The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry [Medición de la presión intraocular sobre lentes de contacto blandas positivas, mediante tonometría de rebote]

Purpose To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. Methods The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects’ right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00D and +6.00D. Measurements were taken over each contact lens and also before and after the CLs had been worn. Results The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p<0.001) but no significant difference was found between the two powers of CLs. Conclusions Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result didn’t change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses.

Drink driving among Indigenous people in Far North Queensland and northern New South Wales: A summary of the qualitative findings

Purpose In response to the threat that drink drivers pose to themselves and others, drink driving programs form an important part of a suite of countermeasures used in Australia and internationally. Unlike New Zealand/Aotearoa, United States and Canada that have programs catering for their First Peoples, all Australian programs are designed for the general driver population. The aim of this study was to identify the factors that contribute to Indigenous drink driving in order to inform appropriate recommendations related to developing a community-based program for Indigenous communities. Broader drivers licensing policy recommendations are also discussed. Methods A sample of 73 Indigenous people from Queensland and in New South Wales with one or more drink driving convictions completed a semi-structured interview in respect of the to their drink driving behaviour. Participants were asked to disclose information regarding their drink driving history, and alcohol and drug use. If participants self-reported no longer drink driving, they were probed about what factors had assisted them to avoid further offending. Results Key themes which emerged to maintain drink driving include motivations to drink and drive, and belief in the ability to manage the associated risks. Factors that appeared to support others from avoiding further offending include re-connecting with culture and family support. Conclusions and Implications A range of recommendations regarding delivery and content of a program for regional and remote communities as well as other policy implications are discussed.

Addressing the offending-related needs of non-violent Indigenous offenders

This report examines publically-available research literature from North America, Australia and New Zealand on the effectiveness of measures that aim to reduce non-violent offending by Indigenous people. It identifies culturally safe and relevant principles for the design and implementation of measures that have been found to be promising in terms of reducing this category of offending. These principles are important for policy-makers and practitioners to understand, given that many Indigenous people come into contact with the criminal justice system in relation to non-violent offences such as public order and driving offences. The principles set out in the report include: incorporating Indigenous culture, family and community into treatment programs; combining Indigenous approaches with effective Western treatment models such as Cognitive Behavioural Therapy; and addressing the substance abuse, trauma, and historical and social context often associated with offending by Indigenous people. In addition to promoting these principles, the report provides an overview of Indigenous people’s contact with the criminal justice system in relation to non-violent crimes, as well as a discussion of specific programs that have been used with this group of offenders.

Keeping clear on costs: Geatches v Anglo Coal (Moranbah North Management Pty Ltd) [2014] QSC 106

In Geatches v Anglo Coal (Moranbah North Management Pty Ltd [2014] QSC 106, a dispute arose in the context of an assessment of costs as to the meaning to be attributed to particular terms of settlement and discharge signed by the parties. The court was required to consider the implications of those documents, and of a subsequent consent order intended to reflect the agreed settlement. Recovery of costs - terms of settlement and discharge exclude recovery of costs against one party and require other party to pay costs of claim against it - whether only subsequent consent order should be construed - implications where costs were common and mixed costs - whether costs should be apportioned

Hypoxic corneal changes following 8 hours of scleral contact lens wear

- Purpose To examine the change in corneal thickness and posterior curvature following 8 hours of miniscleral contact lens wear. - Methods Scheimpflug imaging (Pentacam HR, Oculus) was captured before, and immediately following, 8 hours of miniscleral contact lens wear for 15 young (mean age 22 ± 3 years), healthy participants with normal corneae. Natural diurnal variations were considered by measuring baseline corneal changes obtained on a separate control day without contact lens wear. - Results Over the central 6 mm of the cornea, a small, but highly statistically significant amount of edema was observed following 8 hours of miniscleral lens wear, after accounting for normal diurnal fluctuations (mean ± standard deviation percentage swelling 1.70 ± 0.98%, p < 0.0001). Posterior corneal topography remained stable following lens wear (-0.01 ± 0.07 mm steepening over the central 6 mm, p = 0.60). The magnitude of posterior corneal topographical changes following lens wear did not correlate with the extent of lens-related corneal edema (r = -0.16, p = 0.57). Similarly, the initial central corneal vault (maximum post-lens tear layer depth) was not associated with corneal swelling following lens removal (r = 0.27, p = 0.33). - Conclusions While a small amount of corneal swelling was induced following 8 hours of miniscleral lens wear (on average <2%), modern high Dk miniscleral contact lenses that vault the cornea do not induce clinically significant corneal edema or hypoxic related posterior corneal curvature changes during short-term wear. Longer-term studies of compromised eyes (e.g. corneal ectasia) are still required to inform the optimum lens and fitting characteristics for safe scleral lens wear to minimize corneal hypoxia.

