Modulating Contact Lens Discomfort With Anti-Inflammatory Approaches: A Randomized Controlled Trial

Downie, Laura E; Gad, Anne; Wong, Christine; Gray, John Henry V; Zeng, Weiguang; Jackson, David C.; Vingrys, Algis J.

doi:10.1167/iovs.18-24758

Cited by 32 publications

(31 citation statements)

References 52 publications

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“…However, as other studies have shown that the beneficial effects of using eye drops may not manifest until several months following treatment [233], it may be that the two-week length of the trial was insufficient to see any potential effects. A three month trial of a topical drop omega-3 formulation (Remogen Omega; TRB Chemedica International SA, Vouvry, Switzerland) (marketed as a non-preserved lubricant) found no significant change in CLEDQ-8 or NISDT (termed noninvasive tear film stability on the contact lens surface) score compared to participants orally ingesting a placebo [235].…”

Section: Rewetting Dropsmentioning

confidence: 99%

BCLA CLEAR - Contact lens wettability, cleaning, disinfection and interactions with tears

Willcox

Keir

Maseedupally

et al. 2021

Contact Lens and Anterior Eye

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Contact lens materials have undergone significant changes over the past 20 years, particularly with respect to the introduction of silicone hydrogel materials. Whilst this development addressed hypoxic issues, other important areas relating to contact lens success, notably comfort, require further research.Contact lens wettability remains a crucially important part of biocompatibility. Contact lenses can be made more wettable by incorporation of surfactants into blister packs, internal wetting agents, surface treatments or care solutions. However, there remains no clear association between contact lens wettability and comfort, making it challenging to determine the potential for these approaches to be of significant clinical benefit. Most contact lenses are used on a daily wear, reusable basis, which requires them to be disinfected when not worn. The ideal disinfecting solution would also improve comfort during wear. However, balancing these requirements with other factors, including biocompatibility, remains a challenge. Soft lens materials invariably take up and subsequently release certain components of disinfecting solutions onto the ocular surface. This may affect tear film stability and the normal ocular microbiome, and further research is needed in this area to determine whether this has any affect on comfort. Finally, contact lens materials sorb components of the tear film, and these interactions are complex and may change the biochemistry of the tear film, which in turn may affect their comfort.In conclusion, the interaction between lens materials, tear film and disinfection solution plays an important role in the biocompatibility of lenses. However, the exact role and whether this can be altered to improve biocompatibility and comfort during wear remains debatable. This report summarises the best available evidence to examine this complex relationship and the opportunities for practitioners to enhance in-eye comfort of contemporary lenses, along with providing suggestions for areas of study that may provide further information on this topic.

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Section: Rewetting Dropsmentioning

confidence: 99%

BCLA CLEAR - Contact lens wettability, cleaning, disinfection and interactions with tears

Willcox

Keir

Maseedupally

et al. 2021

Contact Lens and Anterior Eye

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“…Lid hygiene such as warm compresses and lid scrubs [380], commercial eyelid wipes [453], warming masks [471] and microblepharon exfoliation of the eyelids [472], as well as a liposomal spray when applied to the upper eyelids [428] have also shown varying degrees of success for improving symptoms of CLD. Furthermore, oral supplementation with fish oil also improved comfort [468].…”

Section: Managementmentioning

confidence: 95%

“…Numerous management options for CLD are available. The mainstay of treatment options are rewetting drops including saline [461,462], hypo-osmotic saline [463], aqueous-based [362,462,[464][465][466], lipid-based [362,419,465,467,468] and povidone [453] eye drops. Increasingly, eye drops with anti-inflammatory properties including Manuka honey [464] and lifitigrast 5% [469] instilled twice daily (before and after lens wear) and 2% rebamipide [470] instilled four times daily with contact lenses in situ, are being utilised.…”

