Impact in contact lenses and the anterior eye:challenges prevailing in 2015

As we settle into a new year, this second issue of Contact Lens and Anterior Eye allows us to reflect on how new research in this field impacts our understanding, but more importantly, how we use this evidence basis to enhance our day to day practice, to educate the next generation of students and to construct the research studies to deepen our knowledge still further. The end of 2014 saw the publication of the UK governments Research Exercise Framework (REF) which ranks Universities in terms of their outputs (which includes their paper, publications and research income), environment (infrastructure and staff support) and for the first time impact (defined as “any effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia” [8]). The REF is a process of expert review, carried out in 36 subject-based units of assessment, of which our field is typically submitted to the Allied Health, Dentistry, Nursing and Pharmacy panel. Universities that offer Optometry did very well with Cardiff, Manchester and Aston in the top 10% out of the 94 Universities that submitted to this panel (Grade point Average ranked order). While the format of the new exercise (probably in 2010) to allocate the more than £2 billion of UK government research funds is yet to be determined, it is already rumoured that impact will contribute an even larger proportion to the weighting. Hence it is even more important to reflect on the impact of our research. In this issue, Elisseef and colleagues [5] examine the intriguing potential of modifying a lens surface to allow it to bind to known wetting agents (in this case hyaluronic acid) to enhance water retention. Such a technique has the capacity to reduced friction between the lens surface and the eyelids/ocular surface, presumably leading to higher comfort and less reason for patients to discontinue with lens wear. Several papers in this issue report on the validity of new high precision, fast scanning imaging and quantification equipment, utilising techniques such as Scheimpflug, partial coherence interferometry, aberrometry and video allowing detailed assessment of anterior chamber biometry, corneal topography, corneal biomechanics, peripheral refraction, ocular aberrations and lens fit. The challenge is how to use this advanced instrumentation which is becoming increasingly available to create real impact. Many challenges in contact lenses and the anterior eye still prevail in 2015 such as: -While contact lens and refractive surgery complications are relatively rare, they are still too often devastating to the individual and their quality of life (such as the impact and prognosis of patients with Acanthmoeba Keratitis reported by Jhanji and colleagues in this issue [7]). How can we detect those patients who are going to be affected and what modifications do we need to make to contact lenses and patient management prevent this occurring? -Drop out from contact lenses still occurs at a rapid rate and symptoms of dry eye seem to be the leading cause driving this discontinuation of wear [1] and [2]. What design, coating, material and lubricant release mechanism will make a step change in end of day comfort in particular? -Presbyopia is a major challenge to hassle free quality vision and is one of the first signs of ageing noticed by many people. As an emmetrope approaching presbyopia, I have a vested interest in new medical devices that will give me high quality vision at all distances when my arms won’t stretch any further. Perhaps a new definition of presbyopia could be when you start to orientate your smartphone in the landscape direction to gain the small increase in print size needed to read! Effective accommodating intraocular lenses that truly mimic the pre-presbyopic crystalline lenses are still a way off [3] and hence simultaneous images achieved through contact lenses, intraocular lenses or refractive surgery still have a secure future. However, splitting light reaching the retina and requiring the brain to supress blurred images will always be a compromise on contrast sensitivity and is liable to cause dysphotopsia; so how will new designs account for differences in a patient's task demands and own optical aberrations to allow focused patient selection, optimising satisfaction? -Drug delivery from contact lenses offers much in terms of compliance and quality of life for patients with chronic ocular conditions such as glaucoma, dry eye and perhaps in the future, dry age-related macular degeneration; but scientific proof-of-concept publications (see EIShaer et al. [6]) have not yet led to commercial products. Part of this is presumably the regulatory complexity of combining a medical device (the contact lens) and a pharmaceutical agent. Will 2015 be the year when this innovation finally becomes a reality for patients, bringing them an enhanced quality of life through their eye care practitioners and allowing researchers to further validate the use of pharmaceutical contact lenses and propose enhancements as the technology matures? -Last, but no means least is the field of myopia control, the topic of the first day of the BCLA's Conference in Liverpool, June 6–9th 2015. The epidemic of myopia is a blight, particularly in Asia, with significant concerns over sight threatening pathology resulting from the elongated eye. This is a field where real impact is already being realised through new soft contact lens optics, orthokeratology and low dose pharmaceuticals [4], but we still need to be able to better predict which technique will work best for an individual and to develop new techniques to retard myopia progression in those who don’t respond to current treatments, without increasing their risk of complications or the treatment impacting their quality of life So what will your New Year's resolution be to make 2015 a year of real impact, whether by advancing science or applying the findings published in journals such as Contact Lens and Anterior Eye to make a real difference to your patients’ lives?

