Useful Papers

  • Contact lenses for Keratokonus

Contact lenses are the primary form of visual correction for patients with keratoconus

Laura Downie and Richard Lindsay

Contact lenses are the primary form of visual correction for patients with keratoconus. Contemporary advances in contact lens designs and materials have significantly expanded the available fitting options for patients with corneal ectasia. Furthermore, imaging technology, such as corneal topography and anterior segment optical coherence tomography, can be applied to both gain insight into corneal microstructural changes and to guide contact lens fitting. A review paper from Downie and Lindsay
provides a comprehensive summarize of the range of contact lens modalities, including soft lenses, hybrid designs, rigid lenses, piggyback configurations, corneo-scleral, mini-scleral and scleral lenses currently available for the optical management of keratoconus.

  • Myopia Control

The Scientific Bureau of World Society of Paediatric Ophthalmology and Strabismus recommends treatment options for myopia control

Seo Wei Leo

In a review paper, Seo Wei Leo from the Scientific Bureau of World Society of Paediatric Ophthalmology and Strabismus concluded that controlling the onset of myopia is now possible through increasing time outdoors whereas slowing the progression of myopia can be successfully achieved with interventions like atropine and orthokeratology.

  • Compliance

Hand washing essential for safe and effective contact lens wear

Desmond Fonn and Lyndon Jones

Lack of or inadequate hand washing is a risk factor in the development of contact lens related microbial keratitis and corneal inflammatory events. There is compelling evidence that proper hand washing with soap can save lives, which it is now of outmost importance during the covid pandemic. Contact lens wearers are also guilty of poor hand washing behavior but there is scant evidence that education of hand washing procedures of lens wearers alters patient non-compliance. Adequate patient education with regards to hand hashing is critical for safe and effective contact lens wear

  • Myopia Control

The International Myopia Institute has synthesed the research evidence to date on the most important and relevant aspects related to myopia, including recommended guidelines for myopia control

International Myopia Institute

With the growing prevalence of myopia, already at epidemic levels in some countries, there is an urgent need for new management approaches. However, with the increasing number of research publications on the topic of myopia control, there is also a clear necessity for agreement and guidance on key issues, including on how myopia should be defined and how interventions should be appropriately and ethically applied. The International Myopia Institute, with help from more than 85 multidisciplinary experts in the field, recently published seven critical reviews that syntheses the research evidence to date on the most important and relevant aspects related to myopia. These reports form the basis for recommended guidelines for eye care practitioners.

  • COVID-19

The COVID-19 pandemic: Important considerations for contact lens practitioners

Lyndon Jones et al

A novel coronavirus (CoV), the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), results in the coronavirus disease 2019 (COVID-19). As information concerning the COVID-19 disease continues to evolve, patients look to their eye care practitioners for accurate eye health guidance. There is currently no evidence to suggest an increased risk of contracting COVID-19 through contact lens (CL) wear compared to spectacle lens wear and no scientific evidence that wearing standard prescription spectacles provides protection against COVID-19 or other viral transmissions.

  • COVID-19

Could telehealth help eye care practitioners adapt contact lens services during the COVID-19 pandemic?

Manbir Nagra et al

The COVID-19 pandemic has necessitated government-imposed restrictions on social interactions and travel. For many, the guidance has led to new ways of working, most notably a shift towards working remotely. While eye care practitioners (ECPs) may continue to provide urgent or emergency eye care, in many cases the travel restrictions present a unique challenge by preventing conventional face-to-face examination. Telephone triage provides a useful starting point for establishing at-risk and emergency patients. Approaches to teleoptometry in contact lens practice primarily includes smartphone based ocular imaging and assessment of visual acuity. However, the absence of a comprehensive evidence base for teleoptometry limits ECPs, particularly during a pandemic. Advances in the field, such as ocular self-imaging, could help move this field forwards.

  • Care solution

Antimicrobial properties of new rigid gas-permeable contact lens multipurpose solution formulated with polylysine as disinfecting agent

Osamu Mori and Megumi Toyohara

A study presented at a recent conference of the British Contact Lens Association compared the antimicrobial properties of a new rigid gas-permeable (RGP) contact lens multipurpose solution (MPS) formulated with Polylysine as disinfecting agent against other commercially available MPS formulated with other disinfecting agents. Four commercially available RGP-MPS were compared according to ISO14729 stand-alone disinfection test: MPS-A (polylysine), MPS-B (PHMB + chlorhexidine), MPS-C (PHMB), MPS-D (Oxychlorite + hydrogen peroxide) and MPS-E (Polyquad). Antimicrobial properties were assessed with/without artificial tear as organic load for time (5–360 min) and temperature-dependence (10–32 ºC). MPS-A, MPS-B and MPS-E showed sufficient efficacy under all test conditions. MPS-C showed insufficient efficacy against fungi and decreased efficacy at low temperature and with organic load. MPS-D barely showed efficacy against all microorganisms tested. The new RGP-MPS formulated with Polylysine represents a safe and effective care solution for use with rigid gas-permeable contact lenses.

