2008 – Centre for Ocular Research & Education

Scientific Presentations

2026

Chang P, Timmermann F, Lumb E, Bradley A, Guthrie S. Lens preference and visual performance of two myopia control contact lenses Global Specialty Lens Symposium, Las Vegas, Jan 9, 2026

Chow T, Gifford P, Jones L. The Jessen Compression Factor Is Not a Constant: Baseline Predictors of Individual Variation in Orthokeratology American Academy of Optometry Meeting, Anaheim, CA, Oct 1, 2026 [ Show Abstract ]

Purpose:
The Jessen formula remains the benchmark for selecting the back optic zone radius (BOZR) of an orthokeratology (OK) lens, with a compression factor of typically +0.50D to +0.75D, added to compensate for daytime regression. Chan, Cho & Mountford (2008) showed that the conventional +0.75 D compression factor systematically underestimates required lens flattening and proposed a revised constant of approximately 1.48 D. This study extends Chan et al. by treating the compression term as an inter- and intraindividual variable – the individualized Jessen factor – and identifying which baseline corneal and refractive parameters are significantly associated with its variation.

Methods:
This retrospective study used clinical data from a single private practice in Markham, Ontario. Eligible eyes were age 5–30 years at baseline, with manifest spherical equivalent (SE) −0.50 to −9.50 D, cylinder ≤2.50 D, and a post-treatment refractive endpoint from day 7 onward. Negative baseline eccentricity was excluded as suspected prior OK wear, post-treatment baseline capture, or data-entry error. Residual Jessen compression was defined as lens flattening not accounted for by achieved SE change from baseline to endpoint. Associations were assessed using patient-cluster multivariable regression with standardized predictors and Bonferroni correction. Core models included corneal eccentricity, axial length, and central corneal thickness (CCT); biomechanical subset models additionally included corneal hysteresis (CH) and corneal resistance factor (CRF).

Results:
The final dataset included 766 eyes from 423 patients. Complete predictor data were available for 523 eyes from 299 patients in core models and 503 eyes from 285 patients in biomechanical subset models requiring CH and CRF. Residual Jessen compression varied widely (mean 0.91 ± 1.18 D; range −2.67 to +4.02 D). In the core model, longer axial length was associated with greater residual compression (β=+0.22 D per SD, Bonferroni p=0.017). This association was attenuated in the biomechanical subset model and was no longer significant after correction. Corneal eccentricity, CCT, CH, and CRF were not significant predictors after correction.

Conclusion:
Individualized residual Jessen compression varied substantially, supporting the observation that compression does not behave as a fixed constant. Axial length showed an association in the core model, but this was not robust after including biomechanical variables. This could suggest axial length may partly reflect broader ocular or biomechanical differences rather than acting as a standalone predictor. Overall, routine baseline variables showed limited ability to explain individualized compression requirements. These findings suggest that improving orthokeratology predictability may require lens-cornea interface descriptors, such as tear-layer thickness profile metrics.

Ho B, Wong KY, Soomro A, Jones L, Liu J, Phan CM, Ketelson H. Evaluating the protection of commercially available ocular lubricants on human corneal epithelial cells in dry eye disease states ARVO Annual Meeting, Denver, CO, May 3-7, 2026 [ Show Abstract ]

Purpose : Dry eye disease (DED) is characterized by tear film instability and a hyperosmolar ocular surface, which significantly impacts ocular health. The purpose of this study was to develop novel in vitro mammalian cell assays to assess the effects of commercially available sodium hyaluronate-based artificial tear solutions (ATS) for DED protection.

Methods : Commercially available ATS were tested on immortalized human corneal epithelial cells (HCECs) cultured in DMEM/F12 media with 1% FBS. HCECs were seeded into 96-well plates at a density of 15,000 cells/well and incubated for 24 hours at 37oC and 5% CO2. Once confluent, media was aspirated, and HCECs were treated with ATS or a PBS control for 15 minutes. DED was induced by subjecting cells to either desiccation stress (low humidity, 45%) or hyperosmolar stress (~ 500 mOsM NaCl). Cellular health and ATS protection were assessed by three methods: (1) cellular viability using alamarBlueTM, (2) morphological analysis by time-lapse microscopy, and (3) inflammatory gene expression changes by RT-qPCR.

