Use Of Contact Lenses Research Articles

Contact lens adoption and associated knowledge among the general population of South Gujarat, India

: Contact lenses have emerged as a popular alternative to spectacles, offering users enhanced vision correction, cosmetic appeal, and improved quality of life. However, awareness of contact lens care, hygiene, and complications remains a concern, particularly in regions with limited access to proper education on lens use. This study aimed to assess the level of knowledge, awareness, and practices related to contact lens use among the general population of South Gujarat, India.: A cross-sectional study was conducted using a structured online questionnaire administered to 1,500 participants. The questionnaire covered demographics, awareness of contact lens types, usage patterns, hygiene practices, and knowledge of potential complications. Data were analyzed using SPSS software, with chi-square tests used to determine statistical significance.: The study revealed that 60% of participants had some awareness of contact lenses, but only 30% demonstrated "extreme" awareness. Most participants used contact lenses for vision correction (65%), followed by cosmetics (30%). Adherence to recommended hygiene practices was variable, with only 56% consistently using contact lens solutions. Furthermore, 21% of users experienced discomfort while wearing lenses, and the dropout rate within the first six months was 28%.: There are significant gaps in knowledge and adherence to contact lens care, especially among younger users. Educational interventions focusing on hygiene practices, replacement schedules, and proper lens care are crucial to reducing complications and improving user experience.

Incidence, risk factors, and patient characteristics in severe contact lens-related microbial keratitis.

The aim of the present study was to determine the incidence, patient characteristics, and risk factors for severe, contact lens-related keratitis in patients in need of hospitalization. Keratitis was defined as severe when the disease required hospitalization. All patients with contact lens-related keratitis hospitalized at our department between 1 January 2018 and 31 December 2020 were interviewed with a questionnaire, about their use of contact lenses and knowledge of complications. Clinical information was collected from the medical records. A total of 41 patients (42 eyes) were hospitalized with severe keratitis during the 3-year period. The yearly incidence was 2.52 per 10 000 contact lens users over the age of 15 for extended-wear lenses used overnight, and 0.52 per 10 000 for users of daily disposable contact lenses. Pseudomonas aeruginosa was the most frequently isolated microbe. The median age was 50 years (range 15-66 years). Twenty-three patients (56%) were female, 28 patients (66%) used extended-wear contact lenses and 12 patients (29%) used daily disposable lenses. Nineteen patients (45%) admitted improper use. The median duration of contact lens use was 11.5 years. Only 15 patients (37%) had knowledge of keratitis as a potential complication. Most patients were experienced contact lens users. Users of extended-wear contact lenses worn overnight had a significantly higher risk of severe microbial keratitis. More focus on information and education of the risk of keratitis in contact lens users is needed.

Subclinical corneal inflammation and subbasal nerve alterations in keratoconus detected by in vivo confocal microscopy: a cross-sectional study.

To investigate the intracorneal inflammation and subbasal nerve alterations in keratoconus. This prospective cross-sectional study recruited patients with keratoconus, who were diagnosed and graded the severity based on clinical examination and Schiempflug tomography. Laser in vivo confocal microscopy (IVCM) was performed on the corneal subbasal layer centrally to explore the inflammatory cells (ICs), subbasal nerve density (SND), and nerve tortuosity. Keratoconus severity and related factors including ocular allergy, systemic atopy, eye rubbing, floppy eyelids, and contact lens use were recorded. Association between the factors, IC density, SND and keratoconus severity were analyzed. Thirty-four keratoconus eyes were enrolled, and their IVCM findings were compared with those of 20 age-matched normal eyes. Keratoconus showed a significant increase in ICs (44.25 ± 7.01 vs. 13.06 ± 7.51 cells/mm2, p < 0.001) and a significant decrease in SND (16.54 ± 0.79 vs. 20.62 ± 0.72mm/mm2, p < 0.001) when compared to controls. The alterations were pronounced in severe keratoconus as the IC density was significantly higher (p < 0.001), whereas SND was lower (p = 0.001) in high-graded keratoconus than in low-graded keratoconus. However, there was no significant correlation between the number of IC and SND in keratoconus eyes (p = 0.835). Corneal sensitivity and nerve tortuosity were not different between keratoconus and the controls. No keratoconus-related factors were associated with IC density except the severity of keratoconus (p < 0.001, 95% CI [0.70, 0.95]). Keratoconus, a clinically noninflammatory corneal disease, demonstrates subclinical corneal inflammation and subbasal nerve decline as shown by IVCM. These alterations correlate considerably with the severity of keratoconus. What is known Traditionally, Keratoconus is a clinically noninflammatory corneal disease. What is new Our study suspected keratoconus may be subclinical corneal inflammatory disease. In our research, A Keratoconus patient was discovered to have corneal inflammation and a reduction in sub-basal nerve density through the use of In Vivo Confocal Microscopy. Increase in corneal inflammation is considerably correlated with the severity of keratoconus.

