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Peer-reviewed articles

2024

Jabeen,A., Luensmann,D., Woods,J., Hill,J. S., Jones,L. Evaluation of Lag of Accommodation with Full-Field Diffusion Optics Technology™ (DOT) Contrast Management Spectacle Lenses in Emmetropic Children Clinical Ophthalmology 2024;2024(18):1181-1190 [ Show Abstract ]

Purpose: To evaluate the impact on the lag of accommodation (LOA) in emmetropic children after short-term wear of full-field Diffusion Optics TechnologyTM (DOT) spectacle lenses, designed to modulate retinal contrast to control myopia progression.

Patients and Methods: This was a single-visit, prospective, randomized, subject-masked study of emmetropes (ametropes ±1.00D or less in each meridian) with no history of myopia control treatment. Unaided logMAR visual acuity was measured, and ocular dominance was determined using the sighting method. In a randomized order, participants wore plano full-field contrast management (DOT) spectacles (no clear central aperture) or control spectacles (standard single vision spectacle lenses). Each participant was given 5 minutes for adaptation to the respective lenses before open field autorefraction measurements were taken at 6 meters and 40 cm. Ten measurements were taken for each eye. Data were evaluated from the right eye and the dominant eye separately.

Results: A total of 30 participants (20 females and 10 males) with a mean age of 10.4 ± 2.8 (7 to 17) years completed the study. There was no significant difference in right eye mean LOA with contrast management spectacles 0.57 ± 0.39D versus control spectacles 0.62 ± 0.34D; Wilcoxon test, p = 0.37. For dominant eyes, LOA values were 0.60 ± 0.40D and 0.68 ± 0.33D with contrast management spectacles and control spectacles, respectively (p = 0.14). Additionally, no significant difference was observed in mean LOA between males and females or between age groups (7–11 years vs 12–17 years) for either right or dominant eyes with contrast management or control spectacles (all p > 0.05).

Conclusion: Full-field contrast management spectacle lenses had no significant effect on LOA compared to standard single vision spectacle lenses, indicating no differential impact on accommodative response over the short period of lens wear tested.

Jabeen,A., Luensmann,D., Woods,J., Hill,J., Jones,L. Evaluation of Lag of Accommodation with Full-Field Diffusion Optics Technology™ (DOT) Contrast Management Spectacle Lenses in Emmetropic Children Clinical Ophthalmology 2024;18(May):1181-1190 [ Show Abstract ]

Purpose: To evaluate the impact on the lag of accommodation (LOA) in emmetropic children after short-term wear of full-field Diffusion Optics TechnologyTM (DOT) spectacle lenses, designed to modulate retinal contrast to control myopia progression.

Patients and methods: This was a single-visit, prospective, randomized, subject-masked study of emmetropes (ametropes ±1.00D or less in each meridian) with no history of myopia control treatment. Unaided logMAR visual acuity was measured, and ocular dominance was determined using the sighting method. In a randomized order, participants wore plano full-field contrast management (DOT) spectacles (no clear central aperture) or control spectacles (standard single vision spectacle lenses). Each participant was given 5 minutes for adaptation to the respective lenses before open field autorefraction measurements were taken at 6 meters and 40 cm. Ten measurements were taken for each eye. Data were evaluated from the right eye and the dominant eye separately.

Results: A total of 30 participants (20 females and 10 males) with a mean age of 10.4 ± 2.8 (7 to 17) years completed the study. There was no significant difference in right eye mean LOA with contrast management spectacles 0.57 ± 0.39D versus control spectacles 0.62 ± 0.34D; Wilcoxon test, p = 0.37. For dominant eyes, LOA values were 0.60 ± 0.40D and 0.68 ± 0.33D with contrast management spectacles and control spectacles, respectively (p = 0.14). Additionally, no significant difference was observed in mean LOA between males and females or between age groups (7-11 years vs 12-17 years) for either right or dominant eyes with contrast management or control spectacles (all p > 0.05).

Conclusion: Full-field contrast management spectacle lenses had no significant effect on LOA compared to standard single vision spectacle lenses, indicating no differential impact on accommodative response over the short period of lens wear tested.

Wolffsohn,J. S., Berkow,D., Chan,K. Y., Chaurasiya,S. K., Fadel,D., Haddad,M., Imane, T., Jones,L., Sheppard,A. L., Vianya-Estopa,M., Walsh,K., Woods,J., Zeri,F., Morgan,P. B. BCLA CLEAR Presbyopia: Evaluation and diagnosis Contact Lens Anterior Eye 2024;Online ahead of print [ Show Abstract ]

It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.

2023

Schulze,M., Fadel,D., Luensmann,D., Ng,A. Y., Guthrie,S., Woods,J., Jones,L. Evaluating the Performance of verofilcon A Daily Disposable Contact Lenses in a Group of Heavy Digital Device Users Clinical Ophthalmology 2023;173165-3175 [ Show Abstract ]

Purpose: The purpose of this study was to evaluate the performance of verofilcon A daily disposable contact lenses (CL) in CL wearers who identified themselves as heavy digital device users.
Patients and Methods: This prospective, non-masked, open-label study enrolled CL wearers who reported ≥ 6 hours digital device use per day. Participants were dispensed with the verofilcon A study lenses for 14± 2 days, to be worn for at least 5 days a week and 10 hours per day, while continuing their normal routine of digital device use. Participants rated the lens performance at the Day 14 visit using a 0– 100 (with 100 being best) scale. Ratings were completed at lens insertion, after 6 hours of digital device use, just before CL removal and for overall experience. Participants also completed a 4-point (strongly agree/disagree, slightly agree/disagree) Likert scale-based questionnaire.
Results: Thirty-two participants were eligible and completed the study (27 females; age 25.8 ± 6.0 years, ranging from 19 to 40). Overall lens performance ratings at the Day 14 visit (mean ± standard deviation) for comfort, dryness, and clarity of vision were 91 ± 11, 88 ± 11, and 92 ± 9, respectively. Subjective ratings were stable throughout the day with no significant differences after insertion, after 6 hours of digital device use and before CL removal (all p> 0.05). The majority of participants agreed that the study lenses performed well, provided good all-day comfort (28/32; p< 0.01) and good all-day vision (29/32; p< 0.01). Participants also agreed that after ≥ 6 hours of digital device use they were satisfied with CL comfort (27/32; p< 0.01), vision (29/32; p< 0.01) and that the lenses provided good performance (26/32; p< 0.01).
Conclusion: Verofilcon A lenses were found to perform well, with high ratings for comfort, dryness and vision that remained high throughout the day, during extensive digital device use.

2022

Guthrie,S., Ng,A. Y., Woods,J., Vega,J., Orsborn,G., Jones,L. Exploring the factors which impact overall satisfaction with single vision contact lenses Contact Lens Anterior Eye 2022;45(5):101579 [ Show Abstract ]

Purpose
To explore the impact of subjective factors (lens handling, comfort and vision) on overall single vision contact lens satisfaction.

Methods
Correlation analysis of a prospective, randomised, double-masked, bilateral crossover study involving 55 adapted lens wearers fitted with somofilcon A (SiHy) (clariti® 1 day, CooperVision) and etafilcon A (Hy) (1 DAY ACUVUE® MOIST, Johnson & Johnson Vision) was conducted. Subjective ratings of lens handling, comfort and vision collected after 1 week of lens wear for each lens type were correlated with overall satisfaction. Data were analysed by combining data for both lens types and also for each lens separately.

Results
For the combined analysis, significant correlations (p < 0.01) were found between subjective ratings of overall satisfaction and ratings of handing for application (r = 0.64), handling for removal (r = 0.50), comfort upon application (r = 0.59), comfort at end of day (r = 0.61), overall satisfaction with comfort (r = 0.88) and overall satisfaction with vision (r = 0.64).

Correlation analysis of the per lens data showed that lens specific correlations of overall satisfaction with handling for lens application varied greatly with lens material (SiHy: r = 0.26, p = 0.05 vs Hy: r = 0.72, p < 0.01). Correlation strength of comfort upon application/at end of day with overall satisfaction also varied with lens material (Application: SiHy: r = 0.40 vs Hy: r = 0.61; End of day: SiHy: r = 0.76 vs Hy: r = 0.58; all p ≤ 0.01).

Conclusion
Overall satisfaction was significantly correlated with the specific subjective evaluations of handling, vision and comfort. Correlations of overall satisfaction and ease of handling for each lens type suggest that, for habitual contact lens wearers, dissatisfaction with handling at the time of lens application can play a major role in overall dissatisfaction with a lens. Handling for application had a similar correlation (r) value as vision, suggesting that handling for application should not be underestimated when considering overall patient satisfaction.

Ng,A. Y., Woods,J., Jahn,T., Jones,L., Ritter,J. Effect of a novel omega-3 and omega-6 fatty acid supplement on dry eye disease: a 3-month randomized controlled trial Optometry & Vision Science 2022;99(1):67-75 [ Show Abstract ]

SIGNIFICANCE
Supplementing diet with a novel combination of omega-3 and omega-6 fatty acids significantly improved symptoms in extremely symptomatic participants with dry eye disease (DED).

PURPOSE
This study aimed to determine the effect of daily intake of a novel combination of essential fatty acids on signs and symptoms of DED.

METHODS
Participants with moderate to severe DED were enrolled in a prospective, randomized, double-masked parallel group study. Participants ingested either the treatment supplement containing omega-3 and omega-6 fatty acids (1200 mg eicosapentaenoic acid, 300 mg docosahexaenoic acid, 150 mg γ-linoleic acid) or the placebo (coconut and olive oil) daily for 3 months. To determine compliance, Omega-3 Index blood tests were conducted. At baseline and at 1 and 3 months, the following assessments were conducted: Ocular Surface Disease Index (OSDI) questionnaire and Symptom Assessment Questionnaire in Dry Eye, noninvasive tear breakup time, tear meniscus height, tear osmolarity, ocular redness, surface staining, Schirmer test, and meibography.

RESULTS
Fifty participants (mean ± standard deviation baseline OSDI score, 52.2 ± 16.5) completed the study: 24 randomized to treatment and 26 randomized to placebo. Although there was an improvement in OSDI score at 3 months for both groups (treatment: −13.4 points, P = .003; placebo: −7.8 points, P = .02), participants with baseline OSDI scores >52 demonstrated an even larger significant improvement in symptoms with the treatment at 3 months compared with baseline (n = 13, −20.8 points, P = .002). There were no significant changes in any of the ocular assessments at 1 or 3 months (all P > .05). After 3 months, Omega-3 Index increased by 34% in the treatment group (baseline, 5.3 ± 0.8; 3 months, 8.0 ± 2.1; P < .001) and did not change in the placebo group (baseline, 4.8 ± 0.8; 3 months, 4.8 ± 0.6; P = .95).

CONCLUSIONS
Supplementation with eicosapentaenoic acid, docosahexaenoic acid, and γ-linoleic acid resulted in a significant and clinically meaningful improvement of dry eye symptoms in extremely symptomatic participants with DED (OSDI ≥52).

Wolffsohn,J. S., Dhallu,S., Aujla,M., Laughton,D., Tempany,K., Powell,D., Gifford,K., Gifford,P., Wan,K., Cho,P, Stahl,U., Woods,J. International multi-centre study of potential benefits of ultraviolet radiation protection using contact lenses Contact Lens Anterior Eye 2022;45(6):101593 [ Show Abstract ]

Purpose
To examine the effects of long-term ultraviolet radiation (UVR) blocking wearing contact lenses on ocular surface health, eye focus and macular pigment.

Method
210 pre-presbyopic patients were recruited from Birmingham UK, Brisbane Australia, Hong Kong China, Houston USA and Waterloo Canada (n = 42 at each site). All patients had worn contact lenses for ≥ 5 years, half (test group) of a material incorporating a UVR-blocking filter. Ocular health was assessed using slit-lamp biomicroscopy and UV autofluorescence. Accommodation was measured subjectively with a push-up test and overcoming lens-induced defocus. Objective stimulus response and dynamic measures of the accommodative response were quantified with an open-field aberrometer. Macular pigment optical density (MPOD) was assessed using heterochromatic flicker photometry (MPS II).

Results
The two groups of participants were matched for age, sex, race, body-mass-index, diet, lifestyle, UVR exposure, refractive error and visual acuity. Limbal (p = 0.035), but not bulbar conjunctival redness (p = 0.903) was lower in eyes that had worn UVR-blocking contact lenses compared to controls. The subjective (8.0 ± 3.7D vs 7.3 ± 3.3D; p = 0.125) and objective (F = 1.255, p = 0.285) accommodative response was higher in the test group, but the differences did not reach significance. However, the accommodative latency was shorter in eyes that had worn UVR-blocking contact lenses (p = 0.003). There was no significant different in MPOD with UVR filtration (p = 0.869).

Conclusions
Blocking the transmission of UVR is beneficial in maintaining the eye’s ability to focus, suggesting that presbyopia maybe delayed in long-term UVR-blocking contact lenses wearers. These lenses also provide protection to the critical limbal region.

2021

Woods,J., Jones,D., Jones,L., Jones,S., Hunt,C., Chamberlain,P., McNally,J Ocular health of children wearing daily disposable contact lenses over a 6-year period Contact Lens Anterior Eye 2021;44(4):101391 [ Show Abstract ]

Purpose
To report on the ocular health and safety of children fit with soft hydrogel daily-disposable contact lenses, and followed for 6-years in a double-masked clinical trial investigating the performance of a dual-focus contact lens designed to control myopia progression.

Methods
Children aged 8−12 years, naïve to contact lens wear, were enrolled across four international sites. During years 1–3, children were randomised to either MiSight® 1 day or Proclear® 1 day (both omafilcon A, CooperVision, Inc.). The lenses were identical in material and geometry except for the front optical zone design. At the end of year-3, all those wearing Proclear 1 day were switched to MiSight 1 day, therefore all wore MiSight 1 day in years 4−6. Subjects agreed to wear the lenses at least 10-hours/day, 6-days/week. After dispensing, study visits were at 1-week, 1-month, 6-months and every 6-months until 6-years. At each visit, ocular measurements and subjective responses were recorded. Biomicroscopy used 0–4 grading scales; grade 0 represented no findings.

Results
144 children were enrolled: 69F:75M; mean age 10.1 years; mean cycloplegic spherical-equivalent refraction -2.11D; ethnicities included 34 East-Asian, 12 West-Asian, and 79 Caucasian. 92 completed the 6-years. Only three subjects discontinued due to an ocular adverse event (AE). No contact lens related AEs were classified as serious. The incidence rate of infiltrative AEs was 0.61% (6.1/1000 wearing-years; 95%CI: 0.24%–1.57%). The most common biomicroscopy findings were limbal, bulbar and tarsal hyperaemia and tarsal roughness. 99% of all biomicroscopy findings were grade-1 or lower. After 6-years of lens wear, ocular health by biomicroscopy was similar to pre-lens wear.

Conclusions
Across the 6-years, there were no contact lens related serious AEs and biomicroscopy showed no significant changes. Results suggest that children this age can successfully wear daily-disposable hydrogel contact lenses with minimal impact on ocular physiology.

2019

Woods,J., Hutchings,N., Srinivasan,S., Jones,L. Geographic distribution of corneal staining in symptomatic dry eye Ocul Surf 2019;18(2):258-266 [ Show Abstract ]

Purpose
To describe the geographic distribution of corneal fluorescein staining across the five corneal zones, among non contact lens wearers who report symptoms of dry eye and determine which corneal zone most frequently exhibited the worst staining.

Methods
Prior studies conducted at the Centre for Ocular Research & Education, Canada, were reviewed for inclusion in the analysis. Each study assessed dry eye symptoms using OSDI and also assessed corneal fluorescein staining in five corneal zones. For each subject, the corneal zones were ranked 1–5 according to their relative staining grade, Rank-1 representing the highest grade.

Results
Data from 13 studies and 368 subjects were included. The total number of zones assigned Rank-1 (worst) staining was 449 (across 264 subjects). The inferior zone had the most Rank-1 counts of all zones at 193/43%, which involved 52.5% of all subjects. The nasal zone had 77/17% involving 20.9% of subjects, followed by the temporal (69/15.5%, 18.8% subjects) and superior zones (63/14%, 17.1% subjects). The central zone had the lowest count of Rank-1 designations, at only 47/10.5%, involving 12.8% of subjects. Bayesian analysis was used to generate distributions of the credible proportions of subjects likely to present with staining in a single peripheral zone, with or without central zone staining. It illustrated that staining in a peripheral zone without central staining was more credible. The worst single zone staining was most likely to present in the inferior zone (67.9%), followed by the nasal zone (11.3%), the superior zone (9.2%), and the temporal zone (5.6%).

Conclusion
In the presence of dry eye symptoms, the inferior zone typically presents the most severe grade of corneal staining, more likely without central zone staining. This knowledge is valuable when developing a strategy to treat dry eye signs, as the inferior corneal zone has the highest grade of staining thus has the potential to exhibit the greatest reduction in staining post-treatment.