Section: Managementmentioning

confidence: 99%

BCLA CLEAR - Contact lens complications

Stapleton

Bakkar

Carnt

et al. 2021

Contact Lens and Anterior Eye

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Contact lens-related complications are common, affecting around one third of wearers, although most are mild and easily managed. Contact lenses have well-defined anatomical and physiological effects on the ocular surface and can result in other consequences due to the presence of a biologically active material. A contact lens interacts with the tear film, ocular surface, skin, endogenous and environmental microorganisms, components of care solutions and other antigens which may result in disease specific to contact lens wear, such as metabolic or hypersensitivity disorders. Contact lens wear may also modify the epidemiology or pathophysiology of recognised conditions, such as papillary conjunctivitis or microbial keratitis. Wearers may also present with intercurrent disease, meaning concomitant or pre-existing conditions unrelated to contact lens wear, such as allergic eye disease or blepharitis, which may complicate the diagnosis and management of contact lens-related disease.Complications can be grouped into corneal infection (microbial keratitis), corneal inflammation (sterile keratitis), metabolic conditions (epithelial: microcysts, vacuoles, bullae, tight lens syndrome, epithelial oedema; stromal: superficial and deep neovascularisation, stromal oedema [striae/folds], endothelial: blebs, polymegethism/ pleomorphism), mechanical (corneal abrasion, corneal erosion, lens binding, warpage/refractive error changes; superior epithelial arcuate lesion, mucin balls, conjunctival epithelial flaps, ptosis, discomfort), toxic and allergic disorders (papillary conjunctivitis, solution-induced corneal staining, incomplete neutralisation of peroxide, Limbal Stem Cell Deficiency), tear resurfacing disorders/dry eye (contact lens-induced dry eye, Meibomian gland dysfunction, lid wiper epitheliopathy, lid parallel conjunctival folds, inferior closure stain, 3 and 9 o'clock stain, dellen, dimple veil) or contact lens discomfort. This report summarises the best available evidence for the classification, epidemiology, pathophysiology, management and prevention of contact lensrelated complications in addition to presenting strategies for optimising contact lens wear.

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“…Benefits to tear film stability, increased tear secretion and a reduction in DED symptoms have been noted with short‐term consumption, as little as 30 days . Contact lens discomfort as well as interleukin‐17 and interleukin‐6 levels have also been shown to be decreased with oral and topical omega‐3 supplementation, at a level comparable to that effected by topical corticosteroid use . While the balance of evidence is in favour of benefits from omega‐3 supplementation, a year‐long supplementation with a fish‐derived omega‐3 was found to show no significant difference in symptoms of DED according to the ocular surface disease index score relative to a high‐dose olive oil placebo, and more studies evaluating the optimal dosage and duration of treatment from interventions for dry eye, based on the anti‐inflammatory effects of omega‐3, are warranted …”

Section: Effect Of Treatments For Dry Eye Diseasementioning

confidence: 99%

Molecular evidence for the role of inflammation in dry eye disease

Ganesalingam

Ismail

Sherwin

et al. 2019

Clinical and Experimental Optometry

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Ocular surface inflammation is propagated by a complex series of molecular processes and has been implicated in the pathogenesis of dry eye disease (DED), either as a causal or a downstream effect of ocular surface disease. A state of hyperosmolarity elicits an acute immune response in DED, leading to subsequent activation of the adaptive immune response. This cascade incites dysregulation of the immune system, triggering a vicious cycle of events that causes damage to the ocular surface. Symptoms associated with these events include burning, irritation, redness, photophobia and blurred vision. The chronic nature of the disease process can cause permanent alterations to the ocular surface and adnexa. An increasing investment in treatment options, and positive outcomes with novel therapies that have received subsequent regulatory approval, lends further support to the role of inflammation in DED. This review highlights the nature and function of a range of fundamental inflammatory molecules in DED to provide the clinician with an appreciation for the ways in which these factors might be manipulated in DED management.

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Modulating Contact Lens Discomfort With Anti-Inflammatory Approaches: A Randomized Controlled Trial

Cited by 32 publications

References 52 publications

BCLA CLEAR - Contact lens wettability, cleaning, disinfection and interactions with tears

BCLA CLEAR - Contact lens wettability, cleaning, disinfection and interactions with tears

BCLA CLEAR - Contact lens complications

Molecular evidence for the role of inflammation in dry eye disease

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