The Assessment of Dry Eye Syndrome in Relation to the Use of Contact Lenses in the Jazan Region of Saudi Arabia: A Cross-Sectional Study

The Assessment of Dry Eye Syndrome in Relation to the Use of Contact Lenses in the Jazan Region of Saudi Arabia: A Cross-Sectional Study

Assessing Prevalence and Severity of Dry Eye Disease Across Various Types of Allergic Conjunctivitis

Background: Allergic conjunctivitis (AC) is a prevalent ocular condition triggered by environmental allergens, causing significant discomfort and reduced quality of life. Dry Eye Disease (DED), marked by ocular discomfort and visual disturbances, frequently overlaps with AC symptoms. This study examines the prevalence of DED in AC patients and explores the relationship between different AC types and DED severity. Method: A cross-sectional, observational study was conducted from June to September 2023 in the Department of Ophthalmology at a tertiary center in North India. A total of 264 AC patients aged 18 years and older with itchy eyes were included. Patients with contact lens use, recent ocular surgery, trauma, corneal pathology, or certain systemic diseases were excluded. DED was assessed using the Ocular Surface Disease Index (OSDI), Schirmer’s test, and Tear Film Break-Up Time (TFBUT). Results: DED was found in 70% of AC patients, with 20% mild, 19% moderate, and 32% severe cases. Females were more affected (64%). VKC patients showed higher tear production and better TFBUT scores. PAC patients had the most severe DED. Conclusion: DED is common in AC patients, with PAC associated with more severe DED, while VKC shows milder symptoms. Tailored treatment approaches are needed for managing AC and DED.

Dry Eye Disease Prevalence and Associated Risk Factors Among the Middle East Population: A Systematic Review and Meta-Analysis.

Dry eye disease (DED) is a common condition characterized by a loss of the tear film function, leading to symptoms of ocular discomfort and damage to the ocular surface. The prevalence and associated risk factors of DED may vary by region due to environmental, cultural, and genetic differences. The aim of the present study is to systematically review and analyze the prevalence and risk factors of DED in the Middle East (ME) region. This study adhered to the PRISMA 2020 guidelines. A comprehensive literature search was conducted using databases such as Web of Science, Scopus, Google Scholar, and PubMed to identify relevant studies published from January 2004 to July 2024. Studies included in the review were those that provided data on the prevalence and risk factors of DED in Middle Eastern populations. Data were extracted and analyzed to determine overall pooled prevalence and associated risk factors using a random-effects model. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42024583897. The meta-analysis included 17 studies from 10 countries with a total of 22,087 subjects. The estimated pooled prevalence of DED in the ME region was 28.33% (95% CI: 27.74-28.93). The primary risk factors include age, female gender, and smoking. Other risks are contact lens use, prolongedscreen time (over six hours daily), diabetes, glaucoma medications, allergies, autoimmune diseases, refractive surgery, arthritis, high cholesterol, acne treatments, antihistamines, antidepressants, thyroid disease, and a history of conjunctival infections or corneal abrasions. The prevalence of DED in Middle Eastern countries was higher than the global estimate, highlighting significant regional variation. Common risk factors for DED include older age, female gender, and smoking. These findings underscore the need for targeted prevention and management strategies that address the specific risk factors prevalent in the Middle Eastern population.

Corneal Layer Thickness Mapping With Optical Coherence Tomography in Different Stages Reveals Pathologic Processes of Keratoconus.