2018

Woods,J., Varikooty,J., Fonn,D., Jones,L. A novel scale for describing corneal staining Clinical Ophthalmology 2018;12:2369-2375 [ Show Abstract ]

The assessment of corneal staining is a commonly conducted procedure in both clinical practice and as part of various research studies. Different grading scales are employed by many clinicians and researchers to undertake this procedure for corneal staining comparisons between eyes, products and over time. This paper describes the development and use of a grading scale for corneal staining undertaken at an academic research site. The scale involves assessment of three factors across five corneal zones: type, area and depth. Staining type and area are graded on a 0–100 scale, and depth is graded on a 0–4 scale. These factors can be combined to create a three- or two-factor staining grade, or the factors may be reported individually. An additional benefit of this scale is that the staining scores may be reported by zone as “zone staining scores” or the scores of zones may be combined to provide an overall corneal “global staining score”.

Yang,M., Luensmann,D., Fonn,D., Woods,J., Jones,D., Gordon,K., Jones,L. Myopia prevalence in Canadian school children: A pilot study Eye 2018;32(6):1042-1047 [ Show Abstract ]

Purpose: A pilot study to determine the prevalence of myopia, proportion of uncorrected myopia and pertinent environmental factors among children in a suburban region in Canada. Methods: Refraction with cycloplegia and ocular biometry were measured in children of two age groups. Myopia was considered at a spherical equivalent refraction (SER) ≤-0.50 D in at least one eye. Parents completed a questionnaire that captured the child's daily activities. Results: A total of 166 children completed the study (83 aged 6-8 and 83 aged 11-13). Myopia prevalence was 17.5% among the overall group, 6.0% among ages 6-8 and 28.9% among ages 11-13. Mean subjective SER in myopic children was -1.10 D (95% confidence interval (CI), -0.34 to -1.86 D) at ages 6-8 and -2.44 D (95% CI, -1.71 to -3.18 D) at ages 11-13. In this study, 34.5% of the myopic children were uncorrected, which represented 6.0% of the entire group of children. Mean axial length (AL) increased by 1.03 mm from ages 6-8 (mean 22.62 mm; 95% CI, 22.45 to 22.79 mm) to ages 11-13 (mean 23.65 mm; 95% CI, 23.45 to 23.84 mm; p < 0.01). The correlation coefficient between AL and SER was -0.618 (p < 0.01). Binary logistic regression between outdoor time and the prevalence of myopia showed that one additional hour of outdoor time per week lowered the odds of a child having myopia by 14.3% (p = 0.007). Conclusion: Myopia prevalence increased from 6% at ages 6-8 to 29% at ages 11-13. Thirty-five per cent of the myopes in this study were uncorrected. More time outdoors may be beneficial to protect against myopia onset.

2016

Woods,J., Jones,L. W. Pilot study to determine the effect of lens and eye rinsing on Solution-Induced Corneal Staining (SICS) Optometry and Vision Science 2016;93(10):1218-1227 [ Show Abstract ]

Purpose The main purpose of this study was to determine whether two interventions (rinsing the lens before lens insertion and rinsing the ocular surface post-lens removal) had any impact on solution-induced corneal staining (SICS). In addition, the presence of hyper-reflective epithelial cells in the presence of SICS was investigated. Methods Twenty subjects wore new balafilcon A lenses, which had been soaked overnight in a multipurpose care product containing polyhexamethylene biguanide for 2 hours. The study was conducted across three phases. In phase 1 (investigator and subject masked, randomized eye), one lens was rinsed with nonpreserved saline before lens insertion. In phase 2 (investigator masked, randomized eye), one eye was rinsed with nonpreserved saline after lens removal, before staining assessment. Corneal staining was recorded as the percentage area of the cornea exhibiting superficial punctate staining. In both phases, ocular comfort and presence of specific symptoms were captured. In phase 3, there was no randomized treatment; confocal images of the epithelium were obtained after 2 hours of wear. Results In phase 1 (lens-rinse), there was no significant difference in staining between the treated and untreated eyes (84 vs. 92%, respectively; p = 0.06). In phase 2 (eye-rinse), there was also no significant difference between the treated and untreated eye (86 vs. 86%, p = 0.92). Most subjects were asymptomatic. In phase 3, images of hyper-reflective cells were captured in 97% of the eyes imaged. Conclusions The two rinsing procedures did not affect the level of the SICS response. Hyper-reflective epithelial cells were found to be present in a significant number of eyes exhibiting SICS, and their presence warrants further investigation. © 2016 American Academy of Optometry.

2015

Liu,S., Chang,C. N., Verma,M. S., Hileeto,D., Muntz,A., Stahl,U., Woods,J., Jones,L. W., Gu,F. X. Phenylboronic acid modified mucoadhesive nanoparticle drug carriers facilitate weekly treatment of experimentallyinduced dry eye syndrome Nano Research 2015;8(2):621-635

Woods,J., Woods,C., Fonn,D. Visual performance of a multifocal contact lens versus monovision in established presbyopes Optometry and Vision Science 2015;92(2):175-82 [ Show Abstract ]

PURPOSE: To compare subjective and objective visual performance of the Air Optix Aqua Multifocal lens to monovision in a group of subjects requiring a medium level of reading-addition power.

METHODS: Fifty participants with reading additions between 1.25 and 2.00 diopters (inclusive) were randomized into a prospective, crossover clinical trial. They wore monovision and multifocals for 2 weeks in a randomized order. High- and low-contrast logMAR (logarithm of the minimum angle of resolution) acuity and stereopsis were measured at the beginning and end of each period. During each phase, participants performed specific tasks followed by subjective rating surveys and also completed satisfaction rating surveys on days 3, 7, and 12; all were transferred in real time using BlackBerry smartphones. A general rating survey was completed at the dispensing and 2-week visits.

RESULTS: Forty-nine participants completed the study (mean age, 52 years). Distance and near high- and low-contrast acuities were significantly better (p < 0.05) with monovision at all visits. High-contrast intermediate acuity was only better (p < 0.05) with multifocals after 2 weeks. Stereopsis was equivalent after 2 weeks, but better (p < 0.05) with multifocals at dispensing. Subjective ratings were generally equivalent between modalities although there was a trend for multifocals to be rated higher for focus changing and driving, whereas monovision tended to be rated higher for near tasks. For both corrections, the satisfaction survey showed no significant change between days 3, 7, and 12, and the general survey showed that comfort was maintained but subjective vision ratings decreased significantly over the 2 weeks. Twenty-five participants (51%) preferred multifocals, 18 (37%) preferred monovision, and the remaining 6 (12%) declared both unacceptable.

CONCLUSIONS: In this cohort, distance and near acuities were better with monovision, whereas the subjective ratings tended to favor the Air Optix Aqua Multifocal, with the exception of near performance. Preference was statistically similar between both corrections, with a trend toward preferring the multifocal.

2013

Woods,J., Guthrie,S. E., Keir,N., Dillehay,S., Tyson,M., Griffin,R., Choh,V., Fonn,D., Jones,L., Irving,E. Inhibition of defocus-induced myopia in chickens Investigative Ophthalmology and Visual Science 2013;54(4):2662-2668 [ Show Abstract ]

PURPOSE. To determine the effect of wearing a lens with a unique peripheral optical design on the development and progression of defocus-induced myopia in newly hatched chickens.METHODS. Eighty-five newly hatched chickens underwent bilateral retinoscopy and A-scan ultrasound to determine their refractive error and axial length. They were randomly divided into Control and two Test groups, in which each chicken was fitted with a goggle-lens over the right eye, with the left eye remaining untreated. The Control group wore a lens of power - 10.00 diopters (D) of standard spherical optical design. The two Test lenses both had a central optical power -10.00 D, but used different peripheral myopia progression control (MPC) designs. For all groups, retinoscopy was repeated on days 3, 7, 10, and 14; ultrasound was repeated on day 14.RESULTS. On day 0 there was no statistical difference in refractive error (mean +6.92 D) or axial length (mean 8.06 mm) between Test and Control groups or treated and untreated eyes (all P > 0.05). At day 14, 37 (43.5%) of 85 chickens had not experienced goggle detachment and were included in the final analyses. In this cohort there was a significant refractive difference between the treated eyes of the Control group (n = 17) and those of Test 1 (n = 14) and Test 2 (n = 6) groups (both P < 0.01): Control -4.65 ± 2.11 D, Test 1 +4.57 ± 3.11 D, Test 2 +1.08 ± 1.24 D (mean ± SEM). There was also a significant axial length difference (both P < 0.01): Control 10.55 ± 0.36 mm, Test 1 9.99 ± 0.14 mm, Test 2 10.17 ± 0.18 mm.CONCLUSIONS. Use of these unique MPC lens designs over 14 days caused a significant reduction in the development of defocus-induced myopia in chickens; the degree of reduction appeared to be design specific. © 2013 The Association for Research in Vision and Ophthalmology, Inc.

2012

Woods,J., Jones,L., Woods,C., Schneider,S., Fonn,D. Use of a photographic manipulation tool to assess corneal vascular response Optometry and Vision Science 2012;89(2):215-220 [ Show Abstract ]

Purpose. Corneal vasculature change in contact lens wearers has been linked to the level of hypoxia within the cornea. To assess the impact a treatment has on limbal vessels, a sensitive method of measurement and quantification is required. Methods. A group of 21 highly myopic, hydrogel wearers, with preexisting signs of corneal hypoxia, were enrolled into a study where they wore sifilcon A silicone hydrogel lenses (Dk/t = 117), on a daily wear basis for 9 months. At all scheduled visits, photographs were taken of the superior, inferior, temporal, and nasal limbal regions which were then imported into Adobe Photoshop. A red-free filter was applied to enhance the contrast of the blood columns. In each quadrant, the length of the longest visible blood column was measured and the blood columns that penetrated -0.5 mm into the cornea were counted. A control group of 11 non-lens wearers was recruited. Their photographs were taken at the beginning of the study and 9 months later. An independent, masked observer assessed the photographs. Results. There was a significant decrease in the maximum penetration of the blood column in all quadrants (p + 0.001) from baseline to the 9-month visit (e.g., superior: baseline 0.84 ± 0.39 mm; 9 months 0.63 ± 0.20 mm). There was also significant reduction in the number of visible blood columns longer than 0.5 mm in each quadrant (p + 0.001) from baseline to 9 months in all quadrants (e.g., superior: baseline 14.0 ± 8.2; 9 months 6.5 ± 6.0). The control group showed no change over time for the maximum blood column length (p = 0.638) or the number of columns >0.5 mm (p = 0.341). Conclusions. A group of highly myopic subjects exhibited reduction in the maximum length and number of blood columns in the cornea when refit with a highly permeable silicone hydrogel material. The use of photography, along with Adobe Photoshop software, provides a reliable way of measuring corneal vascular responses over time. (Optom Vis Sci 2012;89:215-220). © 2012 American Academy of Optometry.

2009

Subbaraman,L. N., Woods,J., Teichroeb,J. H., Jones,L. Protein deposition on a lathe-cut silicone hydrogel contact lens material Optometry and Vision Science 2009;86(3):244-250 [ Show Abstract ]

PURPOSE: To determine the quantity of total protein, total lysozyme, and the conformational state of lysozyme deposited on a novel, lathe-cut silicone hydrogel (SiHy) contact lens material (sifilcon A) after 3 months of wear. METHODS: Twenty-four subjects completed a prospective, bilateral, daily-wear, 9-month clinical evaluation in which the subjects were fitted with a novel, custom-made, lathe-cut SiHy lens material. The lenses were worn for three consecutive 3-month periods, with lenses being replaced after each period of wear. After 3 months of wear, the lenses from the left eye were collected and assessed for protein analysis. The total protein deposited on the lenses was determined by a modified Bradford assay, total lysozyme using Western blotting and the lysozyme activity was determined using a modified micrococcal assay. RESULTS: The total protein recovered from the custom-made lenses was 5.3 +/- 2.3 microg/lens and the total lysozyme was 2.4 +/- 1.2 microg/lens. The denatured lysozyme found on the lenses was 1.9 +/- 1.0 microg/lens and the percentage of lysozyme denatured was 80 +/- 10%. CONCLUSIONS: Even after 3 months of wear, the quantity of protein and the conformational state of lysozyme deposited on these novel lens materials was very similar to that found on similar surface-coated SiHy lenses after 2 to 4 weeks of wear. These results indicate that extended use of the sifilcon A material is not deleterious in terms of the quantity and quality of protein deposited on the lens.

Woods,J., Woods,C. A., Fonn,D. Early symptomatic presbyopes-What correction modality works best? Eye and Contact Lens 2009;35(5):221-226 [ Show Abstract ]

Purpose: To compare the performance of a low-addition silicone hydrogel multifocal soft lens with other soft lens correction options in a group of habitual soft lens wearers of distance correction who are symptomatic of early presbyopia. METHOD: This clinical study was designed as a prospective, double-masked, randomized, crossover, dispensing trial consisting of four 1-week phases, one for each of the correction modalities: a low-addition silicone hydrogel multifocal soft lens, monovision, habitual correction, and optimized distance visual correction. The prescriptions of all modalities were finalized at a single fitting visit, and the lenses were worn according to a randomized schedule. All lenses were made from lotrafilcon B material. A series of objective vision tests were conducted: high- and low-contrast LogMAR under high- and low-room lighting conditions, stereopsis, and critical print size. A number of other data collection methods used were novel: some data were collected under controlled laboratory-based conditions and others under "real-world" conditions, some of which were completed on a BlackBerry hand-held communication device. RESULTS: All participants were able to be fit with all four correction modalities. Objective vision tests showed no statistical difference between the lens modalities except in the case of low-contrast near LogMAR acuity under low-lighting levels where monovision (+0.29 ± 0.10) performed better than the multifocal (+0.33 ± 0.11, P=0.027) and the habitual (+0.37 ± 0.12, P<0.001) modalities. Subjective ratings indicated a statistically better performance provided by the multifocal correction compared with monovision, particularly for the vision associated with driving tasks such as driving during the daytime (93.3 ± 8.8 vs. 84.2 ± 23.7, P=0.05), at nighttime (88.8 ± 11.7 vs. 74.9 ± 23.6, P=0.001), any associated haloes or glare (92.0 ± 10.6 vs. 78.0 ± 22.8, P=0.003), and observing road signs (90.1 ± 11.8 vs. 79.4 ± 20.2, P=0.027). Preference for the multifocal compared with monovision was also reported when watching television (95.0 ± 6.4 vs. 82.6 ± 20.1, P=0.001) and when changing focus from distance to near (87.0 ± 13.4 vs. 66.1 ± 32.2, P<0.001). CONCLUSIONS: For this group of early presbyopes, the AIR OPTIX AQUA MULTIFOCAL-Low Add provided a successful option for visual correction, which was supported by the results of subjective ratings, many of which were made during or immediately after performing such activities as reading, using a computer, watching television, and driving. These results suggest that making a prediction of "success or not" based on consulting room acuity tests alone is probably unwise. Copyright © Contact Lens Association of Ophthalmologists, Inc.

2007

Fonn,D., Simpson,T., Woods,J., Woods,C. New technologies to assess lens-mediated effects of the cornea Eye and Contact Lens 2007;33(6 PART 2 OF SUPPL 2):364-370 [ Show Abstract ]

Contact lenses can affect the cornea in a variety of ways. Corneal structure can be altered so that its thickness changes to involve the epithelium and the stroma. As a result, the curvature may be affected, but whether it is the front or the back surface that is affected depends on the type of lens used. If thickness increases sufficiently, corneal transparency may decrease. Contact lenses can also affect cellular structure of all layers of the cornea through mechanical trauma, hypoxia, or toxicity from solutions that are used in association with lenses. More serious complications, such as inflammation and infection, can arise. All these changes can be detected by clinicians using slitlamp biomicroscopes and keratometers if the changes are significant enough. Since the development of computers, optical instruments have become more sophisticated and have enabled the detection of subtle changes but have also facilitated more precise measurement of these conditions along with the ability to capture images of the alterations or defects. This article describes some of the newer techniques and, specifically, the application of optical coherence tomography, confocal microscopy, and esthesiometry. © 2007 Lippincott Williams & Wilkins, Inc.

Scientific Presentations

2024

Fadel D, Wong S, Luensmann D, Guthrie S, Seo J, Woods J, Voltz K, Vega J. The use of Scleral Lenses to Manage Dry Eye Symptoms in Habitual Soft Lens Wearers Global Specialty Lens Symposium, Las Vegas, Jan 20, 2024 [ Show Abstract ]

PURPOSE: To determine if scleral lenses (SLs) with and without Hydra-PEG coating can improve ocular comfort and reduce dryness in symptomatic soft lens wearers.

