Contact Lens Users Research Articles

Microbiological analysis of contact lens cases: impact of the hospital environment.

The aim of this study was to analyze the bacterial and fungal microbiota found in contact lens cases among two groups of patients to correlate the data on the habits of contact lens users and to evaluate whether there is a difference in the culture results between users of ridged and nonridged contact lens cases. Two groups (35 patients per group) were included, consisting of hospital workers and those who had not visited a hospital in the past 30 days, and a questionnaire regarding epidemiological data and habits related to contact lens and lens case use was administered. In addition, 140 samples collected from the right and left compartments of each lens case by swabbing the bottom of the wells were tested using bacterioscopy as well as fungal and bacterial cultures via computerized identification of the species. No fungal growth was identified in any of the 70 contact lens cases; however, bacteria were found in 39 cases, and there was no statistical difference between the groups. Most bacteria (>85%) were gram-negative bacilli. Contamination inone compartment of the contact lens case elevated the risk of contamination of the other side (>80%). Moreover, contamination was statistically higher in the ridged cases than in nonridged cases (p=0.0149). The types of bacteria contaminating the cases are generally not seen in eye diseases associated with contact lens use, suggesting that other decisive variables are involved in eye infection from a contaminated lens or case. Fungal contamination of contact lens cases appears to be an exception. Ridged cases are commonly used by contact lens wearers and present a potential risk to eye health. In addition, the results of bacterial tests between hospital workers and those who did not visit a hospital were not significantly different.

Role of Biofilms in Fungal Keratitis- An Overview

Biofilms are generally defined as a community of sessile microbes held together by a polymeric extracellular matrix ECM adherent to a surface that are phenotypic ally distinct from their plank tonic counterparts Fungal keratitis is an important cause of ocular morbidity in the form of corneal opacity and visual loss especially in developing countries Predisposing factors for fungal keratitis include tropical or subtropical climate agricultural work contact lens users and corneal trauma Fungal keratitis is most commonly caused by filamentous fungi like Fusarium spp F solani and F oxysporum followed by Aspergillus spp and dematiaceous fungi Fungal biofilm formation plays an important role in the development of fungal keratitis Here in this review we will be discussing the formation of biofilms and its role in fungal keratitis

Perilaku Remaja Pengguna Lensa Kontak (Soft Lens) dalam Perawatan Kesehatan Mata di SMKN 3 Kota Blitar

The use of contact lenses an alternative to eyeglasses. Lensa tools contacts could be supporting the appeal and appearance of a person to be more stylish and different. In the opinion of one ophthalmologist in dr Soetomo there are 50% of patients with eye disorders contact lens contaminated by amoebas and 1% of patients experienced a severe disorder that causes permanent blindness. The use of contact lenses require secure the right under the guidelines. The aim of research to study the behavior of adolescent users of contact lenses (soft contact lens) in the eye health care in SMK N 3 of Blitar. The study population were students of class XI and the sample studied class XI students who wear contact lenses, using purposive sampling technique. The collection of data by means of a checklist and interview. The results showed as much as 37.1% to behave according to the SOP by 45.7% in the use of contact lenses, but 62.9% showed no behavior according to SOP in the cleaning of contact lenses. This is due to adolescents do not get used to the consultation eye health workers. Recommendations of this study are expected to educational institutions in collaboration with health care providers in improving the UKS program for health promotion in particular about the behavior in the use and cleaning of contact lenses in accordance with the SOP.

Knowledge and practice regarding contact lens among Saudi urban contact lens users

PurposeTo assess the level and determinants of knowledge and practice regarding contact lens (CL) and its accessories among adult Saudi CL users. MethodsThis survey was conducted in 2015 for Saudi contact lens users visiting a Mall in Riyadh, Saudi Arabia. The questions were related to knowledge about contact lenses, correct CL and accessories usage. We inquired indication, initial prescription, CL use, complications experienced and their management. The knowledge and practice responses were correlated to their determinants. ResultsIn this survey, 510 contact lens users participated. The level of knowledge was of excellent grade among 279 [54.7% (95% Confidence Interval 50.4–59)] CL users. The practice was of excellent grade in 210 [41.4% (95% CI 37.1–45.7)] CL users. Variation in knowledge was not associated to gender (P=0.1), education (P=0.4), type of work (P=0.3), funding for CL (P=0.1). Occasional users and those not having prescribed CL had significantly poor knowledge (P<0.001). The excellent level of practice was associated to younger CL users (P=0.004). While it was not associated to gender (P=0.8), type of CL (P=0.9), funding for CL (P=0.2), education (P=0.7) and occupation (P=0.1). ConclusionsThe knowledge and practice among CL users was less than desired. Those using contact lens for cosmetic purpose and procuring them without prescription need special focus for health promotion so that their CL related practice improve and eye complications are reduced.