Results : Upon desiccation stress, the cell viability significantly decreased by approximately 50%. However, pre-treatment with all ATS tested in this study provided protection by significantly increasing viability in desiccation stress compared to the PBS control (p < 0.05, one-way ANOVA). In contrast, only OPTASE® Intense (OI) and Systane® Hydration increased cellular viability in hyperosmotic conditions. Additionally, DED conditions can drastically affect cell and monolayer morphology and integrity, generating large gaps and a broken monolayer. The surface area of the gaps was reduced by treatment with OI. Importantly, pre-treatment of cells with OI reduced the expression of several inflammatory markers in HCECs exposed to either desiccation or hyperosmotic conditions.

Conclusions : This study developed novel in vitro assays modelling DED, which was able to distinguish between therapeutic efficacies of two different ATS products. Therefore, these models can offer valuable insight into developing more targeted DED therapies.

Jones L. Keratolytics: Focused on lid margin and ocular surface disease Dry Eye Society of Americas, New York, USA, July 11, 2026

Jones L. Overview of TFOS DEWS III and update on the management & therapy of dry eye . Japanese Ophthalmology Society, Fukuoka, Japan, Apr 10, 2026

Nagaarudkumaran N, Ngo W. Autophagy Impairment Leads to Cell Cycling Arrest in Human Corneal Epithelial Cells American Academy of Optometry Meeting, Anaheim, CA, Oct 1, 2026 [ Show Abstract ]

Ng E, Choksi T, Nazeri M, Mei S, Jones L, Gu F. Automated Contact Lens Wettability Assays and Analysis Over Air Exposure and Rehydration Cycles at Physiological Temperature Canadian Societies for Chemistry and Chemical Engineering Conference, Toronto, May 25, 2026 [ Show Abstract ]

Over 150 million people worldwide use contact lenses for vision correction, therapeutic treatments, and cosmetics. Despite the large investment to advance contact lens technology, 26% of users drop out of contact lens wear within the first year of commencement, namely due to ocular surface discomfort and sensations of dry eye. Discrepancy between contact lens and corneal surface wettability can contribute to the breakup of the lubricating tear film and leads to excessive ocular friction. Thus, understanding and selecting contact lens materials with sustained wettability is essential to improve tear film stability and subsequently reduce contact lens discomfort.

The in vitro wettability of a contact lens is evaluated using contact angle (CA) measurements of the solid-liquid-air interface of a droplet on the lens surface. Benchtop goniometers are the standard instrument used for CA measurements and wettability analysis, however they are limited in terms of high throughput testing due to reliance on operator handling and manual image analysis. Additionally, measured contact angles for contact lenses are highly sensitive to pre-processing procedures, limiting comparability across wetting studies due to the lack of standardized drying protocols.

This study presents results collected by the Robotic Autonomous Imaging Surface Evaluator tailored to contact lenses (RAISE-Vision), which improves the scalability and consistency of traditional sessile drop contact lens wettability analysis. The RAISE-Vision workflow is automated within the Opentrons OT-2 liquid handler, equipped with 3D printed hardware to integrate a stationary camera and custom lens mount. Additional drying adapter tools standardize lens pre-processing and droplet absorption between CA measurements, reducing the variance caused by human handling. The platform enables sequential CA measurements during lens air exposure, feeding images of the lens and droplets directly to a computer vision-based processing algorithm that determines CA on the curved lens surface without operator input.

To improve the biomimicry of the wettability assay, a heating module and aluminum lens mount were introduced to maintain the lens at physiological temperature (37 °C). Changes in lens surface wettability occurred more rapidly at 37 °C than those observed at room temperature. While some contact lens materials exhibited the similar wettability behaviour under both conditions, other materials maintained low contact angle (<50°) at room temperature but exhibited reduced wettability after 10 minutes of air exposure at 37 °C (<82°). These findings uncover previously uncharacterized aspects of contact lens surface behaviour and demonstrate that wettability analyses conducted at room temperature may not accurately reflect contact lens performance under physiological conditions.

The most recent addition to the platform features automated lens pick up/drop off and 180° rotation mechanisms via magnetic pick and place, and rack and pinion assemblies. Leveraging these capabilities, a stress study was conducted to evaluate wettability performance of contact lenses subjected to sequential drying and rehydration cycles in phosphate-buffered saline. Coupled with gravimetrically determined equilibrium water content measurements, this approach identified an inflection point where contact lenses could no longer return to their original hydrated state.