International contact lens prescribing in 2014

Since the late 1990s, the International Contact Lens Prescribing Survey Consortium has prospectively gathered information about 285,000 contact lens fits from more than 50 countries. This article presents our 14th annual summary of current trends published in Contact Lens Spectrum. With only minor differences in the distribution of our surveys among markets, we have continued to adopt the same approach throughout the past 18 years. Through national coordinators, we approach contact lens prescribers in each country and ask them to record information about the first 10 patients whom they fit with contact lenses after receipt of our survey form. The information collected is generic, and respondents are weighted to reflect the volume of contact lens fits undertaken by each. For this 2014 report, we present information about 25,179 contact lens fits from 32 countries...

Contact lens citation metrics: The Spanish connection

To eye care practitioners, citation metrics may seem to be a somewhat esoteric and irrelevant concept, far removed from the realities or real world, day-to-day clinical practice. However, quantitative analysis of the published literature is becoming increasingly important, and a beautiful example of this is presented in this issue of the Journal of Optometry. My former PhD student, Genís Cardona, has teamed up with Joan Sanz to undertake a thorough and telling analysis of current worldwide publishing trends in the contact lens field. When held in the mirror, this work reflects the growing contributions from Spanish researchers to the field...

Trends in US contact lens prescribing 2002-2014

Purpose To document contact lens prescribing patterns in the United States between 2002 and 2014. Methods A survey of contact lens prescribing trends was conducted each year between 2002 and 2014, inclusive. Randomly selected contact lens practitioners were asked to provide information relating to 10 consecutive contact lens fits between January and March each year. Results Over the 13-year survey period, 1650 survey forms were received from US practitioners representing details of 7702 contact lens fits. The mean (±SD) age of lens wearers was 33.6 (±15.2) years, of whom 65.2% were female. Rigid lens new fits decreased from 13.0% in 2002 to 9.4% in 2014. Across this period, silicone hydrogels have replaced mid water contact lens hydrogels as the soft lens material of choice. Toric lenses represented about 25 to 30% of all soft lens fits. Multifocal soft lenses are generally preferred to monovision. Daily disposable lens fits have recently increased, and in 2014, they represented 27.1% of all soft lens fits. Most lenses are prescribed on 1 to 2 weekly or monthly lens replacement regimen. Extended wear remains a minority lens wearing modality. The vast majority of those wearing reusable lenses use multipurpose lens care solutions. Lenses are mostly worn 7 d/wk. Conclusions This survey has revealed prescribing trends and preferences in the United States over the past 13 years.

Contact lens prescribing trends 2015

Efron, Morgan and Woods share the findings of their latest annual survey of Australian contact lens prescribing habits.

International contact lens prescribing in 2015

We have been collecting data on worldwide contact lens prescribing habits for almost 20 years. Over this time period, we have amassed prospective information about 315,000 contact lens fits in 59 countries. This article marks our 15th report in Contact Lens Spectrum and features a breakdown of more than 23,000 contact lens fits in 34 markets. As in previous years, our international network of coordinators distributed survey forms to eyecare practitioners in their market who then recorded generic information about the first 10 patients fit with contact lenses after receipt. Information is gathered about patient age and gender; whether the contact lenses are prescribed as a new fit or a refit; contact lens material, design, and replacement frequency; number of intended days per week of use; wearing modality; and care system. Contact lens fits are weighted to reflect the number of fits undertaken by each eyecare practitioner. The study data were entered and processed at the University of Manchester and at the University of Waterloo.