The aim of this study was to characterize the corneal layer thickness profile in different stages of keratoconus (KC). Patients with clinical or subclinical KC without a history of contact lens use were retrospectively enrolled. We evaluated 164 eyes, including 69 clinical KC, 32 topographic KC (no clinical signs), 22 very asymmetric ectasia with normal topography and no clinical signs of ectasia (VAE-NT), and 41 control eyes. The corneal epithelial, stromal, and total thicknesses in a 10-mm diameter were evaluated using swept-source anterior segment optical coherence tomography. The epithelial thickness in the control and VAE-NT groups was thicker inferiorly than superiorly. While epithelial thickness parameters between the VAE-NT and control groups did not differ, significant stromal thinning was observed in the paracentral inferior and midperipheral temporal areas. The epithelium in the topographic and clinical KC groups was thinner than that in the control and VAE-NT groups, with focal thinning of the epithelium in the inferior-temporal area. In clinical KC, stromal thinning increased mainly in the central and paracentral inferior/temporal areas. With KC progression, the thinnest epithelial points tended to be placed temporally and inferiorly. Corneal layer thickness mapping using swept-source optical coherence tomography in a 10-mm diameter cornea across various severities of KC, from very mild to advanced, revealed that epithelial and stromal thicknesses changed with KC severity and was involved in the pathogenesis of KC progression. Pathological changes in the stroma may precede those in the epithelium. Epithelial compensatory mechanisms in clinical and topographic KC may not have fully emerged in VAE-NT.

Vision Rehabilitation Using Contact Lenses in Infantile Nystagmus: A Systematic Review

Background and Objectives: Nystagmus has a negative effect on the patient's quality of life (QoL), leading to an increase in their dependence on others and a decrease in self-confidence and social relationships. Therefore, effective treatment and management are crucial in restoring those affected's visual function and social life. To determine whether contact lens (CL) use impairs the vision of infantile nystagmus (IN) patients, this study conducts a systematic review of the relevant literature. Methods: This systematic review adhered to the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We searched databases including PubMed, Scopus, Google Scholar, and the Cochrane Central Register of Controlled Trials for relevant studies published up to May 9, 2022. The search was not limited by study type (except for review articles), publication time, or language. We used medical subject headings (MeSH) and keywords such as “nystagmus,” “CL,” “congenital nystagmus,” “IN,” “rigid gas permeable lenses,” and “soft CLs”. Results: Initially, 102 articles were identified. After removing duplicates, 76 articles remained. Of these, 39 were excluded during screening for irrelevance, and 8 were excluded due to inaccessible abstracts or full texts. Ultimately, 29 articles were included in this review. Conclusion: The majority of studies reviewed reported no significant side effects from using CLs, and most patients achieved similar or improved visual function compared to using glasses. As a result, even if CLs are not superior to glasses, they perform comparably and can be considered a primary treatment option when there are indications for prescribing CLs.

Compliance with rigid gas-permeable contact lens use in children younger than 6 years in China: a 6-year retrospective study.

To explore the abandonment rate and factors influencing the use of rigid gas-permeable contact lenses (RGPCL) among children aged < 6 years. This retrospective case series study included 70 children aged < 6 years who were fitted with RGPCL for visual rehabilitation between January 2016 and December 2021. We collected data on indications, discontinuation rates, and reasons for discontinuation from medical records and via telephone calls and investigated the factors influencing contact lens abandonment. The median age of the 70 participants was 5.0 (interquartile range: 4.0-5.9) years. Further, 36 (51.4%) children stopped wearing contact lenses; among them, 17 (47.2%) stopped within 3 months, and the median duration of lens wearing was 4.0 (interquartile range: 1.0-11.5) months. Additionally, there was a correlation between the duration of lens wearing and lens abandonment (r = -0.698, P < 0.001). A high parental education level (hazard ratio [HR] = 0.425; 95% confidence interval [CI] 0.198, 0.913; P = 0.028) was a protective factor against lens abandonment, while parental assessment indicating harder than expected practicality (HR = 4.062; 95% CI 1.204, 13.707; P = 0.024) was a risk factor for abandonment. Children aged < 6 years are susceptible to early discontinuation of RGPCL use. Since parents perform daily lens manipulation, they are crucial to the continuity of lens use in these children. To improve RGPCL use continuity, communication and supervision should be strengthened before and after RGPCL fittings.

The toxic effects of polystyrene microplastic/nanoplastic particles on retinal pigment epithelial cells and retinal tissue.

