Background: There are a few dry eye remedies available in the market. Currently, artificial tears and lubricants are still the most common management for dry eyes. Objective: We proposed a new method in managing dry eyes. Methods: A pre-soaked contact lens in virgin coconut oil (VCOCL) is being used as a vehicle to deliver virgin coconut oil (VCO) in dry eyes. VCOCL was prepared in sterilised conditions where daily soft hydrogel contact lenses were immersed in raw VCO. The efficacy of VCOCL in delivering the VCO to eyes was assessed by measuring the Tear Break-Up Time (TBUT) values, corneal staining of the anterior eye, Schirmer Test values and the measurement of residual VCO volume in tears at baseline and at 15 minutes after insertion on subjects with dry eyes. Pre- and post-data were used to analyse all the measurable variables. Results: This study showed a significant difference in the TBUT, corneal staining, and residual VCO volume for both eyes (p<0.05). However, there were no changes in the Schirmer Test value (p>0.05). VCOCL was proven to improve tear quality in dry eye subjects and was able to maintain its presence in the eye even after 15 minutes. Conclusion This study suggests a new method for dry eye management.
Contact Lenses ; Therapeutics ; Dry Eye Syndromes

Objective. To create an age-based formula to estimate the base curve needed for contact lens fitting using measured central corneal curvature (CCC) with a handheld auto keratometer from ophthalmologically normal infants.

Methods. This is a prospective cross-sectional study involving 70 ophthalmologically normal full-term infants aged 0 to 12 months. The infants were divided into four groups: 0-3 months, >3-6 months, >6-9 months and >9-12 months. CCC was measured with a handheld auto keratometer and was used to compute for the base curve. Differences in CCC between the four groups were measured and linear regression models were used for formula creation.

Results. The mean CCC was highest in group 1 at 45.5 ±2.4 diopters (D). These values slowly decreased as age increased. A formula predictive of the base curve based on the infants age was derived using linear regression analysis. It predicted that for every month increase in age, there is a 0.063 millimeter increase in the base curve (p<0.001).

Conclusion. Infant CCC is highest at birth and gradually decreases as age increases. The formula can predict the base curve needed for contact lens fitting in infants without the need for a handheld autokeratometer.

Aims: The contact lens (CL) has become one of the most convenience refractive devices used in vision correction, occupational and in cosmetics purposes. Despite the convenience of CL usage, poor hygiene might cause eye infections due to microbial contamination. In this work, a random collection of used CL cases among Universiti Malaysia Terengganu (UMT) students had shown the emergence of antibiotic-resistant bacteria towards commonly used antibiotics to treat eye infections. Methodology and results: The study was carried out from 28 CL cases samples with the duration of one to three months of use. Bacteria that were successfully isolated from the CL cases were then exposed to the commonly prescribed antibiotics followed by identification through the partial 16S rDNA sequencing. Our finding exhibited that the rate of contamination is over 50% where 32 bacteria were isolated, with 20 (62.5%) of the isolates were Gram-positive bacteria. Approximately 31% of the isolated bacteria are resistant and intermediate resistant to the commonly used antibiotics to treat eye infection, especially erythromycin and chloramphenicol. The isolated bacteria were genotypic identified as Bacillus cereus, B. anthracis, Acinetobacter variabilis, Klebsiella pneumoniae, and Serratia marcescens. These bacteria are known as a common cause for microbial keratitis, except for A. variabilis, where the association of this bacteria in causing microbial keratitis is relatively rare. Conclusion, significance and impact of study This study highlights the emergence of antibiotic-resistant bacteria that can cause severe eye infections among CL wearer. The high percentage of contamination (>50%) found from the isolates reflected on the lack of hygiene practice on the CL handling. Thus, it is crucial to perceive this study as microbial contamination will lead to more serious eye infection disease such as conjunctivitis and keratitis.
Drug Resistance, Bacterial ; Contact Lenses

PURPOSE: We used a questionnaire to explore perceptions and clinical practice patterns of Korean pediatric ophthalmologists in terms of amblyopia.METHODS: From September to November 2018, we conducted a web-based questionnaire survey of 99 specialists of the Korean Association for Pediatric Ophthalmology and Strabismus who operated ophthalmology clinics in Korea. We received 56 responses (56.57%) and retrospectively analyzed the data.RESULTS: The average specialist age was 44.0 ± 9.7 years. The mean age of treated amblyopia patients was 3 to 5 years (69.6%); the most common amblyopia was refractive anisometropic amblyopia (75.0%). On average, treatment commenced at 4 years of age (53.6%); child and parent co-operation most significantly influenced treatment success (46.4%). The preferred test was cycloplegic refraction (96.4%) and the preferred treatment occlusion therapy (100%) with glasses correction (98.2%). Occlusion therapy was most commonly performed for 2 hours/day (69.6%); the minimum age for eyeglasses prescription was 2.10 ± 1.18 years. Only three respondents (5.36%) prescribed contact lenses and only one (1.79%) performed refractive surgery.CONCLUSIONS: In Korea, amblyopia treatment is based on occlusion therapy and glasses correction. However, the time of treatment commencement, the duration of occlusion therapy, and the glasses used for correction varied. It is necessary to develop guidelines for amblyopia treatment; these should reflect current medical conditions.
Amblyopia ; Child ; Contact Lenses ; Eyeglasses ; Glass ; Humans ; Korea ; Ophthalmology ; Parents ; Practice Patterns, Physicians' ; Prescriptions ; Refractive Surgical Procedures ; Retrospective Studies ; Specialization ; Strabismus ; Surveys and Questionnaires

