Contact Lens Prescribing Patterns in a University Clinic in Trinidad and Tobago
, Kingsley Kene Ekemiri 1, Gabrielle Nora Harbajan 1, Anesha Cameisha Crooks 1, Danquah Douglas 3, Alex Azuka Ilechie 3 and Khathutshelo Percy Mashige 2
Round 1
Reviewer 1 Report
I find this paper interesting and provide valuable information on the use of contact lenses.
Author Response
Response to reviewer’s comments
We are grateful for the helpful feedback by the reviewers that helped us improve the quality of the manuscript. We carefully responded to all points and have modified the manuscript accordingly.
Reviewer 1: No comments to change
Author Response File: 
Author Response.pdf
Reviewer 2 Report
The manuscript design and outline seem fine. However, my concern is novelty and interest in this work. I would suggest the authors relate their key research findings with international or even regional prescribing patterns for contact lens uses.
Author Response
Response to reviewer’s comments
We are grateful for the helpful feedback by the reviewers that helped us improve the quality of the manuscript. We carefully responded to all points and have modified the manuscript accordingly.
Reviewer 2: The manuscript design and outline seem fine. However, my concern is novelty and interest in this work. I would suggest the authors relate their key research findings with international or even regional prescribing patterns for contact lens uses.
Response to reviewers’ comments
There is no record of any contact lens prescribing pattern in the region. However, the key findings were related and compared with the reported international contact lens prescribing pattern (see line 125 to 196).
Author Response File: Author Response.pdf
Reviewer 3 Report
Thank you for this interesting article that audits contact lens fitting patterns at the UWI Contact Lens Clinic.
The paper is well-written, and the audit process completed and analysed very well. I have only two comments:
Table 1 – there is a formatting issue within the age group section – 21-40(155)??
Conclusion – what are the next steps? Perhaps you could next do a survey of practitioners or patients to discover why there is the preference towards daily disposable? Are there are barriers for practitioners in what they prescribe? Or for patients, what motivates them to use contact lenses – is there a difference between male/female? These are just some suggestions, but it would be good to show what possible studies could come next.
Author Response
Response to reviewer’s comments
We are grateful for the helpful feedback by the reviewers that helped us improve the quality of the manuscript. We carefully responded to all points and have modified the manuscript accordingly.
Reviewer 3:
Table 1 – there is a formatting issue within the age group section – 21-40(155)??
Response
The table has been formatted (see Table 1).
Reviewers ‘comment
Conclusion – what are the next steps? Perhaps you could next do a survey of practitioners or patients to discover why there is the preference towards daily disposable? Are there are barriers for practitioners in what they prescribe? Or for patients, what motivates them to use contact lenses – is there a difference between male/female? These are just some suggestions, but it would be good to show what possible studies could come next.
Response
The recommendation has been added to the conclusion as suggested to read: Further steps would be to assess contact lens practitioners and wearers reason for prefer-ring soft contact lens over RGP and barriers for not prescribing RGP contact lenses (see line 216 to 218).
Author Response File: Author Response.pdf
Reviewer 4 Report
The manuscript presents many areas of the writing that require corrections and further clarity.
Below are highlighted some critical points useful to improve the draft of this article:
SPECIFIC COMMENTS:
ABSTRACT:
Page 1 raw 13: It is recommended to change “Pearson χ2“ with “Pearson's chi-squared test”
Page 1 raw 14: It is recommended to change “lemeshow “ with “Lemeshow”
Page 1 raw 15: It is recommended to change “lemeshow “ with “Lemeshow”
Page 1 raw 18: It is recommended to change “most wearers“ with “about half”
Page 1 raw 18: It is recommended to change “most wearers“ with “about half of the wearers”
Page 1 raw 19: It is not clear if “Conventional” is referred to frequency of replacement
of contact lens fitted
Page 1 raw 24: It is recommended to change “Contact lens “ with “soft contact lens, rigid gas permeable (RGP) contact lens”
Page 1 raw 24: It is recommended to change “pattern “ with “trend”
Page 1 raw 24: It is recommended to remove “and” before “Tobago”
DATA ANALYSIS
Page 2 raw 71: It is recommended to change “Pearson χ2“ with “Pearson's chi-squared test”
Page 2 raw 74: It is recommended to remove one of two brackets “((“
Page 2 raw 75: It is recommended to change “Pearson χ2“ with “Pearson's chi-squared test”
Page 2 raw 79: It is recommended to change “lemeshow “ with “Lemeshow”
RESULTS
Page 2 raw 80: It is recommended to change “40“ with “41”
Page 2 raw 92: It is recommended to change “Hard“ with “RGP”
Page 2 raw 92: It is recommended to change “standard“ with “corneal”
Page 2 raw 92: It is recommended to change “ok lenses“ with “for orthokeratology”
Page 3 raw 100: It is recommended to remove “Boston” maintaining just “multipurpose care solutions”
Page 3 from raw 100 to raw 105: It is suggested to review this part of this contents have already been presented from row 85 to row 91
Page 3 raw 105: It is recommended to add “ ’s” after “Parson”
Page 3 raw 105: It is recommended to add “ ’s” after “Parson”
Page 3 raw 110 and 111: It is not clear the meaning of “non-hydrogel” is this referred to silicone-hydrogel materials?