The increasing use of contact lenses, artificial tears, and anti-vascular endothelial growth factor (anti-VEGF) drug injections for age-related macular degeneration has heightened the likelihood of eye exposure to microplastic particles. Extensive research has established that microplastic particles can induce oxidative stress on the ocular surface, resulting in damage. However, the impact of these particles on the retina remains unclear. Therefore, this study investigated whether microplastics/nanoplastics (MPs/NPs) cause retinal damage. In vitro human retinal pigment epithelial (RPE) cells were exposed to polystyrene MPs and NPs for 48h. Assessment of cell viability using WST-8; evaluation of TNF-α and IL-1β expression; observation of cell morphology and particle invasion via TEM; measurement of ROS levels using the DCFDA reagent; and western blot analysis of SOD2, FIS1, Drp1, and LC3B expression were conducted. In vivo experiments involved intravitreal injection of MPs/NPs in rats, followed by retinal H&E staining 24h later and evaluation of TNF-α and IL-1β expression. Results indicated that exposure to MPs did not significantly alter RPE cell viability, whereas exposure to NPs led to a noticeable decrease. TEM images revealed NPs' penetration into cells, causing increased oxidative stress (SOD2), mitochondrial fission (FIS1, Drp1), and mitochondrial autophagy (LC3B). In vivo experiments demonstrated an increase in inflammatory cells in retinal tissues exposed to NPs, along with elevated levels of TNF-α and IL-1β. Conclusively, both MPs and NPs impact the retina, with NPs displaying greater toxicity. NPs significantly elevate ROS levels in the retina and induce mitochondrial fission and mitophagy in RPE cells compared to MPs.

Millennial Generation’s Choice of Contact Lens as the Preference Over Spectacles: A Study of Corneal Endothelial Cell Density

ABSTRACT Introduction: The cornea of the eye is the most vulnerable organ to external insult. Contact lens is no exception. Changes in corneal epithelium, stroma, and loss of hexagonal shape in the endothelium have been taught in contact lens classes. We wanted to understand the cell density of endothelium in prolonged contact lens wear. Methods: It was a prospective, observational, cross-sectional study. The volunteers were divided into two groups: group 1 wore their contact lenses for over 5 years and group 2 never wore contact lenses. Specular microscopy was performed using Topcon SP-3000P. Computerized morphometry was used to evaluate the mean cell density of the corneal endothelial cells. Result: A statistically significant decrease in corneal endothelial cell density was observed in contact lens wearers. Conclusion: The use of contact lenses for a prolonged period significantly decreases corneal endothelial cell density. Suitable intervention may prevent such changes in the cornea.

A Comprehensive Review on Acanthamoeba Keratitis: An Overview of Epidemiology, Risk Factors, and Therapeutic Strategies.

Acanthamoeba keratitis (AK) is a rare but severe corneal infection caused by the free-living amoeba, Acanthamoeba, which is ubiquitously present in the environment. This condition predominantly affects contact lens wearers but can also occur in non-lens users, particularly those exposed to contaminated water or with compromised immune systems. AK is characterized by progressive corneal inflammation, epithelial defects, and ulceration, which can lead to significant visual impairment or blindness if not promptly diagnosed and treated. This review aims to provide a comprehensive overview of AK by synthesizing current knowledge on its epidemiology, risk factors, pathophysiology, clinical manifestations, diagnostic approaches, and therapeutic strategies. The review also highlights preventive measures and public health strategies to reduce the incidence of this debilitating condition. A detailed examination of existing literature was conducted, focusing on the global incidence of AK, demographic trends, and various risk factors such as contact lens use, environmental exposures, and immunity status. The review also delves into the pathophysiology of Acanthamoeba infection, the host immune response, and the challenges in distinguishing AK from other forms of infectious keratitis. Therapeutic strategies, including medical and surgical interventions, are analyzed, along with emerging treatments. The global incidence of AK has increased, particularly among contact lens users, due to poor hygiene practices and environmental exposures. Early diagnosis remains challenging, often leading to delayed treatment and poorer outcomes. Biguanides and diamidines are the mainstays of medical therapy, with surgical options considered in advanced cases. Emerging therapies, such as photodynamic therapy and antimicrobial peptides, show promise in enhancing treatment outcomes.AK poses a significant threat to ocular health due to its potential for severe visual impairment and the complexities associated with its diagnosis and treatment. Early recognition, appropriate management, and public health initiatives focused on prevention are crucial for improving patient outcomes. Ongoing research and a collaborative approach among healthcare providers are essential to advancing the understanding and management of AK.