Reducing age bias and turnover intentions by enhancing intergenerational contact quality in the workplace: The role of opportunities for generativity and development

Based on socio-emotional selectivity and self-categorization theories, we developed and tested a model on how the interplay between employee age and opportunities for generativity and development predicts age bias and turnover intentions via intergenerational contact quality in the workplace. We hypothesized indirect effects of opportunities for generativity on outcomes through intergenerational contact quality among older workers only, whereas we expected that the indirect effects of opportunities for development are stronger for young compared with older workers. Data came from 321 employees in Belgium who responded to an online questionnaire. Results showed that age moderated the relationships of opportunities for generativity and development with intergenerational contact quality consistent with the expected patterns. Furthermore, age moderated the indirect effects of opportunities for generativity and development on age bias through intergenerational contact quality, but not on turnover intentions. Implications for future research and practical suggestions for managing intergenerational contact at work are discussed.

Drink driving among indigenous people in Far North Queensland and Northern New South Wales: A summary of qualitative findings

In response to the threat that drink drivers pose to themselves and others, drink driving programs form an important part of a suite of countermeasures used in Australia and internationally. Unlike New Zealand/Aotearoa, United States and Canada that have programs catering for their First Peoples, all Australian programs are designed for the general driver population. The aim of this study was to identify the factors that contribute to Indigenous drink driving in order to inform appropriate recommendations related to developing a community-based program for Indigenous communities. Broader drivers licensing policy recommendations are also discussed. A sample of 73 Indigenous people from Queensland and in New South Wales with one or more drink driving convictions completed a semi-structured interview regarding their drink driving behaviour. Participants were asked to disclose information regarding their drink driving history, and alcohol and drug use. If participants self-reported no longer drink driving, they were probed about what factors had assisted them to avoid further offending. Key themes which emerged to maintain drink driving include motivations to drink and drive, and belief in the ability to manage the associated risks. Factors that appeared to support others from avoiding further offending include re-connecting with culture and family support. A range of recommendations regarding delivery and content of a program for regional and remote communities as well as other policy implications are discussed.

Morphological changes in the conjunctiva, episclera and sclera following short-term miniscleral contact lens wear in rigid lens neophytes

PURPOSE To quantify the influence of short-term wear of miniscleral contact lenses on the morphology of the corneo-scleral limbus, the conjunctiva, episclera and sclera. METHODS OCT images of the anterior eye were captured before, immediately following 3h of wear and then 3h after removal of a miniscleral contact lens for 10 young (27±5 years) healthy participants (neophyte rigid lens wearers). The region of analysis encompassed 1mm anterior, to 3.5mm posterior to the scleral spur. Natural diurnal variations in thickness were measured on a separate day and compensated for in subsequent analyses. RESULTS Following 3h of lens wear, statistically significant tissue thinning was observed across all quadrants, with a mean decrease in thickness of -24.1±3.6μm (p<0.001), which diminished, but did not return to baseline 3h after lens removal (-16.9±1.9μm, p<0.001). The largest tissue compression was observed in the superior quadrant (-49.9±8.5μm, p<0.01) and in the annular zone 1.5mm from the scleral spur (-48.2±5.7μm), corresponding to the approximate edge of the lens landing zone. Compression of the conjunctiva/episclera accounted for about 70% of the changes. CONCLUSIONS Optimal fitting miniscleral contact lenses worn for three hours resulted in significant tissue compression in young healthy eyes, with the greatest thinning observed superiorly, potentially due to the additional force of the eyelid, with a partial recovery of compression 3h after lens removal. Most of the morphological changes occur in the conjunctiva/episclera layers.

In response: UV–vis light transmittance through tinted contact lenses and the effect of color on values

In the study, we used the Agilent 8453 spectrophotometer (which is equipped with a limiting aperture that restricts the light beam to the central 5 mm of the contact lens), to measure the transmittance of various coloured contact lenses including the one Day Acuvue define manufactured by Johnson and Johnson which the authors represent. We measured the instrument baseline before the transmittance spectra of lenses were tested. The values of lens transmittances were thus the difference between baseline and lens measurement at each time. The transmittance measurements were obtained at 0.5 nm intervals, from 200 to 700 nm after a soak in saline to remove the influence of any surface active agents within the packaging products. The technique used in our study was not very different from how other research studies [2], [3], [4], [5] and [6] have measured the spectra transmittances of contact lenses...

Tissue compression following short-term miniscleral contact lens wear

To quantify regional (nasal, superior, temporal and inferior) and location specific (corneal and scleral) tissue compression following short-term miniscleral contact lens wear.