Search Results (13)

Our purpose is to evaluate the binocular contrast sensitivity function (CSF) in a presbyopic population and compare the results obtained with four different simultaneous-vision center-near multifocal contact lens (MCL) designs for distance vision under two illumination conditions. Additionally, chromatic CSF (red-green and blue-yellow) was evaluated. A randomized crossover pilot study was conducted. Four daily disposable lens designs, based on simultaneous-vision and center-near correction, were compared. The achromatic contrast sensitivity function (CSF) was measured binocularly using the CSV1000e test under two lighting conditions: room light on and off. Chromatic CSF was measured using the OptoPad-CSF test. Comparison of achromatic results with room lighting showed a statistically significant difference only for 3 cpd (p = 0.03) between the baseline visit (with spectacles) and all MCLs. Comparison of achromatic results without room lighting showed no statistically significant differences between the baseline and all MCLs for any spatial frequency (p > 0.05 in all cases). Comparison of CSF-T results showed a statistically significant difference only for 4 cpd (p = 0.002). Comparison of CSF-D results showed no statistically significant difference for all frequencies (p > 0.05 in all cases). The MCL designs analyzed provided satisfactory achromatic contrast sensitivity results for distance vision, similar to those obtained with spectacles, with no remarkable differences between designs. Chromatic contrast sensitivity for the red-green and blue-yellow mechanisms revealed some differences from the baseline that should be further investigated in future studies. Full article

Fetal alcohol spectrum disorder (FASD) encompasses a range of complex neurodevelopmental challenges that arise because of maternal alcohol use during pregnancy. Contrary to previous beliefs, FASD is a wide-ranging condition that is mostly invisible, affecting cognitive, social, and daily living skills. Furthermore, living with FASD may present other challenges, such as mental health issues, substance abuse, and engagement in criminal behavior. FASD is a long-term disability that requires support across the lifespan. The main objective of this research was to determine what, if anything, has changed since a prior review in 2020 of parents with FASD appearing in child intervention courts in Canada. We found eleven relevant reported cases throughout Canada from 2020 to 2024 where parents had a confirmed diagnosis or a potential FASD to be eligible for our study. Within these cases, only one parent was able to reunite with their children because of the strong and supportive system they had. There were four cases where ongoing contact between parent and child(ren) was permitted, Additionally, we found that professionals lack education regarding the potential skills that people with FASD may demonstrate. A person with FASD is seen through the lens of their diagnosis rather than a strengths-based approach, creating stigma, fear, and power imbalance. Stigma has an impact not just on how professionals see people and make decisions but also on policymakers, funding, and support from governments or other social groups. Individuals or parents with FASD are often reluctant to report their diagnosis for fear of being judged or having their children taken from their care. Thus, parents are unable to obtain access to services, and even when they do have access, they must navigate the system on their own. Parents with FASD who are involved in child intervention may be required to participate in many programs simultaneously, potentially resulting in an overwhelming experience. Full article

This article delves into the enduring self-governing nature of a traditional irrigation system in a rural community in Greece through the lens of the social–ecological system (SES) framework. The aim is to analyze the variables and interactions that have sustained this community-based governance structure over a century. This study underscores the critical role of social capital, where social networks and effective communication facilitate self-governance in the management of this common pool resource. The findings reveal how actors coordinate social and physical capital when performing daily activities, enabling them to collectively solve common dilemmas. By examining the institutional arrangements and operational dynamics of the irrigation system, the study illuminates the community-led social processes that drive its sustainability. This analysis enhances the understanding of the importance of integrating social and physical capital in governance through collective action to achieve resilience. This study provides insights into alternative pathways for building resilience and discusses an irrigation system as a communal autonomous space that prioritizes social equity, democratic decision-making, and social–ecological contacts. Full article