The Role of Pseudomonas aeruginosa in the Pathogenesis of Corneal Ulcer, Its Associated Virulence Factors, and Suggested Novel Treatment Approaches.

Pseudomonas aeruginosa (P. aeruginosa), is a diverse Gram-negative pathogen commonly associated with a wide spectrum of infections. It is indicated to be the most prevalent causative agent in the development of bacterial keratitis linked with the use of contact lens. Corneal infections attributed to P. aeruginosa frequently have poor clinical outcomes necessitating lengthy and costly therapies. Therefore, this review looks at the aetiology of P. aeruginosa bacterial keratitis as well as the bacterial drivers of its virulence and the potential therapeutics on the horizon. A literature review with the articles used for the review searched for and retrieved from PubMed, Scopus, and Google Scholar (date last accessed 1 April 2024). The keywords used for the search criteria were "Pseudomonas and keratitis, biofilm and cornea as well as P. aeruginosa". P. aeruginosa is implicated in the pathogenesis of bacterial keratitis associated with contact lens usage. To reduce the potential seriousness of these infections, a variety of contact lens-cleaning options are available. However, continuous exposure to a range of antibiotics doses, from sub-inhibitory to inhibitory, has been shown to lead to the development of resistance to both antibiotics and disinfectant. Generally, there is a global public health concern regarding the rise of difficult-to-treat infections, particularly in the case of P. aeruginosa virulence in ocular infections. This study of the basic pathogenesis of a prevalent P. aeruginosa strain is therefore implicated in keratitis. To this effect, anti-virulence methods and phage therapy are being researched and developed in response to increasing antibiotic resistance. This review has shown P. aeruginosa to be a significant cause of bacterial keratitis, particularly among users of contact lens. It also revealed treatment options, their advantages, and their drawbacks, including prospective candidates.

Effect of Topical (0.03%) Tacrolimus Eye Ointment in the Management of Vernal Keratoconjunctivitis

Background: Vernal keratoconjunctivitis (VKC) is a chronic, severe ocular inflammatory disorder predominantly affecting children and young adults. Current treatments, including antihistamines and corticosteroids, can have significant side effects, particularly with long-term use. Tacrolimus, a macrolide immunosuppressant, has emerged as a promising alternative due to its ability to inhibit T-cell proliferation and cytokine release, key factors in VKC pathogenesis. Objective: To determine the efficacy and safety of 0.03% tacrolimus eye ointment in the management of vernal keratoconjunctivitis compared to standard steroid-based treatment. Methods: This quasi-experimental study was conducted at the Department of Ophthalmology, Pak-Emirates Military Hospital, Rawalpindi, from January 2022 to May 2024. A total of 40 patients (80 eyes) diagnosed with VKC were included. Patients aged 5 to 60 years with bilateral VKC and no prior treatment in the last month were enrolled. Exclusion criteria included concurrent eye infections, use of contact lenses, systemic comorbidities, and previous ocular surgeries. The intervention group received 0.03% tacrolimus ointment twice daily for two months, followed by once daily for two months, and then on alternate days for the final two months. The control group received a combination of 0.1% fluorometholone eye drops, 0.3% tobramycin/0.1% dexamethasone ointment, and 0.1% olopatadine, with steroid tapering after two weeks. Patients were followed up at two weeks, one month, three months, and six months. The primary outcome was the change in symptom and sign scores from baseline to six months. Data were analyzed using SPSS version 25, with statistical significance set at p≤0.05. Results: The median age of the study population was 15.50 years (IQR: 10.00), with 57.4% female. The tacrolimus group showed significant improvement in eye discharge (p=0.033), itching (p=0.004), lacrimation (p=0.008), and foreign body sensation (p=0.015) compared to the control group. The average symptom score decreased more significantly in the tacrolimus group (p&lt;0.001). Clinical signs such as punctate keratitis (p=0.031) and papillae (p=0.018) also showed greater resolution in the tacrolimus group, with a significant reduction in the average sign score (p=0.009). Conclusion: Topical 0.03% tacrolimus eye ointment is an effective and safe treatment for VKC, providing superior symptom relief and clinical improvement compared to standard steroid-based therapy. It offers a promising alternative for long-term management of VKC, with fewer side effects than traditional corticosteroids.

