases. 1 case is still having ongoing treatment. No case has required surgical treatment. Several patients admitted to exposing their CL to unsterile water either via swimming, showering or tap water. All patients had purchased their lenses from contact lens practitioners. ConclusionOverall, our study shows excellent outcomes. Almost all patients had resolution of symptoms with medical treatment and an improvement in visual acuity. Several contributing factors have aided us in achieving this including early diagnosis, a robust treatment protocol and diagnostic modalities such as Polymer Chain Reaction (PCR) and Confocal Microscopy (CFM). However, the increased incidence compared to previous years is a worrying trend and there will be an ongoing analysis looking at patterns of incidence in the future.

Myopia control: A pilot study in Greece

Purpose: To anecdotally evaluate the attitude of contact lens (CL) practitioners and ophthalmologists in Greece when dealing with myopia control.

Scleral Lens Clearance Assessment with Biomicroscopy and Anterior Segment Optical Coherence Tomography.

It is important to be able to accurately estimate the central corneal clearance when fitting scleral contact lenses. Tools available have intrinsic biases due to the angle of viewing, and therefore an idea of the amount of error in estimation will benefit the fitter. To compare the accuracy of observers' ability to estimate scleral contact lens central corneal clearance (CCC) with biomicroscopy to measurements using slit-lamp imaging and anterior segment optical coherence tomography (AS-OCT). In a Web-based survey with images of four scleral lens fits obtained with a slit-lamp video imaging system, participants were asked to estimate the CCC. Responses were compared with known values of CCC of these images determined with an image-processing program (digital CCC) and using the AS-OCT (AS-OCT CCC). Bland-Altman plots and concordance correlation coefficients were used to assess the agreement of CCC measured by the various methods. Sixty-six participants were categorized for analysis based on the amount of experience with scleral lens fitting into novice, intermediate, or advanced fitters. Comparing the estimated CCC to the digital CCC, all three groups overestimated by an average of +27.3 ± 67.3 μm. The estimated CCC was highly correlated to the digital CCC (0.79, 0.92, and 0.94 for each group, respectively). Compared with the CCC measurements using AS-OCT, the three groups of participants overestimated by +103.3 μm and had high correlations (0.79, 0.93, and 0.94 for each group). Results from this study validate the ability of contact lens practitioners to observe and estimate the CCC in scleral lens fittings through the use of biomicroscopic viewing. Increasing experience with scleral lens fitting does not improve the correlation with measured CCC from digital or the AS-OCT. However, the intermediate and advanced groups display significantly less inter-observer variability compared with the novice group.

Contact Lens Methods for Clinical Myopia Control.

A number of optical methods for slowing myopia progression have been tested and are now available. However, data on real-world use in clinical use is scarce. Here, we present a review of the clinical outcomes for patients attending a specialist myopia control clinic at The University of Auckland Optometry School, NZ. We report a comparative case series of 110 patients (aged 4-33 years, mean: 12.13 ± 4.58 years, 62% female) who attended the clinic between 2010 and 2014. Fifty-six were prescribed orthokeratology, 32 dual focus soft contact lenses, and 22 received advice only. Initial myopia, vitreous and axial eye length, previous myopia progression, age, number of myopic parents, and gender were not significantly different between orthokeratology and dual focus soft contact lens groups. Mean follow-up time for the orthokeratology and dual focus lens groups was the same (orthokeratology: 1.30 ± 0.88 years; dual focus lens: 1.33 ± 0.80 years (p = 0.989)). There was a significant reduction in the annualized myopia progression in both groups (orthokeratology: -1.17 ± 0.55 to -0.09 ± 017 D/yr, p < 0.001; dual focus soft contact lens: -1.15 ± 0.46 to -0.10 ± 0.23 D/yr, p < 0.001). There was no difference between orthokeratology and dual focus lens treatment efficacy (p = 0.763), nor in axial or vitreous chamber length changes after treatment (p = 0.184). One adverse event was reported over the 4-year period. Both orthokeratology and dual focus soft contact lenses are effective strategies for targeting myopia progression in the clinic. We saw no significant difference in the efficacy of the two methods in this regard, and so we believe there are very few barriers for any contact lens practitioner to be actively promoting myopia control treatment to at-risk patients.

Optician Awards 2015: Contact lens practitioner winner

Managing director of Edinburgh-based practice Cameron Optometry, Ian Cameron, took home a gong from the Optician Awards 2015 with the Contact Lens Practitioner of the Year title. Saul Sebag reports.