METHODS: This prospective, randomized, double masked, 1-month bilateral cross over, daily wear study recruited symptomatic soft lens wearers who presented with healthy eyes and a CLDEQ-8 score ≥12 with their habitual contact lens (hab-CL). Eligible participants were fit with SLs (Onefit MED, CooperVision, Inc.) and wore these with and without HydraPEG coating (coated (C-SL) / uncoated (U-SL)) in a randomized order for 1 month per pair. Participants completed a CLDEQ-8 and rated comfort, vision clarity, dryness and handling after each 1-month wear period using a 0-10 scale (10=best) and these data were compared between study SLs and to their hab-CL.

RESULTS: Twenty participants (16F:4M), mean age 29.3±12.4 years [18-64 years] completed the study. The mean refraction of the right eye was Sph -4.69±3.42DS [-15.25 to -0.50DS] and Cyl -0.84±0.79DC [0.00 to -2.75DC]. At 1 month, the CLDEQ-8 score improved with both study SLs in comparison to hab-CL (p0.05) and both were rated better compared to hab-CL (p0.05). At study exit, 9 of the 20 participants requested the SL details to be shared with their eye care professional because they wanted to continue wearing these SLs in future.

CONCLUSIONS: Switching symptomatic soft lens wearers into scleral lenses improved comfort and reduced dryness symptoms after 1 month of wear, with little reduction in ease of lens handling. Subjective ratings were similar with uncoated and HydraPEG coated scleral lenses, with the latter providing slightly better visual clarity.

Jabeen A, Luensmann D, Woods J, Hill J, Jones L. Short-term effect of DOT spectacle lenses on choroidal thickness in emmetropic children The Association for Research in Vision and Ophthalmology, Seattle, WA, May 9, 2024 [ Show Abstract ][ PDF ]

Purpose: To investigate regional changes in choroidal thickness (ChT) following short-term wear of Diffusion Optics Technology™ (DOT) spectacle lenses, designed to control myopia by lowering retinal contrast.

Method: Emmetropic children (SER +1.00 to -0.75 D) aged 8 to 14 years wore plano DOT spectacle lenses without central apertures and +3.00D spectacle lenses in a two-visit, prospective, randomized, subject-masked crossover study. High-resolution OCT (Triton DRI-OCT, Topcon) evaluated central, parafoveal (3 mm from the fovea) and perifoveal (6 mm from the fovea) ChT after 0, 30 and 60 minutes of viewing a high contrast video at each visit.

Results: A total of 30 participants (17F, 13M) with a mean (± SD) age of 10.9 (1.7) years completed the study. After 30 minutes of spectacle lens wear, a significant increase in ChT was observed with DOT spectacle lenses compared to +3.00D spectacle lenses in 4 of the 9 macula regions evaluated (p<0.05 for all). DOT spectacles showed a significant ChT thickening in the central (+7.69 ± 4.19 μm), parafoveal regions at nasal (+9.01 ± 2.77 μm) and temporal (+6.20 ± 5.46 μm) and inferior perifoveal (+9.79 ± 2.31 μm) compared to myopic defocus with +3.00D lenses. After 60 minutes, ChT remained higher only in the inferior parafoveal region (+3.96 ± 8.33 μm, p=0.03), while all other regions returned to baseline levels.

Conclusion: After short-term DOT spectacle lens wear, emmetropic children experienced macula ChT thickening, similar or greater than the response observed with +3.00D spectacle lens wear. These results indicate the choroid is able to respond to contrast reduction. Further research is required to investigate the long-term impact of contrast modulation on ChT.

NG AY, Jones L, Woods J, Basuthkar S, Keir N. Diurnal changes in corneal dendritic cell density and morphology in symptomatic and asymptomatic contact lens wearers The Association for Research in Vision and Ophthalmology, Seattle, WA, May 6, 2024 [ Show Abstract ][ PDF ]

Purpose: To explore corneal dendritic cell (DC) density and morphology in soft contact lens (CL) wearers using in vivo confocal microscopy (IVCM) after different wear times, imaging with and without CLs in situ.

Methods: This was a prospective study involving hydrogel and silicone hydrogel CL wearers (17F, 3M; 29.5±10.5 years): 10 symptomatic (S-CL) and 10 asymptomatic (A-CL), by Young’s criterion and comfortable wear time. Eligible participants attended a baseline day (no CL wear, IVCM conducted in the morning (AM) and 8 hours later (PM), three separate CL wearing days (IVCM after 1, 4 or 8 hours [randomized] with CLs removed immediately before imaging and topical anesthesia), and a day where CLs were worn all day (IVCM after 1, 4 and 8 hours of CL wear, with CLs in situ during imaging and no anesthesia). At least five non-overlapping sequence scans were taken at the central and inferior cornea with the Heidelberg Retina Tomograph III with Rostock Cornea Module. Up to five images per location were analyzed with automated DC counting software. A linear mixed model was applied for all statistical analyses.

Results: At the central cornea, DC density was greater in the AM/1 hour compared to PM/8 hours (p<0.001), and for the A-CL group compared to the S-CL group (p=0.041). There was no effect of imaging with CLs in situ on DC density; DC density with and without CLs in situ strongly correlated across all time points at both corneal locations (r=0.694 to 0.843, all p≤0.01). For cell morphology, immature dendritic cells were the dominant cell type in both groups at both locations (S-CL ≥77%, A-CL ≥78%). Mature cells made up 8-15% of all DCs. The A-CL group had 5% more mature cells than the S-CL group at the inferior cornea only (p=0.034). At both locations, 5% more mature cells were observed on lens wearing days (central p=0.043, inferior p=0.027). Time of imaging was not a significant effect on the proportion of immature or mature cells at either location.

Conclusions: This study shows subtle differences in DC density and morphology between symptomatic and asymptomatic CL wearers and over the course of the day in different corneal regions. The clinical significance of these results requires further investigation. This study supports the imaging of DCs with CLs in situ, which could simplify monitoring these cells during CL wear.

Wong S, Fadel D, Seo J, Luensmann D, Guthrie S, Woods J, Voltz K, Vega J. Dry eye management with scleral lenses in non-lens wearers NCC, Veldhoven, Netherlands, Mar 10, 2024 [ Show Abstract ]

PURPOSE: To assess the benefits of scleral lenses (SLs) with and without Hydra-PEG in non-lens wearers with dry eye symptoms.

METHODS: This prospective, randomised, double-masked, 1-month bilateral cross-over study recruited symptomatic non-wearers with healthy eyes and an OSDI score ≥13. Participants were fitted with SLs (hexafocon A, Onefit MED, CooperVision, Inc.) with and without Hydra-PEG coating (Tangible Science) (coated (C-SL)/uncoated (U-SL)) for 1-month daily wear per pair. LogMAR visual acuity was measured, and participants rated overall satisfaction with ocular comfort, dryness and vision clarity using a 0-10 scale (10=best) at baseline (BL) and after each 1-month wear period with the two SLs.

RESULTS: In total, 22 participants were eligible and 18 completed the study (18F:0M, mean age 34.9±13.4 years [20-66], OSDI score 39.8±18.0 [14-80], reason for discontinuation: n=3 handling, n=1 comfort). Mean refraction of the right eye was -3.28±1.13DS [-12.00 to +1.00] and -1.11±0.90DC [0.00 to -3.25]. At 1-month, satisfaction with ocular comfort and dryness was similar between study SLs (p>0.05), and both were rated better than BL (p0.05) (BL: 7.6±19, C-SL: 7.8±2.3, U-SL: 7.8±2.9), which was confirmed by LogMAR visual acuity with no clinically relevant differences noted (BL: -0.14±0.07, C-SL: -0.17±0.07, U-SL: -0.18±0.08). At study exit, 44% asked to share their SL details with their eye care professional to continue wear in the future.

CONCLUSIONS: Symptomatic non-lens wearers were successfully fit with SLs, which improved ocular comfort and reduced dryness after 1 month of wear. Although no difference was noted between Hydra-PEG-coated and uncoated lenses, participants with a wide range of dryness symptoms benefited from SL wear and almost every second participant indicated an interested to continue SL wear.

Woods J, Guthrie S, Luensmann D, Vega J, Orsborn G. Evaluating the Success of Habitual Multifocal Soft Lens Wearers when Refit with a Progressive Multifocal Lens System NCC, Veldhoven, Netherlands, Mar 11, 2024 [ Show Abstract ]

PURPOSE: To evaluate the ease and predictability of fit and success when switching habitual, multifocal (MF) wearers from a somofilcon A (som-A) multifocal 2-Add system to a som-A 3-Add system.

METHODS: Presbyopic habitual MF wearers were recruited to a crossover, daily wear, subject-masked study. At first, participants were fit and dispensed bilaterally with som-A 2-Add (CooperVision) lenses and power optimizations were permitted at the fitting visit and the 1-week visit. The optimal lens powers were worn for 2-weeks. Next, som-A 3-Add (CooperVision) was fit and worn following the same visit schedule. Visual acuity and subjective ratings (0–10 scale;10=best) were collected after each lens wear period and preference ratings were completed at study exit (5-point Likert).

RESULTS: Fifty-eight participants (mean age 53.5±6.2 years, 46F:12M) completed the study. Mean refraction OD: Sph -1.11±2.44D [-4.75D to +3.50D], Cyl -0.27±0.25D [-0.75D to 0.00D], near addition +2.05±0.36D [+1.25D to +2.50D]. There was no difference between lenses for satisfaction with comfort (p=0.76), vision quality (p=0.78), or overall satisfaction (p=0.94). The only statistical difference among preferences related to vision clarity for near tasks, where som-A 3-Add was preferred (p=0.03). After 2-weeks, LogMAR acuity was significantly better with som-A 3-Add for distance vision (p<0.01) and near vision (p=0.02), but not different for intermediate vision (p=0.10). When strictly following the fitting guides, som-A 2-Add was successful with the first pair of lenses in 59% of participants, whereas som-A 3-Add was successful with the first pair in 80% of participants (p=0.03).

CONCLUSIONS: The performance of som-A 3-Add either matched or exceeded that of som-A 2-Add based on visual acuity, participant ratings and participant preferences. The 3-Add lens system had a higher rate of success with the first lens pair than the 2-Add system. Results indicate that switching som-A 2-Add wearers to the updated som-A 3-Add lens system was successful and well accepted.

Woods J, Richards J, Guthrie S, Kollbaum P. Can Optical Modelling Predict Clinical Vision Outcomes of Myopia Control Contact Lenses? NCC, Veldhoven, Netherlands, Mar 11, 2024 [ Show Abstract ]

PURPOSE: To understand if optical metrology and computational modelling can predict the clinical visual performance of two myopia control contact lenses which employ different optical designs: non-coaxial senofilcon A (NC) (Acuvue Abiliti 1-Day, Johnson & Johnson Vision) and dual-focus omafilcon A (DF) (MiSight 1 day, CooperVision).

METHODS: For clinical assessments, children aged 8-15 years with no history of contact lens wear or recent myopia control intervention completed a randomised, non-dispensing, contralateral double-masked trial. After 1-hour of wear, participants rated their lens preference (Likert) and subjective vision (0-100 scale, 100=best), then distance visual acuity (VA) was measured.
For optical metrology and modeling, wavefront errors were measured with an aberrometer (Optocraft GmbH). Custom software was used to compute point spread functions, image quality and simulated retinal images for 3-6mm pupils by combining the lens optics with the optics of a model young eye, assuming centred and decentred lens positions.

RESULTS: Twenty-six participants completed the clinical study: 17M; mean age 11.6yrs [8-15yrs]; mean OD refraction: -1.96DS [-0.25 to -3.50DS], -0.34DC [0.00 to -1.00DC]. Ratings of distance vision at 1-hour were better with DF (88±14) versus NC (79±18), p<0.01. Distance logMAR VA was better with DF (0.02±0.04) versus NC (0.09±0.08), p<0.01. A higher number of participants indicated overall preference for DF, with vision the most common reason (DF:14 vs NC:6, p=0.17).
Optical modelling of well-centred lenses showed reduction in image quality for both lenses as the pupil increased. Lens decentration degraded image quality for both designs, but more for the NC design. Differences in add power zone geometry and NC optics may account for these differences.

CONCLUSIONS: Both optical modelling and clinical subjective results support better image quality with the dual-focus design. These results suggest that optical modelling techniques may be valuable in evaluating and comparing myopia control lens designs prior to on-eye testing.

2023

Guthrie S, Chow T, Luensmann D, Woods J, Lumb E, Orsborn G. Short term visual performance of two myopia control soft contact lenses British Contact Lens Association Clinical Conference & Exhibition, Manchester, Jun 9-11, 2023 [ Show Abstract ]

PURPOSE: To gain insights into the short-term visual performance of two myopia control contact lenses which employ different optical designs.

METHODS: Children aged 8 to 15 years, with no history of contact lens wear or recent myopia control intervention, participated in a non-dispensing, single visit, double masked trial where the study lenses were fit and worn contralaterally in randomised eyes. The myopia control study lenses were senofilcon A (AA1D, Johnson & Johnson Vision) and omafilcon A (M1D, CooperVision). After participants had worn the lenses for 1 hour, they rated their subjective experience with vision using a 0-100 scale (100 is best) and distance visual acuity (LogMAR (VA)) was measured. Lens preference was determined at the end of the wear period using a 5-point Likert scale and reasons for preference were provided.

RESULTS: Twenty-six participants completed the study (9F:17M; mean age 11.6 ± 2.1 years). Mean refraction was OD Sph -1.96 ± 0.93D (-0.25 to -3.50D), Cyl -0.34 ± 0.35D (0.00 to -1.00D) and OS Sph -1.77 ± 0.97D (-0.25 to -3.50D), Cyl -0.38 ± 0.38D (0.00 to -1.00D). Subjective ratings of distance vision at 1 hour were better (Wilcoxon matched pairs, p<0.01) with M1D (88 ± 14) versus AA1D (79 ± 18). Distance VA was also significantly better (Wilcoxon matched pairs, p<0.01) with M1D (0.02 ± 0.04 logMAR) over AA1D (0.09 ± 0.08 logMAR). When asked to provide an overall lens preference after 1 hour of wear, more participants preferred M1D than AA1D, and vision was reported as the main reason for their preference (M1D:14 vs AA1D:6, No preference:6; p=0.17).

CONCLUSIONS: When worn contralaterally for 1 hour, the different optical designs of M1D and AA1D performed significantly differently. M1D resulted in better distance vision ratings and visual acuity, and both of these differences would also be considered clinically relevant.

Guthrie S, Woods J, Luensmann D, Chow T, Lumb C, Orsborn G. Subjective Vision Experience in Soft Myopia Control Contact Lenses by Age American Academy of Optometry, New Orleans, October 12, 2023 [ Show Abstract ]

PURPOSE: To compare the short-term vision experience of preteens (PT) and teens (T) with two myopia control (MC) contact lenses of different optical designs: senofilcon A, with a noncoaxial ring-focus design (AA1D, Johnson & Johnson Vision) and omafilcon A, with a dual-focus design (M1D, CooperVision, Inc.).

METHOD: Children aged 8-15 years who had no prior history of contact lens wear or recent MC intervention were recruited for a single-visit, double-masked trial with study lenses randomly fit and worn contralaterally. Participants were separated into two age groups: PT: 8-12 years and T:13-15 years. After wearing the lenses for 1 hour, participants rated their subjective visual experience on a 0-100 scale (where 100 indicated the best experience), and distance visual acuity was measured using LogMAR (VA). At the end of the wear period, lens preference was determined using a 5-point Likert scale, and participants provided reasons for their preference.

RESULTS: Twenty-six participants completed the study (9F:17M; mean age 11.6 ± 2.1 years), 16 PT and 10 T. Mean refraction was OD Sph -1.96 ± 0.93D (-0.25 to -3.50D), Cyl -0.34 ± 0.35D (0.00 to -1.00D) and OS Sph -1.77 ± 0.97D (-0.25 to -3.50D), Cyl -0.38 ± 0.38D (0.00 to -1.00D). When participants rated their subjective experience with vision at 1 hour, both age groups reported better distance vision with M1D compared to AA1D (PT:M1D: 90 ± 15, AA1D: 82 ± 17, p<0.01; T:M1D: 85 ± 13, AA1D: 73 ± 18, p=0.02). Distance visual acuity (VA) was also better with M1D over AA1D in both groups, with the difference in the PT group being statistically significant (PT:M1D: 0.03 ± 0.04, AA1D: 0.09 ± 0.08, p<0.01; T:M1D: 0.02 ± 0.04, AA1D: 0.08 ± 0.09, p=0.07). For near VA, M1D performed better than AA1D in PT (PT:M1D: 0.07 ± 0.08, AA1D: 0.12 ± 0.08, p<0.05; T:M1D: 0.05 ± 0.05, AA1D: 0.06 ± 0.06, p=0.29). When asked to provide an overall lens preference after 1 hour of wear, more PT preferred M1D than AA1D (M1D:8 vs AA1D:4, No preference:4) and more T preferred M1D than AA1D (M1D:6 vs AA1D:2, No preference:2), with both groups reporting vision as the main reason for their preference.