The effect of extended periods of mini-scleral lens wear on the conjunctival/episcleral and scleral thickness

PurposeTo evaluate the conjunctival/episcleral thickness (CET) and anterior scleral thickness (AST) in patients with keratoconus with an extended duration of mini-scleral contact lens wear by utilizing anterior segment optical coherence tomography (ASOCT). MethodsThis study included 17 eyes of 17 patients with keratoconus with mini-scleral contact lens wear (Group 1), 20 eyes of 20 patients with keratoconus without any contact lens wear (Group 2), and 20 eyes of 20 healthy controls (Group 3). CET and AST were measured using AS-OCT (Triton, Topcon, Japan) at 1, 2, and 3 mm posterior to the scleral spur in the nasal, temporal, superior, and inferior quadrants. ResultsThe median age of the mini-scleral contact lens group was 26, and the number of male patients was 14 (82.4 %). The superior CET values at 1 mm, 2 mm, and 3 mm statistically differed between the groups, with Group 1 having significantly lower values than Group 3 and Group 2 having statistically similar values to the remaining two groups. The inferior CET at 2 mm was lower in Groups 1 and 2 than in Group 3. The inferior CET at 3 mm was lower in Group 1 compared to Groups 2 and 3.AST was similar between the groups at all measured quadrants and distances. The duration of lens wear had a strong, statistically significant, negative correlation with the superior CET at 2 mm (rho: −0.847, p < 0.001) and a moderate, statistically significant, negative correlation with the superior CET at 3 mm (rho: −0.506, p < 0.038). ConclusionsIn this study, it was found that mini-scleral contact lens usage causes thinning in the conjunctival-episcleral layer, especially in the superior and inferior quadrants, but does not affect scleral thickness. AS-OCT is a non-invasive and clinically applicable technique for assessing the impact of contact lens use on the conjunctiva/episclera and sclera.

Tingkat Pengetahuan Pegawai Perkantoran di Kawasan DKI Jakarta Mengenai Perawatan Lensa Kontak (Softlens) Tahun 2024

High mobility is one of the biggest motivations for contact lens wearers among office workers in DKI Jakarta and surrounding areas. Apart from being affordable and easy to use, contact lenses have additional value on the aesthetic side for most users, both from the types of contact lenses that vary in color, and for users who have a history of myopia or astigmatism, there is certainly no need to distract the surrounding because the thick glasses lenses that are considered to reduce aesthetic value are a thing that is not too worried about with the use of contact lenses. Although it has a high percentage as a sharp vision aid that is highly demanded by many people, it does not mean that users and/or potential users of contact lenses are well aware of how to properly care for contact lenses. Taking into account the background of contact lens users and/or potential users in terms of education, age range and financial condition, this study aims to improve the quality of contact lens care knowledge. This research was conducted using a qualitative method by filling out questionnaires about contact lens care knowledge to participants who have been determined. The results of this study indicate that the factors of age maturity, education level, income level and experience in working do not guarantee the knowledge of contact lens care. Keywords: Contact Lens, Care

Demographic and lifestyle factors associated with dry eye disease in China: A cross-sectional multi-center study

PurposeAssociations were assessed between demographic/lifestyle factors and tear film breakup time (TBUT) defined dry eye disease (DED) in China. MethodsThe cross-sectional study involved 50,280 subjects (54 ± 17 y) in 217 clinics (25 provinces). Data included sleep disorders; digital screen exposure; and use of cosmetics, contact lenses, and eye drops (for asthenopia). Clinical examinations included TBUT; Schirmer I test; meibomian gland plug status. TBUT-defined DED was TBUT <10 s, with TBUT ≤5 s also considered (i.e., short TBUT-type DED), either unilateral or bilateral. ResultsTBUT-defined DED was present in 81.6 % overall. The highest rates were in those 71 years or older, living in the north, with chronic daily sleep disorder, or daily cosmetic application; or daily digital screen exposure for 5 years, contact lenses 4 h, or 3 months eye drops. Compared with those without TBUT-defined DED, those with TBUT-defined DED showed lower Schirmer I results and more severe meibomian gland plug status (each, P < 0.001). Independent risk factors of DED were: aging; living in the southwest; daily digital screen exposure ≥3 h; and occasional cosmetic use. Risk factors of DED TBUT ≤5 s were: living in the southwest; wearing contact lenses (>3 y); and using eye drops. Rates of unilateral and bilateral DED were comparable. ConclusionsDED in China is more likely in the aged and those in the north/southwest. DED rates increase with digital screen exposure, and use of cosmetics, contact lenses, or eye drops for asthenopia. Unilateral DED should be treated as promptly as bilateral.