Background and Objectives: Dry eye disease (DED) affects 5–50% of the global population and deeply influences everyday life activities. This study compared the efficacy, tolerability, and safety of novel Respilac artificial tears containing lipidure and hypromellose (HPMC) with the widely used Nextal artificial tears, which are also HPMC-based, for the treatment of moderate DED in contact lenses (CL) wearers. Materials and Methods: In a prospective, single-center, randomized investigation, 30 patients aged ≥18 years, diagnosed with moderate DED, and wearing CL were randomly assigned to the Respilac (n = 15) or Nextal group (n = 15). Patients self-administrated one drop of Respilac or Nextal in both eyes three times daily for 21 days. Changes in the endpoint (visual analogue scale (VAS) score for ocular tolerability, symptom assessment in dry eye (SANDE) score, non-invasive first break-up time (NIF-BUT) results, tear analysis value, meibography results, and CL tolerability results were assessed, comparing treatment groups and time-point evaluations. Adverse events (AEs) were also recorded and evaluated. Results: VAS scores decreased with time (p < 0.001) in both groups, showing no statistically significant difference among them (p = 0.13). Improvements were also detected from screening to end-of-treatment, which were indicated by the SANDE scores for severity and frequency (p < 0.001) and by tear analysis results (p < 0.001) with no observed difference between the Nextal and Respilac arms. NIF-BUT, meibography, and CL tolerability values were shown to be non-significantly affected by treatment and time. There were no AEs detected in this study cohort. Conclusions: Respilac was confirmed to be effective, safe, and well-tolerated. Lipidure-based ophthalmic solution was shown not to be inferior to the currently used Nextal, however, showing improvements in DED symptoms. Within the existing literature, our study is one of the first to report that MPC plus HPMC-containing eye drops are an effective option for the treatment of moderate dry eye disease and desiccation damage prevention in contact lens wearers. Full article

The pre-lens tear film (PLTF) over (i) delefilcon A silicone hydrogel water gradient (WG; 33–80% from core to surface) contact lenses (CLs) (SHWG-CLs) and (ii) subjects’ own non-WG soft CLs (SCLs) (SO-SCLs) was studied in 30 eyes of 30 subjects to assess the hypothesized PLTF stabilization over SHWG-CLs. In both eyes, delefilcon A SHWG-CLs (DAILIES TOTAL1^®; Alcon, Fort Worth, TX, USA) or SO-SCLs were worn. After 15 min of wearing each lens, the tear meniscus radius (TMR, mm), lipid-layer interference grade (IG) and spread grade (SG), and non-invasive breakup time (NIBUT, seconds) were evaluated and compared between the SHWG-CLs and the SO-SCLs. The comparison between the SHWG-CL and SO-SCL groups (SHWG-CL and SO-SCL, mean ± SD) revealed that TMRs temporarily decreased and reached a plateau value after 15 min (0.21 ± 0.06; 0.21 ± 0.06) compared to the value prior to CL insertion (0.24 ± 0.08; 0.25 ± 0.08), with no significant difference between the two groups. The NIBUT, IG, and SG values after 15 min of wearing the CLs were (9.7 ± 3.7; 4.7 ± 4.2), (1.0 ± 0.2; 1.8 ± 1.0), and (1.1 ± 0.4; 1.9 ± 1.5), respectively, and all values were significantly better in the SHWG-CL group (p < 0.0001, p = 0.0039, and p < 0.0001, respectively). We found that compared to the SO-SCLs, the maintenance of the PLTF on the SHWG-CLs was supported by the thicker and more stable PLTF. Full article

The aim of this study was to explore the impact of dry eye disease (DED) on the uncorrected distance visual acuity (UDVA) and refractive status after small incision lenticule extraction (SMILE). This prospective cohort study enrolled 29 patients (DED group, 11 eyes; non-DED group, 18 eyes) who underwent SMILE in our center from July to September 2022. The examinations on DED, refractive status and UDVA were performed before surgery, and on day 7 and 20 after surgery. The results showed that on day 20 after SMILE, subjects in the non-DED group reported greater changes of ocular surface disease index value increase and tear-film breakup time reduction compared to baseline than those in the DED group (p < 0.001 and p = 0.048, respectively). Compared to preoperative status, DED patients had greater improvements of UDVA and better optometric outcomes on day 20 after surgery than non-DED subjects (p = 0.008 and 0.026, respectively). Multiple linear regression analysis showed age, contact lens daily wearing time, and tear meniscus height before surgery were of the highest value to predict UDVA on day 20 after SMILE in contact lens wearers (p = 0.006, 0.010 and 0.043, respectively). In conclusion, preoperative tear function could affect UDVA after SMILE. The impact of DED on UDVA and refraction should be taken into consideration before surgery. Full article