CONCLUSION: When worn contralaterally for 1 hour, the different optical designs of M1D and AA1D performed significantly differently. The preteen and teen groups responded similarly, with M1D preferred by both groups for better distance vision. In addition, while teens had an equivalent vision experience to the preteens, they were overall more likely to rate that experience lower than preteens, indicating a potential difference in subjective experience between the groups and a more critical assessment of vision in teenagers.

Jones D, Guthrie S, Woods J, Nguyen M, Chamberlain P, Hammond D. . Young Adult Acceptance of Dual Focus Myopia Control Soft Contact Lenses British Contact Lens Association Clinical Conference & Exhibition, Manchester, Jun 10, 2023 [ Show Abstract ]

Purpose: Myopia can continue to progress during early adulthood and previously observed acceptance of dual focus contact lenses in adolescents does not verify that progressing young adult myopes will similarly accept potential minor vision compromises when achieving the desired myopia control effect. This study assessed acceptance of dual focus myopia control contact lenses by myopic young adults.

Methods: Habitual single vision (SV) contact lens wearers (age 17-25) were dispensed MiSight 1 day (M1d, omafilcon A, CooperVision, Inc.) for 3 months. The Quality of Vision (QoV) questionnaire (McAlinden, 2010) was performed at baseline, 2 weeks, 1, 2 & 3 months. Frequency, severity and bothersome scores were summed for each vision symptom (e.g. glare) to give a combined metric (Best:0/Worse: 9). Non-parametric repeated measure ANOVA with Wilcoxon post-hoc analysis was used to determine how visual experience in M1d changed over the duration of the study and compared to SV at baseline.

Results: 27/29 of participants completed the study (23F:4M; age 22.5±1.7; SERE -3.55D±1.55D). Subjects self-reported that M1d was worn at least 6 days per week and this wear pattern was sustained over three months, averaging >12h per day (2w: 12.5±1.9h, 1M: 12.6±2.0h, 3M: 12.2±1.7h). Perception of starbursts, hazy vision, blurred vision, distortion, and fluctuating vision were not significantly different in M1d than SV. While glare, haloes, focusing difficulties, depth perception and double vision summed symptom scores at all timepoints were significantly increased compared to SV (range between 2-4 points higher, p<=0.002), 70% of subjects responded that they were likely to continue M1d wear given the likely myopia control benefits.

Conclusion: Full day wear of MiSight 1 day soft contact lenses was well tolerated in young myopic adults with mild increases in a limited number of vision symptoms that had no impact on wear time.

Luensmann D, Guthrie S, Woods J, Voltz K, Vega J.. Software Guided Orthokeratology Fitting Success American Academy of Optometry, New Orleans, October 12, 2023 [ Show Abstract ]

PURPOSE: To evaluate the ease of fit and success rate of the recommended orthokeratology lens parameters as determined by the Visavyä software (CooperVision Inc.).

METHOD: This four-site prospective study recruited participants aged 6-35 years and fit them bilaterally with Paragon CRT® or Paragon CRT Dual Axis® orthokeratology lenses (CooperVision Inc.), worn every night for 1 month. Four different topographers were used in the study: Medmont E300, Oculus Keratograph 5, Oculus Pentacam or Topcon CA-800. Topography data were uploaded into the software and together with subjective refraction and white-to-white corneal diameter data, the software calculated the recommended lens parameters for the first trial lens. If fit and/or vision was not acceptable, lens modifications were permitted at the dispense visit, after the first night or after one week of wear. Best-corrected visual acuity was determined at baseline and unaided acuity was measured after one month of overnight lens wear.

RESULTS: 54 participants (33F:21M), mean age 17.5±7.4 years [7 to 35 years] were included in the analysis. An additional 8 participants were successfully screened and dispensed but exited the study early for lens related and other reasons, they are not included in the analysis. The mean subjective refraction (OU) of all completed participants was Sph -2.60±1.30DS [-5.75 to 0.00] and Cyl -0.50±0.47DC [-1.75 to 0.00]. The software recommended either CRT or CRT Dual Axis lenses depending on the corneal toricity: • Medmont: 13 CRT, 17 Dual Axis • Oculus Keratograph 5: 10 CRT, 28 Dual Axis • Oculus Pentacam: 11 CRT, 9 Dual Axis • Topcon CA-800: 13 CRT, 7 Dual Axis Only four eyes (<4%) involving 3 different participants required a lens parameter change from the initial lens recommendation by the fitting software (all CRT Dual Axis) and involved two different topographers. For the cohort, the best-corrected visual acuity (logMAR) prior to lens wear was -0.07±0.11 (-0.30 to 0.14) and unaided vision after 1 month of lens wear was -0.03 ± 0.15 (-0.30 to +0.38) (p<0.01). Remaining refraction after 1 month was Sph –0.04 ± 0.34 DS. (-1.25 to +0.75). The 1-month unaided vision by lens type was: • CRT: -0.07 ± 0.12 (-0.30 to 0.14) • CRT Dual Axis: -0.01 ± 0.16 (-0.30 to 0.38) There were no significant or serious ocular adverse events in this study.

CONCLUSION: The Visavy™ software successfully integrated data from four different topographers and provided a >96% first fit success rate for Paragon CRT® and Paragon CRT Dual Axis®. This predictable outcome makes the Visavy™ software a valuable tool for eye care professionals when fitting these lenses to minimize chair time and optimize wearer satisfaction.

Luensmann D, Guthrie S, Woods J, Voltz K, Vega J.. Orthokeratology fitting success using a new software British Contact Lens Association Clinical Conference & Exhibition, Manchester, Jun 9-11, 2023 [ Show Abstract ]

PURPOSE:
To determine vision outcome after orthokeratology (Ortho-K) lens wear when using the new Visavy software (CooperVision Specialty EyeCare) to determine the recommended lens parameters.

METHODS:
This multisite (3) prospective study recruited participants aged 6-35 years and fit them with Paragon CRT or Paragon CRT Dual Axis Ortho-K lenses (CooperVision Specialty EyeCare), worn every night for 1 month. Topography images (Oculus Keratograph 5, Medmont E300, or Topcon CA-800) were uploaded in the software and together with entries for subjective refraction and white-to-white corneal diameter, the software provided the recommended lens parameters. If fit and/or vision was not acceptable, lens modifications were permitted at the dispense visit, after the first night or after one week of wear. Best-corrected visual acuity was determined at baseline and unaided after one day, one week and one month of Ortho-K wear. Subjective comfort was collected after the first lens application and after one month (0-10 scale, 10=very comfortable).

RESULTS:
Thirty participants (19F:11M), mean age 13.6±5.9 years [7 to 35 years] were included in the analysis. The mean refraction of all 60 eyes was Sph -2.98±1.27DS and Cyl -0.54±0.43DC. Best-corrected visual acuity (logMAR) prior to lens wear was -0.01±0.04 and unaided vision was +0.30±0.33 after the first night, +0.05±0.13 after 1 week and +0.06±0.10 after 1 month of Ortho-K lens wear. Remaining subjective refraction after 1 month was Sph –0.37±0.82DS. Only two eyes (<3%) required a lens parameter change after the initial lens recommendation by the fitting software. Comfort ratings were significantly better after 1 month (7.8±1.6) compared to the dispense visit (5.6±2.2)(p<0.01). There were no ocular adverse events in this study.

CONCLUSIONS:
The software provided a 97% first fit success rate for Paragon CRT and Paragon CRT Dual Axis. This predictable outcome makes the Visavy software a valuable tool for ECPs when fitting Ortho-K lenses.

Luensmann D, Schulze M, Guthrie S, Woods J, Jones L. Evaluating the change in symptoms when symptomatic daily disposable lens wearers are refit with delefilcon A Optometry's Meeting ePosters Virtual Event, Jun 13, 2023

Luensmann D, Schulze M, Guthrie S, Woods J, Jones L. Early lens handling experience of neophyte wearers fitted contralaterally with a hydrogel and a silicone hydrogel daily disposable contact lens Optometry's Meeting ePosters Virtual Event, Jun 13, 2023

Luensmann D, Tucker AW, Voltz K, Guthrie S, Woods J, Vega J. Orthokeratology Lens Fit Success Using a New Software Global Specialty Lens Symposium, Las Vegas, Jan 20, 2023 [ Show Abstract ][ PDF ]

Purpose: To determine orthokeratology (Ortho-K) lens parameters in as few steps possible is beneficial for the eye care professionals (ECPs) and patient and this study investigated how the new Visavy software can help to inform the initial lens parameters.

Methods: This prospective study recruited participants aged 6-35 years and fit them with Paragon CRT or Paragon CRT Dual Axis Ortho-K lenses (CooperVision Specialty EyeCare), worn every night for 1 month. Topography images (Oculus Keratograph 5) were uploaded in the software and together with additional entries for subjective refraction and white-to-white corneal diameter, the software populated the initial lens parameters. Lens modifications for fit and/or vision were permitted at any of the following three timepoints: the dispense visit, after the first night or after one week of wear. Visual acuity (LogMAR) was determined with subjective refraction at baseline and unaided after one month of Ortho-K wear. Subjective comfort was collected after the first lens application and after one month (0-10 scale, 10=very comfortable). Subjective vision clarity was collected via home ratings just after lens application on the first night and after one month (0-10 scale, 10=Sharp, clear/ very good vision).

Rresults: Sixteen participants (12F:4M), mean age 11.3±3.2 years [7 to 18 years] were included in the analysis. The mean refraction of all 32 eyes was Sph -2.80±1.38DS [-1.00 to -5.75DS] and Cyl -0.56±0.46DC [0.00 to -1.25DC]. Best-corrected visual acuity prior to lens insertion was 0.00±0.01 logMAR and unaided vision after 1 month was +0.09±0.11 logMAR. Remaining correction after 1 month was Sph -0.12±0.46DS [+0.75 to -1.25DS]. Almost all lens designs predicted by the software were considered acceptable (fit and vision) by the investigator with just one lens requiring a modification after the first night due to corneal staining. Comfort ratings were significantly better after 1 month (7.8 ± 1.4) compared to the dispense visit (5.2 ± 2.2)(p<0.01). Vision clarity ratings were also better after 1 month (8.4 ± 1.5) compared to after the first night (7.0 ± 3.2)(p=0.02).

Conclusions: The Visavy software could help determine acceptable lens parameters for the Paragon CRT or Paragon CRT dual axis Ortho-K lenses in 97% of eyes (31 of 32 eyes). This high initial success rate has the potential to reduce chair time and assist ECPs to confidentially fit these lenses to their patients.

Woods J, Guthrie S, Luensmann D, Vega J, Orsborn G. Task-based Evaluations of Two Daily Disposable Soft Multifocal Lenses American Academy of Optometry, New Orleans, October 12, 2023 [ Show Abstract ]

Purpose: Drop-outs from contact lens (CL) wear remains problematic across the entire sector, however for presbyopes it has been reported to be higher
and largely related to comfort and vision problems. Many practitioners use daily disposable (DD) CLs to improve comfort, therefore it is of high
interest to evaluate two recently launched DD multifocal (MF) CLs with a particular emphasis on evaluating subjective comfort and situational or
task-related vision performance: stenfilcon A (stenA) DDMF (CooperVision, Inc.) and senofilcon A (senoA) DDMF (Johnson & Johnson Vision).

Methods: Habitual MFCL wearers were recruited for this randomized, subject masked, cross-over study. After a successful screening both lenses were fit
following manufacturers’ fitting guides. Lens 1 was dispensed and optimized 3-8 days later, prior to entering a 2-week optimized lens wear period,
after which Likert ratings were completed for comfort, vision and everyday tasks. Then, Lens 2 was dispensed and the same power optimization
and data collection schedule were followed. Likert ratings used 4-point forced choice, with strongly or slightly agree considered positive responses
and strongly or slightly disagree considered negative responses.

Results: 54 subjects, 43F/11M, completed the study with demographic means [range]: age 53yrs [42-75]; OD: sphere -1.72D [+4.00 to -5.50], cyl -0.29D [0.00 to -0.75] near addition +1.94D [+1.00 to +2.50]. At the end of each optimized lens wear period, Likert data showed no differences between lenses (p>0.05). Each lens showed statistically higher counts of positive versus negative responses for each statement (all p<0.05). Percentage of positive responses were:
• These CLs feel good on my eyes: stenA 93%; senoA 89%
• These CLs gave me all day comfort: stenA 87%; senoA 87%
• These CLs give me crisp clear vision at all distances: stenA 81%; senoA 69%
• These CLs give me crisp clear vision in different lighting conditions: stenA 89%; senoA 74%
• These CLs give me crisp clear vision even in dim/dark light conditions: stenA 80%; senoA 69%
• These CLs give me crisp clear vision when driving: stenA 90%; senoA 81%
• These CLs give me crisp clear vision when using a laptop: stenA 88%; senoA 92%
• These CLs give me crisp clear vision when reading text on my phone: stenA 91%; senoA 85%
• These CLs give me crisp clear vision when reading up close: stenA 83%; senoA 80%
• These CLs give me reliable vision: stenA 93%; senoA 87%
• I do not experience halos and starbursts in my vision: stenA 94%; senoA 94%

Conclusion
The high percentage of positive responses to these task specific reports of lens performance suggests that both lenses largely met or exceeded the needs of these subjects for those tasks. It seems plausible to assume that if a MFCL is reported as comfortable and it also performs well in frequent everyday vision tasks and situations, then it is likely to help minimise future drop-out.

Woods J, Guthrie S, Luensmann D, Vega J, Orsborn G. Investigation of Ease of Fit to a Different Daily Disposable Multifocal Soft Lens American Academy of Optometry, New Orleans, October 12, 2023 [ Show Abstract ]

PURPOSE: Eye care professionals (ECPs) regularly need to decide whether to switch their multifocal contact lens (MFCL) patients to new products. Common reasons for switching are visual or comfort performance, prescription availability, new optical designs, or lens material benefits. This study evaluated the visual and comfort impacts of switching habitual MFCL wearers from somofilcon-A MF 2 add design (somA) into stenfilcon-A MF 3 add system (stenA) (both 1-day, CooperVision, Inc.) and collected information about the ease of fit.

METHOD: In this crossover, subject-masked study, subjects were first fit and dispensed with somA; power adjustments were permitted at the fit visit and also 1-week later. Optimal lens powers were worn for 2 weeks. After this adaptation period to optimized somA MFCLs, subjects were refit with stenA MFCLs which were worn and optimized following the same schedule. Fitting guides were followed for both. Subjects used diaries on days 6 and 13 to report whether stenA performance exceeded or met their needs (positive response) or whether they failed to meet their needs (negative response). Likert ratings were collected at the end of the stenA wear period.

RESULTS: Sixty participants (mean age 52.6±6.9; 50F:10M) completed. Mean OD refraction: sph -1.97D [-5.00D to +2.75D], cyl -0.50D [0.00 to -0.75], near addition: +1.95D [+1.00D to +2.50D]. All achieved successful fit with both MFCLs. 78% subjects achieved optimal fit with the first pair of trial stenA, the remaining 22% required just one adjustment. Lenses were worn on average >13hrs/day, ≥5 days/week. Diary responses showed stenA resulted in statistically more positive responses vs negative responses for various comfort and vision criteria (all p<0.01): • Comfort on lens application: Day 6 & 13: 98% & 100% positive responses • Comfort at time of removal: Day 6 & 13: 90% & 95% • Dryness at time of removal: Day 6 & 13: 90% & 92% • Vision stability throughout the day: Day 6 & 13: 93% & 95% • Overall speed & ability to change focus between distances: Day 6 & 13: 95% & 92% Through Likert questions, statistically more subjects agreed than disagreed with the following statements: • I could see clearly right away with these [stenA] contact lenses, and it was easy to adapt (p<0.01) • My vision improved when I switched from somA to stenA (p<0.01) • The transition from somA to stenA was easy (p<0.01)

CONCLUSION: Success was high with the first trial lens pair for stenA 3 add system lenses. Subjects reported the transition to be easy, resulting in clear vision straight away and through the wear period most reported that comfort and vision experiences met or exceeded their needs. These results should reassure ECPs when considering refitting their presbyopic patients from somA 2 add to stenA 3 add system; these subjects reported transitioning was easy and performance improvements were recognized within 2-weeks.

2022

Guthrie S, Luensmann D, Woods J, Vega J, Orsborn G. Acceptability of different lens materials in habitual wearers of frequent replacement lenses American Academy of Optometry, San Diego, 2022 [ Show Abstract ]

Purpose: New soft lens materials frequently enter the market for different lens wear modalities and the question remains as to how these compare to established products. The purpose of this study was to compare the subjective performance of two silicone hydrogel (SiHy) lenses that employ different technologies to improve wearer comfort: the recently introduced lehfilcon A (leh-A)(Alcon) lens employs ‘Water Gradient Technology’ and the established comfilcon A (com-A)(CooperVision) lens employs ‘Aquaform Technology’.

