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1.
Cosmetically tinted soft contact lenses are an attractive option for contact lens wearers. Data that we have gathered from annual contact lens fitting surveys demonstrate that those wearing tinted lenses are more likely to be female (4.6% of all soft lenses fitted vs. 1.6% for males; p < 0.0001) and younger (27 ± 11 years vs. 33 ± 13 years for those wearing non-tinted lenses; p < 0.0001). Tinted lenses tend to be worn more on a part-time basis and are replaced less frequently than non-tinted lenses. The decline in fitting tinted lenses over the past 12 years may be due to (a) the current limited availability of tinted lenses in silicone hydrogel materials and daily disposable replacement frequencies, which together represent a significant majority (78%) of new soft lenses fits today, (b) growing concerns among lens wearers and practitioners relating to the risks of complications associated with the wearing of tinted lenses, and (c) reduced promotion of such lenses by the contact lens industry.  相似文献   

2.
    
Scleral contact lenses have a range of therapeutic and optical applications. In recent years, scleral lens prescribing has increased due to significant advances in ocular imaging technology, lens manufacturing processes, and the widespread availability of scleral lenses globally. While the optical principles of scleral lenses are identical to those of corneal rigid lenses (i.e. the post-lens tear layer neutralises the majority of anterior corneal astigmatism and higher order aberrations), the nature of scleral lenses and their typical fitting characteristics means that many of the assumptions of ‘thin lens’ paraxial optics traditionally used for corneal rigid lens calculations may be inappropriate in certain clinical scenarios. This review provides a comprehensive overview of a variety of lens and fitting characteristics that are unique to scleral lenses, or not typically encountered with corneal rigid lenses, and how these factors may potentially influence optical performance based on theoretical modelling, in particular; scleral lens parameters, the post-lens tear layer, and dynamic changes during lens wear. Current front and back surface lens designs and future scleral lens applications are also discussed, along with lens modifications to improve visual outcomes and transient changes in corneal optics induced by appropriately fitted modern scleral lenses.  相似文献   

3.
PurposeTo investigate the efficacy of spherical aberration (SA) correction with aspheric contact lenses (aspheric lenses) based on lens power, and compare the results with those of spherical contact lenses (spherical lenses).MethodsOcular higher-order aberrations were measured with a wavefront sensor, in 11 myopic subjects wearing an aspheric lens (Medalist Fresh fit (PUREVISION 2 HD); Bausch + Lomb) or a spherical lens (ACUVUE Oasys; Johnson & Johnson). Six different lens powers (−7.00 diopters (D), −5.00 D, −3.00 D, −1.00 D, +1.00 D, +3.00 D) were used for all subjects. The amount of SA correction from the contact lens at each power was calculated as the difference between SA with the contact lens on-eye and SA of the eye alone.ResultsFor the spherical lenses, SA correction was close to 0.00 μm for the +1.00 D lens, became more positive as the labeled lens power increased and became more negative as the labeled lens power decreased. For the aspheric lenses, SA correction was consistent, from −0.15 to −0.05 μm, for all lens powers except for the −1.00 D lens. SA correction for the spherical and aspheric lenses was significantly different at −7.00 D (p = 0.040), −3.00 D (p = 0.015), −1.00 D (p < 0.001), +1.00 D (p = 0.006), and +3.00 D (p < 0.001) powers.ConclusionAn aspheric lens is capable of correcting SA at different lens powers, and has SA correction in the range of −0.15 to −0.05 μm over a 6 mm aperture.  相似文献   

4.

Purpose

Pilot study to investigate the feasibility of an axis-free correction approach of regular astigmatism using soft, bifocal contact lenses (CL).

Methods

The investigation covers an optical simulation and a pilot study for the assessment of visual performance (over refraction OR, monocular visual acuity VA). The power of the two zones was adjusted according to the power of the astigmatic meridians, individually. Subjective performance was assessed in 30 participants with a mean horizontal cylindrical component of J0 = ? 0.65 ± 1.29 D (cylinder from ?0.75 to ?4.00 DC). OR and VA were measured directly after fitting the CL, after one hour and after 5 days (3FUP).

