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Research Update

Welcome to our monthly Research Update, available exclusively to IACLE and BCLA members to support your teaching and practice.

Issue 42 – June 2020

Eye care and contact lens wear in the COVID-19 pandemic situation continue to be topics of interest for educators and practitioners worldwide. As the ocular surface is drawing attention as a potential site for infection, we begin this month’s issue with a review that explores its role. A team from the UK looks at telehealth as a way to provide contact lens services in the current situation. Another study evaluates what personal protective equipment eye care practitioners intend to use.

Returning to myopia, a review provides evidence-based information to manage myopic and pre-myopic children. A Chinese group investigates the possibility of predicting the progression of childhood myopia using short-term axial change after orthokeratology.

A group of researchers in France studies the risk factors for keratoconus. And finally, we include a paper that attempts to identify risk factors for microbial keratitis in contact lens wearers. 

Happy reading!!

The IACLE Education Team

JOURNALS

Journals reviewed in this issue:

Clinical & Experimental Optometry  Early view
Contact Lens & Anterior Eye  43:3
Ophthalmic & Physiological Optics  40:3
Eye & Contact Lens  46:3
Cornea  39:6

CORONAVIRUS

The ocular surface and COVID-19

Willcox et al reviewed 287 publications to examine whether the ocular surface is a site of infection with Coronavirus-2 (SARS-CoV-2) and is responsible for the coronavirus disease-19 (COVID-19). The review focuses on what is known about the ability of coronaviruses to adhere to ocular surface cells, the presence of coronaviruses at the ocular surface and the association of conjunctivitis with COVID-19. Current evidence suggests the virus is unlikely to bind to the ocular surface to initiate infection. Ocular manifestations such as conjunctivitis and presence of SARS-CoV-2 in tears have been found rarely, and primarily in people with confirmed, symptomatic COVID-19.

Clin Exp Optom 2020 May 13;DOI:10.1111/cxo.13088. Read the full text

Telehealth and contact lens services

Nagra et al discuss ways of offering remote patient screening in the context of contact lens practice. Telephone triage provides a useful starting point for establishing at-risk and emergency patients. While other health professions are transitioning to telehealth services, the absence of a comprehensive evidence base for tele-optometry limits eye care practitioners. Gaps in the research need to be addressed to facilitate development of optometry specific evidence-based guidance for telecare; specifically, advances in ocular self-imaging and its standardization.

Cont Lens Anterior Eye 2020;43:3 204-207.  Read the full text

Future use of PPE in optometry practice

To evaluate which personal protective equipment (PPE) eye care practitioners (ECPs) intend to use in light of the COVID-19 pandemic and what they plan on asking their patients to use in their clinical practices, Pult administered this social media survey to 257 optometrists and opticians from Germany, Austria and Switzerland. Most ECPs planned on continuing to use higher standards of PPE. Those who intended to wear masks themselves would also ask their patients to do so, combined with hand disinfection.

Cont Lens Anterior Eye 2020;43:3 208-210. Read the full text

MYOPIA

Where are we with myopia control?

Bullimore & Richdale conducted this review to provide practitioners with evidence-based information to fully manage myopia. They also address challenges to the implementation of commonly-employed myopia control modalities by clinicians and review the safety of the modalities. The authors recommend the management of children should be underpinned by the evidence-based literature and clinicians must stay alert to ongoing myopia research. The standard of care of myopic and pre-myopic children is expected to evolve.

Ophthalmic Physiol Opt 2020;40:3 254-270. Read the full text

Short term axial change after OK and myopia progression

Zhao et al designed this retrospective cohort study to investigate changes in axial length in children undergoing orthokeratology (OK) and evaluate short-term axial change in predicting post-OK myopia progression. Axial length changes of 70 myopic children at 0.5, 1, 2, and 3 years relative to the baseline were measured. The authors concluded that the half-year axial change can be used to predict long-term myopia development and can serve as a practical and valuable measurement to identify some aspects of rapid myopia progression.

Eye & Contact Lens 2020;46:3 136-140. Read the abstract

KERATOCONUS

Risk factors for keratoconus

To evaluate the risk factors associated with keratoconus in a case-control setting, Moran et al followed 202 patients with keratoconus and 355 controls in this prospective, single-centre, case-control study. Data on multiple variables were gathered, including eye rubbing, pattern of eye rubbing, dominant hand, allergies, history of dry eye, screen time, sleep position, and night-time work. The authors find a strong correlation between eye rubbing and keratoconus, particularly when rubbing is performed with the knuckles.

Cornea 2020;39:6 697-701. Read the abstract

INFECTIONS

Contact lenses and microbial keratitis

Sauer et al conducted this retrospective, multicentre, case-control study to identify risk factors for CL-related microbial keratitis (MK) involving a total of 2267 patients (1198 cases and 1069 controls). Risk factors for the daily disposable lenses group were exceeding the lens renewal period and occasionally wearing CLs when sleeping. The most important risk factors in the non-daily disposable lenses group were lens cleaning solution and failure to renew lens cases.

Cornea 2020;39:6 769-774. Read the abstract

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© International Association of Contact Lens Educators 2020

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