Penggunaan Lensa Kontak untuk Astigmatisma Paska Keratoplasti

Background: Fitting Contact Lenses for post penetrating keratoplasty patiens can be a great challenges to contact lens practitioner. Despite advances in surgical techniques for penetrating keratoplasty, post- operative ametropia and high irregular astigmatism still remain common. Patients who have such those problems may need contact lenses to achieve optimal vision.Case Illustration: Case 1. A 12 years old boy have a high myop and astigmatism after undergone penetrating keratoplasty combined with traumatic cataract extraction and IOL implantation. His right eye vision was 6/24 with corrections of S – 8.00 C – 6.50 x 150. His right eye was fitted with RGP contact lens with Base curve of 7.20 mm, Power of – 10.25 D, and diameter of 8.80 mm. His RE vision with RGP contact lens was 6/12; Case 2. Female, 18 years old, was diagnosed with compound high myopia astigmatism of right eye due to disfigured cornea post keratoplasty and high astigmatism of the left eye due to corneal scar. Piggyback contact lens system is then used to treat her right eye.The patient’s uncorrected visual acuity on the right eye was half meter counting finger, became 6/40 with spectacle and 2 meters counting finger became 3/60 with spectacle on the left eye. With piggyback contact lens consisting of soft contact lens 8.60/-10.00/14.20 and RGP lens 7.20/-4.00/8.8 on the right eye, and RGP lens 7.90/-5.00/9.2 on left eye, her visual acuity became 6/12 on her right eye became 6/9 on the left eye.Conclusion: Rigid gas-permeable and combination of rigid gas permeable and soft contact lenses can be fitted with piggy-back system successfully in patients unable to achieve optimal vision with spectacle correction after penetrating keratoplasty

Trends in US Contact Lens Prescribing 2002 to 2014.

To document contact lens prescribing patterns in the United States between 2002 and 2014. A survey of contact lens prescribing trends was conducted each year between 2002 and 2014, inclusive. Randomly selected contact lens practitioners were asked to provide information relating to 10 consecutive contact lens fits between January and March each year. Over the 13-year survey period, 1650 survey forms were received from US practitioners representing details of 7702 contact lens fits. The mean (±SD) age of lens wearers was 33.6 (±15.2) years, of whom 65.2% were female. Rigid lens new fits decreased from 13.0% in 2002 to 9.4% in 2014. Across this period, silicone hydrogels have replaced mid water contact lens hydrogels as the soft lens material of choice. Toric lenses represented about 25 to 30% of all soft lens fits. Multifocal soft lenses are generally preferred to monovision. Daily disposable lens fits have recently increased, and in 2014, they represented 27.1% of all soft lens fits. Most lenses are prescribed on 1 to 2 weekly or monthly lens replacement regimen. Extended wear remains a minority lens wearing modality. The vast majority of those wearing reusable lenses use multipurpose lens care solutions. Lenses are mostly worn 7 d/wk. This survey has revealed prescribing trends and preferences in the United States over the past 13 years.

A frequency analysis of cone characteristics for the different stages of keratoconus

Background: The stages of keratoconus can be classified according to the degree of corneal conicity as either early or advanced, or morphologically by the shape of the cone. Knowledge of the different cone characteristics for the different stages of keratoconus may assist practitioners in diagnosing and managing these patients.Aim: To describe the cone characteristics for the different stages of keratoconus.Methods: In this retrospective study, a sample of 190 eyes from 106 cases of previously diagnosed keratoconic patients was analysed. The stage of keratoconus and cone characteristics, namely: cone location, cone decentration, morphology, and topographical patterns were analysed using an Oculus 3M corneal topographer.Results: Our study revealed that for all stages of keratoconus centrally located cones were the most frequent, with corneal apical decentration between 0 mm and 2 mm. Frequency analysis revealed that nipple cones were most frequent in all stages. Topographical pattern frequencies revealed a wide distribution amongst the different corneal patterns in all stages of keratoconus.Conclusion: Cone analysis should be of consideration to the contact lens practitioner when deciding on management of the condition. It additionally serves to compliment the clinical signs such as nerve visibility, Fleischer’s ring, Vogt’s striae and corneal scarring.

Contact lens practitioner behaviour in Greece

Purpose: To evaluate the attitude of contact lens practitioners in Greece when dealing with possible and current contact lens wearers.

The penetrance and characteristics of contact lens wear in Australia

BackgroundA population‐based, cross‐sectional telephone survey was conducted to estimate the penetrance and characteristics of contact lens wear in Australia.MethodsBased on postcode distribution, 42,749 households around Australia were randomly selected from the national electronic telephone directory. During calls, the number of individuals and contact lens wearers in each household aged between 15 and 64 years was ascertained. Contact lens wearers were interviewed using a structured questionnaire, to determine details of demographics, lens type, mode of lens wear and hygienic habits. Contact lens wear characteristics and habits were compared by lens type and mode of use.ResultsOf the 32,405 households contacted, 19,171 (59.2 per cent) agreed to participate. The penetrance of contact lens wear during the study period was 5.01 per cent (95% : 4.78–5.24). The mean age of lens wearers was 36.5 ± 18.3 years and 63.4 per cent were female. There were significant differences in the habits and characteristics of lens wearers depending on their lens type and mode of use.ConclusionsThe penetrance of contact lens wear concurs with market estimates and equates to approximately 680,000 contact lens wearers aged between 15 and 64 years in Australia. This is the most detailed and extensive population‐based survey of contact lens wearers ever conducted. The discrepancies found between the characteristics of lens wearers surveyed in this study compared to those in previous studies of contact lens practitioners highlights the importance of study design. These results may be applied to other regions with similar health‐care and regulatory systems.

Astigmatism and soft torics–the challenge or is it?”

Astigmatism and soft torics–the challenge or is it?”