Ocular surface health with contact lens wear

Eye care practitioners (ECPs) would tend to agree that wearing contact lenses increases the risk for infection, but millions of patients are still fitted with lenses every year because ECPs feel that the risk is manageable and that their patients' eye health can be protected. The Fusarium and Acanthamoeba keratitis outbreaks of years past were a wake-up call to manufacturers, ECPs, and regulatory agencies that risk cannot be managed without diligence, and that the complex relationship between contact lens materials, contact lens solutions, and compliance needs to be better understood in order to optimize the efficacy of contact lens care and improve care guidelines.

Determinants of the frequency of contact lens wear

Objectives To characterize and discover the determinants of the frequency of wear (FOW) of contact lenses. Methods Survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for 5 consecutive years (2007–2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Only data for daily wear lens fits were analyzed. Results Data were collected in relation to 74,510 and 9,014 soft and rigid lens fits, respectively. Overall, FOW was 5.9±1.7 days per week (DPW). When considering the proportion of lenses worn between one to seven DPW, the distribution for rigid lenses is skewed toward full-time wear (7 DPW), whereas the distribution for soft daily disposable lenses is perhaps bimodal, with large and small peaks at seven and two DPW, respectively. There is a significant variation in FOW among nations (P<0.0001), ranging from 6.8±1.0 DPW in Greece to 5.1±2.5 DPW in Kuwait. For soft lenses, FOW increases with decreasing age. Females (6.0±1.6 DPW) wear lenses more frequently than males (5.8±1.7 DPW) (P=0.0002). FOW is greater among those wearing presbyopic corrections (6.1±1.4 DPW) compared with spherical (5.9±1.7 DPW) and toric (5.9±1.6 DPW) designs (P<0.0001). FOW with hydrogel peroxide systems (6.4±1.1 DPW) was greater than that with multipurpose systems (6.2±1.3 DPW) (P<0.0001). Conclusions Numerous demographic and contact lens–related factors impact FOW. There may be a future trend toward a lower FOW associated with the increasing popularity of daily disposable lenses.

An evidence-based brochure to educate contact lens wearers about safe contact lens wear

Contact lenses are a successful and popular means to correct refractive error and are worn by just under 700,000 Australians1 and approximately 125 million people worldwide. The most serious complication of contact lens wear is microbial keratitis, a potentially sight-threatening corneal infection most often caused by bacteria. Gram-negative bacteria, in particular pseudomonas species, account for the majority of severe bacterial infections. Pathogens such as fungi or amoebae, which feature less often, are associated with significant morbidity. These unusual pathogens have come into the spotlight in recent times with an apparent association with specific lens cleaning solutions...

A data analytics case study assessing factors affecting pavement deflection values

Road networks are a national critical infrastructure. The road assets need to be monitored and maintained efficiently as their conditions deteriorate over time. The condition of one of such assets, road pavement, plays a major role in the road network maintenance programmes. Pavement conditions depend upon many factors such as pavement types, traffic and environmental conditions. This paper presents a data analytics case study for assessing the factors affecting the pavement deflection values measured by the traffic speed deflectometer (TSD) device. The analytics process includes acquisition and integration of data from multiple sources, data pre-processing, mining useful information from them and utilising data mining outputs for knowledge deployment. Data mining techniques are able to show how TSD outputs vary in different roads, traffic and environmental conditions. The generated data mining models map the TSD outputs to some classes and define correction factors for each class.

Laboratory study on the performance of recycled concrete aggregates blended with reclaimed asphalt pavement as pavement granular material

Production of recycled concrete aggregates (RCA) from construction and demolition (C&D) waste has become popular all over the world since the availability of land spaces are limited to dispose. Therefore it is important to seek alternative applications for RCA. The use of RCA in base and sub-base layers in granular pavement is a viable solution. In mechanistic pavement design, rutting (permanent deformation) is considered as the major failure mechanisms of the pavement. The rutting is the accumulation of permanent deformation of pavement layers caused by the repetitive vehicle load. In Queensland, Australia, it is accepted to have the maximum of 20% of reclaimed asphalt pavement (RAP) in RCA and therefore, it is important to investigate the effect of RAP on the permanent deformation properties of RCA. In this study, a series of repeated load triaxial (RLT) tests were conducted on RCA blended with different percentage of RAP to investigate the permanent deformation and resilient modulus properties of RCA. The vertical deformation and resilient modulus values were used to determine the response of RCA for the cyclic loading under standard pressure and loading conditions.

