Research Update

Research Update Issue 17

May 2018

The eye care community is acknowledging the threat posed by the growing prevalence of myopia and its sequelae. An editorial in Ophthalmology invites stakeholders to collaborate and design a strategy to control myopia. Another review discusses optical and pharmacological interventions, and future research directions 

May 2018  
 
 
 
 

Welcome to our monthly research update
 
Research Update is a resource available exclusively to IACLE and BCLA members to support your teaching and practice. Each month we send you a summary of some of the interesting findings appearing in peer-reviewed journals that month. Our aim is to help you keep up to date with the latest contact lens and anterior eye research, and to locate articles when you want to know more about a particular topic.
 
More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.
 
 
 
Issue 17 – May 2018
 
The eye care community is acknowledging the threat posed by the growing prevalence of myopia and its sequelae. An editorial in Ophthalmology invites stakeholders to collaborate and design a strategy to control myopia. Another review discusses optical and pharmacological interventions, and future research directions.

We include a study that assesses how effective multifocal contact lenses are at removing foveal hyperopic defocus during binocular near viewing in young eyes. A Spanish group evaluates visual function in patients with irregular corneas fitted with scleral contact lenses. We report on a study that investigates the effect of soft contact lens modality and lens material on ocular surface physiology.

In this issue, we explore topics that are outside mainstream contact lenses yet very relevant to contact lens practice. A review article discusses the prevalence of and interventions for digital eye strain (DES). And finally, from the archives we include a useful report on smart phone assisted, slit lamp free anterior segment imaging.

For almost all of this month’s articles, we are able to supply full text. Happy reading!

The IACLE Education Team
 
 
 
Journals reviewed in this issue  
  JOURNAL VOLUME AND ISSUE NUMBER
  Ophthalmology 125:5
  Clinical and Experimental Optometry 101:3
  Optometry and Vision Science 95:5
  Eye & Contact Lens 44:3
  Contact Lens & Anterior Eye 41:3, 39:1
  BMJ Open Ophthalmology 3:1
 
 
 
 
 
 MYOPIA
 

Public health burden and potential interventions for myopia
In their editorial, Modjtahedi et al appeal to ophthalmologists and optometrists to determine a collaborative framework for myopia control. An estimated 1.406bn people in the world are myopic (22.9% of the population) and 163m have high myopia (2.7%). Uncorrectable visual impairment is seen in 4% of 75-year-olds with myopia and 39% with high myopia. There is also a tremendous economic impact, with a loss in global gross domestic product from uncorrected refractive error of around $202bn annually. Until we better refine our understanding of myopia, and interventions to lower its prevalence and severity, current interventions are readily available and inexpensive.

Ophthalmology 2018;125:5 628-630. Click here for full text

 
 
 
 
 
 MYOPIA
 

Optical and pharmacological strategies for myopia control
This review by Kang discusses the efficacy of various myopia control interventions and potential future research directions. Currently there are no guidelines for the selection of the ideal myopia control treatment for an individual child. The optimal age to start myopia control, and which treatment options are better suited to which children, is unknown. There are limited studies on the influence of ethnicity on treatments. To improve the efficacy of current myopia control treatments, the impact of combining two treatment options is being explored, including combining orthokeratology with atropine eye drops.

Clin Exp Optom 2018;101:3 321-332. Click here for full text

 
 
 
 
 
 MULTIFOCALS
 

Accommodation with multifocal contact lens designs
Altoaimi et al examined accommodative behavior of eight young adults fit bilaterally with an aspheric single-vision contact lens, and center-distance and center-near multifocal contact lenses (MFCL), to assess the effectiveness of these lenses at removing foveal hyperopic defocus during binocular near viewing. Young eyes fit with MFCLs incorporating significant transition zones accommodated to focus pupil regions between the near and distance optics, which resulted in less than optimal retinal image quality, and myopic or hyperopic defocus in either the pupil center or pupil margins. Convergence accommodation, as well as pupil size and zonal geometry, is likely to contribute to the final accommodative responses.

Optom Vis Sci 2018;95:5 416-427. Click here for abstract

 
 
 
 
 
 SCLERAL LENSES
 

Vision function in patients with irregular corneas
To assess visual function and patient satisfaction in patients with irregular corneas who did not tolerate gas permeable (GP) corneal lenses, Eguileor et al recruited 15 subjects (15 eyes) who were fitted with scleral GP lenses (Rose K2 XL). Visual function was assessed using visual acuity and the visual function index (VF-14). The VF-14 was used as an indicator of patient satisfaction. Both visual acuity and VF-14 improved after fitting with the scleral contact lenses. Also, patients used these scleral lenses for longer comfortable hours of wear than GP corneal lenses.

Eye & Contact Lens 2018;44:3 159-163. Click here for abstract

 
 
 
 
 
 PHYSIOLOGY
 

Replacement schedule and ocular surface physiology
In this longitudinal clinical trial, Sapkota et al investigated the effect of soft contact lens wearing modality and lens material on changes in conjunctival bulbar and limbal redness, conjunctival and corneal staining, and comfort. Forty-seven neophyte subjects were fitted with one of three monthly lenses in one eye and one of three daily disposable lenses in the other eye, randomly selected. Changes in ocular surface physiology and comfort score were similar with daily and monthly wear modalities. CL practitioners are advised to recommend lenses according to material characteristics rather than wearing modality.

Cont Lens Anterior Eye (2017); https://doi.org/10.1016/j.clae.2017.12.005. Click here for full text

 
 
 
 
 
 DIGITAL EYESTRAIN
 

DES: prevalence, measurement and amelioration
In this review, Sheppard and Wolffsohn discuss prevalence and interventions for digital eye strain (DES) including recent data and information on usage of digital devices, assessment techniques and management. Estimates suggest the prevalence of DES may be 50% or more among computer users. With ≥6h of computer use, CL wearers were more likely to be affected than non-wearers, with prevalence of 65% and 50% respectively. With high prevalence of DES and near-universal use of digital devices, it is important that the condition is considered by practitioners, and treatment options are supported by research evidence.

BMJ Open Ophth 2018;3:e000146. DOI:10.1136/bmjophth-2018-000146. Click here for full text

 
 
 
 
 
 PHOTOGRAPHY
 

The smart way to capture the anterior segment
Mohammadpour et al introduced a user-friendly technique to simplify anterior segment image capture with a smartphone that does not require a slit lamp or specialized training. A smart phone with resolution of at least 8 megapixel can be used by holding a 90D double aspheric lens manually or attaching by clear tape. Although slit-lamp images are more informative, this method is designed for situations where photo-documentation with slit lamp is not available, especially in rural areas in developing countries.

Cont Lens Anterior Eye 2016;39:1 80-81. Click here for full text

 
 
 
 
 
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