Page 3 raw 116: It is recommended to change “hard“ with “RGP”
Page 3 table 2: It is recommended to change “hard“ with “RGP”
Page 4 table 3: it is suggested to split “non-spherical frequency” in “toric” and “multifocal” frequencies
Page 4 raw 116: It is recommended to change “Homeshow “ with “Hosmer”
DISCUSSION
Page 5 from raw 149 to raw 151: It is recommended to move the following sentence “Despite the current market popularity of silicone hydrogels contact lenses and RGP, conventional hydrogel lenses still represent a significant proportion of the contact 150 lenses in the global market [9].” after raw 147. It is also suggested to delete RGP in the sentence.
Page 5 raw 154: It is suggested to include “corneal” after “RGP”
Page 5 from raw 160 to raw 161: It is recommended to change “a complicated“ with “no”
LIMITATIONS
Page 6 raw 211: It is recommended to remove “bias“
Page 6 raw 211: It is recommended to remove “bias“ after “selection and information”
Page 6 raw 211: It is recommended to remove “bias“
CONCLUSIONS
Page 6 raw 221: It is recommended to remove “conventional“
Page 6 raw 223: It is not clear if the term “toric” is related to “soft” or “RGP” lenses
Page 6 raw 223: It is recommended to change “rigid“ with “RGP”
Author Response
Response to reviewer’s comments
We are grateful for the helpful feedback by the reviewers that helped us improve the quality of the manuscript. We carefully responded to all points and have modified the manuscript accordingly.
Reviewer 4
ABSTRACT:
Reviewers’ comment
Page 1 raw 13: It is recommended to change “Pearson χ2“ with “Pearson's chi-squared test”
Response
Pearson χ2 has been changed to Pearson's chi-squared test as suggested (see line 13).
Reviewers’ comment
Page 1 raw 14: It is recommended to change “lemeshow “ with “Lemeshw”
Response
lameshow has been changed to Lameshow (see line 14).
Reviewers’ comment
Page 1 raw 15: It is recommended to change “lemeshow “ with “Lemeshow”
Response
lameshow has been changed to Lameshow (see line 16)
Reviewers’ comment
Page 1 raw 18: It is recommended to change “most wearers“ with “about half”
Response
Most wearers have been changed to about half (see line 18).
Reviewers’ comment
Page 1 raw 18: It is recommended to change “most wearers“ with “about half of the wearers”
Response
Most wearers have been changed to about half of the wearers (see line 18).
Reviewers’ comment
Page 1 raw 19: It is not clear if “Conventional” is referred to frequency of replacement
of contact lens fitted
Response
The statement has been modified to read: Conventional soft CL were the most prescribed modality of wear accounting for 129 (53.1%) of the fits (see line 20).
Reviewers’ comment
Page 1 raw 24: It is recommended to change “Contact lens “ with “soft contact lens, rigid gas permeable (RGP) contact lens”
Response
Contact lens has been changed to soft contact lens and rigid gas permeable contact lens as suggested (see line 24).
Reviewers’ comment
Page 1 raw 24: It is recommended to change “pattern “ with “trend”
Response
Pattern has been changed to trend (see line 24).
Reviewers’ comment
Page 1 raw 24: It is recommended to remove “and” before “Tobago”
Response
And has been removed before Tobago (see line 24).
Reviewers’ comment
DATA ANALYSIS
Page 2 raw 71: It is recommended to change “Pearson χ2“ with “Pearson's chi-squared test”
Response
Pearson χ2 has been changed to Pearson's chi-squared test across board. (see line 73).