Results

Evaluating the modulation transfer function, CL increased the Strehl ratio by 10% and the transferred spatial frequency was improved from 6.6 cpd to 21.3 cpd. Analysis of Sturm’s interval revealed a residual astigmatism of DAst = 0.73 D. OR revealed a statistically significant reduction of spherical error between baseline and all follow up (ΔM = ?2.14 D, p < 0.001) and between the J0 from baseline to 3FUP (ΔJ0 = ?0.46 D, p = 0.04). Wearing the CL for 5 days did not result in a significant difference of VA (ΔVA3FUP = +0.01 logMAR, p = 0.99).

Conclusion

Axis-free correction of astigmatism using bifocal CL resulted in reasonable performance based on computer simulation. Participants showed no clinically reduced visual acuity or contrast sensitivity. Further clinical studies are needed to show if this approach provides a good alternative to conventional astigmatic correction.  相似文献   

5.
We examined the ability of autorefractors to provide an accurate means of contact lens over-refraction measurement. Over-refraction measures, performed using six commercially available automated infrared autorefractors and retinoscopy, were compared with subjective refraction. A total of 40 contact lens wearers (20 soft lens wearers and 20 rigid gas permeable (RGP) lens wearers) participated in the study. All six autorefractors were able to provide over-refraction measures in all subjects. Data analysis revealed differences in autorefractor performance between the two types of contact lens wearer with greater accuracy and lower variability being found in the soft lens wearing subjects compared with the RGP group. The level of agreement between retinoscopy and subjective over-refraction results was lower in soft lens wear and higher in RGP wear than the levels found between the autorefractor and subjective over-refraction measures. We conclude that autorefractors provide a useful means of measuring contact lens over-refraction in soft lens wearers. Over-refraction results should be treated more cautiously in RGP wearers.  相似文献   

6.
单眼视(Monovjsiori)作为矫正老视的方法之一,其机理是用接触镜将一眼矫正为看远,而另一眼矫正为看近,因此使用单眼视方法会人为的造成双眼的屈光参差。这种由离焦产生的横糊会对视功能产生一定的影响。本文从空间视觉、调节及其长期影响三方面讨论了使用单眼视方法对法对视功能的影响。以期为临床应用堤供叁考。  相似文献   

7.
    
PurposeTo report on a second-generation prototype contact lens (modified lens) with enhanced optics to correct coma aberration and compare its performance with that of the prototype contact lens (conventional lens) used to optimise correction of coma aberration in keratoconus (KC).MethodsBoth lenses were designed as a set of standardised soft contact lenses (SCLs) with asymmetric powers along the posterior surface. The modified lens differs from the conventional lens in that the optical zone is decentred superiorly by 0.7 mm. The on-eye performance was compared between the SCLs and no-lens wearing in terms of manifest refraction, corrected distance visual acuity (CDVA), ocular aberrations, subjective quality of vision, and on-eye lens position relative to the pupil.ResultsThirty-four KC eyes were included. SCLs significantly decreased coma aberration compared to no-lens wear (none, 0.68 ± 0.27 μm; conventional lens, 0.37 ± 0.28 μm; modified lens, 0.19 ± 0.15 μm; P < 0.001), with the reduction in coma aberration being significantly greater with the modified lens than with the conventional lens (P = 0.018). No significant difference in manifest refraction or CDVA was found among the three conditions. Quality of vision was significantly better with the modified lens than with no SCL wear (P < 0.05) but no differences were found between the SCLs. The on-eye optical center position relative to the pupil was closer to the pupil centre using the modified lens than the conventional lens (P < 0.001).ConclusionOptimisation of the location of the optical zone in a standardised asymmetric SCL improves correction of coma aberrations and on-eye optical centration.  相似文献   

8.
    