Acanthamoeba keratitis in noncompliant soft contact lenses users: Genotyping and risk factors, a study from Cairo, Egypt.

The study aimed to diagnose AK in soft CL users presenting with infectious keratitis, and to identify the prevalent genotypes isolated from different cases. Another aim was to determine the CL hygiene-related risk behaviors, and to explore the risk of water exposure for developing AK. A cross sectional study was performed. A questionnaire was carried out including 260 clinically diagnosed cases as infectious keratitis (170 females and 90 males); all of them were soft CL users for the suspected risk factors. Corneal scrapes from the affected eyes were cultured to diagnose bacterial and AK. PCR was performed and the amplified products were sequenced and compared with GenBank data. The parasite was positively amplified from 32 samples (12.3%). Acanthamoeba T4 genotype was identified in 27/32 (84.4%) of isolates. Other detected genotypes belonged to T5 and T3 genotypes at rates of 9.4%, and 6.25%, respectively. The most important risk factors associated with development of AK were female sex, sleeping while wearing CL, and exposure to water resources through different practices. These practices included rinsing the CL case in tap water, swimming and/or showering while wearing CL, using multipurpose solution for cleaning the lenses, using water from over-building tanks. Rubbing the eyes due to discomfort when applying CL was an additional important risk factor associated with AK. The protective factor was regular hand washing before using CL. CL users were more exposed to AK and should gain enough health education regarding proper lens hygiene and dangers of tap water exposure.

Fibrous Catalyst-Enhanced Acanthamoeba Disinfection by Hydrogen Peroxide.

SIGNIFICANCEHydrogen peroxide (H2O2) disinfection systems are contact-lens-patient problem solvers. The current one-step, criterion-standard version has been widely used since the mid-1980s, without any significant improvement. This work identifies a potential next-generation, one-step H2O2, not based on the solution formulation but rather on a case-based peroxide catalyst.PURPOSEOne-step H2O2 systems are widely used for contact lens disinfection. However, antimicrobial efficacy can be limited because of the rapid neutralization of the peroxide from the catalytic component of the systems. We studied whether the addition of an iron-containing catalyst bound to a nonfunctional propylene:polyacryonitrile fabric matrix could enhance the antimicrobial efficacy of these one-step H2O2 systems.METHODSBausch + Lomb PeroxiClear and AOSept Plus (both based on 3% H2O2 with a platinum-neutralizing disc) were the test systems. These were tested with and without the presence of the catalyst fabric using Acanthamoeba cysts as the challenge organism. After 6 hours' disinfection, the number of viable cysts was determined. In other studies, the experiments were also conducted with biofilm formed by Stenotrophomonas maltophilia and Elizabethkingia meningoseptica bacteria.RESULTSBoth control systems gave approximately 1-log10 kill of Acanthamoeba cysts compared with 3.0-log10 kill in the presence of the catalyst (P < .001). In the biofilm studies, no viable bacteria were recovered following disinfection in the presence of the catalyst compared with ≥3.0-log10 kill when it was omitted. In 30 rounds' recurrent usage, the experiments, in which the AOSept Plus system was subjected to 30 rounds of H2O2 neutralization with or without the presence of catalytic fabric, showed no loss in enhanced biocidal efficacy of the material. The catalytic fabric was also shown to not retard or increase the rate of H2O2 neutralization.CONCLUSIONSWe have demonstrated the catalyst significantly increases the efficacy of one-step H2O2 disinfection systems using highly resistant Acanthamoeba cysts and bacterial biofilm. Incorporating the catalyst into the design of these one-step H2O2 disinfection systems could improve the antimicrobial efficacy and provide a greater margin of safety for contact lens users.

