Therapeutic Lenses Research Articles

An Integrated Approach Using Physical Therapy and Therapeutic Lenses to Treat Post Encephalitis Syndrome and Lupus

An Integrated Approach Using Physical Therapy and Therapeutic Lenses to Treat Post Encephalitis Syndrome and Lupus

Kids, courts and canines: Evaluating the Justice Facility Dog Program through a therapeutic lens in the Perth Children's Court

Court environments can be stressful and induce anxiety in victims, witnesses, and other court users. Taking heed from justice facilities in other jurisdictions, the Children's Court of Western Australia introduced Winston, a justice facility dog, at the Perth Children's Court facility to help reduce the stress and anxiety of victims, witnesses, and court users. This article presents survey ( n = 55) and interview data ( n = 17) from staff and stakeholders who reported positive changes in the court atmosphere, with limited negative impacts on the running of the court. Surveys were also conducted with child victims/survivors ( n = 13), caregivers ( n = 44), and other court users (including accused young people; n = 23). Children and caregivers’ results indicated significantly reduced stress and anxiety levels associated with attending the Children's Court after interacting with the facility dog. When analysed through a lens of therapeutic jurisprudence, the positive impacts on court-user well-being and limited impact on the court and legal processes solidified the therapeutic principles of the program. The findings of this study highlight that justice systems could implement similar positive therapeutic programs at other courts to reduce negative impacts on people attending and working at the facilities.

Modification of contact lenses via metal‐organic frameworks for glaucoma treatment

AbstractThe prevention of blindness from glaucoma requires multiple treatments to lower intraocular pressure. Here, human contact lenses are modified with highly porous metal‐organic frameworks with sustained release of brimonidine for prolonged glaucoma treatment. Various metal‐organic frameworks were screened for their attachment to lenses, loading with brimonidine, and drug‐release properties. Optimized therapeutic ocular lenses conjugated with MIL‐101(Cr) frameworks maintain optical transparency and power. Coating of lenses with MIL‐101(Cr) nanoparticles reduced brimonidine washout with tears and ensured a gradual and localized release of the drug into the eyeball through the cornea. The hybrid lenses provided a 4.5‐fold better decrease in eye pressure, compared by area under the curve (AUC) value to a commercially available brimonidine tartrate solution. Therapeutic lenses did not induce any notable eye irritation or corneal damage in vivo. The newly developed hybrid lenses are expected to provide a robust platform for the therapy and prevention of various ocular diseases.

Patient Experiences With Therapeutic Contact Lenses and Dry Eye Disease.

To report patient-reported experiences with dry eye disease and therapeutic contact lenses. A survey was distributed to patients with dry eye disease. Demographics, Ocular Surface Disease Index (OSDI), systemic disease, contact lens history, and burden of care information were collected. Descriptive statistics are presented and categorized by nonlens, soft lens, and scleral lens (SL) wearers. Of 639 respondents, 15% (94/639) were currently using therapeutic soft or SLs (47 soft and 69 SL). Mid-day fogging or clouding of vision was reported by SL (75%, 50/67) and soft lens (62%, 29/47) wearers. Seventy-two percent of SL wearers spent more than 20 min daily on dry eye treatment while 43% of soft lens wearers spent more than 20 min. Median annual expenditure was higher for SL ($1,500, n=63) than nonlens ($500, n=371) or soft lens wearers ($700, n=43). Mean OSDI scores in all groups were in the severe category (51±22 years, n=401 nonlens wearers; mean age; 45±22 years, n=47 soft lens wearers; 60±24 years, n=69 SL wearers). Mid-day fogging and blurring of vision was reported by most of the individuals using therapeutic lenses for dry eye disease. SL wearers allocate the most resources for dry eye care.

Understanding Family Violence From a Therapeutic Lens

Mitigating and understanding family violence is the cornerstone of this paper. Family violence can happen for multiple reasons without any exclusivity. A firsthand account of how I experienced violence in my life will be discussed to give meaning to my worldview and therapeutic lens. Exploration of family violence theories ranging from the ecological model to feminist theory will be conducted. Comprehending sexual minority violence must become a priority to move the conversation forward and emphasize inclusivity. Family violence ethical components are considered. Conclusively, understanding family violence fully prepares a therapist to deal with various presenting problems daily.