Perception and awareness of the public about presbyopia and its corrective approaches in Saudi Arabia: a population-based survey

BackgroundThis study investigated patients’ awareness of presbyopia and its management approaches and their preferred methods for near vision correction.MethodsIn Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants’ awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants’ responses.ResultApproximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants’ age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p < 0.05).ConclusionPresbyopia is a highly prevalent age-related ocular disorder, and a significant percentage of cases are uncorrected due to a lack of awareness or reluctance to wear spectacles. More efficient health education about presbyopia and its corrective alternatives is urgently needed.

Evolving Trends in the Diagnosis and Management of Keratoconus Over 3 Decades.

To report the trends in the clinical presentation, diagnosis, and management of keratoconus (KC) in patients presenting to a multitier hospital network over 33 years. This retrospective study included patients with KC presenting from 1987 to 2020. Patients with KC in at least 1 eye were included. The data of 20,576 patients included in this study were retrieved from the electronic medical record database. Data on patient demographics, ocular diagnosis, contact lens usage, and surgical history were collected and exported for analysis. Descriptive statistics and chi square test were used for statistical analysis. A total of 20,576 KC cases were seen from 1987 to 2020. Mean age at diagnosis reduced from 29.3 years (1987-1991) to 22.2 years (2016-2020). Adults (76.64%) were commonly affected with a majority being male (61.25%). Use of contact lenses increased from 4.34% (2002-2006) to 11.23% (2016-2020). Of the total number of surgical interventions, collagen crosslinking (CXL) constituted more than 1/5th (22.28%) between 2007 and 2011, which increased to more than half between 2012 and 2016 (53.61%) and almost 3/4th (72.53%) between 2017 and 2020. Advances in lamellar surgery have led to more patients undergoing deep anterior lamellar keratoplasty (DALK) as compared with penetrating keratoplasty. In the last 8 years, 17.2% patients underwent surgery and the most common was CXL (14.77%) followed by DALK (1.72%) and penetrating keratoplasty (1.04%). We report the trends in the clinical presentation and management of KC over 3 decades. In the last 33 years, advances in diagnostics have helped diagnose KC earlier. Contact lenses and advances in CXL have reduced the number of keratoplasties in KC, DALK being more common.

Scoping review: Reporting characteristics for the safety of contact lenses in the pediatric population.

Contact lenses are an increasingly popular option for correcting pediatric refractive error due to increased awareness of interventions to slow myopia progression. With limited information on the safety profiles of contact lenses in children, it is important to characterize the current understanding and promote this device's safe and effective use. This scoping review evaluates characteristics of the current literature that have examined the safety of contact lenses in pediatric patients. It provides future directions for systematic reviews and identifies any gaps in the current literature or areas for future research. Literature searches in MEDLINE via PubMed, EMBASE, The Cochrane Library, trial registries, and U.S. Food and Drug Administration clinical trial documentation were performed. Included studies (i.e., experimental and quasi-experimental studies; observational studies including prospective and retrospective cohort, case-control, and analytical cross-sectional studies, and case series of 30 or more participants) reported safety and/or complications of the use of any contact lens for correcting refractive error in children (0 to 18 years). Two independent reviewers first screened the titles and abstracts, and then full-text reports for eligibility. Conflicts in eligibility were resolved by discussions with a third reviewer. Two independent reviewers extracted data, including details about the participants, context, study methods, and key findings relevant to the review question. This scoping review included 73 studies from 10 countries using different contact lens modalities, primarily orthokeratology and soft contact lenses, in children (6 to 18 years). The most common adverse event reported by the studies was corneal staining (60% orthokeratology, 45% soft contact lens). The need for uniform reporting standards for adverse events poses challenges for comprehensive data synthesis. However, this scoping review identified a sufficient number of studies for a future systematic review to quantify the risks associated with orthokeratology and soft contact lens use in children.