Methods: This study was a prospective, bilateral, double-masked, randomized, cross-over, daily-wear design involving two different monthly replacement SiHy lens types (leh-A and com-A). Young adults who habitually wore frequent replacement spherical lenses were recruited at four clinical sites in the US. Each of the two lens types was worn for one month and participants used their habitual care products. Throughout each month, participants recorded their lens wear comfort on several days at home and during study visits (0-10 scale, 10=can’t feel the lenses) and answered agreement (5-point strongly/slightly agree, neither agree or disagree, strongly/slightly disagree) and preference (5-point strong/slight prefer first/second lens pair, no preference) questions. Statistical differences were determined by Wilcoxon matched pairs and binomial testing.

Results: Sixty-three participants (44F:19M), mean age 27.5 ± 4.8 years [18 to 35 years] were included in the analysis. The mean spherical refraction was -3.12 ± 1.6D [-6.50D to +1.25D]. Overall comfort ratings on Days 1, 14, 27 were 8.5, 8.0, 7.7 for com-A and 8.8, 8.2, 8.1 for leh-A. For both lens types, comfort ratings were higher at the beginning of the month (p0.05). The mean drop in overall comfort after one month of wear was the same for both lens types (com-A: 0.7, leh-A: 0.7, p>0.05). At 1-month, participants rated overall satisfaction with comfort similarly (com-A: 8.0, leh-A: 7.8, p>0.05) and there was no difference in the number of participants preferring each lens when considering comfort on application (26:24), removal (27:24) and overall (29:27)(com-A:leh-A, all p>0.05). For each lens type, a similar number of participants agreed compared to disagreed with the statement “These lenses feel like nothing even after one month of wear” (each lens type p>0.05) and no statistically significant differences were found between the lens types (p>0.05).

Conclusion: Despite significant differences in material composition and surface technologies between com-A and leh-A, the subjective contact lens comfort experience over 1 month was similar. The preference ratings further highlight the importance of providing patients with different options and deciding together which lens type is best for them to help ensure long-term success with lens wear.

Luensmann D, Guthrie S, Woods J, Vega J, Orsborn G. Performance evaluation of two toric multifocal contact lenses available in different parameter increments Nederlands Contactlens Congres, Veldhoven, Netherlands, Jun 27, 2022 [ Show Abstract ]

Purpose:
Toric multifocal contact lenses (TMFCLs) offer vision correction to the astigmatic presbyopic population. The vision outcome was determined in existing soft lens wearers when fit with two TMFCLs, available in different parameter steps; 5 vs 10 degree axis increments and 6 vs 2 near adds.

Methods:
In a multisite, prospective, randomised, participant-masked, 1-month crossover, bilateral dispensing study, habitual soft lens wearers ≥42years old with minimum 0.75DC astigmatism were fit with two monthly replacement, silicone hydrogel TMFCLs (comfilcon A (com-A); CooperVision, samfilcon A (sam-A); Bausch & Lomb). The manufacturer’s fitting guides were followed, and lens prescriptions were optimised after 3-7 days of wear, before the 1-month wear period. Vision outcomes included visual acuity (LogMAR), 3-point ratings (met/exceeded or did not meet my needs), and 5-point preference ratings (strongly/slightly prefer lens 1 or 2, no preference).

Results:
Fifty-six participants age 53.6±8.6 years were included in the analysis (OD mean(±SD): sph -2.47D(±2.38), cyl -1.27D(±0.47), add 1.88D(±0.48)). For com-A axes ending in 5 degrees were chosen for 47% of eyes and each add power was prescribed. After one month, LogMAR acuity was similar for both lens types for distance, intermediate and near (p>0.05 for all). On days 7, 14 and 28 participants rated that com-A met their needs better for ‘Overall speed and ability to change focus between distances’, ‘Vision stability throughout the day’ and ‘Overall vision clarity’ (p<0.05 for all); other ratings showed no difference between lenses. A preference was found for com-A for vision clarity for ‘intermediate tasks’ (p=0.03), ‘near tasks’ (p=0.01), ‘during digital device use' (p0.05).

Conclusion:
The higher accuracy of prescribing for com-A due to the 5-degree axis steps and the 6 near adds may have contributed to the better vision outcomes reported with com-A.

Ng AY, Dantam J, Woods J, McEwen B, Jones L.. Examining Symptomatic Relief and Kinetic Tear Film Stability of I-DROP MGD Eye Drops Optometry's Meeting ePosters Virtual Event, Jun 8, 2022 [ Show Abstract ]

Background:
I-DROP MGD is a novel formulation of viscoadaptive hyaluronan, phosphorylcholine and glycerin to support integration, stabilization and enhancement of the tear film lipid layer as well as hydration of the ocular surface. The purpose of this study was to compare the difference in tear film measures after instilling I-DROP MGD (test) compared with another hyaluronic acid-based lubricant, Thealoz Duo (control), and to examine the subjective relief of dry eye symptoms with I-DROP MGD over 1-week.

Methods:
This prospective pilot study (n=10) comprised of two parts. Part 1 was a non-dispensing, doublemasked study involving contralateral application of test and control drops, followed by a two-hour observation period. Non-invasive tear break-up time (NITBUT), tear meniscus height (TMH) and lipid layer thickness (LLT) were measured out to 2 hours. Part 2 was a dispensing study, where one bottle of I-DROP MGD was provided to participants to use bilaterally at least once daily for 7 days. After 7 days, subjective ratings (0-100 scale) of comfort, soothing and quality of vision along with OSDI and SPEED scores were collected and compared with participant's habitual eye drops.

Results:
Part 1: NITBUT and TMH were significantly greater with I-DROP MGD (14.2 ± 5.1s and 0.42 ± 0.22mm) compared to Thealoz Duo (10.5 ± 5.7s and 0.29 ± 0.10mm) after 60 minutes (p =0.037) and 5-minutes of instillation (p =0.022) respectively; LLT was significantly thicker with Thealoz Duo (79.5 ± 15.7nm) compared to I-DROP MGD (68.5 ± 13.8nm) after 5 minutes of instillation (p=0.005). Part 2: Subjective ratings for comfort and soothing were significantly greater with I-DROP MGD (81.6 ± 5.7 and 86.8 ± 8.1) compared to habitual eye drops (73.3 ± 13.7 and 75.3 ± 19.8), p=0.027 and p=0.010 respectively. No significant differences were observed for quality of vision. OSDI and SPEED scores were significantly lower following use of I-DROP MGD (33.2 ± 11.7 and 11.1 ± 3.6) when compared to habitual drops (45.2 ± 14.7 and 14.9 ± 2.7), p=0.017 and p=0.006 respectively.

Conclusion:
When used for 7 days, I-DROP MGD resulted in clinically relevant reductions in dry eye symptoms, measured with OSDI.

Ng AY, Woods J, Jones L. The impact of fluid intake on dry eye symptoms and signs American Academy of Optometry, San Diego, 2022 [ Show Abstract ][ PDF ]

Purpose: Preventing dehydration is essential for optimal bodily function. This study investigated if maintaining the recommended daily fluid intake set out by the Dietitians of Canada affects tear film measures and ocular symptoms in participants with and without dry eye disease (DED).

Methods: This was a prospective, non-randomized interventional pilot study. Twenty participants were enrolled: 10 with DED and 10 healthy controls. At Baseline, symptom questionnaires (Ocular Surface Disease Index [OSDI] and Ocular Comfort Index [OCI]) and habitual fluid intake was documented. Baseline tear film measures (non-invasive tear break-up time [NITBUT], tear meniscus height [TMH], non-anaesthetized Schirmer test) were also assessed. Eligible participants were instructed to attain the recommended daily intake (3.0L for males, 2.2L for females) for 7 days, while keeping a diary to track all fluids consumed during this time. On Day 8, participants returned for follow-up: symptom questionnaires and tear film measures were reassessed and fluid intake diaries were collected.

Results: Twenty participants completed the study; 4/20 (3 DED, 1 control) met the fluid intake recommendation prior to starting the study and were excluded from data analysis. All remaining 16 participants (8 male, 8 females; 7 DED, 9 control) increased their fluid intake for 7 days. There was a statistically significant and clinically relevant improvement in OSDI scores in the DED group after the fluid intake intervention only (Control baseline: 4 ± 3, Day 8: 2 ± 3, p>0.05; DED baseline: 40 ± 12, Day 8: 29 ± 8, p<0.001). Similarly, OCI scores (0-100, where 100=worst level of discomfort) were 5-points better in both groups after maintaining the fluid intake (Control baseline: 26 ± 5, Day 8: 21 ± 9; DED baseline: 40 ± 3, Day 8: 35 ± 4; both p0.05; DED baseline: 0.21 ± 0.09, Day 8: 0.31 ± 0.15, p=0.043. Schirmer Control baseline: 26 ± 12, Day 8: 27 ± 10; DED baseline: 24 ± 14, Day 8: 23 ± 15; both p>0.05). Compared to baseline, a small increase in NITBUT was observed in the control group and a small decrease observed in the DED group, however neither changes were statistically significant (Control baseline: 11.7 ± 6.5, Day 8: 12.9 ± 8.3; DED baseline: 8.1 ± 4.2, Day 8: 6.4 ± 3.1; both p>0.05).

Conclusions: In participants with DED, maintaining increased fluid intake for 7 days significantly improved OSDI and OCI scores and increased tear volume however, there was no change in non-anaesthetized Schirmer tests or NITBUT. In the control group, small changes in tear film measures were found, however these were not clinically or statistically significant.

Postnikoff C, Woods J, Weiss S, Jones D, Kasthurirangan S, Chamberlain P, McNally J. Preliminary modification and adaptation of quality of vision questionnaire for children American Academy of Optometry, San Diego, October, 2022

Postnikoff C, Woods J, Weiss S, Jones D, Kasthurirangan S, Chamberlain P, McNally J. Preliminary modification and adaptation of a visual ability questionnaire for children International Myopia Conference, Rotterdam, Netherlands, September, 2022

Schulze M, Luensmann D, Ng A, Guthrie S, Woods J, Jones L. Performance of verofilcon A daily disposable contact lenses in digital device users American Academy of Optometry, San Diego, 2022 [ Show Abstract ][ PDF ]

Purpose: To evaluate the performance of Precision1 (verofilcon A) daily disposable (DD) contact lenses (CLs) in habitual CL wearers who undertake substantial digital device use.

Methods: CL wearers between 18-40 years of age who reported a daily digital device use of ≥6 hours while wearing their habitual CLs participated in the study. Eligible participants were dispensed with verofilcon A DD CLs for a period of 12-16 days and were asked to wear these for at least 5 days/week and at least 10 hours/day, while continuing their normal routine of ≥6 hours digital device use. At the 2-week follow-up visit, participants rated their experience with the study lenses on a 0 to 100 scale, with 100 being best, and reported their lens wear times and digital device use. Comfort, dryness and clarity of vision ratings with verofilcon A lenses were collected directly after lens insertion, after 6 hours of digital device use, just before removal, and for overall lens performance. Participants also completed a 4-point (strongly agree, slightly agree, slightly disagree, strongly disagree) Likert scale-based questionnaire. Subjective ratings were not normally distributed, therefore non-parametric analysis was conducted and data are reported as median (range). The Likert scale responses were analyzed using binomial testing.

Results: Thirty-two participants completed the study (27F:5M), mean age of 25.8 ± 6.0 years (range 19-40). Participants reported total and comfortable CL wear time of 14 hours (10-17) and 11.6 hours (2.8-16), respectively, and digital device use of 8.5 hours (6-18) on a typical day. Subjective ratings for overall lens performance after 2 weeks of CL wear were high, with median ratings of 90 (68 – 100) for comfort, 90 (52-100) for dryness and 95 (70-100) for clarity of vision. There were no differences in comfort, dryness and clarity of vision ratings over the course of a typical day, with similar ratings at insertion, after 6 hours of digital device use and just before removal (all p≥0.05). The majority of participants agreed that the study lenses provided good comfort (28/32 subjects; p<0.01) and good vision (29/32; p<0.01) all day long. Considering CL performance when using digital devices for 6 hours, the majority of participants were satisfied with CL comfort (27/32; p<0.01) and vision (29/32; p<0.01) and most agreed that the verofilcon A lenses provided good performance (26/32; p<0.01). Most study participants (24/32; p<0.01) agreed that they did not experience any eye strain during digital device use while wearing verofilcon A lenses. No significant lens-related ocular health findings were observed after 2 weeks of wear.

Conclusions: After 2 weeks of wear, most participants rated the performance of verofilcon A DD CLs highly, with median overall performance ratings for comfort, dryness and vision all 90 on a 0 to 100 scale.

2021

Guthrie S, Luensmann D, Woods J, Vega J, Orsborn G. Relationships between success factors in daily disposable multifocal lenses American Academy of Optometry, Boston, 2021 [ Show Abstract ]

PURPOSE:
To evaluate relationships between subjective responses to two daily disposable multifocal contact lenses (MFCLs), stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

METHODS:
Habitual MFCL wearers participated in a prospective, randomized, subject-masked, bilateral crossover study at five optometry offices. Subjects wore each study contact lens (SCL) for 2 weeks and answered lens handling (0-10), satisfaction (1-fell short of needs; 2-met needs; 3-exceeded needs) and agreement (4-strongly agree; 3-slightly agree; 2-slightly disagree; 1-strongly disagree) questions. Responses were analyzed using Wilcoxon Matched-Pairs testing for differences between lens types. Spearman correlations were done for each lens type separately.

RESULTS:
Fifty-eight subjects (50F:8M; mean 54.4 ± 7.3 years) were included in the analysis; mean spherical-equivalent refraction OD: -1.10 ± 2.7D [-6.50D to +3.75D], add +2.00 ± 0.4D [+1.00D to +2.50D]. Subjects had greater agreement for stenA-MF compared to delA-MF for “SCL met my needs for vision” (stenA-MF: 3.3; delA-MF: 2.9; p=0.02) and for “I would like to wear SCL in the future” (stenA-MF: 2.9; delA-MF: 2.6; p=0.03). For each SCL there was a significant correlation between responses to these two questions (stenA-MF: rs=0.81; delA-MF: rs=0.84; p<0.05). For stenA-MF, “SCL met my needs for vision” was significantly correlated (p0.05). Similarly, for stenA-MF, “I would like to wear SCL in the future” was significantly correlated (p0.05). There were no statistically significant differences between stenA-MF and delA-MF for D13 EOD satisfaction with comfort (stenA-MF: 2.0; delA-MF: 2.0; p=0.72) or dryness (stenA-MF: 1.9; delA-MF: 1.9; p=0.88). For both SCLs, EOD satisfaction with comfort was significantly correlated (all p<0.05) with EOD satisfaction with dryness (stenA-MF: rs=0.71; delA-MF: rs=0.67), ease of handling for removal (stenA-MF: rs=0.35; delA-MF: rs=0.51) and comfortable wear time (CWT) (stenA-MF: rs=0.30; delA-MF: rs=0.37). CWT was similar for both SCLs (stenA-MF: 11.6 hours; delA-MF: 11.0; p=0.08), but stenA-MF was rated significantly better for ease of handling for removal (stenA-MF: 8.4 vs delA-MF: 7.6, p=0.02).

CONCLUSIONS:
While end-of-day comfort and dryness are important factors in contact lens success, these results suggest that satisfaction with vision for these multifocal lens wearers was a better indicator (both rs>0.80) of their desire to continue wearing the multifocal lenses in the future.

Guthrie S, Luensmann D, Woods J, Vega J, Orsborn G. Comfort and vision correlations in daily disposable multifocal lenses BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: To evaluate the subjective responses to two daily disposable multifocal contact lenses (MFCLs), stenfilcon A (stenA-MF) and delefilcon A (delA-MF), and to see if there is a correlation between preferences based on vision and comfort.
Method: Habitual MFCL wearers participated in a prospective, randomized, subject-masked, bilateral crossover study at five sites. Subjects wore the study MFCLs for 2-weeks each and then responded to preference questions comparing the study lenses for comfort and vision for near, intermediate, distance, digital device use and overall at all distances. A 5-point Likert scale (Strong/slight preference for each lens or no preference) was used.
Results: For the 58 eligible subjects (50F:8M; mean 54.4±7.3 years), preferences were as follows (#stenA-MF:#delA-MF, p-value): subjects favoured stenA-MF for overall comfort (26:9, p=0.03), intermediate vision (25:8, p=0.03), overall vision (34:10, p=0.04) and vision for digital device use (27:10, p=0.03). Preferences were equivocal for near vision (29:14, p=0.06) and distance vision (13:19, p=0.51). Correlation analysis found that the lens preference based on overall comfort was significantly correlated (all p<0.05) with lens preference based on vision at near (rs=0.61), intermediate (rs=0.48), overall (rs=0.65) and for digital device use (rs=0.66). Lens preference based on overall vision was also correlated with lens preference based on vision at near (rs=0.85), intermediate (rs=0.71), and for digital device use (rs=0.87). Lens preference based on vision with digital device use correlated with lens preference based on vision at near (rs=0.85), and intermediate distance (rs=0.69).
Conclusions: Subjects preferred stenA-MF for a range of comfort and distance measures. Preferences for overall comfort and overall vision were both significantly correlated to the same three preferences of near, intermediate and digital device vision, illustrating how comfort and vision are intricately related when evaluating MFCLs and supporting how poor vision could potentially impact comfort.