Kontaktlinsen als vielversprechende Therapiemittel

Purpose. Insights into the scientific research about contact lenses and their development, and information about their use as therapeutic tools for various eye diseases are provid- ed. The specificities of the human eye due to its particular physiology and anatomy are outlined and the relation with the resulting therapeutic difficulties is presented. Therapeutic lenses as bandage and as drug-delivering contact lenses are described. Material and Methods. The topics of the selected literature include relevant developments in biomaterials for contact lenses. Reports and publications on worldwide ocular dis- eases, global current market analysis in the field of eye drops, as well as publications on modern drug release methods for ocular systems tend to depict the topic. Results. As a result of a long-lasting development, contact lenses are worldwide successful on the optical device market. Therapeutic contact lenses as bandage lenses are effective tools in ophthalmic surgery and therapy. Conclusions. Novel therapeutic contact lenses used for ocular drug delivery significantly improve the bioavailability and thus perform better as conventional eye treatments. Keywords copolymers, protein adhesion, vision threatening disorders, blood ocular barrier, therapeutic and bandage contact lenses, ocular drug delivery systems

Murder Trials in the Maldives from a Therapeutic Lens

Section 92 of the Maldives Penal Code (9/2014) reserves the capital penalty for the most serious homicides, and the law tries to reduce the imposition of capital punishment by rigidifying the procedural requirement. However, the case law demonstrates the opposite effect. This article seeks to advance therapeutic values of procedures and promote less severe punishments in murder cases by utilising knowledge from therapeutic jurisprudence and sharia. To validate the research claim, three randomly selected cases were examined. According to the findings, current court practises in murder cases do not promote therapeutic values or result in less severe punishment.

Эффективность и безопасность коррекции миопии методом трансфрк в комбинации с применением лечебной мкл, пропитанной раствором дексаметазона 0,1 %

Purpose. To evaluate the efficacy and safety of myopia correction by the TransPRK method using therapeutic soft contact lens (SCL) impregnated with a 0.1 % dexamethasone solution Material and methods. A prospective, controlled study included 32 patients (64 eyes). The left eyes were combined into the “With DEX” study group, the right ones into the “Without DEX” control group. After the TransPRK was performed, SCL soaked with dexamethasone was put on the eyes of the “With DEX” group. The same SCL without impregnation was put on the eyes of second group “Without DEX”. Results. 1 and 3 months after, the operation there were no significant differences in UDVA between the groups. Mean UDVA 3 months after the operation in the group “With DEX” was 1.0 ± 0, in the group “Without DEX” 1.0 ± 0.1 (p-value = 0.625). There were no significant differences in the rate of formation of the refractive result, its predictability and stability. After 1 month in the “Without DEX” group, the difference in the level of UDVA before surgery and CDVA after was the same (without loss of the number of lines read) in 44 %, in the “With DEX” group, in 67 % (p-value = 0.607). The same picture was observed after 3 months, in the group "With DEX" – in 83 %, “Without DEX” – in 61 % (p-value = 0.607). The difference is not statistically significant, but there was a trend towards an accelerated recovery of UDVA in the “With DEX” group. The pain syndrome was significantly less in the “With DEX” group (p-value = 0.021). There were no significant differences in the epithelialization time between groups, as well as subepithelial fibroplasia. Conclusion. According to the results obtained, TransPRK with therapeutic SCL impregnated with dexamethasone can be considered as an effective and safe method, which also makes possible to reduce pain in the early postoperative period without delaying epithelialization. Keywords: dexamethasone, corneal syndrome, photorefractive keratotomy, therapeutic lens.

Is a ‘Both/and' Approach to Integration Possible? A Practice Reflection on Working with Children in Out‐of‐Home Care and Their Caregivers

The prevalence and complexity of children's mental health concerns is increasing for children living in out‐of‐home‐care settings in Australia and in other Western countries. Therapists face an amplified challenge of finding innovative ways of working with children and their caregivers, often drawing upon multiple therapeutic approaches to respond to such complexity. This article discusses some tensions of integration in practice. A case example is offered to demonstrate a way of enacting integration with Deanne, a six‐year girl, and her foster family. These practice reflections illustrate a certain way of doing a ‘both‐and’ approach to integration, drawing on narrative therapy and attachment therapeutic lenses. The reflections on practice reveal how a nuanced and reflexive approach to integration is needed to ensure theoretical congruence, to avoid contradictory therapeutic stances of ‘knowing' and ‘not‐knowing.'