An observational study of changes in corneal parameters following use of soft contact lens and rigid gas permeable lens

Background: There have been significant advancements in contact lens designs and materials over the past few decades, the lenses still represent a foreign body in the ocular environment and may lead to physiological (corneal oedema or thinning) as well as mechanical (on corneal curvature) effects on the eye.As there are not many studies reporting the effect of contact lens on eyes in Indian population, this study was designed tofill the lacunae of knowledge in this context.Aims and Objective: To evaluate and compare the change in anterior central corneal curvature &amp; central corneal thickness following use of soft contact lens (silicon-hydrogel) and Rigid Gas Permeable (fluoropolymer) contact lens.Materials and Methods: It was a Prospective, Observational, Comparative study Conducted at Venu Eye Institute &amp; Research Centre, New Delhi. Forty eyes of 21 subjects who required contact lens were included in two groups: 20 eyes in group A (RGP contact lens users) and 20 eyes in group B (Soft contact lens users). A “baseline” parameters was measured prior to contact lens use &amp; changes associated with contact lens wear was considered in relation to the normal baseline parameters when followed up at 3 and 6 months.Results: The Change in anterior central corneal curvature in both the groups was NOT statistically significant (p-value of &gt;0.05) between pre-contact lens wear and with contact lens wear at 3 &amp; 6 months. And, there was Significant Corneal thinning between pre-contact lens wear and with contact lens wear at 3 &amp; 6 months in both the groups individually (p-value &lt;0.05). However, on comparing the difference in change in CCT between both the groups was NOT statistically significant at 3 and 6 months.Conclusions: With contact lens use, there was no significant change in Anterior Central Corneal Curvature in Soft as well as RGP contact lens group at 3 &amp; 6 months. Though there was significant central corneal thinning in both the groups individually at 3 &amp; 6 months, However, on comparing the change in CCT between both the groups at 3 and 6 months was NOT significant.Asian Journal of Medical Sciences Vol.8(5) 2017 70-74

Folded bandage contact lens retention in a patient with bilateral dry eye symptoms: a case report

BackgroundBandage contact lenses are commonly used by ophthalmic practitioners to protect the patient’s cornea. We report a case of folded bandage contact lens retained for six and a half years in the upper subtarsal space. To our knowledge, no other cases of retained bandage contact lens have previously been reported in the literature.Case presentationA patient was applied a pair of bandage contact lenses due to persistent ocular pain secondary to dry eye symptoms. At her subsequent visit, bandage contact lens was removed from her left eye, but none was found in the right eye. Documentation from further visit stated that the bandage contact lenses were no longer in situ. 6.5 years since the lens insertion, lid eversion revealed a ‘foreign body’ retained beneath her right upper eyelid, which was noted to be a folded, discoloured bandage contact lens.ConclusionsThe ‘upper fornix trap’, where the contact lens may be retained by the upper tarsal edge, presents an anatomical hazard for contact lens users. Moreover, soft contact lenses may be more likely to retain asymptomatically and to fold onto itself compared to hard lenses. Our case report highlights the importance of performing a thorough eye examination, which includes double eversion of the upper eyelids and sweeping of the fornices with cotton buds, and maintaining clinical suspicion of contact lens retention.

Bacterial Interactions among Soft Contact Lens Users and Lens Care Solutions with Antibiotic Susceptibility Pattern