Reviewers’ comment
Page 2 raw 74: It is recommended to remove one of two brackets “((“
Response
The bracket has been removed (see line 73).
Reviewers’ comment
Page 2 raw 75: It is recommended to change “Pearson χ2“ with “Pearson's chi-squared test”
Response
Pearson χ2 has been changed to Pearson's chi-squared test across board (see line 73).
Reviewers’ comment
Page 2 raw 79: It is recommended to change “lemeshow “ with “Lemeshow”
Response
lameshow has been changed to Lameshow (see line 77).
Reviewers’ comment
RESULTS
Page 2 raw 80: It is recommended to change “40“ with “41”
Response
40 has been changed to 41 (see line 84).
Reviewers’ comment
Page 2 raw 92: It is recommended to change “Hard“ with “RGP”
Response
Hard has been changed to RGP (see line 88).
Reviewers’ comment
Page 2 raw 92: It is recommended to change “standard“ with “corneal”
Response
Standard has been changed to corneal (see line 88).
Reviewers’ comment
Page 2 raw 92: It is recommended to change “ok lenses“ with “for orthokeratology”
Response
Ok lenses have been changed to orthokeratology (see line 89).
Reviewers’ comment
Page 3 raw 100: It is recommended to remove “Boston” maintaining just “multipurpose care solutions”
Response
Boston has been removed (see line 96).
Reviewers’ comment
Page 3 from raw 100 to raw 105: It is suggested to review this part of this contents have already been presented from row 85 to row 91
Response
Raw 100 to raw 105 has been reviewed and the repeated sentences deleted (see line 97 to 100).
Reviewers’ comment
Page 3 raw 105: It is recommended to add “ ’s” after “Parson”
Response
S has been added after Pearson across board in the manuscript (see line 97).
Reviewers’ comment
Page 3 raw 105: It is recommended to add “ ’s” after “Parson”
Response
S has been added after Pearson across board in the manuscript (see line 97).
Reviewers’ comment
Page 3 raw 110 and 111: It is not clear the meaning of “non-hydrogel” is this referred to silicone-hydrogel materials?
Response
It has been clarified to read as: silicon hydrogel material lenses and non-silicon hydrogel material lenses (see line 102).
Reviewers’ comment
Page 3 raw 116: It is recommended to change “hard“ with “RGP”
Response
Hard has been changed to RGP
Reviewers’ comment
Page 3 table 2: It is recommended to change “hard“ with “RGP”
Response
Hard has been changed to RGP (see line 107).
Reviewers’ comment
Page 4 table 3: it is suggested to split “non-spherical frequency” in “toric” and “multifocal” frequencies
Response
It will be difficult to split them because some of the multifocal lenses were spherical. Hence, they were classified as spherical and non-spherical.
Reviewers’ comment
Page 4 raw 116: It is recommended to change “Homeshow “ with “Hosmer”
Response
Homeshow has been changed to Hosmer (see line 115).
Reviewers’ comment
DISCUSSION
Page 5 from raw 149 to raw 151: It is recommended to move the following sentence “Despite the current market popularity of silicone hydrogels contact lenses and RGP, conventional hydrogel lenses still represent a significant proportion of the contact 150 lenses in the global market [9].” after raw 147. It is also suggested to delete RGP in the sentence.
Response
The sentence has been moved and RGP deleted as suggested (see line 139 to 141).
Reviewers’ comment
Page 5 raw 154: It is suggested to include “corneal” after “RGP”
Response
Corneal has been added after RGP (see line 144).
Reviewers’ comment
Page 5 from raw 160 to raw 161: It is recommended to change “a complicated“ with “no”
Response
a complicated has been changed to ‘’no’’ as suggested (see line 149).
Reviewers’ comment
LIMITATIONS
Page 6 raw 211: It is recommended to remove “bias“
Response
Bias has been removed (see line 199).
Reviewers’ comment
Page 6 raw 211: It is recommended to remove “bias“ after “selection and information”
Response
Bias has been removed after selection (see line 200).
Reviewers’ comment
Page 6 raw 211: It is recommended to remove “bias“
Response
Bias has been removed (see line 200).
Reviewers’ comment
CONCLUSIONS
Page 6 raw 221: It is recommended to remove “conventional“
Response
Conventional has been removed (see line 211).
Reviewers’ comment
Page 6 raw 223: It is not clear if the term “toric” is related to “soft” or “RGP” lenses
Response
The statement has been modified to read: The use of toric soft and RGP lenses (see line 211 to 212).
