Biocompatibility, SiH lenses and the impact of hydration on comfort

Silicone hydrogel (SiH) contact lenses have been available for over a decade. During that time, these highly innovative materials and designs have continually improved and now represent a major percentage of fits within the global contact lens market.1 Their high oxygen transmissibility has drastically reduced the incidence of hypoxia-related conditions such as corneal edema, limbal hyperaemia, and corneal vascularisation.2,3 However, there remain significant challenges in the quest for the ideal contact lens. The silicone material used in SiH contact lenses is inherently more hydrophobic than the non-silicone hydrogel materials. SiH lens manufacturers must find ways to overcome lens surface hydrophobicity since it can create issues in terms of lens wettability and surface deposition. Achieving ideal lens water content presents yet another challenge since increasing water content in a silicone hydrogel lens can reduce oxygen transmissibility. This is because increasing water content results in decreased silicone content in the lens and silicone is a better transmitter of oxygen than water.

Contact lens prescribing : USA vs the world

Along with other facets of commericialization, the contact lens market has become globalized during the past 30 years. The major international companies have worldwide distribution networks and supply lenses of the same product names and replacement frequencies to all nations, with a few minor adjustments for marketing and regulatory reasons. Small and medium-sized companies, often producing more specialized lenses, are also active in markets across the world.

Contact lens prescribing in Canada 2011

For the past 12 years, the International Contact Lens Prescribing Survey Consortium has sent surveys to a selection of Canadian optometrists in order to collect information on the contact lenses they fit and basic demographic data of the patients. Canada is one of about 40 countries that contributes to the global study and while annual reviews of the study data are presented, information published for any one market is limited due to the size of the dataset.1 This manuscript presents a more detailed analysis on the Canadian market for 2011.

Trends in contact lens prescribing 2012

The 13th annual survey of Australian contact lens prescribing was conducted between January and April 2012. The same format as in previous years was employed. About 3,000 members of Optometrists Association Australia were sent an e-mail message with a link to a downloadable questionnaire, and a request that this be accessed, printed and completed to provide details of the first 10 patients fitted with contact lenses after receipt of the questionnaire.

Choroidal thickness in myopic and non-myopic children assessed with enhanced depth imaging optical coherence tomography

Purpose To examine choroidal thickness (ChT) and its topographical variation across the posterior pole in myopic and non-myopic children. Methods One hundred and four children aged 10-15 years of age (mean age 13.1 ± 1.4 years) had ChT measured using enhanced depth imaging optical coherence tomography (OCT). Forty one children were myopic (mean spherical equivalent -2.4 ± 1.5 D) and 63 non-myopic (mean +0.3 ± 0.3 D). Two series of 6 radial OCT line scans centred on the fovea were assessed for each child. Subfoveal ChT and ChT across a series of parafoveal zones over the central 6mm of the posterior pole were determined through manual image segmentation. Results Subfoveal ChT was significantly thinner in myopes (mean 303 ± 79 µm) compared to non-myopes (mean 359 ± 77 µm) (p<0.0001). Multiple regression analysis revealed both refractive error (r = 0.39, p<0.001) and age (r = 0.21, p = 0.02) were positively associated with subfoveal ChT. ChT also exhibited significant topographical variations, with the choroid being thicker in more central regions. The thinnest choroid was typically observed in nasal (mean 286 ± 77 µm) and inferior-nasal (306 ± 79 µm) locations, and the thickest in superior (346 ± 79 µm) and superior-temporal (341 ± 74 µm) locations. The difference in ChT between myopic and non-myopic children was significantly greater in central foveal regions compared to more peripheral regions (>3 mm diameter) (p<0.001). Conclusions Myopic children have significantly thinner choroids compared to non-myopic children of similar age, particularly in central foveal regions. The magnitude of difference in choroidal thickness associated with myopia appears greater than would be predicted by a simple passive choroidal thinning with axial elongation.

Stability of corneal topography and wavefront aberrations in young Singaporeans

Purpose To investigate the differences between and variations across time in corneal topography and ocular wavefront aberrations in young Singaporean myopes and emmetropes. Methods We used a videokeratoscope and wavefront sensor to measure the ocular surface topography and wavefront aberrations of the total eye optics in the morning, mid-day and late afternoon on two separate days. Topography data were used to derive the corneal surface wavefront aberrations. Both the corneal and total wavefronts were analysed up to the 4th radial order of the Zernike polynomial expansion, and were centred on the entrance pupil (5 mm). The participants included 12 young progressing myopes, 13 young stable myopes and 15 young age-matched emmetropes. Results For all subjects considered together there were significant changes in some of the aberrations terms across the day, such as spherical aberration ( ) and vertical coma ( ) (repeated measures ANOVA, p<0.05). The magnitude of positive spherical aberration ( ) was significantly lower in the progressing myope group than that of the stable myopes (p=0.04) and emmetrope group (p=0.02). There were also significant interactions between refractive group and time of day for with/against-the-rule astigmatism ( ). Significantly lower 4th order RMS of ocular wavefront aberrations were found in the progressing myope group compared with the stable myopes and emmetropes (p<0.01). Conclusions These differences and variations in the corneal and total aberrations may have significance for our understanding of refractive error development and for clinical applications requiring accurate wavefront measurements.