PurposeTo investigate by using computational simulations the optical impact of the change in the vault of two geometries of scleral contact lenses (SCLs).MethodsRay-tracing simulations were performed using specialized software in three eye models with different levels of primary SA (6 mm pupil). Two different geometries of SCL were used in such simulations characterized by the conic constants of the anterior surface of the lens (K1, −0.1 and −0.3). Likewise, the fitting of the SCL was simulated for different vaults (50–250 µm). The impact on the quality of the images through the eye models was assessed by analyzing the modulation transfer function (MTF) at different spatial frequencies (10 Lp/mm, 30 Lp/mm, and 50 Lp/mm). This impact was not only simulated for a distant object, but also for intermediate and near objects (vergence demands from 0.00 to 3.00 D). All these optical simulations were performed assuming a centered SCL, but also assuming a downward vertical decentration of 0.5 mm.ResultsThe thinnest vault (50 µm) provided the best ocular optical quality in all three eye models for low vergence demands. For medium and high vergence demands, Lens 1 (K1 = −0.3, K2 = −0.4) resulted in a considerable improvement in optical quality in Eye 2 (C40 = −0.078 µm), while for eyes 1 (C40 = 0.408 µm) and 3 (C40 = −0.195 µm), this improvement only tended to happen for medium vergence demands. Overall, all the aberrations increased after lens fitting. Lens decentration did not cause significant variations in the results obtained with the well-centered lenses.ConclusionsChanges in the vault of a SCL have an impact on the optical quality achieved for different vergence demands independently on the level of SA of the eye in which it is fitted. The clinical relevance of such impact should be investigated further.  相似文献   

9.
A 58-year-old man presented with corneal dellen twelve days after pterygium removal on his left eye. Initial treatment with lubrication and artificial tears was unsuccessful. The fitting of a conventional contact lens was not possible because of conjuctival chemosis. Additionally the patient denied eye patching due to professional reasons. As an alternative treatment a large diameter bandage soft contact lens approved for extended wear was applied ((David Thomas Contact Lens T74/85 Extended Wear/Bandage of 18 mm diameter). The next day corneal dellen had already began to retreat and four days later the contact lens was removed since there was no sign of dellen in the slit lamp examination. In conclusion, the use of a large diameter soft contact lens was an effective alternative solution for the treatment of corneal dellen in our patient.  相似文献   

10.
    
An 80 year-old male patient was prescribed a bandage contact lens on the left eye 5 years ago because of an injury on the eye by a wooden stick. He was never followed up to remove the contact lens. Two years ago, he suffered from gradually decreased visual acuity in the left eye. After removing the contact lens, his visual acuity gradually increased to 12/20 and the symptom revealed. Intraocular pressure, corneal endothelium density, corneal curvature, and the anterior chamber depth were within the normal range in the left eye, and were comparable with the right eye. Although no permanent damage was found in the patient, a strict follow-up procedure is strongly recommended for patients who receive a bandage contact lens.  相似文献   

11.
    
PurposeTo report 2 patients with colonization of therapeutic contact lens with dematiaceous fungi.MethodsCase report.ResultsThe first patient had a retained soft contact lens on an opaque cornea for 4 years with brownish black multiple colonies on the soft contact lens and culture grew Bipolaris spp. The second patient was on therapeutic contact lens for pseudophakic bullous keratopathy for 4 months and developed a brownish colonization of contact lens with unidentified dematiaceous fungi. Both the patients had conjunctivitis but did not develop fungal keratitis.ConclusionJudicious use of therapeutic contact lens is required in agrarian countries with adequate emphasis on strict adherence to the standard protocols and frequent replacement of the lens.  相似文献   

12.
    
The aim of this review is to mark the 75th anniversary of the introduction of the original corneal contact lens of Tuohy in 1948.American documents in the public domain, such as census records and draft registration cards, were consulted in order to provide a more comprehensive biography of Kevin M Tuohy, inventor of the corneal contact lens, than those previously published.Perhaps due to a failure to consult original sources concerning the Tuohy corneal lens, some historical accounts have provided incomplete or incorrect information about its design and dimensions. The back surface specification of the bi-curve Tuohy lens in its standard diameter of 11.50 mm has been tabulated and edge lift and edge clearance values calculated. A colour photograph illustrates the fluorescein pattern of a Tuohy lens.Patients wearing Tuohy lenses were able to achieve a much longer wearing time compared to those wearing sealed scleral lenses since they eliminated corneal epithelial oedema, a frequent problem which necessitated removal of lenses after a few hours of wear due to cloudy vision. Only some of Tuohy lens wearers exhibited an adverse corneal response such as fluorescein staining after 12, or more, hours of wear.The clinical success of the Tuohy lens and the fact that its fitting procedure was simpler and quicker than that for scleral lenses encouraged optometrists to commence contact lens practice and to implement improvements in the design of the corneal lens.  相似文献   

13.
    