Although microplastics (MPs) are intrinsically toxic and function as vectors for organic micropollutants, their discharge from wastewater treatment plant effluents and human activity remains unknown owing to the limitations of detection and treatment technologies. It is imperative to quantify MPs from human activities involving the consumption of various plastic products. This study warns that contact lenses can generate MPs and nanoplastics (NPs) after being discharged into aquatic environments. Identification via micro-Fourier transform infrared spectroscopy revealed that the fragmented particles (from a few tens to a few hundred micrometres) could not be detected as poly(2-hydroxyl methacrylate), the component of contact lenses, owing to changes in its chemical properties. After the degradation process, the median size of the contact lens particles decreased from 313 to 85 µm. Approximately 300,600 g of contact lens waste is discharged into sewage systems daily in the United States of America (USA), where 45 million people wear contact lenses and throw away one-fifth of them every day. Contact lens waste (1 g) has the potential to release 5653.3–17,773.3 particles of MPs. This implies that the currently reported MP amounts in the environmental matrix exclude significant amounts of MPs and NPs from discharged contact lenses. The identification method should be examined, and a registration of the disposal process should be established. Full article

To evaluate pre-lens tear film volume, stability and lipid interferometry patterns with a silicone hydrogel water content contact lens, a novel, noninvasive, ocular-surface-analyzer technology was used. A prospective, longitudinal, single-center, self-control study was performed in daily or monthly replacement silicone hydrogel contact lens wearers. A tear film analysis was achieved with the Integrated Clinical Platform (ICP) Ocular Surface Analyzer (OSA) from SBM System. The subjects were reassessed, with the contact lens, after 30 min of wearing to quantify the volume, stability and lipid pattern of the short-term pre-lens tear film. Lipid layer thickness decreased from 2.05 ± 1.53 to 1.90 ± 1.73 Guillon patterns (p = 0.23). First pre-lens NIBUT decreased from 5.03 ± 1.04 to 4.63 ± 0.89 s (p = 0.01). Mean pre-lens NIBUT significantly increased from 15.19 ± 9.54 to 21.27 ± 11.97 s (p < 0.01). Lid opening time significantly increased from 26.36 ± 19.72 to 38.58 ± 21.78 s (p < 0.01). The silicone hydrogel contact lens with water gradient technology significantly increased the mean pre-lens NIBUT and lid opening time. Lehfilcon A suggested an improvement in contact lens wearers with tear film instability or decreased subjective symptoms of dry eye disease. Full article

Background: Determine whether the presence of ocular symptoms in soft-contact-lens wearers changes depending on the refractive status. Methods: During the months of January to March 2022, the CLDEQ-8 questionnaire was administered to soft-contact-lens wearers. The statistical analysis was carried out using the SPSS 27.0 computer program (SPSS Inc., Chicago, IL, USA). Results: A total of 251 subjects participated in the study, with a higher percentage of myopes than hyperopes (82.1% versus 16.7%; p < 0.001). Out of all total participants, 21.5% suffered from dry-eye symptoms. It was noted that hyperopes presented a higher rate of dry-eye symptoms (p = 0.041). At the same time, the spherical equivalent was more positive in the participants with dry-eye symptoms (p = 0.014). Significant differences were found based on the symptoms present with contact lenses and the degree of myopia. The intensity of visual disturbances was higher in the participants with medium myopia (median [IQR]: 1/5 [2]) compared to those with low (median [IQR]: 0/5 [2]) and high myopia (median [IQR]: 0/5 [1]) (p = 0.009). Conclusions: Contact-lens wearers with hyperopia showed a higher rate of ocular dryness than those with myopia. In turn, wearing daily-replacement lenses could be one of the reasons for the lesser presence of ocular dryness compared to monthly-replacement lenses. Full article

