Research Update

Research Update Issue 6

June 2017  

Welcome to our monthly research update
Welcome to Research Update, a new resource available to IACLE and BCLA members to support your teaching and practice. Each month we will 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 6 – June 2017
Strategies to control the progression of myopia continue to be a focus for current research. In this issue, we take a look at the intriguing association between time spent outdoors and development of myopia, and also the efficacy vs adverse effects of atropine in myopic children.

With increasing interest in fitting children with soft contact lenses, we present a timely review of studies that estimate the incidence of corneal infiltrative events and microbial keratitis in children. Two studies look at other ocular responses to soft lens wear: changes to limbal topography and ocular surface inflammation. And finally we report on visual acuity and quality of life in dry eye disease.

Happy reading!

The IACLE Education Team
Journals reviewed in this issue  

  Acta Ophthalmologica Early view
  JAMA Ophthalmology 135:6
  Optometry & Vision Science 94:6
  Contact Lens & Anterior Eye Articles in Press
  The Ocular Surface 15:2

Outdoor time: role in myopia prevention and control
To evaluate the evidence for an association between time outdoors and risk of developing myopia, Xiong et al conducted a systematic review followed by a meta-analysis and a dose–response analysis of 25 relevant research papers. They found a significant protective effect of outdoor time for incident myopia. Increased time outdoors is effective in preventing the onset of myopia as well as in slowing the myopic shift in refractive error. However, outdoor time was not effective in slowing progression in eyes that were already myopic.

Acta Ophthalmol 2017; DOI: 10.1111/aos.13403. Click here for full text


Atropine in childhood myopia therapy
In this meta-analysis, to evaluate the efficacy vs adverse effects of various doses of atropine as myopia therapy in children, Gong et al included 19 studies (randomised clinical trials and cohort studies) that examined 3,137 children. All doses of atropine were equally beneficial with respect to myopia progression. High-dose atropine (0.5% to 1.0%) was associated with more adverse effects, such as a 43% incidence of photophobia, compared with 6% for low dose (0.01%) and 18% for moderate dose (>0.1% to <0.5%). The findings suggest that efficacy of atropine is dose independent, whereas the adverse effects are dose dependent.

JAMA Ophthalmol 2017; 135:6 624-630. Click here for abstract


Are soft contact lenses safe for children?
To estimate the incidence of corneal infiltrative events and microbial keratitis in soft lens wearers under the age of 18 years, Bullimore reviewed and summarized a broad range of studies including large-scale epidemiological studies, hospital-based case series, long- and short-term prospective studies, and multicenter retrospective studies. None of the nine prospective studies reported any cases of microbial keratitis. The incidence of corneal infiltrative events in children was found to be no higher than in adults, and in the age range of 8 to 11 years, it may be markedly lower.

Optom Vis Sci 2017;94:6 638-646 Click here for full text


Limbal changes following soft lens wear
Consejo et al conducted a prospective study to assess whether short-term soft contact lens (SCL) wear affects the anterior ocular surface. Twenty-two subjects were imaged using a corneo-scleral profilometer. Measurements were obtained without lens wear (baseline), immediately after lens removal following 5h of wear and 3h after lens removal. Six types of daily disposable CLs were considered. Short-term SCL wear significantly modified corneo-scleral limbal radius and the changes were repeatable. Assessing topographical limbus after CL wear could be a tool to optimize lens selection.

Cont Lens Anterior Eye 2017; DOI: Click here for full text


Measuring ocular surface inflammation
Chao et al reviewed non-invasive contemporary techniques for detecting inflammatory responses in SCL wearers. More than 1,500 proteins have been identified on the ocular surface and tear film. Among them, at least 25 inflammatory mediators can be detected in tears in healthy subjects. Tear analysis of inflammatory mediators is relatively less invasive and requires few collection and extraction procedures. Possible methods to collect tears include microcapillary tubes, Schirmer strips and microsponges. Apart from tear analysis, conjunctival cells have been used to assess the ocular surface inflammatory responses.

Cont Lens Anterior Eye 2017; DOI: Click here for full text


Visual acuity and quality of life in dry eye disease
This article by Benítez-del-Castillo et al was developed from a meeting of the OCEAN group. The effects of dry eye disease (DED) on visual acuity result in difficulties with driving, reading and computer use, and negatively impact psychological health. Patients with DED often have poor quality of life (QoL). This may be due to both the physical effects of DED, such as ocular discomfort, and decreased visual function. Clinicians should consider the impact of decreased visual function, which needs to be measured dynamically, and the impact on QoL.

Ocul Surf 2017;15:2 169-178. Click here for abstract

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