We report the long-term clinical courses of 8 aphakic eyes of 2 sets of siblings who used contact lenses for both refractive correction and amblyopia treatment following neonatal cataract extraction. Early cataract removal, aggressive contact lens use, and robust professional supervision seem to have substantially contributed to visual success in our four patients. All eyes did well visually with contact lenses, all developing acuities close to 20/20 despite contact lens and non-contact lens related complications that were managed. Complications of most concern were corneal neovascularization and glaucoma. We believe this to be the first case series documenting consistent long-term visual and ocular health outcomes of sets of bilaterally aphakic siblings optically treated with contact lenses.  相似文献   

14.

Purpose

To evaluate the therapeutic and optical application of a semi-limbal diameter (S-LIM) rigid gas permeable (RGP) contact lens.

Method

A retrospective non-comparative case series of 14 consecutive patients (22 eyes) who were referred to one senior optometrist for the fitting of S-LIM contact lenses at Moorfields Eye Hospital. The cases comprised of 11 patients (17 eyes) with keratoconus, 1 patient (2 eyes) post-surgical ectasia from previous LASIK, 1 (1 eye) post-graft patient, and 1 patient (2 eyes) who required corneal protection secondary to lagophthalmos. These patients had failed previously with other lens designs because of lens intolerance, unstable vision, chronic 3 and 9 o’clock corneal staining, and inadequate corneal protection for the patient with lagophthalmos. A conventional method of using diagnostic lenses with fluorescein assessment was adopted in fitting the S-LIM lenses.

Results

The median duration of problems encountered with previous lenses was 4 years (range 0.5-10 years). The median visual acuity with the S-LIM lens was 6/9 (range 6/5-6/24). A median of 1 diagnostic lens (range 1-3 lenses) was required to achieve a satisfactory fit. At the last recorded follow-up, 10 patients (14 eyes) had no clinically observable problem and were wearing their lenses with a median wearing time of 8 h per day (range 1-18 h). The median duration of follow up was 6 months (range 2-18 months). One patient (1 eye) abandoned lens wear because of satisfactory unaided vision.

Conclusion

The use of a semi-limbal diameter lens can be an effective modality in patients with intolerance to other lens designs. However, lens modification from the standard design and the use of ocula lubricants are often required to optimise lens fit and to enhance tolerance.  相似文献   

15.
    
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16.
There are important clinical, academic and commercial reasons for seeking to develop a comprehensive understanding of the frequency of wear of different forms of contact lenses. Data that we have gathered from annual contact lens fitting surveys over the past 12 years demonstrate that contact lenses are worn, on average, 5.4 ± 1.9 days per week. Rigid lenses tended to be worn on a full-time basis, typically seven days per week. The distribution of daily disposable lens wear is bimodal, with peaks at two days and seven days per week of wear. Over the survey period there appears to have been a small trend toward the use of contact lenses on a part-time basis.  相似文献   

17.
    
PurposeTo evaluate the power profile of multifocal contact lenses (CLs) using a new technology based on quantitative deflectometry.MethodsThe Nimo TR1504 was used to analyze the power distribution of multifocal CLs. The CLs under study were: Air Optix Aqua Multifocal Low, Medium and High Addition and Focus Progressives. Three lenses of each model were considered.ResultsAll multifocal CLs showed a power profile characterized by a change toward more positive power values when aperture sizes become smaller. The near refractive addition of the lenses under study was +2.61 D, +1.44 D, +1.30 D and +0.30 D for the Focus Progressives, the Air Optix Aqua Multifocal High, Medium Add and Low Add, respectively. The refractive power of the Focus Progressives did not reach the value of the nominal distance power until a radial distance of 0.9 mm from the center of the lens. For the Air Optix Aqua Multifocal Low Add the distance nominal power was reached at a radial distance of 1.5 mm from the center of the lens, whereas this occurred at a distance of 1.8 mm for the Air Optix Aqua Multifocal Medium and High Add.ConclusionThe relation between the pupil diameter of the patients and the power profile of these CLs has a crucial implication on the final distance correction and near addition that these lenses provide to patients. Practitioners should know the power profile of these CLs and measure the pupil diameter of each patient in different situations in order to carry out a customized fitting.  相似文献   