This study aimed to describe the basic optical properties for presbyopia correction, including eyeglasses and contact lenses. Conventional eyeglasses are the most established technology for presbyopia correction, and contact lenses have been recognized to have a huge potential in presbyopia correction. However, successful treatment using contact lenses is dependent on age-related factors, such as upper and lower eyelid movements, palpebral aperture, and decreased lacrimal secretion and tear stability. Monovision and multifocality are optical properties of the lens that form the basis of presbyopia correction. The monovision method is based on the principle of neuro-adaptation, wherein one eye automatically selects a clear image and suppresses an unclear image for processing in the brain when there is a difference in the clarity of the images obtained from both the eyes because of anisopia, which is characterized by unequal visual power between the two eyes. Simultaneous views of near and far objects cannot be achieved using eyeglasses, but these can be realized using contact lenses or intraocular lenses. Alternative views of near and far objects can be achieved using a variety of bifocal contact lenses, which function similar to bifocal eyeglasses. Traditional strategies for presbyopia correction, including the use of monovision, bi/tri/multifocal, and progressive eyeglasses and the use of contact lenses, are being challenged by novel strategies involving pharmacotherapy and electrostimulation. Although the immediate prospect of any newly developed innovation remains slim, improved lens profiles would lead to a better match between the lens and the needs of individuals with presbyopia.
Brain ; Contact Lenses ; Drug Therapy ; Eyeglasses ; Eyelids ; Lenses, Intraocular ; Methods ; Presbyopia ; Tears

PURPOSE: To describe the clinical features of Korean patients with contact lens-induced limbal stem cell deficiency (CL-LSCD).METHODS: Medical records of 22 patients who were diagnosed with CL-LSCD between 2014 and 2019 were reviewed retrospectively. Outcome measures included demographics, clinical presentation, treatment, clinical course, and pattern of contact lens (CL) wear.RESULTS: Forty-two eyes of 22 patients were found to have typical changes associated with CL-LSCD. Twenty (91%) patients were women and mean age was 36 ± 12 years. All patients had myopia with mean spherical equivalent of −7.52 ± 3.2 diopter. Twenty (91%) patients had bilateral disease and the location of limbal involvement was diffuse in 20 eyes (47.6%) and partial in 22 eyes (52.4%, superior in 20 eyes and inferior in 2 eyes). Fourteen (63.6%) patients complained of decreased visual acuity. Average period of CL wear was 14 ± 9 years. Four patients used cosmetic colored CLs and four patients had a history of overnight CL wear. All 12 patients who completed follow-up (28 ± 42 weeks) showed improvement in visual acuity and ocular surface condition after cessation of CL wear and medical treatment. Of them, five (42%) patients showed full recovery while seven (58%) showed partial recovery.CONCLUSIONS: If a patient with a history of CL wear for an extended period of time presents with decreased visual acuity, practitioners should perform detailed examinations with suspicion of CL-LSCD, including fluorescein staining. CL-LSCD is usually reversible and close follow-up with conservative treatment is recommended as the initial treatment option.
Contact Lenses, Hydrophilic ; Demography ; Female ; Fluorescein ; Follow-Up Studies ; Humans ; Medical Records ; Myopia ; Outcome Assessment (Health Care) ; Retrospective Studies ; Stem Cells ; Visual Acuity

PURPOSE: We report a case of Aeromonas keratitis presenting as radial keratoneuritis. CASE SUMMARY: A 33-year-old woman with a history of cleaning her contact lenses with tap water presented with decreased visual acuity for 1 day in the left eye. The patient showed diffuse corneal edema, stromal infiltration, and radial keratoneuritis, which were thought to be pathognomonic for Aeromonas keratitis. Based on the patient's clinical findings and past history, a diagnosis of Aeromonas keratitis was made and she was prescribed topical fortified cefazolin (50 mg/mL, 5%), tobramycin (3 mg/mL), and 0.02% chlorhexidine per hour. Culture results from the contact lens and contact lens solution confirmed infection by Aeromonas hydrophilia. Polymerase chain reaction results for Aeromonas were negative. After 8 days of treatment, the uncorrected visual acuity was 0.7/0.3 with improvement in her corneal findings. CONCLUSIONS: Radial keratoneuritis is not always pathognomic for Aeromonas keratitis and can be present in Aeromonas keratitis. Therefore, ophthalmologists should be cautious when interpreting this clinical sign.
Adult ; Aeromonas ; Cefazolin ; Chlorhexidine ; Contact Lens Solutions ; Contact Lenses ; Cornea ; Corneal Edema ; Diagnosis ; Female ; Humans ; Keratitis ; Polymerase Chain Reaction ; Tobramycin ; Visual Acuity ; Water