PURPOSE: To evaluate the bacterial contamination associated with contact lenses and lens care solutions used by a group of soft contact lens (CL) users (daily & extended wear CL) and the susceptibility pattern of the isolated organisms to antibiotics for 12 months duration. METHODS: This prospective case controlled, non randomized study included 50 participants of contact lens (CL) wearers from Outpatient Clinics at Al-Azhar University Hospitals, International Eye Hospital New Damietta and available special clinics, (between 2013 and 2014). The sample population was divided into two groups: a Case group: 30 contact lens users (60 eyes) were suffering from symptoms and signs of conjunctivitis in one or both eyes; a Control group: 20 CL users were not suffering from conjunctivitis. Samples were takenfromsolution in contact lens storage cases; daily wear CL, extended wear CL, andconjunctiva were cultured on different media. Microbiological identification of the organisms and their antimicrobial susceptibility were done in accordance to standard protocols. RESULTS: In the case group, positive growth was found in 85% of the lens care solution, 65% of the contact lenses, and 56.7% of the conjunctiva of participants. While in the control group, it was found in 10% , 20% and 15% respectively, with a statistically significant difference between both groups (P<0.001). There was no statistically significant differences between the two usage schedules (daily wear and extended wear) regarding results of solution and contact lens cultures (p =0.599) and (p=0.694) respectively, but there was a significant higher growth in the conjunctival cultures of extended wear contact lenses (p =0.014). The isolated organisms in case group were; Staphylococcus epidermidis (36.3%), followed by Pseudomonas aeruginosa (34.7%), Staphylococcus aureus (15.3%), Anthracoid (5.6%), Escherichia coli (4.1%), Diphtheroid (1.6%), Non haemolytic streptreptococci (1.6 %) and least was found to be Mycoplasma (0.8%). Antibiotic susceptibility tests revealed that all isolates are sensitive to gatifloxacin, Impenem and ciprofloxacin which are commercially ophthalmological antibiotics. CONCLUSION: Prevention of bacterial contamination of contact lens can reduce the risk of developing ocular infections. Lens care practices amongst the participants were not optimum which resulted into high contamination level. Hence, creating awareness among the users about the lens care practices and regular cleaning and replacements of lens cases are required.

Molecular and morphological characterization of Acanthamoeba isolated from corneal scrapes and contact lens wearers in Argentina

In this study, we describe the frequency of Acanthamoeba keratitis (AK) in patients that assisted in the Ophthalmology Department and determine the species/genotypes of free living amoebas (FLA) isolates. FLA from Corneal scrapes (CS) and contact lens (CL) wearers were studied by morphological and molecular characterization. A database was constructed with sociodemographic, clinical findings and history of use of CL variables. During January 2000 and September 2016 patients with corneal pathology admitted to the Ophthalmology Service of the University Hospital in Córdoba city, Argentina were included in the study. FLA were detected in 1.5% (11/739) and in 17% (11/65) of CS and CL analyzed respectively. FLA isolates from CL users evidenced an 80.9% of inappropriate lens maintenance, 4.8% (1/21) were not CL users that have been in contact with waters in outdoor environment and 14,3% (3/21) with no data about CL users. Acanthamoeba was confirmed in 100% and 82% of CS and LC respectively. The most frequent symptom associated with AK was red eye and photophobia. FLA from CS belonged to group II but 82% (9/11) and 18% (2/11) from CL belonged to group II and III respectively. T4 genotype and A. polyphaga species were detected in 100% of Acanthamoeba isolates. Poor CL hygiene practices, highlights the need for improved education about the severity of AK and consequences of improper CL hygiene. Genotype T4 detected in 100% of both CS and CL samples, consistently with previous findings indicating that this genotype is by far the most prevalent isolated from ocular infection.

Knowledge, usage and barriers associated with contact lens wear in Ghana

Despite findings that contact lens wear for vision correction provides better quality of life than spectacles, contact lens use in developing countries is low. This study evaluated knowledge, usage and barriers associated with contact lens wear among spectacle wearers in Cape Coast, Ghana. A cross-sectional survey using a structured questionnaire was conducted on an adult population of spectacle wearers to assess their knowledge of contact lens wear for vision correction. The participants were proportionately sampled from three eye clinics in the Cape Coast Metropolis, Ghana. Questionnaires were either self-administered or completed with the help of a research assistant. Of the 422 participants, only 147 (34.8%) knew of contact lens wear for vision correction. The proportion of spectacle wearers reporting history of contact lens wear was 14 (3.3%). Barriers to contact lens wear reported were satisfaction with vision through spectacles 102 (25.0%), lack of adequate information 111 (27.2%), fear of side effects 94 (23.0%) and cost 78 (19.1%). The younger adults and those with higher number of changes of spectacles were more likely to know of contact lenses. Knowledge and usage of contact lenses among spectacle wearers was low. Contact lens education and demonstration of visual performance through fitting of trial contact lenses on potential candidates may help overcome barriers to contact lens wear.

Smart Reinvention of the Contact Lens with Graphene.