Dry eye disease (DED) is difficult to detect in young contact lens (CL) wearers, who usually have no signs, mild symptoms and an ocular surface disease index (OSDI) below the DED diagnosis values (OSDI ≥ 13). We investigate if some of the 12 OSDI questions (OSDI A—ocular symptoms; OSDI B—vision-related functionality; OSDI C—environmental triggers) contribute the most to classify young CL as symptomatic. TBUT and tear volume are also measured. Age, gender and refraction error-matched eye glasses (EG) wearers participated as the control. CL and EG data were compared with t-test and z-test. Confusion matrices and logistic correlation analyses were performed to define the contribution of each OSDI question to classify symptomatic subjects. OSDI classified symptomatic CL better than the tear volume or TBUT values. In CL, only OSDI B and C values were significantly higher in symptomatic vs. asymptomatic subjects (p < 0.001), while values of all twelve OSDI questions were significantly higher in symptomatic vs. asymptomatic EG (p < 0.05–0.001). All OSDI questions contribute equally to identify symptomatic EG, while only OSDI B questions on daily life visual functions are significant to classify symptomatic CL wearers at risk to develop DED or at a subclinical stage. CL wearers scoring ≥ 2 on the OSDI B questions should be considered for preventive treatments, even if their clinical sings are scarce or absent. Full article

Microbial keratitis (MK) is an eye infection caused by opportunistic bacteria or fungi, which may lead to sight-threatening corneal ulcers. These microorganisms can be introduced to the eye via improper contact lens usage or hygiene, or ineffective multipurpose solutions (MPSs) to disinfect daily wear contact lenses. Thus, the patient’s choice and use of these MPSs is a known risk factor for the development of MK. It is then critical to determine the efficacy of popular MPSs against ubiquitous ocular microorganisms. Therefore, we compare the efficacy of nine major MPSs on the global market against four different microorganism species, and with four different common contact lenses. In accordance with International Standards Organization protocol 14729 and 18259, the microorganisms were inoculated into each MPS with and without contact lenses, and held for the manufacturer’s disinfection time, 24 h, and 7 days after challenge with Serratia marcescens or Fusarium spp. Plates were incubated for 2–7 days and plate counts were conducted to determine the number of surviving microorganisms. The majority of MPSs demonstrated significantly higher disinfection efficacies without contact lenses. Broadly, among the microorganisms tested, the OPTI-FREE products (Puremoist, Express, and Replenish) maintained the highest disinfection efficacies at the manufacturer’s stated disinfection time when paired with any contact lens, compared with other MPSs. These were followed closely by RevitaLens and renu Advanced. MPSs containing dual biocides polyquaternium-1 and myristamidopropyl dimethylamine possessed the highest disinfection efficacy against multiple ocular pathogens. Full article

The wettability of silicone hydrogel (SiHy) contact lens (CLs) is crucial for the pre-lens tear film stability throughout the day. Therefore, sessile drop and captive bubble setups were used to study the advancing and receding water contact angles (CA) of four SiHy materials: narafilcon A (TE), senofilcon A (AOD), stenfilcon A (MD), and delefilcon A (DT). TE and AOD have 48% and 38% water content, respectively, and no surface coating. MD (54% water) implements “smart chemistry” with just 4.4% bulk silicone content, while DT has >80% water at its surface. These SiHy were subjected to continuous blink-like air exposure (10 s)/rehydration (1s) cycles for 0, 1, 2, 3, 4, 6, 8, 10, 12, 14, and 16 h. The advancing CA, which measures the rehydration propensity of the CL surface, proved to be the most sensitive parameter to discriminate between the samples. The order of performance for the entire time scale was DT > MD >> AOD ≥ TE. The extended desiccation/rehydration cycling increased the differences between the CA of DT and MD compared to AOD and TE. This suggests that the low Si surface content and the high surface hydration are major determinants of SiHy wettability. Full article

Patients of diabetes mellitus urgently need noninvasive and continuous glucose monitoring in daily point-of-care. As the tear glucose concentration has a positive correlation with that in blood, the hydrogel colloidal crystal integrated into contact lens possesses promising potential for noninvasive monitoring of glucose in tears. This paper presents a new glucose-responsive sensor, which consists a crystalline colloidal array (CCA) embedded in hydrogel matrix, attached onto a rigid gas permeable (RGP) contact lens. This novel sensing lens is able to selectively diffract visible light, whose wavelength shifts between 567 and 468 nm according to the alternation of the glucose concentration between 0 and 50 mM and its visible color change between reddish yellow, green, and blue. The detection limit of responsive glucose concentration can be reduced to 0.05 mM. Its combination with a contact lens endows it with excellent biocompatibility and portability, which shows great possibility for it to push the development of glucose-detecting devices into new era. Full article