Nichols K, Jones L, Schallhorn J, Abbott K, Gleeson M, Alster Y, Bosworth C. AZR-MD-001 0.5% significantly improves meibomian glands yielding liquid secretions with clinically meaningful benefit across the dry eye disease spectrum ARVO Annual Meeting, Denver, CO, May 3-7, 2026 [ Show Abstract ]

Purpose : AZR-MD-001 (AZR) 0.5% is a keratolytic ophthalmic ointment that has shown efficacy in opening meibomian glands and improving signs and symptoms of DED in previous clinical trials. Participants in these studies had dysfunctional meibomian glands with an average of ~2 out of 15 measured meibomian glands yielding liquid secretion (MGYLS) at baseline (BL). This analysis will evaluate if participants in the AZR or vehicle groups for these trials achieved an improvement of ≥ 3 MGYLS (responders) at month (M) 3 and the impact the improvement had on signs and symptoms.

Methods : Three vehicle-controlled clinical trials in DED evaluating AZR were analyzed to determine the proportion of participants achieving a ≥ 3 MGYLS improvement. ARIES (AZR n=33, vehicle n=32) enrolled DED participants with MGD and with exacerbation of symptoms during contact lens (CL) wear, CELESTIAL (AZR n=82, vehicle n=80, NCT) enrolled DED participants with MGD and early to moderate symptoms, and ASTRO (long term safety, AZR n=282, vehicle n=280, NCT03652051) enrolled DED participants with MGD and a broad spectrum of disease including mixed disease. Sign outcomes for all studies included corneal fluorescein staining/clearance, and symptoms included mean OSDI, SPEED, and VAS Dryness. Comfortable CL wear time (minutes) and ability to wear lenses as long as desired were assessed in ARIES.

Results : At M3, significantly more AZR-treated participants achieved MGYLS ≥3 improvement compared with vehicle: ARIES (97.0% vs 15.6%; p<0.0001), CELESTIAL (68.3% vs 44.4%; p=0.0060), ASTRO (58.5% vs 49.6%; p=0.0424). An MGYLS improvement of ≥3 was associated with statistically significant (p<0.05) improvements in ≥70% of signs and symptoms across the studies.

Conclusions : An improvement of ≥3 glands on MGYLS from BL - indicating restored meibomian gland function - was associated with measurable improvements in DED signs and symptoms. In three vehicle-controlled MGD clinical trials encompassing the full range of DED severity, AZR treatment yielded significantly higher rates of clinically meaningful MGYLS improvement compared with vehicle.

Qiu S. Looking Beyond the Horizontal Iris Diameter: A Computational Approach for Limbal Diameter Calculation Global Specialty Lens Symposium, Las Vegas, Jan 8, 2026

Qiu S. Empirically Fit Translimbal Orthokeratology for the Management of High Myopia Global Specialty Lens Symposium, Las Vegas, Jan 8, 2026

Qiu S, Liao J, Fadel D, Consejo A, Bray C, Hui A, Jones L. Predictors of limbal ovality from corneoscleral topography ARVO Annual Meeting, Denver, CO, May 3-7, 2026 [ Show Abstract ]

Purpose : This study aimed to evaluate horizontal and vertical limbus-to-limbus diameters using a computational method derived from corneoscleral topography and to compare these values with the clinically used horizontal visible iris diameter (HVID). A secondary objective was to use multiple regression analysis to identify potential factors that contribute to the limbal ovality.

Methods : Corneoscleral topography was obtained using the Eaglet Eye Surface Profiler (ESP) in healthy subjects with no corneal irregularities. Two scans were collected per eye, and the resulting measurements were averaged to derive a single value for analysis. A custom Matlab program performed automated 360° limbus detection by fitting ESP elevation data with a second-order Zernike polynomial and locating the point of maximal residual error, marking the cornea-conjunctiva curvature transition and limbus location. Horizontal and vertical limbal diameters were calculated as the sums of the limbal radii at 0°/180° and 90°/270°, respectively. A multiple linear regression analysis was conducted to evaluate the influence of sex, race, corneal astigmatism (J0 and J45), spherical equivalent, scleral toricity at the 12.8 mm chord (1 mm larger than the average HVID of 11.8 mm), and the 16 mm chord (within a typical scleral lens’ landing zone) on limbal ovality, defined as the horizontal-vertical limbal diameter difference.