18.
The ageing population highlights the need to provide effective optical solutions for presbyopic contact lens wearers. However, data gathered from annual contact lens fitting surveys demonstrate that fewer than 40% of contact lens wearers over 45 years of age (virtually all of whom can be presumed to suffer a partial or complete loss of accommodation) are prescribed a presbyopic correction. Furthermore, monovision is prescribed as frequently as multifocal lenses. These observations suggest that an optimal solution to the contact lens correction of presbyopia remains elusive.  相似文献   

19.
    
PurposeTo determine (1) the factors associated with a high degree of self-reported symptoms with Japanese translations of the 8-Item Contact Lens Dry Eye Questionnaire (J-CLDEQ-8) in a cross-section of soft contact lens (SCL) wearers in Japan and (2) whether the difference in translation of the CLDEQ-8 affects the scores between validated and non-validated versions of the Japanese translation.MethodsHabitual SCL wearers completed the validated J-CLDEQ-8 and a previous non-validated version. Demographics and SCL history questions were queried when they presented for routine eye care in nine geographically distinct clinics across Japan. The following risk factors for high J-CLDEQ-8 scores (≥11) were tested: sex, age, SCL replacement (daily disposable vs. bi-weekly and monthly reusable), years of SCL wear, and self-reported use of rewetting drops. The scores of the validated and non-validated questionnaires were compared.ResultsSignificant patient-related risk factors for high J-CLDEQ-8 scores were female sex, use of reusable SCLs, longer years of SCL wear, and use of rewetting drops. Scores for six out of eight questions in the validated J-CLDEQ-8 were significantly higher than those of the non-validated version, resulting in a significant difference in the average total score between the two questionnaires (validated J-CLDEQ-8: 10.5 ± 5.9 vs non-validated J-CLDEQ-8: 9.5 ± 5.8, P < 0.001).ConclusionsFemale sex, use of reusable SCLs, longer years of SCL wear, and use of rewetting drops were significant risk factors for high J-CLDEQ-8 scores in a cross-sectional clinical population of Japanese SCL wearers. Symptoms with SCL are not predicted by age and must therefore be queried at follow-up visits for all SCL wearers. Differences in the two translations affected the ability of the questionnaire to identify individuals with high symptoms associated with SCL wear.  相似文献   

20.
    
PurposeThis study aimed to evaluate the structural changes in meibomian glands (MGs) and meibomian gland dysfunction (MGD)-associated ocular surface alterations in contact lens (CL) wearers.MethodsThis prospective, multi-center, cross-sectional study included 44 soft CL wearers, 21 rigid CL wearers, and 26 healthy non-wearers. After completing the Ocular Surface Disease Index (OSDI) questionnaire, the participants were examined for lid margin abnormalities, tear breakup times, ocular surface staining, meibum quality and expressibility. Afterwards upper and lower eyelid meibography and Schirmer I test were performed.ResultsA total of 91 participants (64 females and 27 males) (91 eyes) were classified into three groups. The mean percentage of meibomian gland loss (PMGL) was 25.3 ± 12.5 % in soft CL wearers, 34 ± 13.4 % in rigid CL wearers, and 18.4 ± 9.2 % in the control group. Mean OSDI score was higher in soft CL wearers (15.5 ± 18) than in the control group (3.5 ± 2.6) (p < 0.001) and the OSDI scores were correlated with mean PMGL in CL wearers (r = 0.411, p = 0.002, r = 0.588, p = 0.005, respectively). In soft CL wearers, the duration of CL use was the only predictive variable for mean PMGL in multivariate analysis. In a regression model including both CL groups, age and rigid CL material were predictive variables for mean PMGL.ConclusionsCL use may cause MGD and this effect may be more pronounced in rigid CL wearers. In soft CL wearers, the duration of CL use is an important variable associated with MG loss, and subjective symptoms may guide the prediction of MG loss in these cases.  相似文献   

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