Luensmann D, Schulze M, Woods J, Lazon de la Jara P, Vega J, Orsborn G. Fitting success with stenfilcon A daily disposable multifocal lenses
BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: Multifocal contact lens (MFCL) fitting sometimes raises concerns about the number of fitting attempts required to determine the optimal lens prescription. This study compared the fit process and success rates of stenfilcon A (stenA) MFCL with delefilcon A (delA) MFCL when fitted to existing MFCL wearers in a randomized order.

Method: Successful MFCL wearers with <1.00DC of astigmatism were recruited at five clinical sites in the US. The first trial lenses were determined from current subjective refraction and the respective fitting guides. Prescription changes were reviewed at this first fit visit and also when participants returned for an optimization visit after wearing the lenses for 3-7 days. Multiple lens powers could be trialed at each visit, all were recorded.

Results: Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years [42 to 70 years] were included in the analysis. The spherical-equivalent refraction was OD -1.10±2.7D [-6.50D to +3.75D] with near add +2.00±0.4D [+1.00D to +2.50D]. StenA-MFCL was successfully fit with the first pair of trial lenses in 83% (48) participants, while 10% (6) needed one additional lens and 7% (4) needed an extra two lenses to reach their final power. Regarding count of eyes, 12% (14) needed power optimizations. DelA-MFCL was successfully fit with the first pair of trial lenses in 66% (38) participants, while 17% (10) needed one additional lens, 10% (6) needed two extra lenses and 7% (4) needed three extra lenses to reach their final lens power. Regarding count of eyes, 25% (30) needed power optimizations.

Conclusions: Habitual MFCL wearers were successfully fitted with both MF lens types when following the respective fitting guides. There was a higher success rate with the first lens pair for stenA-MFCL (>8/10 patients) compared to delA-MFCL (<7/10 patients), and no more than one additional fitting lens (per eye) was needed when fitting stenA-MFCL.

Luensmann D, Schulze M, Woods J, Vega J, Orsborn G. Intermediate vision with multifocal contact lenses American Academy of Optometry, Boston, 2021 [ Show Abstract ]

Purpose:
Fitting multifocal contact lenses (MFCL) typically focusses on optimizing distance and near vision, however many presbyopes require good intermediate vision to focus on targets such as desktop screens. This study determined the performance of habitual MFCL (hab-MFCL), stenfilcon A MFCL (stenA-MFCL) and delefilcon A MFCL (delA-MFCL) for intermediate distance vision in existing MFCL wearers.

Methods:
Five clinical sites in the US recruited habitual MFCL wearers with <1.00DC of astigmatism. Habitual MFCL were power optimized and both study lens types were fit following the respective fitting guides. After two weeks of hab-MFCL wear, study MFCL were worn in a masked/randomized order for the same period of time. Intermediate visual acuity (VA) at 0.75m was determined and subjective responses (fell short of needs; met needs; exceeded needs) were collected along with preference ratings (strongly prefer, slightly prefer, no preference). Subjective responses and logMAR VA were analyzed using Wilcoxon Matched-Pairs testing for differences and binomial testing was conducted on preference ratings.

Results:
Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years [42 to 70 years] were included in the analysis. The mean spherical-equivalent refraction was OD -1.10±2.7D [-6.50D to +3.75D]. The average near spectacle Rx add was +2.00±0.4D [+1.00D to +2.50D] and included 18 participants (31%) who required an add of up to +1.75D and 40 (69%) with an add of at least +2.00D. After two weeks of wear, intermediate logMAR VA with stenA-MFCL (0.08±0.10 logMAR) was statistically significantly better compared to hab-MFCL (0.12±0.11 logMAR, p=0.002) and compared to delA-MFCL (0.12±0.12 logMAR, p0.05 for both).

Conclusion:
All MFCL were worn successfully for two weeks, however differences in the intermediate vision clarity were noted between lens types, in favour of stenA-MFCL compared to delA-MFCL. Digital devices are frequently used at work and during leisure time today and form part of the need for optimal intermediate vision. While it may often be overshadowed by distance and near vision assessments, good performance at the intermediate distance can be just as critical to ensure success in MFCL wearers.

Schulze M, Luensmann D, Woods J, Vega J, Orsborn G.. Comfort and vision with two daily disposable multifocal lenses when worn by habitual multifocal contact lens wearers BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: Practitioners can be reluctant to switch successful multifocal soft contact lens (MF) wearers to different materials or replacement frequencies, fearing the new MF will be less accepted. Subjective responses are highly valued in MF fitting and this study investigated subjective responses from habitual MF (hab-MF) wearers after a refit into daily disposable MF; stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

Method: After optimising the lens powers, subjects wore hab-MF and both study-MFs for 2-weeks each. Study-MF brands were masked and randomised. Throughout the study, subjects answered 13 experience questions per lens type, and 6 preference questions (comfort and vision for distance, intermediate, near, digital-device use, overall vision) to compare between hab-MF and each study MF, and also between study MFs.

Results: Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years were included. Mean spherical-equivalent OD refraction: -1.10±2.7D [range -6.50D to +3.75D], mean near add +2.00±0.4D. 44% habitually wore daily disposable MF yet all were naïve to the study-MFs. Hab-MF wear resulted in positive responses for all experience questions (p<0.05); for stenA-MF 12 answers were positive (p<0.05), 1 was equivocal (p=0.90); for delA-MF 6 were positive (p0.05). Preferences between stenA-MF and hab-MF showed no differences (p>0.05). Subjects preferred hab-MF over delA-MF for intermediate vision (p=0.03) but no other preference (p>0.05). Comparing between study MFs, the preference for stenA-MF was stronger than delA-MF for comfort (p=0.03), intermediate vision (p=0.03), digital-device use (p=0.03) and overall vision (p=0.02) with no difference for distance or near vision (p>0.05).

Conclusions: This study showed that even when habitual MF wearers are already successful, refitting with a new design does not necessarily lead to compromised performance; stenA-MF performed comparably to hab-MF, and for some metrics better than delA-MF. These results should give practitioners confidence to recommend newer materials and different replacement frequencies when managing their existing MF wearers.

Woods J, Luensmann D, Schulze M, Vega J, Orsborn G. Subjective lens experience when refit with daily disposable multifocal contact lenses BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: Practitioners can be reluctant to switch successful multifocal soft contact lens (MF) wearers to different materials or replacement frequencies, fearing the new MF will be less accepted. Subjective responses are highly valued in MF fitting and this study investigated subjective responses from habitual MF (hab-MF) wearers after a refit into daily disposable MF; stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

Method: After optimising the lens powers, subjects wore hab-MF and both study-MFs for 2-weeks each. Study-MF brands were masked and randomised. Throughout the study, subjects answered 13 experience questions per lens type, and 6 preference questions (comfort and vision for distance, intermediate, near, digital-device use, overall vision) to compare between hab-MF and each study MF, and also between study MFs.

Results: Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years were included. Mean spherical-equivalent OD refraction: -1.10±2.7D [range -6.50D to +3.75D], mean near add +2.00±0.4D. 44% habitually wore daily disposable MF yet all were naïve to the study-MFs. Hab-MF wear resulted in positive responses for all experience questions (p<0.05); for stenA-MF 12 answers were positive (p<0.05), 1 was equivocal (p=0.90); for delA-MF 6 were positive (p0.05). Preferences between stenA-MF and hab-MF showed no differences (p>0.05). Subjects preferred hab-MF over delA-MF for intermediate vision (p=0.03) but no other preference (p>0.05). Comparing between study MFs, the preference for stenA-MF was stronger than delA-MF for comfort (p=0.03), intermediate vision (p=0.03), digital-device use (p=0.03) and overall vision (p=0.02) with no difference for distance or near vision (p>0.05).

Conclusions: This study showed that even when habitual MF wearers are already successful, refitting with a new design does not necessarily lead to compromised performance; stenA-MF performed comparably to hab-MF, and for some metrics better than delA-MF. These results should give practitioners confidence to recommend newer materials and different replacement frequencies when managing their existing MF wearers.

2020

Guthrie S, Woods J, Vega J, Orsborn G, Ng AY, Jones L. Exploring the factors which impact overall satisfaction with contact lenses Academy at Home, 2020 [ Show Abstract ]

Purpose: To evaluate the performance of two spherical lenses, one silicone hydrogel (SiHy) (somofilcon A) and one hydrogel (Hy) (etafilcon A), using subjective evaluations after 1-week and to correlate the relationships between specific subjective evaluations of lens performance and subjective overall satisfaction.
Methods: Fifty-five subjects participated in a prospective, double-masked, bilateral crossover dispensing study, wearing each lens for 1 week in a randomized order. Subjective ratings (0-10 scale) were completed after 1 week based on a typical day experience and a 4-point Likert scale (Strong/slight preference for each lens) was used to determine lens preference.
Results: Data for both lenses were combined and correlation analyses were conducted. Overall satisfaction was found to be significantly correlated (p<0.01) with handling for insertion (r=0.64), overall satisfaction with vision (r=0.64), handling for removal (r=0.50), comfort at insertion (r=0.59), comfort at end of day (r=0.61) and overall satisfaction with comfort (r=0.88). In addition, insertion comfort was significantly correlated with overall satisfaction with comfort (r=0.66). Considering the lenses separately, SiHy was rated significantly higher for handling for lens insertion compared to Hy (9.4 vs 8.1, p<0.01) and correlation strength with overall satisfaction varied greatly with lens material (SiHy: r=0.26, p=0.05 vs Hy: r=0.72, p<0.01). Overall lens preference based on lens handing for insertion also strongly favoured SiHy (37 subjects vs 18, p<0.01). Comfort at insertion was rated significantly higher at insertion with SiHy (9.0 vs 8.1, p<0.01) and similarly at end of day (8.1 vs 7.9, p=0.80). Correlation strength of comfort at insertion/end of day with overall satisfaction again varied with lens material (Insertion: SiHy: r=0.40 vs Hy: r=0.61; End of day: SiHy: r=0.76 vs Hy: r=0.58; all p≤ 0.01). There were no other statistically significant differences in subjective results for SiHy and Hy.
Conclusions: Significant correlations were found between overall satisfaction and the specific subjective evaluations of handling, vision and comfort. Interestingly, handling for insertion had a similar correlation (r) value as vision, suggesting that handling for insertion should not be underestimated when considering overall patient satisfaction. And while insertion and end of day comfort correlated moderately with overall satisfaction, overall satisfaction with comfort highly correlated with overall satisfaction. Separate analysis of SiHy and Hy also indicate that lower handling and comfort scores for Hy at insertion drove a higher correlation, suggesting that dissatisfaction with both handling for lens insertion and comfort upon lens insertion can play major roles in overall dissatisfaction with a lens.

Luensmann D, Schulze M, Ng AY, Woods J, Jones L. Refitting symptomatic daily disposable contact lens wearers with dry eye disease with delefilcon A lenses Academy at Home, 2020 [ Show Abstract ]

Purpose: To refit symptomatic wearers of daily disposable (DD) contact lenses with a confirmed dry eye diagnosis with Dailies Total1 (delefilcon A, Alcon) to evaluate the performance of the new lenses after one month of wear.
Methods: In this prospective, participant-masked study (over-labelled lenses), symptomatic DD lens wearers were recruited who demonstrated symptoms and signs of dry eye disease according to the TFOS DEWS II criteria. The performance of the lenses after one month was evaluated using subjective ratings and comfort scores, and by determining average wear time and comfortable wear time. Lens wear times as well as subjective symptom scores for comfort, dryness and vision (0-100 scale, with 100 being best) with habitual DD were collected at the screening visit and these results were then compared to delefilcon A after 1 month of wear. The data were not normally distributed, therefore non-parametric analysis (Wilcoxon Matched Pairs Test) was conducted. Data are reported as median (range), with delefilcon A data reported first.
Results: In total, 27 symptomatic DD lens wearers (19 female, 8 male) completed the study. Comfort ratings across all participants were significantly higher (p=0.014) for delefilcon A (80 (40-100)) compared to habitual DD lenses (80 (25-90)). Participants reported less dryness (p=0.007) with delefilcon A compared to their own lenses (80 (40-100) vs 70 (20-95)), and no difference in vision (p>0.05, 90 (50-100) vs (85 (60-100)). There were no statistically significant differences in total hours of lens wear per day (p>0.05, 12.5 hours (6.5-17) vs 11 hours (2.5-16)) or for comfortable wearing time (p>0.05, 8 hours (1-17) vs 6 hours (1-14.8). There were no lens-related ocular findings after one month of delefilcon A wear.
Conclusion: In general, participants had a positive lens wear experience with delefilcon A and rated this lens more comfortable and less dry compared to their habitual DD lenses. This suggests that symptomatic DD lens wearers with dry eye disease may benefit when refit into delefilcon A lenses.

Luensmann D, Woods J, McParland M.. Toric lens fitting success supported by an online fitting App Contact Lens Anterior Eye 2020 [ Show Abstract ][ PDF ]

Purpose: To provide eye care professionals quick access to lens parameter availability and to make soft toric lens fitting easier, online tools are now available to calculate and suggest a first choice prescription based on the patient’s subjective refraction. How close the recommended prescription matches the dispensed lens has been investigated in this study.

Method: In clinical studies, two daily disposable toric lenses, stenfilcon A and somofilcon A, and one monthly replacement toric lens, comfilcon A (all CooperVision, Inc.), were fitted and dispensed to 54, 37 and 47 habitual lens wearers respectively, following the manufacturer’s fitting guides. The final lens prescriptions were determined by the clinician based on over-refraction and lens rotation (Final-Rx). In a secondary analysis the subjective refraction data and back vertex distance were entered in the OptiExpert™ app to determine the recommended initial trial lens (App-Rx). The prescription results from both approaches were compared by calculating the mean differences (Bland-Altman) and the percentages of matching prescriptions following predetermined allowances for sphere, cylinder and axis.

Results: The mean differences between OptiExpert™ and the clinician final prescriptions for sphere, cylinder and axis were within ±0.13DS, ±0.01DC and ±1.38 degrees, respectively. For allowance combination sphere ±0.25D, cylinder ±0.00DC, axis ±10 degrees, the lens prescriptions from both methods matched in 75-82% of eyes (82% stenfilcon A, 75% somofilcon A, 79% comfilcon A). For allowance combination of sph ±0.50D, cyl ±0.00DC, axis ±20 degrees the Final-Rx and the App-Rx matched in 86-92% of eyes (91% stenfilcon A, 92% somofilcon A, 86% comfilcon A).

Conclusions: All three toric lens types showed a predictable on-eye performance, resulting in a close agreement between the initial OptiExpert recommended prescription and the lens prescription dispensed by the clinician. The OptiExpert™ app can therefore confidently be used to assist CooperVision toric lens fitting in order to help optimize patient chair time.

Luensmann D, Woods J, McParland M.. The use of a modern web-application to assist reusable toric lens fitting success Contact Lens Anterior Eye 2020 [ Show Abstract ][ PDF ]

Purpose: Increasing numbers of online tools are available to assist ECPs in fitting contact lenses. In this study, the contact lens prescription of a reusable toric silicone hydrogel lens was determined using a traditional fitting guide and the results were compared to the prescription recommended by the lens fitting app OptiExpert™.

Method: Forty-seven habitual lens wearers were fit with monthly replacement toric silicone hydrogel contact lenses (comfilcon A; CooperVision, Inc.).The manufacturer’s fitting guide was followed and the final lens prescription was determined based on the subjective refraction, the over-refraction and lens rotation (Final-Rx). Following this clinical study, the participant’s subjective refraction data and back vertex distance were entered in the OptiExpert online app to determine the recommended initial trial lens prescription (App-Rx). In this secondary analysis, the fitting results from both approaches were compared using Pearson correlation analysis. Different allowances for sph (±0.25, ±0.50D), cyl (±0.00DC) and axis (±10, ±20degrees) were combined to calculate the percentage of matching fitting results between both methods. Additionally, Bland-Altman graphs were plotted.

Results: A high correlation was found in respect to sphere, cylinder and axis between the Final-Rx and the App-Rx (all r ≥0.88). For the allowance combination of sphere ±0.25D / cylinder ±0.00DC / axis ±10, the lens prescriptions from both methods matched in 79% of eyes. For the allowance combination of sphere ±0.50D / cylinder ±0.00DC / axis ±20, the Final-Rx and the App-Rx matched in 86% of eyes. Bland-Altman comparisons between methods determined a mean difference of +0.06D for sph, +0.01D for cyl and 1.38 degrees for axis.

Conclusions: For most participants, the initial trial lens power recommended by the OptiExpert app was in close agreement to the final power dispensed in the clinical setting. The OptiExpert app can confidently be used as a clinical tool to aid comfilcon A toric lens fitting success.