With potential benefits to the 71 million contact lens users worldwide, contact lenses are being reinvented in the form of smart wearable electronics. In this issue of ACS Nano, Lee et al. report on the fascinating functions of a graphene-based smart contact lens that is able to protect eyes from electromagnetic waves and dehydration. Graphene and two-dimensional materials can be exploited in many opportunities in the development of smart contact lenses. Here, we briefly review and describe prospects for the future of smart contact lenses that incorporate graphene in their platforms.

Risk of Developing Complications among Contact Lens Wearers in Northern Border Region, Saudi Arabia. A Retrospective Cohort Study.

The present study aims towards investigating the risk of developing complications upon usage of different types of contact lens as well as the role played by different variables related to contact lens usage (replacement time, regular follow-up, etc). This is a retrospective cohort study. The total study sample (n = 143) were recruited from Rafha General Hospital, Northern Border Region, Saudi Arabia. All their data were collected and analyzed using chi square test. A &lt;em&gt;P-Value&lt;/em&gt; of&lt;em&gt; &amp;lt;&lt;/em&gt;0.05 was considered statistically significant. Reusable contact lens wearers were noted to have significantly more complications than disposable contact lens wearers (P&lt;em&gt;&amp;lt;&lt;/em&gt;0.05). The majority of the sample was reported to use contact lens for cosmetic (decorative) purpose than for therapeutic or optical indications (&lt;em&gt;63%&lt;/em&gt;). Regular follow-up was significantly associated with decrease incidence of contact lens complications (P&lt;em&gt;&amp;lt;&lt;/em&gt;0.01). Handling of reusable contact lenses must be done with care as complications are more likely to occur by using them than daily disposable contact lenses. Moreover, contact lens wearers must be advised about the importance of frequent replacement and regular follow-up as it showed significant decrease in complications. We can conclude from our finding that cosmetic usage of reusable contact lenses without proper handling and cleaning system is not advisable.

No differences in central corneal thickness between open-angle and pseudoexfoliation glaucoma patients.

IntroductionMeasurements of intraocular pressure (IOP) with Goldmann applanation tonometry are affected by central corneal thickness (CCT), as thinner corneas underestimate and thicker corneas overestimate the true IOP value. The literature is controversial regarding CCT values in patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (XFG). The aim of this study was to evaluate CCT in patients with XFG and POAG.MethodsCCT was evaluated with optical coherence tomography (OCT). All participants who were previously diagnosed with either POAG or XFG underwent ophthalmological examinations. Contact lens users and patients with corneal diseases were excluded.ResultsTotally, 145 patients were enrolled in this study. The mean CCT was 535±30.4 µm in patients with POAG and was 536±33.7 µm in patients with XFG. The result was not statistically significant (P=0.98). The mean age for all participants was 73.8±7.7 years. The study included totally 61 women and 84 men. The two groups were similar in their demographic data, and mean deviation was the only parameter that differed statistically when comparing POAG with XFG (P=0.02).ConclusionOur data indicate that patients with XFG do not have thinner corneas than those with POAG, and therefore, CCT can not explain why they progress differently.

Evaluation of the Tear Function Tests and the Ocular Surface in First-Time Users of Silicone Hydrogel Contact Lenses

ABSTRACTPurpose: To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (balafilcon A, senofilcon A, and comfilcon A) on tear function tests, corneal thickness, and ocular surface cytology in first time contact lens users.Materials and methods: In this prospective study, 120 eyes of 60 subjects were evaluated. Balafilcon A users were designated as group 1, senofilcon A users as group 2, and comfilcon A users as group 3. In all cases, before and after 6 months of contact lens wear, ocular surface disease index score (OSDI), tear breakup time (TBUT), Schirmer 1 test, central corneal thickness (CCT), central corneal epithelium thickness (CCET), and conjunctival impression cytology samples were evaluated.Results: In group 1, 40 eyes of the 20 patients, in group 2, 40 eyes of the 20 patients, and in group 3, 40 eyes of the 20 patients were evaluated. The mean OSDI scores did not differ between the three groups after contact lens wear (p > 0.05). In group 1 and group 2, significant decrease was found in the mean TBUT 6 months after contact lens wear (p = 0.04, p < 0.001, respectively). In group 3, after 6 months of contact lens wear, the mean Schirmer 1 tear test was decreased significantly (p = 0.021). In all 3 groups, no significant change was observed in the mean CCT and CCET after contact lens wear (p > 0.05). After 6 months, the morphological changes in temporal and superior conjunctival epithelial cells were found to be significant in all groups (p < 0.001).Conclusion: Six months after SHCL wear, marked morphological changes occurred in the conjunctival epithelium. Tear function tests were also affected, while corneal thickness did not show any significant difference.