  • Myopia control

Overnight orthokeratology

Mark A Bullimore and Leah A. Johnson

A recent publication in the Contact Lens & Anterior Eye provided an interesting review of the current status of the use of overnight orthokeratology contact lenses. Overnight orthokeratology lenses are currently approved in countries all over the world for the temporary reduction in myopia, and recently, one lens design has received regulatory approval for myopia control in Europe. The modern orthokeratology lens has a substantial history from its origins of attempting to flatten the corneal curvature with a spherical rigid contact lens to sophisticated gas permeable lenses, designed to reshape the cornea. Currently, these lenses are predominantly prescribed for children to slow myopia progression and limit axial elongation of the eye. The article reviews the peer-reviewed literature on the efficacy of orthokeratology for myopia control, sustainability after treatment is discontinued, and the safety concerns of overnight contact lens wear.

  • Myopia control

Short-term and long-term changes in corneal power are not correlated with axial elongation of the eye induced by orthokeratology in children

Jacinto Santodomingo-Rubido et al

In this study, it was assessed the relationship between short-term and long-term changes in power at different corneal locations relative to the change in central corneal power and the 2-year change in axial elongation relative to baseline in white European children wearing orthokeratology contact lenses (Ortho-K).
The result showed the reduction in central corneal power and relative increase in paracentral and pericentral power induced by OK over 2 years were not significantly correlated with concurrent changes in axial length of white European children.

  • Myopia control

Short- and Long-Term Changes in Corneal Aberrations and Axial Length Induced by Orthokeratology in Children Are Not Correlated

Jacinto Santodomingo-Rubido et al.

The study was conducted to assess the correlation between changes in corneal aberrations and the 2-year change in axial length in children fitted with orthokeratology contact lenses (ortho-K).
It was found short-term and long-term ortho-K lens wear induces significant changes in corneal aberrations that are not significantly correlated with changes in axial elongation after 2-years.

  • Myopia control

Long-term Efficacy of Orthokeratology Contact Lens Wear in Controlling the Progression of Childhood Myopia

Jacinto Santodomingo-Rubido, César Villa-Collar, Bernard Gilmartin, Ramón, Gutiérrez-Ortega & Keiji Sugimoto

The study was conducted over 7 years to compare the axial length growth of white European myopic children from 6 to12 years old wearing orthokeratology contact lenses (ortho-K) to a control group over a 7-year period. The axial length growth of ortho-K group was 33% slower than the on

  • Myopia control

The effects of entrance pupil centration and coma aberrations on myopic progression following orthokeratology

Jacinto Santodomingo Rubido et al.

The study was conducted in Spain to assess the potential association between entrance pupil location relative to the coaxially sighted corneal light reflex (CSCLR) and the progression of myopia in children fitted with orthokeratology (OK) and to investigate whether coma aberration induced by decentration of the entrance pupil centre relative to the CSCLR, as well as following OK treatment, is correlated with the progression of myopia. A significant increase in vertical coma was found with OK lens wear compared to baseline (p < 0.001) but total root mean square (RMS) coma was not associated with the change in axial length (all p > 0.05). Entrance pupil location relative to the CSCLR was not significantly affected by either OK lens wear or an increase in axial length. Greater magnitude coma aberrations found at the entrance pupil centre in comparison to the CSCLR might be attributed to centration of orthokeratological treatments at the CSCLR.

  • Myopia control

Effect of low-addition soft contact lenses with decentered optical design on myopia progression in children: a pilot study

Takashi Fujikado et al.

The pilot study was conducted to evaluate the effect of decentered optical design low-addition soft contact lenses for controlling myopia progression over 2 years. Control group wore monofocal soft contact lenses. As a result of this study, it was observed that the decentered optical design low-addition soft contact lenses was effective to suppress the axial elongation compared to control group, however, we did not find significant difference on refractive error.
The reduction of the progression of myopia by low-addition soft CLs warrants further investigations.

  • Myopia control

Factors Preventing Myopia Progression With Orthokeratology Correction

Jacinto Santodomingo-Rubido et al

The study was conducted in Spain to examine which baseline measurements constitute predictive factors for axial length growth over 2 years in children wearing orthokeratology contact lenses (ortho-k) and single-vision spectacles (SV). Orthokeratology is a successful treatment option in controlling axial elongation compared to SV in children of older age, had earlier onset of myopia, were female, had lower rate of myopia progression before baseline, had lower myopia at baseline, had longer anterior chamber depth, had greater corneal power, had more prolate corneal shape, had larger iris and pupil diameters, and had lower levels of parental myopia.

  • Myopia control

Myopia Control with Orthokeratology Contact Lenses in Spain (MCOS): Refractive and Biometric Changes

Jacinto Santodomingo-Rubido et al

The study was conducted for 2 years in Spain, for the purpose of comparing axial length growth between white children with myopia wearing orthokeratology contact lenses (ortho-k) and distance single-vision spectacles (SV). The axial length growth was observed with both groups, however, that of SV group was significantly greater than ortho-k group. This result showed the ortho-k lowered the axial length growth and might be effective to control the myopia progression.
Open Access

  • Myopia control

Retardation of Myopia in Orthokeratology (ROMIO) Study: A 2-Year Randomized Clinical Trial

Pauline Cho; Sin-Wan Cheung

The study was conducted for 2 years in Hong Kong, for the purpose to evaluate the effectiveness of orthokeratology contact lenses (ortho-k), which is thought to be one of the means for the myopia progression control. One group was assigned to wear ortho-k, and the other to wear single-vision glasses as a control. As a result of measuring the axial length, the axial length elongation of ortho-k group was 43% slower than of the control group, so that the ortho-k might be effective to control the myopia progression.

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