Assessment of recycled concrete aggregates as a pavement material

Population increase and economic developments can lead to construction as well as demolition of infrastructures such as buildings, bridges, roads, etc resulting in used concrete as a primary waste product. Recycling of waste concrete to obtain the recycled concrete aggregates (RCA) for base and/or sub-base materials in road construction is a foremost application to be promoted to gain economical and sustainability benefits. As the mortar, bricks, glass and reclaimed asphalt pavement (RAP) present as constituents in RCA, it exhibits inconsistent properties and performance. In this study, six different types of RCA samples were subjected classification tests such as particle size distribution, plasticity, compaction test, unconfined compressive strength (UCS) and California bearing ratio (CBR) tests. Results were compared with those of the standard road materials used in Queensland, Australia. It was found that material type ‘RM1-100/RM3-0’ and ‘RM1-80/RM3-20’ samples are in the margin of the minimum required specifications of base materials used for high volume unbound granular roads while others are lower than that the minimum requirement.

Predicting freeway pavement construction cost using a back-propagation neural network : a case study in Henan, China

The objective of this research was to develop a model to estimate future freeway pavement construction costs in Henan Province, China. A comprehensive set of factors contributing to the cost of freeway pavement construction were included in the model formulation. These factors comprehensively reflect the characteristics of region and topography and altitude variation, the cost of labour, material, and equipment, and time-related variables such as index numbers of labour prices, material prices and equipment prices. An Artificial Neural Network model using the Back-Propagation learning algorithm was developed to estimate the cost of freeway pavement construction. A total of 88 valid freeway cases were obtained from freeway construction projects let by the Henan Transportation Department during the period 1994−2007. Data from a random selection of 81 freeway cases were used to train the Neural Network model and the remaining data were used to test the performance of the Neural Network model. The tested model was used to predict freeway pavement construction costs in 2010 based on predictions of input values. In addition, this paper provides a suggested correction for the prediction of the value for the future freeway pavement construction costs. Since the change in future freeway pavement construction cost is affected by many factors, the predictions obtained by the proposed method, and therefore the model, will need to be tested once actual data are obtained.

Groundwater table response to sea level rise and its impact on pavement structure

It has been predicted that sea level will rise about 0.8 m by 2100. Consequently, seawater can intrude into the coastal aquifers and change the level of groundwater table. A raise in groundwater table due to seawater intrusion threats the coastal infrastructure such as road pavements. The mechanical properties of subgrade materials will change due to elevated rise of groundwater table, leading to pavement weakening and decreasing the subgrade strength and stiffness. This paper presents an assessment of the vulnerability of subgrade in coastal areas to change in groundwater table due to sea-level rise. A simple bathtub approach is applied for estimating the groundwater level changes according to sea-level rise. Then the effect of groundwater level changes on the soil water content (SWC) of a single column of fine-sand soil is simulated using MIKE SHE. The impact of an increase in moisture content on subgrade strength/stiffness is assessed for a number of scenarios.