Reviewers’ comment
Page 6 raw 223: It is recommended to change “rigid“ with “RGP”
Response
rigid has been changed to RGP (see line 212).
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
The authors have adequately addressed the comments.
Author Response
Response to reviewer 2 comments round 2
We are grateful for the helpful feedback by the reviewers that helped us improve the quality of the manuscript. We carefully responded to all points and have modified the manuscript accordingly.
There was no specific suggestion as to what to change or modify in the introduction. However, the introduction and conclusion have been improved (see line 28 to 50 and 213 to 222).
Reviewer 4 Report
The authors updated the article considering the information provided previously.
There are still a few corrections to be made as follows:
line 106: It is recommended to include a space between 120 and (49.4%)
line 110: It is recommended to include a space between 24 and (9.8%)
line 123: It is recommended to change “non-Hydrogel“ with “silicone-hydrogel”
line 124: It is recommended to change “Prescribing rates of silicon hydrogel material lenses and non-silicon hydrogel material “with “Prescribing rates of contact lens in hydrogel and silicon-hydrogel materials”
table 1 heading: It is recommended to include CL after “hydrogel”
table 1 heading: It is recommended to change “ non-hydrogel” with “silicone-hydrogel CL”
table 2 heading: It is recommended to change “ hard” with “RGP”
table 3 heading: It is recommended to include CL after “non-spherical”
line 145: It is recommended to change “and” with “-“ between “Hosmer and Lemeshow” and “Cox and Snell”
line 157: It is recommended to change “ SiHy” with “silicone-hydrogel”
line 160: It is recommended to change “ SiHy” with “silicone-hydrogel”
line 244-245: It is recommended to change “soft contact lens over RGP” with “soft over RGP contact lenses”
Author Response
Reviewers’ comments
We are grateful for the helpful feedback by the reviewers that helped us improve the quality of the manuscript. We carefully responded to all points and have modified the manuscript accordingly.
Reviewer’s comment
Line 106: It is recommended to include a space between 120 and (49.4%)
Response
A space has been included between 120 and (49.4%) (See line 92).
Reviewer’s comment
Line 110: It is recommended to include a space between 24 and (9.8%)
Response
A space has been included between 24 and (9.8%) (See line 96).
Reviewer’s comment
Line 123: It is recommended to change “non-Hydrogel“with “silicone-hydrogel”
Response
Non-Hydrogel has been changed to silicone-hydrogel (See line 104).
Reviewer’s comment
Line 124: It is recommended to change “Prescribing rates of silicon hydrogel material lenses and non-silicon hydrogel material “with “Prescribing rates of contact lens in hydrogel and silicon-hydrogel materials”
Response
Prescribing rates of silicon hydrogel material lenses and non-silicon hydrogel material has been changed to Prescribing rates of contact lens in hydrogel and silicon-hydrogel materials as suggested (See line 106).
Reviewer’s comment
Table 1 heading: It is recommended to include CL after “hydrogel”
Response
CL has been included after hydrogel in table 1 (See Table 1).
Reviewer’s comment
Table 1 heading: It is recommended to change “non-hydrogel” with “silicone-hydrogel CL”
Response
non-hydrogel” has been changed with “silicone-hydrogel CL” (See Table 1).
Reviewer’s comment
Table 2 heading: It is recommended to change “hard” with “RGP”
Response
Hard has been changed to RGP (See Table 2).
Reviewer’s comment
Table 3 heading: It is recommended to include CL after “non-spherical”
Response
CL has been included after non-spherical (See Table 3).
Reviewer’s comment
Line 145: It is recommended to change “and” with “-“between “Hosmer and Lemeshow” and “Cox and Snell”
Response
‘’And” has been removed as suggested (See line 125).
Reviewer’s comment
Line 157: It is recommended to change “SiHy” with “silicone-hydrogel”
Response
SiHy” has been changed to silicone-hydrogel” (See line 137).
Reviewer’s comment
Line 160: It is recommended to change “SiHy” with “silicone-hydrogel”
Response
SiHy” has been changed to silicone-hydrogel” (See line 140).
Reviewer’s comments
Line 244-245: It is recommended to change “soft contact lens over RGP” with “soft over RGP contact lenses”
Response
Soft contact lens over RGP” has been changed with “soft over RGP contact lenses” (See line 221).
Author Response File: Author Response.pdf