PURPOSE: This study aimed to evaluate the influence of varying concentrations of sodium hyaluronate (SH) eye drops on corneal aberrations in normal individuals wearing silicone hydrogel contact lenses. METHODS: Normal individuals wearing silicone hydrogel contact lenses were enrolled in this study. Subjects were classified into two groups depending on the concentration of the preservative-free SH used (group 1, 0.1% SH; group 2, 0.3% SH). All subjects were asked to blink five times after instillation of the SH eye drop and before the Galilei measurements. Corneal aberrations were measured over the contact lenses before and after SH eye drop instillation. Visual acuity (VA) over the contact lenses was also measured both before instillation of the SH eye drop and after the subjects completed the five blinks. RESULTS: There was no change in VA after SH instillation in group 1; however, group 2′s VA significantly deteriorated after SH instillation. Changes in VA after SH instillation compared to baseline were significantly higher in group 2 than in group 1. Similarly, the increase in corneal aberrations after SH instillation was significant in group 2 but not significant in group 1. Among the significantly increased corneal aberration parameters, defocus was the main type in group 2. Changes in corneal aberrations after SH instillation compared to baseline were significantly higher in group 2 than in group 1. CONCLUSIONS: A 0.3%-concentration of SH increases corneal aberration and decreases VA in soft contact lens wearers. Defocus is the main type of aberration that increased in the 0.3% SH instillation group.
Contact Lenses ; Contact Lenses, Hydrophilic* ; Hyaluronic Acid* ; Hydrogel ; Ophthalmic Solutions ; Silicon ; Silicones ; Sodium* ; Visual Acuity

PURPOSE: We report short-term treatment effects of a mini-scleral lens in patients with Stevens-Johnson syndrome and corneal ectasia. CASE SUMMARY: A 54-year-old female who had been diagnosed with Stevens-Johnson syndrome and keratoconus presented with persistent right eye pain and decreased visual acuity. Therapeutic lenses, topical antibiotic eye drops, and topical steroid eye drops were used; however the symptoms were not controlled, then the patient was treated with a mini-scleral contact lens in the right eye. At the time of the first visit to our hospital 17 years ago, and the best-corrected visual acuity (BCVA) of the right eye was logMAR 0.22. However, Stevens-Johnson syndrome and corneal ectasia were severe and cataract surgery was considered because of worsening cataracts, but the patients refused this surgery. At the time, the BCVA of the right eye was then reduced to logMAR 1.10. On ophthalmic examination, there was conjunctival fibrosis and corneal neovascularization of the right eye. The symptoms were not managed with a using a therapeutic lens, and then the patient was prescribed a mini-scleral contact lens. After wearing the mini-scleral contact lens, the corneal and conjunctival neovascularization was reduced. After 6 months, the BCVA of the right eye improved to logMAR 0.60. CONCLUSIONS: In patients with Stevens-Johnson syndrome and corneal ecstasia, mini-scleral contact lens can be considered as a useful treatment option for visual improvement and symptom control.
Cataract ; Contact Lenses ; Corneal Neovascularization ; Dilatation, Pathologic ; Eye Pain ; Female ; Fibrosis ; Humans ; Keratoconus ; Middle Aged ; Ophthalmic Solutions ; Stevens-Johnson Syndrome ; Visual Acuity

PURPOSE: To investigate the change of retinal volume according to anterior segment refractive power using contact lens by spectral domain optical coherence tomography (SD-OCT). METHODS: The retinal volume was measured using a SD-OCT (Heidelberg retinal angiography Spectralis + OCT, Heidelberg Engineering, Heidelberg, Germany) in 60 subjects without any underlying disease. The same examiner performed a 31-section macular volume-scan at 240 µm intervals, re-measured the same area by changing the refractive power of the anterior segment by wearing soft contact lenses of +6.0 diopters and −6.0 diopters. By using the ImageJ software to calculate the cross-sectional area and of the cross-sectional area and the volume was measured. RESULTS: The mean age of the participants was 25.6 ± 1.5 years and the mean axial length was 25.7 ± 1.57 mm. The volume of the posterior pole retina measured without the contact lens was 13.48 ± 0.05 and the mean volume of the retina measured with +6.0 diopter and −6.0 diopter contact lens in the same patient was 13.47 ± 0.07 mm³ and 13.48 ± 0.05 respectively. The mean volume was significantly lower(p = 0.036) in the measurement with the +6.0 diopter lens than in the measurement without the lens, and the mean volume was significantly higher in the measurement with the +6.0 diopter lens (p = 0.042). The change in retinal thickness was increased with longer axial length (r = 0.32, p < 0.05), but the central foveal thickness did not correlate with anterior corneal power (p = 0.463). CONCLUSIONS: The volume of the retina measured using the SD-OCT is affected by the refractive power of the anterior segment and the axial length. Therefore, it is necessary to consider the change of refractive index because it can change the retinal volume measured by SD-OCT.
Angiography ; Contact Lenses, Hydrophilic ; Humans ; Refractometry ; Retina ; Retinaldehyde ; Tomography, Optical Coherence