BCLA CLEAR Presbyopia: Management with contact lenses and spectacles.

This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice.

Multifocal contact lens success predictability.

Purpose: The current multi-study analysis combined data from three studies to quantify the relationship between the initial reaction to soft multifocal contact lens (MFCL) design types at dispensing and evaluate the predictability of overall vision satisfaction (OVS) and intention to purchase (ITP) after 1 week of wear.

Method: Three prospective studies tested MFCLs over 1-week of wear following the same protocol, using a range of potentially predictive ratings at dispensing, and both OVS and ITP at 1-week as an indicator acceptance level. In each study, two of MyDay® multifocal, clariti® 1 day multifocal, Biofinity® multifocal (worn as a daily disposable lens) or 1 DAY ACUVUE® MOIST MULTIFOCAL were dispensed for 1-week of daily wear.

Six years of wearer experience in children participating in a myopia control study of MiSight® 1 day.

Purpose: To evaluate the experience of children wearing soft contact lenses (CLs) during a trial of MiSight® 1 day (omafilcon A, CooperVision, Inc.), a dual-focus myopia-control daily disposable CL.

Methods: A 3-year, double-masked, randomised trial (Part 1) comparing experiences with MiSight 1 day and a single-vision control (Proclear® 1 day, omafilcon A, CooperVision, Inc.

Challenges to the new soft contact lens wearer and strategies for clinical management.

Soft contact lens discontinuations have a dramatic impact on the overall success of this form of vision correction, and evidence suggests that the reasons for contact lens cessation are different for new wearers than for established lens users. In descending order, these relate to vision, discomfort, handling, inconvenience/loss of interest, ocular health and cost. This paper considers the background and underlying evidence for these causes of soft lens discontinuation in new wearers, and presents clinical management strategies to minimise this phenomenon.

Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens.

Purpose: A large observational survey was undertaken to determine eye care professional (ECP) and patient experience of stenfilcon A multifocal soft contact lens (MyDay multifocal) when prescribed in a real-world setting.

Methods: A total of 196 ECPs from eleven countries fit up to ten presbyopes with stenfilcon A multifocal. Data were collected on fit success at the initial visit, patient satisfaction with comfort, vision at distance, intermediate, and near, overall vision, overall satisfaction, and handling at the initial and follow-up visits after 1-2 weeks of wear.

CLEAR - Evidence-based contact lens practice.

Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.

An investigation into disposal and recycling options for daily disposable and monthly replacement soft contact lens modalities.

Purpose: To examine the annualised waste and end-of-life disposal options with two representative soft contact lens (CL) modalities.

Methods: The component parts of two representative soft CL modalities were catalogued, separated, weighed and inspected for material identification: somofilcon A soft CLs (clariti elite, CooperVision Inc.) used with multi-purpose solution (MPS) (All in one Light, CooperVision Inc.

Silicone hydrogel daily disposable benefits: The evidence.

Daily disposable (DD) contact lenses first came to the market approximately 25 years ago and eye care professionals (ECPs) started prescribing silicone hydrogel (SiH) contact lenses, primarily for extended or continuous wear, approximately 20 years ago. It has now been over ten years since SiH DD contact lenses have been available, and while SiH materials are routinely prescribed by ECPs for reusable daily wear, hydrogel materials are still frequently selected for the DD modality of contact lens wear. This article reviews the evidence to support the benefits of both a DD modality and SiH materials and how patients' needs may be met with SiH DD contact lenses, with respect to clinical performance, health outcomes, satisfaction, compliance and convenience.

Management of digital eye strain.

Digital eye strain, an emerging public health issue, is a condition characterised by visual disturbance and/or ocular discomfort related to the use of digital devices and resulting from a range of stresses on the ocular environment. This review aims to provide an overview of the extensive literature on digital eye strain research with particular reference to the clinical management of symptoms. As many as 90 per cent of digital device users experience symptoms of digital eye strain.

Retention Rates in New Contact Lens Wearers.

Purpose: To determine the retention rate (RR) for neophyte patients fitted with contact lenses (CLs) and to identify factors associated with retention and dropout.

Method: This multisite, sponsor-masked registry study evaluated the 1-year status of neophyte CL wearers fitted in a representative range of UK practices. A total of 26 UK investigational sites each recruited up to 89 neophyte patients.

Theoretical fitting characteristics of typical soft contact lens designs.

Purose: To calculate theoretical fitting success rates (SR) for a range of typical soft contact lens (SCL) designs using a mathematical model.