Opportunity Development Association (ODA) Center for Advanced Vision Care: A Structured Approach Towards Remediation of Visual Dysfunction

This paper presents the development and the on-going mission of The Center for Advanced Vision Care, a Vision Therapy Center established within ODA (Opportunity Development Association) Primary Health Care Network. The Center is designed to remediate visual dysfunction with an emphasis on therapeutic lenses, prisms and vision therapy. A structured approach towards Vision Therapy will be introduced highlighting the way in which remediation of visual dysfunction can occur without regression. The Center for Advanced Vision Care was founded with the primary goal of improving vision care for the children of Williamsburg, NY and the surrounding areas. The providers at this Center utilize therapeutic lenses and prisms in conjunction with vision therapy in order to achieve remediation of visual dysfunction, without regression. This unique program provides an opportunity for children to attain a higher level of self-esteem, thereby enabling them to reach their fullest potential. Working alongside other professionals comprising ODA’s exceptional multidisciplinary therapy service, ODA’s Vision Center is redefining the standard for which pediatric behavioral vision care is rendered. A Vision Therapy program, as part of a distinct multidiscipline therapy center, will be presented as a unique facility utilizing therapeutic lenses and prisms, in conjunction with vision therapy, in a way that serves to remediate visual dysfunction, as part of an interdisciplinary approach.

All Things Wise and Wonderful: A Christian Understanding of How and Why Things Happen, in Light of COVID-19

All Things Wise and Wonderful: A Christian Understanding of How and Why Things Happen, in Light of COVID-19

Unboxing dendritic cells: Tales of multi-faceted biology and function.

Often referred to as the bridge between innate and adaptive immunity, dendritic cells (DCs) are professional antigen-presenting cells (APCs) that constitute a unique, yet complex cell system. Among other APCs, DCs display the unique property of inducing protective immune responses against invading microbes, or cancer cells, while safeguarding the proper homeostatic equilibrium of the immune system and maintaining self-tolerance. Unsurprisingly, DCs play a role in many diseases such as autoimmunity, allergy, infectious disease and cancer. This makes them attractive but challenging targets for therapeutics. Since their initial discovery, research and understanding of DC biology have flourished. We now recognize the presence of multiple subsets of DCs distributed across tissues. Recent studies of phenotype and gene expression at the single cell level have identified heterogeneity even within the same DC type, supporting the idea that DCs have evolved to greatly expand the flexibility of the immune system to react appropriately to a wide range of threats. This review is meant to serve as a quick and robust guide to understand the basic divisions of DC subsets and their role in the immune system. Between mice and humans, there are some differences in how these subsets are identified and function, and we will point out specific distinctions as necessary. Throughout the text, we are using both fundamental and therapeutic lens to describe overlaps and distinctions and what this could mean for future research and therapies.

Indications of Scleral Contact Lenses in Ocular Surface Diseases

The use of scleral lenses is increased over the last decade. Not only it helps in the patient’s visual rehabilitation but also provides wearing comfort to the patient. Previously scleral lenses were mostly prescribed in cases where traditional therapies don’t work well. But nowadays due to advanced designing and customized fitting this lens are widely prescribed in various ocular surface diseases where these lenses not only improve patient comfort but act as an important tool in promoting healing of the corneal epithelium. Therapeutic Scleral lens indications include DED syndrome, exposure keratitis, graft-versus-host disease, Stevens-Johnson syndrome, ocular cicatri¬cial pemphigoid, persistent epithelial defects, neurotrophic keratitis, chemical burns, limbal stem cell deficiency etc.

Release of Aloe vera Extracts from Therapeutic Lenses

Aloe vera extracts have been used for drug therapy due to their antimicrobial, anti-inflammatory, and epithelia-regenerative actions. Considering the possible adverse side effects on the corneal surface of anti-microbial agent administration after ocular surgery, it is of interest to identify the ability of Aloe vera extract release from a therapeutic lens to prevent ocular irritation. The aim of this research was to evaluate the effects of different lens types on the availability and efficacy of releasing Aloe vera extracts in which they are soaked. Two lens types were examined: (1) non-ionic hydrogel lenses and (2) ionic hydrogel lenses. Aloe vera availability was quantified by LC–MS, and activity was quantified by a spectrophotometer (Nanodrop) at different times: (a) 30 min, (b) 60 min, (c) 2 h, (d) 6 h, and (e) 24 h. The lens allowing for the most abundant passage of Aloe vera extracts was the ionic hydrogel lens, followed by the non-ionic hydrogel lens. The obtained results demonstrate that the best lens allowing for the high and stable release of Aloe vera extract to the corneal surface are those composed of ionic hydrogels.