Results : A total of 108 scans from 54 eyes (27 subjects) were analyzed. The mean horizontal limbal diameter was 12.9 ± 0.5 mm and the mean vertical diameter was 11.9 ± 0.5 mm. The limbal ovality averaged 1.0 ± 0.7 mm. The mean HVID was 12.0 ± 0.3 mm. Sex, race, spherical equivalent, and scleral toricity at the 16 mm chord were identified as significant factors in limbal ovality (all p<0.05), whereas corneal astigmatism and scleral toricity at the 12.8 mm chord did not.

Conclusions : This computational method demonstrated that the limbus is consistently and substantially oval, with horizontal diameter approximately 1 mm larger than vertical and typically exceeding HVID. These results indicate that HVID may underestimate limbal dimensions and fail to capture limbal ovality. Multiple regression findings suggest that limbal ovality may vary with demographic factors, refractive error, and scleral toricity, underscoring the importance of individualized limbal geometry where its position may be crucial, such as in scleral lens design.

Soomro A, Tiop W, Ho B, Wong K, Jones L, Liu J, Phan CM. Characterization of human corneal epithelial and meibomian gland epithelial cells in a hyperosmolar dry eye disease model ARVO Annual Meeting, Denver, CO, May 3-7, 2026 [ Show Abstract ]

Purpose : Our study aims to monitor and quantify phenotypic changes and cell viability in human corneal epithelial cells (HCECs) and meibomian gland epithelial cells (MGECs) due to dry eye disease (DED), to provide a standardized quantitative method to assessing the overall health of the eye.

Methods : HCECs and MGECs were cultured at 37 °C, 45% humidity to ~90% confluence in DMEM (300 mOsm NaCl, 1% FBS, 1% P/S) or KSFM with 5 ng/mL EGF, 50 µg/mL BPE, respectively, and 1% P/S. MGECs were differentiated in DMEM/F12 with 10% FBS and 5 ng/mL EGF. Cells were seeded at 65%, 80%, or 100% confluence and exposed to hyperosmolar media (400, 500, 650 mOsm NaCl) for 24 h. After treatment, cells were labeled with CellTracker and imaged by brightfield/fluorescence microscopy. A fully automated pipeline (flat-field normalization, cytoplasm detection, watershed segmentation) quantified field-level coverage. Viability was measured by alamarBlue™. Statistics used pairwise t-tests (*, **, *** for p<0.05, 0.01, 0.001).

Results : HCECs display a large, polygonal morphology, whereas MGECs form compact globular aggregates. Under hyperosmolar conditions, both cell types undergo pronounced morphological disruption, most notably loss of cell–cell contacts and reduced monolayer coverage. HCECs coverage decrease by ~0.25-fold vs control. In contrast, 100% confluent HCECs show marked resilience. Differentiated healthy MGECs appear as clumps that undergo increasing apoptosis with higher osmolarity, while 65% confluent MGECs show minimal aggregation. Hyperosmolarity also reduces HCEC viability, with 100% and 80% confluence providing better protection at 400–500 mOsm NaCl. For MGECs, viability is maintained at 400 mOsm but declines with an additional 100 mOsm; 65% confluence shows slightly greater resistance than the other confluency levels.

Conclusions : Higher confluency in both HCECs and MGECs provided partial protection against hyperosmotic stress in the DED model partly due to increased cell–cell contact, limiting direct salt exposure. MGECs secrete lipid mixtures that may strengthen the membrane barrier, improving protection. Future work will incorporate AI-based models to standardize and refine single-cell characterization of robust assessment for DED screening and therapeutic testing.

Walsh K, Jung L, Woods J, Marullo R, Moezzi A, de la Jara PL. Transitioning existing spherical soft contact lens wearers with low astigmatism into a soft toric lens

American Academy of Optometry Meeting, Anaheim, CA, Oct 1, 2026

Wu,J., Shokrollahi,P., Wong,K., Jones,L., Phan,C.-M.. Protein removal from orthokeratology RGP materials using hydrogen peroxide care systems American Academy of Optometry Meeting, Anaheim, Oct 1, 2026 [ Show Abstract ]