Schulze M, Ng AY, Luensmann D, Guthrie S, Woods J, Jones L. The subjective response to verofilcon A daily disposable contact lenses during extensive digital device use Academy at Home, 2020 [ Show Abstract ]

Purpose: To evaluate the subjective response of habitual lens wearers during extensive digital device use when switched to Precision1 (verofilcon A) daily disposable (DD) contact lenses (CLs).
Methods: Volunteers between 18-40 years of age who used digital devices for at least 6 hours/day while wearing their habitual CLs were recruited for the study. Eligible participants were dispensed with verofilcon A DD CLs for a period of 2 weeks, during which they were required to wear the study CLs for at least 5 days/week and at least 10 hours/day. Participants returned after 142 days for their final visit, where they reported their CL wear time and time spent using digital devices, and rated their typical experience on a 0 to 100 scale, with 100 being best. Comfort, dryness and clarity of vision with verofilcon A were rated directly after insertion, after 6 hours of digital device use, and just before removal, as well as by rating their overall performance. Participants also completed a 4-point (strongly agree, slightly agree, slightly disagree, strongly disagree) Likert scale-based questionnaire. Subjective ratings were not normally distributed, therefore non-parametric analysis was conducted and data are reported as median (range). The Likert scale responses were analyzed using binomial testing.
Results: Twenty participants completed the study (18F:2M), mean age of 25.1 ± 6.0 years (range 19-40). They reported their typical day to include median CL wear time of 13.8 hours (10.5-17), comfortable CL wear time of 12.1 hours (8-16.5) and digital device use of 9 hours (6-12). After 2 weeks of verofilcon A DD CL wear, subjective ratings after 6 hours of digital device use were high, with ratings for a typical day of 93 (68-100) for comfort, 93 (52-100) for dryness and 96 (70-100) for clarity of vision. After 2 weeks of wear, the majority of participants agreed that the study lenses provided good comfort (16/20 subjects; p=0.01) and good vision (18/20; p<0.01) all day long. Similarly, the majority of participants were satisfied with the comfort (16/20; p=0.01), vision (18/20; p<0.01) and overall performance (16/20; p=0.01) they experienced with the study lenses while using digital devices for 6 hours. Additionally, most reported they did not experience any eye strain while using verofilcon A lenses (n=16/20; p=0.01). No significant lens-related ocular findings were observed after 2 weeks of wear.
Conclusions: After 2 weeks of wear, participants rated the performance of verofilcon A DD CLs very highly, with median overall performance ratings for comfort, dryness and vision all 93 on the 0 to 100 scale (with 100 being best). Verofilcon A DD CLs may be a viable alternative for those struggling with their habitual lens performance when spending long hours using digital devices.

Woods J, Guthrie S, Varikooty J, Jones L. Satisfaction of habitual wearers of reusable multifocal lenses when refitted with a daily disposable, silicone hydrogel multifocal lens Contact Lens Anterior Eye 2020 [ Show Abstract ][ PDF ]

Purpose: Visual performance with multifocal contact lenses (MFCL) can vary with lens design. This study simulated a real-world refit of habitual wearers of reusable MFCL with a silicone hydrogel (somofilcon A), daily disposable multifocal (DDMF) lens to assess visual and overall experience with the new design and modality.

Method: Subjects rated the DDMF and compared it with their habitual reusable MFCL. The habitual MFCL prescription was not reviewed or confirmed as optimal, though all reported having an eye-examination within 2-years. Subjects were masked to the DDMF brand. After 2 weeks of daily wear with the new lens, subjects reported their experience using 0-10 ratings and Likert scales.

Results: Twenty-eight subjects, spanning 14 habitual lens brands, completed the study. Visual acuity with DDMF was statistically better than with habitual MFCL for all four distances measured (all p<0.05); distance (≥6m): -0.04±0.09, long intermediate (1.5m): -0.11±0.11, short intermediate (0.75m): -0.10±0.09, and near (0.4m): 0.02±0.09. Subjective vision clarity was statistically better with the DDMF for distance tasks in the dark, long intermediate tasks, and when considering all visual needs (all p0.05) for vision clarity performing tasks at distance, short intermediate and near. When asked for a preference, the DDMF was significantly preferred over habitual for long intermediate tasks (p=0.03), but not different for tasks at other distances. Ease of insertion was statistically better with the DDMF (p=0.03); ease of removal was not different. End of day comfort was not different from the habitual lenses (p=0.10), however the DDMF was rated better for end-of-day dryness (p=0.01) and overall satisfaction with lenses (p=0.04).

Conclusions: This daily disposable, silicone hydrogel (somofilcon A), multifocal lens provided good vision and overall performance. Many ratings showed it to provide statistically better performance than their habitual reusable MFCL, supporting the benefits of a trial wear period.

2019

Guthrie S, Moezzi A, Varikooty J, Woods J, Jones L. A bilateral dispensing evaluation of two different toric lens geometries
BCLA Conference, Manchester, UK, 2019 [ Show Abstract ][ PDF ]

Purpose: To evaluate the subjective acceptance of two different types of prism ballast toric lens geometries, when worn on a daily wear modality over 1 month.
Methods: The study was a prospective, double-masked, bilateral, randomized, cross-over, 1-month wear, dispensing study where 45 astigmats wore two different soft toric lenses: comfilcon A toric which utilises a uniform horizontal iso-thickness design and samfilcon A toric which utilises a thin-edge design. Assessments were completed at 1-month. Ratings (0-10 scale) were competed at 2-weeks and 1-month.
Results: At 1-month, investigator-rated lens fit acceptance was high for both lens designs (3.65 vs 3.58, p=0.29), as was logMAR visual acuity for high contrast, high illumination (-0.12 vs -0.12, p=0.63) and low illumination (-0.10 vs -0.09, p=0.71). Subjective ratings for ‘overall visual quality’ were significantly higher for comfilcon A at 1-month (8.1 vs 7.4, p=0.04), but not different at 2-weeks (8.2 vs 7,6, p=0.05). ‘Vision stability’ ratings were significantly higher for comfilcon A at 2-weeks (8.2 vs 7.3, p=0.01) and 1-month (8.0 vs 7.2, p=0.03). ‘Overall comfort’ was rated significantly better with comfilcon A at 2-weeks (8.1 vs 7.4, p=0.04) and 1-month (8.1 vs 7.4, p=0.03). ‘End of day comfort’ ratings were similar after 1-month but significantly better with comfilcon A at 2-weeks (7.2 vs 6.5, p=0.03). ‘Overall satisfaction’ was statistically higher for comfilcon A after 2-weeks (8.0 vs 7.0, p<0.01) and 1-month (7.8 versus 7.0, p=0.02). Comfortable wearing time was not different at 2-weeks (9.2 vs 8.8, p=0.12), but was significantly longer with comfilcon A at 1-month (8.9h vs 8.0h, p=0.03).
Conclusions: Although both comfilcon A and samfilcon A use a prism ballast stabilisation principle and both provide excellent acuity and lens fit results, comfilcon A provided better subjective results for vision, vision stability, comfort, comfortable wear time and overall satisfaction.

Guthrie S, Woods J, Moezzi A, Varikooty J, Jones L. Comparing in-office evaluations to subjective evaluations for two toric lenses American Academy of Optometry, Orlando, 2019 [ Show Abstract ][ PDF ]

Purpose: To evaluate the performance of two monthly replacement silicone hydrogel toric lenses, comfilcon A toric and samfilcon A toric, using in-office assessments and subjective evaluations after 1 month.

Methods: A prospective, double-masked, bilateral, cross-over, dispensing study was conducted, where 45 subjects wore each lens type in a reusable, daily wear modality for 1 month, in a randomised order. Both in-office and subjective evaluations (0 [worst]-10 [best] scale) were completed at 1-month.

Results: Comfilcon A and samfilcon A toric lenses both performed well and similarly in all aspects of investigator lens evaluation. At 1-month, there was no significant difference for ‘fit acceptance’ grades (3.65 vs 3.58, p=0.29), ‘overall lens stability’ (3.56 vs 3.42, p=0.09) or for measures of logMAR high contrast acuity under ‘high illumination’ (-0.12 vs -0.12, p=0.63) or ‘low illumination’ (-0.10 vs -0.09, p=0.71). However, subject evaluations did show some significant differences related to comfort and vision. At 1-month comfilcon A toric lenses were rated significantly better for ‘overall comfort’ (8.1 vs 7.4, p=0.03). The difference in the 1-month ratings for ‘end of day comfort’ was not statistically significant (7.1 vs 6.7, p=0.15), however the ‘comfortable wear time’ was significantly longer for comfilcon A toric (8.9h vs 8.0h, p=0.03). For vision, comfilcon A toric was rated significantly better for ‘overall vision quality’ (8.1 vs 7.4, p=0.04) and ‘vision stability’ (8.0 vs 7.2, p=0.03). Subjects were asked to rate their ‘overall satisfaction’ and comfilcon A toric was rated significantly higher (7.8 versus 7.0, p=0.02). Subjects were also asked if they had a lens preference. Of those with a preference, significantly more subjects preferred the comfilcon A toric lens in terms of comfort (32 vs 10, p<0.01), dryness (28 vs 10, p=0.01) and overall (31 vs 13, p=0.01).

Conclusions: Although both comfilcon A and samfilcon A toric lenses both provided similar, high-level results for lens fit, stability and acuity, comfilcon A toric was rated statistically significantly higher in the subjective evaluations, specifically for comfort, vision, vision stability, overall satisfaction and comfortable wear time. These results illustrate that the patient experience cannot always be predicted from in-office evaluations.

Luensmann D, Woods J, Patel S. Validation of an online lens fitting app for two daily disposable toric lenses BCLA Conference, Manchester, UK, 2019 [ Show Abstract ][ PDF ]

Purpose: With recent increases in online tools to aid lens fitting, it was of interest to compare the prescriptions provided to wearers of two daily disposable silicone hydrogel (DDSH) toric lenses using traditional fitting guides to the prescriptions recommended by the OptiExpert online lens fitting app.

Method: Investigators determined the optimal toric lens prescription (Rx) for two DDSH toric lenses; stenfilcon A and somofilcon A using subjective refraction data (sph/cyl/axis), following the manufacturer’s fitting guide. The final lens prescription (Investigator-Rx) was determined based on the over-refraction and lens rotation. Subjects wore the lenses for one week. Retrospectively, the subjects’ refraction data were entered into the fitting app, which calculated the recommended Rx (App-Rx). Pearson correlation analysis was conducted between the Investigator-Rx and the App-Rx for each lens type. A success matrix for each lens type was further created to show how closely the results matched, using different criteria for sph (±0.25, ±0.50D), cyl (±0.00DC) and axis (±10, ±20degrees).

Results: Data of 54 and 37 subjects were analyzed for stenfilcon A and somofilcon A, respectively. Both lens types showed high correlation for sph, cyl and axis between Investigator-Rx and the App-Rx (stenfilcon A r >0.92, somofilcon A r >0.97). Compared to Investigator-Rx the matrix success rate for the app was 82% and 75% for criteria sph ±0.25D, cyl ±0.00DC, axis ±10 for stenfilcon A and somofilcon A respectively, and the success rate reached 91% and 92% for criteria sph ±0.50D, cyl ±0.00DC, axis ±20.

Conclusion: The OptiExpert app showed close agreement to the investigator prescribed lens in 9 out of 10 eyes for both toric DDSH lens types. Today’s toric lenses are generally stable and predictable in performance and this modern app-based approach can help to make toric lens fitting easy.

Ng AY, Woods J, Jahn T, Jones L, Ritter J. The effect of a novel oral supplement containing omega-3 and omega-6 fatty acids on the signs and symptoms of dry eye disease American Academy of Optometry, Orlando, 2019 [ Show Abstract ][ PDF ]

Purpose: To determine the effect of daily intake of an essential fatty acid supplement on the signs and symptoms of dry eye disease (DED) in patients with moderate to severe symptoms. The supplement contains omega-3 fatty acids (1200mg eicosapentaenoic acid [EPA] and 300mg docosahexaenoic acid [DHA]) and the novel addition of an omega-6 fatty acid (150mg gamma-linoleic acid [GLA]).

Methods: This was a prospective, double-masked, randomized, parallel group pilot study. Participants were eligible if they had an Ocular Surface Disease Index (OSDI) score ≥ 23 and had not taken omega-3 or -6 supplements in the previous 3 months. Participants were randomized to use one of two liquid supplements: the treatment supplement (EPA, DHA and GLA combination), or the placebo supplement (coconut and olive oil). Participants were instructed to take one teaspoon, once daily for three months. In addition to keeping a diary, an omega-3 index blood test was conducted at baseline and 3 months to confirm compliance of supplement use. At baseline, 1 and 3 months the following assessments were conducted: OSDI questionnaire, non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), tear osmolarity, ocular redness and surface staining, Schirmer test and meibography to assess meibomian gland (MG) dropout.

Results: Fifty participants completed the study: 24 randomized to the treatment group, 26 randomized to placebo. Participants were 95% compliant with daily dosing over the study period. After 3 months of supplement use, a 34% increase in omega-3 index blood values was observed in the treatment group (baseline: 5.3±0.8, 3 months: 8.0 ± 2.1, p50) at baseline demonstrated a clinically significant improvement with the treatment supplement (n=13, 20.8 point reduction, p=0.002) at 3 months compared to the placebo group (n=12, 8.4 point reduction, p=0.066). There were no clinically significant changes in NITBUT, TMH, tear osmolarity, ocular redness and surface staining, Schirmer test or MG dropout, (all p>0.05).

Conclusions: Omega-3 supplementation is an established therapeutic option for DED. This cohort of participants who were predominantly in the severe DED category by OSDI classification, experienced clinically meaningful improvements in their dry eye symptoms associated with supplementation with EPA, DHA and GLA. The addition of the omega-6 GLA in this formulation may have contributed to the significant improvement in dry eye symptoms.

Rappon J, Woods J, Jones D, Jones L. Tolerability of novel myopia control spectacle designs Invest Ophthalmol Vis Sci 2019;E-abstract 5845

Rappon JM, Chalberg TW, Neitz M, Woods J, Jones D, Jones L Neitz J. Clinical Development of a Novel Myopia Treatment for Myopia Management The 17th International Myopia Conference, Tokyo, Japan, 2019

Varikooty J, Woods J, Jones L. Visual performance with a daily disposable silicone hydrogel center-near progressive design multifocal lens with two independent intermediate zones BCLA Conference, Manchester, UK, 2019 [ Show Abstract ][ PDF ]

Purpose: Multifocal contact lens visual performance can vary with add-power and lens design. This study compared logMAR acuity (VA) and subjective ratings in habitual multifocal lens (HabMF) wearers refitted with a daily disposable multifocal lens (DDMF) of center-near progressive design, with two intermediate zones.

Methods: VA with HABMF was measured at four working distances (WDs) - distance (DV), long-intermediate (LI=1.5m), short-intermediate (SI=0.75m), and near (NV= 0.4m). Subjects were refit with a DDMF (somofilcon A) and after 2 weeks, VA and vision clarity rating (VC-rating) at these four WDs were measured; VC-rating options were ‘Exceeded expectations’, ‘Met expectations’ or ‘Fell-Short of expectations’. For each WD, changes in VA were analysed for the whole group and also for subjects grouped according to their VC-rating.

Results: For the 48 subjects who completed the study, VA was better at every WD with DDMF compared to HabMF (all p<0.032): mean logMAR VA improvement was DV=0.03, LI=0.06, SI=0.04 and NV=0.07. VC-ratings were significantly better for DDMF at LI (p=0.013), SI (p=0.042), NV (p=0.001), but not different at DV (p=0.068). When grouped by subjective VC-ratings into Exceeded and Met expectations, VA was also
better at every WD with DDMF: mean logMAR VA improvement was DV=0.05 (n=42), LI=0.07 (n=44), SI=0.05 (n=41) and NV=0.08 (n=40). Subjects reporting VC-ratings of Fell Short of expectations showed mean logMAR VA improvement with DDMF at SI=0.02 (n=7) and NV =0.05 (n=8) but showed reduction in mean logMAR VA with DDMF at DV=0.03 (n=6) and LI=0.04 (n=4).

Conclusions: While positive subjective responses for all WDs were always associated with improved VA, the negative subjective responses were not always associated with reduced VA. This supports the importance of allowing the wearer to experience the lens in order to determine acceptance, rather than rely solely on VA measures.

Woods J, Varikooty J, Lumb E. Validation of a multifocal contact lens online fitting app BCLA Conference, Manchester, UK, 2019 [ Show Abstract ][ PDF ]

Purpose: Online tools to assist complex contact lens fittings are becoming more commonplace, replacing traditional fitting guides. Data from a daily disposable multifocal lens refit study were used to conduct a post-study comparison of the multifocal lens power recommendations of one such online tool, the OptiExpert app, with those powers determined by investigators who used the traditional fitting guide.