The penetrance and characteristics of contact lens wear in Australia

Background A population-based, cross-sectional telephone survey was conducted to estimate the penetrance and characteristics of contact lens wear in Australia. Methods Based on postcode distribution, 42,749 households around Australia were randomly selected from the national electronic telephone directory. During calls, the number of individuals and contact lens wearers in each household aged between 15 and 64 years was ascertained. Contact lens wearers were interviewed using a structured questionnaire, to determine details of demographics, lens type, mode of lens wear and hygienic habits. Contact lens wear characteristics and habits were compared by lens type and mode of use. Results Of the 32,405 households contacted, 19,171 (59.2 per cent) agreed to participate. The penetrance of contact lens wear during the study period was 5.01 per cent (95% CI: 4.78-5.24). The mean age of lens wearers was 36.5 ± 18.3 years and 63.4 per cent were female. There were significant differences in the habits and characteristics of lens wearers depending on their lens type and mode of use. Conclusions The penetrance of contact lens wear concurs with market estimates and equates to approximately 680,000 contact lens wearers aged between 15 and 64 years in Australia. This is the most detailed and extensive population-based survey of contact lens wearers ever conducted. The discrepancies found between the characteristics of lens wearers surveyed in this study compared to those in previous studies of contact lens practitioners highlights the importance of study design. These results may be applied to other regions with similar health-care and regulatory systems.

Corneal changes following short-term miniscleral contact lens wear

Purpose To examine the influence of short-term miniscleral contact lens wear on corneal shape, thickness and anterior surface aberrations. Methods Scheimpflug imaging was captured before, immediately following and 3 hours after a short period (3 hours) of miniscleral contact lens wear for 10 young (mean 27 ± 5 years), healthy participants. Natural diurnal variations were considered by measuring baseline diurnal changes obtained on a separate control day without contact lens wear. Results Small but significant anterior corneal flattening was observed immediately following lens removal (overall mean 0.02 ± 0.03 mm, p < 0.001) which returned to baseline levels three hours after lens removal. During the three hour recovery period significant corneal thinning (-13.4 ± 10.5 μm) and posterior surface flattening (0.03 ± 0.02 mm) were also observed (both p < 0.01). The magnitude of posterior corneal flattening during recovery correlated with the amount of corneal thinning (r = 0.69, p = 0.03). Central corneal clearance (maximum tear reservoir depth) was not associated with corneal swelling following lens removal (r = -0.24, p > 0.05). An increase in lower-order corneal astigmatism Z(2,2) was also observed following lens wear (mean -0.144 ± 0.075 μm, p = 0.02). Conclusions Flattening of the anterior corneal surface was observed immediately following lens wear, while ‘rebound’ thinning and flattening of the posterior surface was evident following the recovery period. Modern miniscleral contact lenses that vault the cornea may slightly influence corneal shape and power but do not induce clinically significant corneal oedema during short-term wear.

Scheimpflug imaging of the post lens tear film during contact lens wear

A new imaging methodology is described to visualise the post lens tear film (PLTF) during contact lens wear. A rotating-Scheimpflug camera in combination with sodium fluorescein allows evaluation of the PLTF for different contact lens modalities, including mini-scleral, rigid gas permeable (RGP) and soft contact lenses. This imaging technique provides an extension of the instrument’s current functionality. The potential advantages and limitations of the technique are discussed.

In response: Changes in ultraviolet transmittance of hydrogel and silicone hydrogel contact lenses induced by wear

We thank Dr Shedden and Dr Pall for their insightful comments and the opportunity to clarify a number of points from our work.1 The “protection factor” (PF) expressed as the inverse of the transmittance of contact lens (CL) material (1/Tλ), where T is the percentage transmittance of ultraviolet radiation (UVR) in a given waveband (UVC, UVB or UVA) of the UV spectrum for contact lenses is the standard method for reporting PF values and as such there should not be any controversy. We have calculated the PF for each wavelength across the entire UV spectrum (UVC, UVB, UVA) as presented in figure 3 of our previous publication.1 In that article, we were simply stating the observation when transmission in the UVC spectra band is considered especially because appreciable amounts of potentially carcinogenic short UV wavelengths was shown to be present in sunlight in our region three decades ago2 and these short wavelength photons are reported to be more biologically damaging to ocular tissues.3 In addition, the depletion of the Ozone layer is still continuing. Nevertheless, we understand the concern of the authors that the results of the PF might be confusing to those who are not familiar with the science of UVR and as such we have made some revisions to the findings of the calculated PF...