The good enough facilitator: exploring online interprofessional therapeutic facilitation in times of COVID-19

ABSTRACT In the time of COVID-19, universities have been forced to engage with online learning more than ever before. The facilitator is a key player in the orchestration of online learning and as such, this paper seeks to present a radical reworking of the Garrison and Archer Community of Inquiry model that emphasizes the importance of a therapeutic presence in online interprofessional facilitation. Drawn from a strand of inductive empirical qualitative research based on 15 years’ experience of online interprofessional education, this paper employs a therapeutic lens to propose the good enough facilitator as a theoretical construct that emphasizes the importance of the facilitator understanding when to intervene and when to retreat within the online space. Online interprofessional asynchronous discussion groups are explored to illustrate the value of the good enough facilitator in online learning.

Numerical modeling of therapeutic lens drug delivery in the anterior human eye for the treatment of primary open-angle glaucoma.

A numerical model of drug delivery from a therapeutic lens in the anterior portion of the human eye has been developed for a more effective treatment plan of primary open-angle glaucoma. The numerical model takes into account the drug diffusion through the therapeutic lens along with heat transfer and aqueous humor flow in different orientations of the human eye (supine (two-dimensional) as well as standing (three-dimensional)). Results illustrate that the drug diffuses through the therapeutic lens to the cornea and is convected into the anterior chamber of the eye due to the temperature gradient across the eye. In addition, eye orientation significantly affects drug delivery with supine orientation providing better and uniform drug exposure in different target regions of the eye as compared to standing in the case of the therapeutic lens. Furthermore, a comparison of the therapeutic efficacy of the therapeutic lens has been done with topical administration and the drug uptake results from both the drug delivery modes have been validated with the experimental data reported in the literature. The developed model may help ophthalmologists to comprehend the transport and retention of different drugs in different domains and orientations of the human eye when administered through a therapeutic lens.

Diclofenac sustained release using an LbL coated silicon based hydrogel

Introduction: Eye drops remain the primary dosage form for ocular therapy because of the easiness of administration by the patient, but they provide low drug bioavailability [1]. Soft contact lenses have been evaluated for several decades as potential drug vehicles for ocular therapy. Nevertheless, their usual low drug uptake prevents the achievement of therapeutic levels [2]. An approach to overcome some limitations of contact lenses is to use the layer-by-layer (LbL) method to form a surface barrier that regulates drug release within the therapeutic window. The main objective of this work was to develop LBL coated therapeutic lenses loaded with the anti-inflammatory drug diclofenac (DCF). Materials and methods: A silicon based hydrogel material (TRIS) was synthesized, loaded with sodium diclofenac (DCF) and coated with different polyelectrolytes by the LbL method. The polyelectrolytes alginate (ALG), chitosan (CHI) and hyaluronic acid (HA) were chosen and genipin was used as cross-linking agent. The coating consisted in a triple layer of ALG/CHI/HA. DCF release kinetics was evaluated in sink conditions in NaCl solution. Uncoated and coated hydrogels were submitted to the chorioallantoic membrane test (HET-CAM test) for potential ocular irritation. The hydrogel-lachrymal protein (lysozyme) interaction was evaluated by quartz-crystal microbalance with dissipation (QCM-D). Transmittance and oxygen permeability were studied. A mathematical model was used to estimate the in vivo efficacy of the coated lenses. Results: The coating allowed a controlled release of DCF, while maintaining the required properties for daily contact lens application. Both uncoated and coated hydrogels successfully passed the HET-CAM test. QCM-D data revealed the stability of the layers and some antifouling activity of the coating against lysozyme. The effective diffusion of DCF through the samples was calculated: lower diffusivity was found for the coated hydrogels (1.9 ± 0.7e−13 m2/s) compared to the uncoated (8.6 ± 1.1e−13 m2/s). The mathematical modelling appoint to a significant difference between the samples: by admitting the half maximal inhibitory concentration (IC50) of DCF, an estimated 200% increase in the predicted in vivo efficiency was obtained due to the presence of the coating. Discussion and conclusions: The coated hydrogel presents adequate characteristics to be used in therapeutic contact lenses, concerning the evaluated properties. DCF released was significantly enhanced by the presence of the coating, showing favourable kinetics due to the interactions between the polyelectrolytes and the drug. The applied mathematical model revealed a sustainable release of DCF within the therapeutic window for two weeks.