State–society relations in a dynamic framework:the case of the Far East and Sub-Saharan Africa

According to the textbook approach, the developmental states of the Far East have been considered as strong and autonomous entities. Although their bureaucratic elites have remained isolated from direct pressures stemming from society, the state capacity has also been utilised in order to allocate resources in the interest of the whole society. Yet, society – by and large –has remained weak and subordinated to the state elite. On the other hand, the general perception of Sub-Saharan Africa (SSA) has been just the opposite. The violent and permanent conflict amongst rent-seeking groups for influence and authority over resources has culminated in a situation where states have become extremely weak and fragmented, while society – depending on the capacity of competing groups for mobilising resources to organise themselves mostly on a regional or local level (resulting in local petty kingdoms) – has never had the chance to evolve as a strong player. State failure in the literature, therefore, – in the context of SSA – refers not just to a weak and captured state but also to a non-functioning, and sometimes even non-existent society, too. Recently, however, the driving forces of globalisation might have triggered serious changes in the above described status quo. Accordingly, our hypothesis is the following: globalisation, especially the dynamic changes of technology, capital and communication have made the simplistic “strong state–weak society” (in Asia) and “weak state–weak society” (in Africa) categorisation somewhat obsolete. While our comparative study has a strong emphasis on the empirical scrutiny of trying to uncover the dynamics of changes in state–society relations in the two chosen regions both qualitatively and quantitatively, it also aims at complementing the meaning and essence of the concepts and methodology of stateness, state capacity and state-society relations, the well-known building blocks of the seminal works of Evans (1995), Leftwich (1995), Migdal (1988) or Myrdal (1968).

Reshoring:opportunities and limits for manufacturing in the UK - the case of the auto sector

In recent years, offshoring and outsourcing have transformed fundamentally nationally based auto sectors into global networks of design, production and distribution across the global value chains coordinated by the major automotive Original Equipment Manufacturers (OEMs). As manufacturing activities tended to be shifted to low-labour cost locations in Asia, Africa and Latin America, high-end design, R&D, product development have stayed anchored mostly to high-cost and high knowledge-intensive home economy locations (perhaps with the except of some design and styling activities which are often located in major end markets around the world. However, very recently the weaknesses of and risks inherent in such global value chains (GVCs) have been exposed, triggering attempts to rethink their nature and also raising possibilities to reshore some manufacturing activities to home countries. A combination of a more competitive exchange rate (despite the very recent appreciation of sterling), increased transport costs, rising wages in key areas of China, and a greater awareness of supply chain resilience have all contributed to a perceived change in some business fundamentals. The potential for some supply chain relocalisation also links in with the servitisation of manufacturing including the auto sector and shift to a hybrid model where manufacturing and services are increasingly intertwined. However, there are limits as to how far this can go and these raise some important questions and issues over the possible role for industrial policy.

Dimensioning RS codes for mitigation of phase noise induced cycle slips in DQPSK systems

We present a semi-analytical method for dimensioning Reed-Solomon codes for coherent DQPSK systems with laser phase noise and cycle slips. We evaluate the accuracy of our method for a 28 Gbaud system using numerical simulations.

Mitigation of EEPN in long-haul n-PSK coherent transmission system using modified optical pilot carrier

We present the compensation of the equalization enhanced phase noise (EEPN) in the long-haul n-level phase shift keying (n-PSK) coherent optical transmission system, by employing a scheme of phase modulated optical pilot carrier. © OSA 2013.

Analysis of carrier phase extraction methods in 112-Gbit/s NRZ-PDM-QPSK coherent transmission system

We present a comparative analysis on three carrier phase extraction approaches, including a one-tap normalized least mean square method, a block-average method, and a Viterbi-Viterbi method, in coherent transmission system considering equalization enhanced phase noise. © OSA 2012.

45°-TFG based in-fiber polarizer at 800nm by UV inscription

We show in-fiber polarizers at 800nm range with polarization extinction ratio (PER) up to 37dB, fabricated by UV-inscribing grating structures tilted at 45° in standard single mode fiber. The results show that the PER of such polarizers increases linearly with the grating length. © OSA 2012.

Influence of digital dispersion equalization on phase noise enhancement in coherent optical system

The phase noise enhancement due to digital dispersion equalization is investigated, which indicates that the phase noise from transmitter laser can also interact with the dispersion depending on the choice of digital dispersion compensation methods. © OSA 2012.

Global trends in myopia management attitudes and strategies in clinical practice

PURPOSE: Myopia is a global public health issue; however, no information exists as to how potential myopia retardation strategies are being adopted globally. METHODS: A self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. RESULTS: Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5 (±37.8)% prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%). CONCLUSIONS: Regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.

Teaching English to young learners in Europe:teachers' attitudes and perspectives

The introduction of languages into the primary curriculum has been the major development in language-in-education policy around the world over the last 20-25 years. In the vast majority of countries the language taught is English and it is being taught at an ever-earlier age. A relatively large amount of research has been carried out in Asia into teaching English to young learners (TEYL) from the point of view of language policy and planning and of policy implementation, especially in terms of the gap between policy and practice caused by the introduction of new methodologies such as communicative language teaching. However, to date far less research has been carried out into the situation in Europe, particularly concerning the attitudes of those most closely involved in policy implementation - the teachers themselves. This chapter examines the attitudes of teachers in six European countries (Italy, Latvia, Macedonia, Poland, Spain and Ukraine), uncovering the challenges they face and the changes they would like to see enacted to improve English language learning and teaching in their countries. The implications for policy, planning and teacher education are also discussed.

Fiber Bragg grating inscription in four core fibers and their sensing applications

We inscribe FBGs in all cores of four core fiber simultaneously and investigate their thermal, strain and bending (both direction and magnitude) responses. The influence of fiber core distance on bending sensitivity is also discussed. © 2015 OSA.

Reach extension of high-capacity LR-PONs in chain configuration of distributed amplifier structure

We show 100-Gb/s single-channel transmission in LR-PONs with at least 512 way split and up to 160 km total distance is feasible by means of "chained" cable with amplifier solutions, and appropriate FIR filter designs. © 2015 OSA.