Conjunctival Microbiome Changes Associated With Soft Contact Lens and Orthokeratology Lens Wearing.

Usage of different types of contact lenses is associated with increased risk of sight-threatening complications. Changes in the ocular microbiome caused by contact lens wear are suggested to affect infection development in those individuals. To address this question, this study compares conjunctival microbial communities in contact lens wearers with those in noncontact lens wearers. Paired-end sequencing of the V3 region of the 16S rRNA gene was used to characterize the bacterial communities on the conjunctival surfaces of contact lens wearers and nonwearers. No differences in microbial diversity were detected between contact lens wearers and nonwearers. Nevertheless, some slight microbe variability was evident between these two different groups. Bacillus, Tatumella and Lactobacillus abundance was less in orthokeratology lens (OKL) wearers than in nonwearers. In soft contact lenses (SCL) wearers, Delftia abundance decreased whereas Elizabethkingia levels increased. The difference in the SCL and nonwearer group was smaller than that in the OKL group. Variations in the conjunctival taxonomic composition between SCL wearers were larger than those in other groups. Sex differences in the conjunctival microbiota makeup were only evident among nonwearers. Even though there were slight percentage changes between contact lens wearers and nonwearers in some microbes, there were no differences in their diversity. On the other hand, contact lens usage might cause relative abundance of some taxa to change. Our results will help assess whether or not conjunctival microbiome changes caused by contact lens wear affect infection risk.

Contact Lens-Related Infectious Keratitis: Review of 29 Cases

Aim: To describe the epidemiological, clinical, microbiological and therapeutic features of corneal abscesses related to Contact Lens (CL) wear. Patients and Methods: Retrospective review of 29 patients (29 eyes) with infectious keratitis associated with contact lens wearing was conducted at Ophthalmology Department Fattouma Bourguiba University Hospital of Monastir, Tunisia between January 2006 and June 2016. All patients underwent detailed ophthalmological examination. Slit lamp examination and corneal culture were performed on all patients. The Contact Lens and Contact Lens cases were also analyzed if available. The mean follow-up period was 88 days (range: 30-360 days). Results: The mean age of our patients was 27 year old. Twenty-three patients (97.3%) were females and 6 patients (20.7%) were males. Twenty-seven patients (93.1%) were soft contact lens users. The mean initial Visual Acuity (VA) was 20/1000. Stromal infiltrates were associated with ulcers in all cases, and were located in central cornea in 21 cases (72.4%). Hypopyon was noted in 10 cases (34.5%). Microbial cultures were positive in 18 patients (72.4%). Pseudomonas aeruginosa was isolated in 41.4% of cases.Amoebic cysts were found in 5 cases (17.3%). Fusarium was isolated in one eye (3.5%). Antimicrobial treatment was based on the suspected or isolated causative agent. Final VA was 20/125. Conclusion: Corneal abscesses are a rare but serious complication of CL wear. Educating CL users, early diagnosis and appropriate management are important elements so as to reduce ocular morbidity.

Functional Vision with X Chrome Lenses

Purpose: To implement x chrome lens in children Methods: A pilot, cross sectional study was performed in the tertiary eye centre during the period of 1 year. Functional vision like Visual Acuity, Contrast Sensitivity, Stereopsis and color vision of 10 existing x chrome soft contact lenses users were analyzed with and without lenses. Results: Visual functions were compared statistically using paired t test with SPSS 20 software. Negligible change observed in visual acuity and contrast sensitivity with p value of 0.015 and 0.010 respectively. No change is observed in stereopsis. Ishihara shows normal color vision with x chrome lenses while D-15 test shows reduction in severity of color vision deficiency. Conclusions: If X chrome color contact lenses are implemented during child’s learning period, it will eliminate many of the academic challenges that are faced with color coded learning and teaching materials and improve their quality for many recreational activities.