Effect of vitamin-E integration on delivery of prostaglandin analogs from therapeutic lenses

HypothesisGlaucoma is effectively treated by prostaglandin analogs. Low corneal bioavailability (<5%) of daily-instilled prostaglandin drops complemented by frequent application results in low patient compliance (<50%). One alternative route is ocular delivery via commercial hydrogel contact lens. Commercial lenses, however, release prostaglandins rapidly in a few hours owing to their small molecular size, resulting in toxic side-effects. Here, the feasibility of sustained prostaglandin, namely bimatoprost and latanoprost delivery by vitamin-E integrated polymeric hydrogels is explored. Inclusion of these barriers is expected to augment transport resistance and influence delivery rates. ExperimentsLens immersion in vitamin-E concentrated ethanol is done to enable formation of nano-barrier depots. FindingsPilot in vitro studies indicate that ACUVUE® OASYS® and ACUVUE® TruEye™ lenses loaded with ∼0.2 g of vitamin-E/g of hydrogel effectively prolong bimatoprost dynamics by 10–40-fold, delivering therapeutic dosages for >10 days. Incorporation of vitamin-E into the lenses retains visible light transmission and other properties. Further, vitamin-E integration does not influence latanoprost transport. An in vivo model involving coupled mass transport in the lens and post-lens tear film (POLTF) domains predicts >50% corneal bioavailability of bimatoprost delivered via modified lenses.

'MLK 50: Where Do We Go from Here?': Teaching the Memphis Civil Rights Movement Through a Therapeutic Jurisprudence Lens

As the nation pauses to commemorate the 50th anniversary of the assassination of Dr. Martin Luther King, Jr. on April 4, 1968, in Memphis, Tennessee, it is imperative that we study the epic civil rights history of Memphis which preceded this dreadful event, especially in the legal academy. Therapeutic Jurisprudence (TJ), with its focus on laws, legal processes, and legal actors and the extent to which they can be therapeutic or antitherapeutic is a fitting academic vantage point. The TJ repertoire of principles and techniques and the “genius loci,” a spirit of time and place which comes from the field of historic preservation, are teaching rubrics with which to assist law students to reflect upon the tightrope which Dr. King walked in 1968 Memphis and to prepare them for modern day civil rights challenges. Dr. King’s soul remains in Memphis. According to law professor John Nivala, “[T]he places where we work and live have a spirit which enlivens our present by reminding us of our past and anticipating our future.” The places where law students walk and study have a past and future, too, none more venerable than the Downtown Memphis Corridor, where civil rights battles were fought and won, and where Dr. King died. The University of Memphis Cecil C. Humphreys School of Law occupies a former Federal Courthouse, Customs House, and Post Office. Too little has been written about the civil rights history of this building and the Downtown Memphis Corridor it anchors. Yet precedent-setting desegregation lawsuits were filed here to integrate Memphis State University, the public schools, the public libraries, buses, and places of public and private accommodations. The Corridor was the scene of student sit-ins to protest segregation. Criminal prosecutions of civil rights activists took place at the state courthouses. The U. S. Civil Rights Commission held influential hearings here. These historic moments were a prelude to Dr. King’s 1968 visits to Memphis that led to his death. MLK 50 offers a teaching opportunity for all of the nation and especially for students of the law. It is regrettable that Memphis Law, and indeed most law schools, do not offer a civil rights curriculum that includes Memphis civil rights history. The Memphis experience must be taught. I suggest that TJ offers a theoretical framework for such a pedagogical endeavor.

Corneal melting and perforation under topical moxifloxacin and tobramycin: case report

PurposeTo describe a case of corneal melting with perforation after treating a corneal abscess with topical moxifloxacin + tobramycin for 2 weeks.MethodsRetrospective case report.ResultsA 56 year old patient presented 5 weeks after a retinal surgery with a central corneal abscess. Topical tobramycin 0.3% + moxifloxacin 0.5% 1/h + desomedine 1% 8/days was initiated and tapered 3 days later to 1/h, 5/days and 5/days respectively. Four days later a large erosion (3.5 × 3.5 mm) appeared while the abscess had disappeared. Topical tobramycin 5/days and moxifloxacin 3/days were continued for 1 more week when the patient presented to our clinic with a large corneal melting (3 × 2 mm) in a clear cornea that perforated centrally (1 × 1 mm) the next day with Descemet folds, fibrin, anterior cells ++, and, dilated iris vessels and posterior synechiae. Both blood tests and medical history were otherwise unremarkable. Moxifloxacin and tobramycin were discontinued and replaced by preservative free ofloxacin 0.3%1/h tapered quickly, tropicamide 3/days, oral valaciclovir (3 g/day), oral levofloxacin 500 mg/days and therapeutic lens. All cultures for bacteria, virus, amoeba or fungi as well as PCR for HsV1, HsV2 and VZV from corneal smear remained negative. Systemic treatment was consequently stopped, cornea healed quickly and therapeutic lens could be removed after a 3 days. No recurrence has been observed for the next 2 months.ConclusionsThis case suggests that topical moxifloxacin (combined with tobramycin) may inhibit the healing of corneal ulcers and induce a corneal melting leading to perforation.