Method: A spreadsheet mathematical model was used to calculate fitting SR for various SCL designs. Designs were evaluated using ocular topography data from 163 subjects.

Inter-relationship of Soft Contact Lens Diameter, Base Curve Radius, and Fit.

Purpose: To evaluate the inter-relationship of soft contact lens base curve radius (BC), diameter, and lens fit using a mathematical model.

Methods: A spreadsheet mathematical model was used to evaluate theoretical fitting characteristics for various combinations of soft lens BC and diameter. The designs were evaluated using ocular topography data collected from 163 UK subjects.

Factors in the success of new contact lens wearers.

Purpose: To determine the first-year retention rate for patients fitted with contact lenses (CLs) and identify factors associated with retention and dropout.

Methods: This multi-site study was a retrospective chart review of the status of neophyte CL wearers fitted in representative UK eye care practices.

Results: Consecutive records for 524 patients at 29 sites were reviewed.

The Effect of Temperature on Soft Contact Lens Diameter.

Purpose: The diameters of soft contact lenses are conventionally measured at room temperature (RT), however, all soft lenses shrink when raised to eye temperature (ET). The purpose of this study was to evaluate RT to ET shrinkage in a representative sample of contemporary spherical soft contact lenses.

Methods: Twenty-four reusable and daily disposable lens types (10 hydrogel and 14 silicone hydrogel) in three powers were measured for total diameter at RT (20°C±1°C) and ET (34°C±1°C).

Demonstrating correction of low levels of astigmatism with realistic scenes.

Purpose And Method: Modern standard visual acuity tests are primarily designed as diagnostic tools for use during subjective refraction and normally bear little relation to real-world situations. We have developed a methodology to create realistic rendered scenes that demonstrate potential vision improvement in a relevant and engaging way. Low-cylindrical refractive error can be made more noticeable by optimizing the contrast and spatial frequencies, and by testing four different visual perception skills: motion tracking, pattern recognition, visual clutter differentiation and contrast sensitivity.

Resultant vertical prism in toric soft contact lenses.

Purpose: Rotational stability of toric soft contact lenses (TSCLs) is achieved using a range of designs. Designs utilising prism or peripheral ballast may result in residual prism in the optic zone. This study quantifies the vertical prism in the central 6mm present in TSCLs with various stabilisation methods.

Conjunctival UV autofluorescence--prevalence and risk factors.

Purpose: Autofluorescence of ultraviolet (UV) light has been shown to occur in localised areas of the bulbar conjunctiva, which map to active cellular changes due to UV and environmental exposure. This study examined the presence of conjunctival UV autofluorescence in eye care practitioners (ECPs) across Europe and the Middle East and its associated risk factors.

Method: Images were captured of 307 ECPs right eyes in the Czech Republic, Germany, Greece, Kuwait, Netherlands, Sweden, Switzerland, United Arab Emirates and the United Kingdom using a Nikon D100 camera and dual flash units through UV filters.

Clinical evaluation of fitting toric soft contact lenses to current non-users.

Purpose: To evaluate the ease with which astigmats from three groups of current non-wearers of toric contact lenses can be fitted with current toric soft lenses, and to determine toric lens-wearing success.

Methods: This was a 1-month, randomized, bilateral, open-label, daily wear study involving 200 subjects and 16 investigational sites in the UK. Three groups of astigmatic subjects aged from 16 to 60 and with a mean age of 36 years (67 spherical soft contact lens users, SW; 72 contact lens drop-outs, DO; and 61 neophytes, Neo) were fitted with one of two toric soft lens types: a daily disposable toric soft lens (1 Day Acuvue Moist for Astigmatism, Johnson & Johnson Vision Care) or a 2-weekly replacement, re-usable toric soft lens (Acuvue Oasys for Astigmatism, Johnson & Johnson Vision Care).

Prevalence of astigmatism in relation to soft contact lens fitting.

Purpose: To estimate the proportion of potential soft contact lens wearers requiring an astigmatic correction and to estimate the proportion of astigmats who can be accommodated with toric soft lenses of varying prescription range.

Method: A database of 11,624 spectacle prescriptions was used to calculate the prevalence of astigmatism for various thresholds (0.50-2.

Anomalies in the prescribing of soft contact lens power.

Objectives: To determine the proportion of prescribed soft lenses rounded to the nearest half diopter and any variations from country to country and between lens types.

Methods: Marketing data were obtained for soft lenses supplied during a 1-year period for lenses representing each of the following categories: mid-water hydrogel (MWH), silicone hydrogel, daily disposable, and toric silicone hydrogel (TSH). The data were analyzed for several countries/regions.