Ocular response to environmental variations in contact lens wearers.

To assess the influence of different indoor environments simulated in an environmental chamber on soft contact lens (CL) wearers. Fifty-four CL wearers were grouped based on their symptoms while wearing their CLs. Subjects were fitted with two different CL types, conventional hydrogel (Omafilcon A) and silicone hydrogel (comfilcon A), and exposed to two controlled indoor environmental conditions, standard [50% relative humidity (RH), 23°C, 930mb of atmospheric pressure] and adverse (in-flight air cabin environment: 5% RH, localised air flow, 23°C, 750mb atmospheric pressure), for 90min in an environmental chamber, making a total of four visits. Symptoms, tear osmolarity, pre-lens tear breakup time (PLBUT), phenol red thread test, visual acuity, bulbar and limbal hyperaemia, corneal and limbal staining, and CL dehydration were assessed using repeated measures analysis of variance. A linear mixed model was used to analyse the effect of environment, CL type, discomfort-based grouping, and time on blink rate. Environment was found to significantly (p≤0.018) affect limbal and bulbar hyperaemia, PLBUT, tear osmolarity, and CL dehydration. Likewise, CL type significantly (p≤0.04) affected nasal and total corneal staining, limbal conjunctival staining, CL dehydration, comfort, and blurred vision. The environment, CL type, and time had significant effects (p≤0.0001) on the blink rate. Ocular surface integrity and blink rate in CL wearers depend on the environment CL users are exposed to, as well as on the soft CL type that they are wearing. Tight control of environmental conditions can contribute to a better understanding of CL-related discomfort.

Mental Health Status of the Keratoconus Patients Visually Corrected with Contact Lens Compared to Spectacles

1.1.Aim of the Study:To analyse the mental health status and psychological well being of the keratoconus patients using rigid contact lenses compared to spectacle corrected ones. The objective is to study if the correcting vision with contact lenses impacts the mental health status of the patients suffering from keratoconus. 1.2.Methodology:In the month of January to April, 2015 a cross sectional study was conducted in Ahooja eye hospital, Gurgaon, Haryana, India and Rajan eye care hospital, Tnagar, Chennai, Tamilnadu, India. Thirty two keratoconus patients were enrolled for the study and subjects were asked to the mental health status questionnaire MHI 38 with informed consent. Fifteen were habitual contact lens wearers and seventeen non contact lens wearers who volunteered to participate this study. Study included those contact lens users who wore lenses all waking hours and had been wearing them for atleast one year. All the questions were score coded for entering the data in Microsoft Excel sheet. The status of mental health was based on eight indicises which provided information on mental well being. 1.3.Results:17 males and 15 females participated in this study. The mean age of the participant was 28.03± 5.56 (range 20-39 years). The mean score of keratoconus patients of non contact lens wearer and contact lens wearer in Anxiety was 32.84 ± 2.99 &18.79 ± 3.67, Depression 13.34 ± 4.08 & 7.71 ± 2.19, Loss of behavioural / Emotion Control 30.29 ± 2.22 & 22.77 ± 6.70, General Positive Affect 49.00 ± 3.86 & 29.73 ± 4.48, Emotion Ties 10.17 ± 1.44 & 5.28 ± 1.71, Life Satisfaction 3.44 ± 0.96 & 4.94 ± 0.73, Psychological Distress 81.28 ± 4.48 & 53.15 ± 9.62, Psychological Well Being 41.15 ± 4.75 & 69.08 ± 5.26, Mental Health Index 119.81 ± 5.53 & 185.82 ± 11.03 respectively. Our results show that P value is <0.05 is statistically significant in all subscales and on the global scale variable of MHI 38. It suggests those who wear contact lenses have significantly better life satisfaction and Mental Health. Proper contact lens option as vision correction in Keratoconus patients improves the mental health status and are more positive in attitude compared to non users. A successful contact lens fit influences the mental health status compared to those who do not opt to wear it. 1.4.Conclusion:Eye care practitioners should motivate and proactively advise contact lenses to patients with Keratoconus as they will have better life satisfaction and psychological well being.