Methods: For 48 habitual multifocal lens wearers, subjective refraction data (sph, cyl, add, ocular-dominance) were determined by investigators who refit them with a somofilcon A lens, using the fitting guide. At an ‘optimization visit’ 3-10 days later, lens power was re-assessed and new powers dispensed if necessary. Subsequent to study completion, subjects’ refraction data was input to the online app, and the
recommended power for each eye (App-Rx) was compared to the power dispensed at the optimization visit (Optimized-Rx). Bland-Altman and correlation analyses were conducted to measure agreement between methods.

Results: The 48 presbyopes (38F:10M) had a mean (±SD) age of 55.6 (±7.3SD, range 41-67) years. Subjective refraction range across all 96 eyes was +5.25 to -6.75DS, all with cylinder ≤-1.00D. Reading add ranged between +1.25 to +2.50D. At the optimization visit, 10% of eyes (10 eyes across 10 subjects) required change in lens power, meaning 100% of eyes were successfully fit with just 1 additional lens. The App-Rx was significantly correlated with Optimized-Rx (r=0.996 and p<0.0001). Bland Altman analysis showed a mean difference (and 95% limits of agreement) between App-Rx and Optimized-Rx of 0.08D (-0.58 to +0.42). The app predicted powers were within 0.25D of the investigatoroptimized lens powers in 82% of eyes, within 0.50D in 96% eyes.

Conclusions: The OptiExpert app recommended CL powers were in close agreement with those determined by investigators. Therefore, OptiExpert multifocal app is a useful tool to aid somofilcon A multifocal fitting success.

Yang M, Moezzi A, Woods J, Jones L. Comparing Strip Meniscometry to Tear Meniscus Height & Schirmer Test American Academy of Optometry, Orlando, 2019 [ Show Abstract ][ PDF ]

Purpose: Evaluation of tear volume is an important parameter for investigating aqueous deficient dry eye disease (DED). Historically, this has been achieved using Schirmer (SCH) strips or non-invasively using estimation of tear meniscus height (TMH). A method using strip meniscometry (SM) (SMTube, Shirakawa Factory, Tokyo, Japan) has recently been developed as a fast (5-second) in-office diagnostic test. The purpose of this study was to determine how tear volume assessed by SM compared to TMH and SCH in a mixed cohort of subjects with and without DED.

Methods: Both eyes of 27 participants (7 males; 20 females) aged between 21 and 64 (mean 40.7 years) underwent all measurements. TMH and non-invasive tear breakup time (NITBUT) were assessed using the Keratograph5M (Oculus, Germany). Subjects completed the ocular surface disease index (OSDI). SM was undertaken, and after a 1 hour delay, SCH (without anesthetic) was measured over five minutes. Subjective preference between SM and SCH was also collected. The correlation between SM and NITBUT, TMH and SCH were analysed.

Results: Only right eye data is presented. The mean (±SD) scores were: SM 5.6 (±3.2) mm; NITBUT 8.82 (±5.35) seconds; TMH 0.23 (±0.07) mm; SCH 22.2 (±10.1) mm. Mean OSDI was 13.1 (±9.3). The linear correlations (Pearson r) with SM were all low: NITBUT (0.479), TMH (0.006), SCH (0.301) and OSDI (0.075). 100% of participants preferred SM to SCH, citing the reasons for their preference as better comfort and shorter test time.

Conclusion: Strip meniscometry (SM) is a more rapid test compared to Schirmer test, and was found to be significantly more comfortable by the participants. However, given the low correlation with standard tear film evaluation tests its ability to discriminate between patients with and without DED requires further evaluation.

2018

Sivak A, Woods J, Srinivasan S, Subbaraman L, Jones L. The Centre for Ocular Research & Education American Academy of Optometry, San Antonio, USA, 2018 [ Show Abstract ]

The Centre for Ocular Research & Education (CORE) at the University of Waterloo, Canada has been conducting ocular research for over 30 years (formerly as the Centre for Contact Lens Research), and has been involved in some of the most meaningful advances in eye and contact lens research. CORE seamlessly integrates clinical observations and educational materials with insights grounded in basic bioscience. The CORE team has the experience, technology and regulatory framework to support fundamental and clinical research focusing on pharmaceuticals, biomaterials (including contact lenses), ocular physiology and imaging.

CORE’s biosciences team has the expertise to analyze biological samples; engineer novel biomaterials; test product biocompatibility; analyze contact lens materials; develop in vitro models; test lens care systems for antimicrobial efficacy and cytotoxicity; analyze proteins, lipids and inflammatory markers; evaluate, analyze and identify bacteria and biofilms; and test the viability of ocular surface cells.

CORE’s clinical team has the capacity to execute all stages of study development, from protocol design through report generation for clinical research and Phase II, III and IV clinical trials. Features include specialized imaging and image analysis; resources for coordinating multi-site clinical trials; staff trained to collect patient and practitioner perspectives via focus groups, interview and web-based surveys; dedicated in-house teams dedicated to regulatory oversight, data analysis and subject recruitment.

Over the years, CORE’s team has published hundreds of peer-reviewed publications, presented results at scientific conferences and meetings around the world, and lent its expertise to a variety of scientific panels and associations. In addition to providing training for post-graduates and industry teams, CORE is committed to sharing its observations and knowledge with eye care professionals worldwide via web-based resources, information sheets and posters, conventional print articles, continuing education seminars, conference reports, user manuals and fitting guides and instructional videos.

Varikooty J, Woods J, Lumb E. Validation of Multifocal Soft Lens Power Calculator in OptiExpert Application for Clariti 1-Day Multifocal Lens Fitting American Academy of Optometry, San Antonio, USA, 2018 [ Show Abstract ][ PDF ]

Purpose: The multifocal soft lens calculator component of the OptiExpert-multifunctional app was developed by CooperVision Inc to make multifocal CL fitting easy, by predicting the required powers for clariti-1 day multifocal (C1DM) from the spectacle prescription, in a presbyopic population. This retrospective data analysis was conducted to validate the software.

Methods: The data used for validation came from a sample of 26 subjects, whose subjective refraction data (sph, cyl, add, ocular dominance) was already determined and C1DM had already been fit and dispensed according to clinical assessments using the C1DM fitting guide. After 3-10 days all subjects attended a power optimization visit where the contact lens (CL) power was re-assessed and, if required, a new prescription was dispensed. The subjective refraction data was subsequently entered in the OptiExpert app, and the recommended CL power for each eye (OptiExpert-Rx) was compared to the power dispensed after the optimization visit (Optimized-Rx). Correlation analysis was conducted between OptiExpert-Rx and Optimized-Rx. A Bland-Altman analysis comparison was also conducted to measure agreement between methods.

Results: The 26 presbyopes (21 female, 5 male) had a mean (±SD) age of 56.7 (±7.4) years. Subjective refraction range across all 52 eyes was +5.00 to -6.00 D sph with ≤ -1.00 D cyl. The reading add ranged between +1.50 to +2.50 D. 96% (25) of the subjects were successfully fit in the initial trial with the first pair of C1DM CLs, and the remaining 1 subject required 2 pairs of CLs. At the optimization visit a few days later, only 10% of eyes (5 eyes across 4 subjects) required a change in lens power, meaning 100% of eyes were successfully fit with just 1 additional lens. In subjective responses, 92% reported that C1DM CLs met or exceeded their visual needs. The suggested OptiExpert-Rx was significantly correlated with Optimized-Rx (r ≥ 0.996 and p <0.0001). Bland Altman analysis showed a mean difference (and 95% limits of agreement) between OptiExpert-Rx and Optimized-Rx of 0.09 D (-0.64 to +0.46). Compared to the final optimized lens powers, over 80% of eyes were within 0.25DS of the predicted power using OptiExpert.

Conclusion: The clariti-1 day multifocal powers recommended by the OptiExpert app were in close agreement with investigator determined CL powers. Given this high level of agreement, OptiExpert multifocal soft lens calculator can be confidently used as a clinical tool to aid clariti-1 day multifocal fitting success, potentially saving valuable chair time.

Woods J, Moezzi A, Varikooty J, Jones L. Comparison of lens orientation stability of two daily disposable silicone hydrogel toric lenses Contact Lens & Anterior Eye 2018;41, Supp 1:S93

Woods J, Ng AY, Luensmann D, Guthrie S, Jones L. Short-term comfort comparison of two daily disposable contact lenses of different material and modulus Invest Ophthalmol Vis Sci 2018;E-Abstract 1753 [ Show Abstract ][ PDF ]

Purpose: Daily disposable contact lenses (DDs) are now widely available in both silicone hydrogel (SH) and hydrogel (H) materials. The higher oxygen transmissibility of SH materials provides many benefits, but their higher modulus has been linked with reduced lens comfort compared to H lenses. This randomized, double-masked clinical trial assessed the short-term comfort of two DDs of differing modulus, yet similar water content (WC): a SH-DD (somofilcon A; clariti® 1 day; CooperVision; 0.50MPa modulus, 56% WC) and a H-DD (etafilcon A; 1-Day Acuvue® Moist®; Johnson & Johnson; 0.29MPa modulus, 57% WC).

Methods: 120 subjects wore the lenses contralaterally, over one day. Targeted recruitment meant that 60 subjects were habitual H-DD wearers (all adapted wearers of 1-Day Acuvue Moist), 60 were non-DD habitual wearers (adapted to various SH and H re-usable lenses). Subjects rated lens comfort on a 0-100 integer scale (100= cannot be felt) at insertion and then hourly until 8hrs. Of particular interest was the comfort at the beginning and end of the 8hr wear period and these data points were tested for equivalence. At the final visit subjects were asked for their lens preference, based on comfort.

Results: Mean subjective comfort was not different between SH-DD and H-DD across the wear period (p>0.05), on insertion (87±14 SH-DD vs 89±14 H-DD; p>0.05) or after 8hrs (82±18 SH-DD vs 83±17 H-DD; p>0.05). Based on equivalency margins of ±5-points, the study lenses showed equivalent comfort at insertion (p=0.03) and at 8hrs (p=0.001). Both lenses exhibited a significant reduction in comfort over the 8hr period (both p0.05). Lens preference was not different between lenses at dispensing or at the final visit (both p>0.05).

Conclusions: Initial and 8hr comfort were not compromised with the SH-DD compared to the H-DD, despite its higher modulus, and there was no difference in the lens preference distribution. The results suggest that lower comfort should not be anticipated when fitting SH-DDs of an appropriate design, thus allowing other material properties such as high oxygen permeability to be considered.

Woods J, Ng AY, Luensmann D, Jones L. Short-term comfort comparison of a low modulus hydrogel vs a higher modulus silicone hydrogel daily disposable lens Contact Lens & Anterior Eye 2018;41, Supp 1:S42

Woods J, Panjwani F, Papinski D, Varikooty J, Jones L. In-vivo dehydration comparison of omafilcon A and stenfilcon A with delefilcon A Contact Lens & Anterior Eye 2018;41, Supp 1:S41

2017

Woods J, Hutchings N, Srinivasan S, Jones L. Geographic distribution of corneal staining in symptomatic dry eye Optom Vis Sci 2017;94: E-Abstract 174056

2016

Chamberlain P, Back A, Woods J, Logan N, Peixoto-de-Matos S, Mei Sae S, Young G. Wearer experience and subjective responses with a dual focus myopia control 1 day soft contact lens Optom Vis Sci 2016;93: E-abstract 165326

Yang M, Luensmann D, Fonn D, Woods J, Gordon K, Jones L, Jones D. Myopia prevalence in canadian school children Optom Vis Sci 2016;93: E-abstract 165328 [ PDF ]

2015

Guthrie S, Woods J, Dumbleton K, Fonn D, Jones L. Contact lens discomfort management strategies of ECPs Optom Vis Sci 2015;92: E-abstract 155050 [ PDF ]

Panjwani F, Papinski D, Varikooty J, Woods J, Jones L. In-vivo dehydration of stenfilcon A and delefilcon A silicone hydrogel materials Optom Vis Sci 2015;92: E-abstract 155262 [ PDF ]

Panjwani F, Papinski D, Woods J, Jones L. In-vivo dehydration of omafilcon A and delefilcon A Optom Vis Sci 2015;92: E-abstract 155048 [ PDF ]

2014

Dillehay S, Woods J, Situ P, Guthrie S, Paynor R, Griffin R, Tyson M, Jones L. Comparison of Three Power Levels of A Novel Soft Contact Lens Optical Design to Reduce Suspected Risk Factors for the Progression of Juvenile Onset Myopia Invest Ophthalmol Vis Sci 2014;55: E-abstract 3637

Feng W, Woods J, Keir N, Chamberlain P. Subjective questionnaire data collection using two different scales Optom Vis Sci 2014;91: E-abstract 145054

Liu S, Chang C, Verma M, Hileeto D, Muntz A, Stahl U, Woods J, Jones L, Gu F. Phenylboronic acid modified mucoadhesive nanoparticles facilitate weekly treatment of dry eye syndrome Invest Ophthalmol Vis Sci 2014;55: E-abstract 2160

Payor R, Woods J, Fonn D, Situ P, Dillehay S, Griffin R, Tyson M, Jones L. Feasibility Testing of a Novel Soft Contact Lens Optical Design to Reduce Suspected Risk Factors for the Progression of Juvenile Onset Myopia Invest Ophthalmol Vis Sci 2014;55: E-abstract 3638

Varikooty J, Woods J, Jones L. Assessment of pre-lens tear film particle velocity measurements in participants wearing daily disposable silicone hydrogel lenses BCLA Clinical Conference and Exhibition, 2014 [ PDF ]

2013

Woods J, Subbaraman L, Jones L. In-vitro wettability of four silicone hydrogel lenses with differing surface properties Contact Lens & Anterior Eye 2013;36, S2:e29

Woods J, Woods C, Foon D, Jones L. Acceptance of a silicone hydrogel multifocal lens in emmetropic presbyopes Canadian Optometry Schools Research Conference, Waterloo, Canada, 2013

2012

Dumbleton K, Woods CA, Woods J, Moezzi A, Fonn D, Jones L. An Investigation Into The Role Of Masked Lens Replacement On Subjective Comfort And Vision With Aging Soft Contact Lenses Invest Ophthalmol Vis Sci 2012;53:ARVO E-Abstract 4722

Woods J, Keir N, Jones L. Solution-induced-corneal-staining (SICS): symptoms and staining patterns Optom Vis Sci 2012;89:E-abstract 125625

Woods J, Keir N, Jones L. The impact of saline rinsing on solution-induced corneal staining (SICS) Contact Lens & Anterior Eye 2012;35, S1:e36-e37

2011

Guthrie S, Woods J, Keir N, Dillehay S, Tyson M, Griffin R, Fonn D, Jones L, Irving E. Controlling lens induced myopia in chickens with peripheral lens design Optom Vis Sci 2011;88:E-Abstract 110421

Woods J, Guthrie S, Keir N, Choh V, Fonn D, Jones L, Irving E. Myopia development – what can the chicken tell us? Contact Lens & Anterior Eye 2011;34, Supplement 1:s13

Woods J, Guthrie S, Keir N, Dillehay S, Tyson M, Griffin R, Jones L, Irving E. The effect of a unique lens designed for myopia progression control (MPC) on the level of induced myopia in chicks Invest Ophthalmol Vis Sci 2011;51:E-Abstract 6651

2009

Woods J, Woods CA, Fonn D. Using objective tests and novel subjective rating assessments to compare the performance of a new silicone hydrogel multifocal lens design to monovision Contact Lens & Anterior Eye 2009;32, 5:232

2008

Jones L, Subbaraman L, Woods J. Protein deposition on a novel lathe-cut silicone hydrogel contact lens material (sifilcon A) Contact Lens & Anterior Eye 2008;31, 5:262

Woods J, Schneider S, Woods CA, Fonn D. Application of a novel method for evaluating corneal vascularization Optom Vis Sci 2008;85: E-Abstract 80083

Woods J, Woods CA, Fonn D. Comparison of the simplicity of completing an initial fit of symptomatic early presbyopes with monovision and an aspheric multifocal silicone hydrogel Optom Vis Sci 2008;85: E-Abstract 80089

2007

Dumbleton K, Woods J, Woods C, and Fonn D. Compliance with current contact lens care regiments Optom Vis Sci 2007;84: E-abstract 070087

Subbaraman L, Woods J, Jones L. Protein deposition on a novel lathe-cut silicone hydrogel contact lens material (sifilcon A) Optom Vis Sci 2007;84:E-abstract 070038

Woods J, Schneider S, Woods CA, Jones LW, Fonn D. Short term satisfaction and physiological response in wearers of high power hydrogel lenses refit with a custom silicone hydrogel lens Optom Vis Sci 2007;84: E-abstract 070034

Woods J, Woods CA. Vision test that discriminates multifocal contact lenses BCLA Clinical Conference and Exhibition, 2007

2006

Woods C, Scott M, Woods J, Simpson T, Fonn D. Clinical grading scales: how many images is ideal? Contact Lens & Anterior Eye 2006;29, 4:207

Woods J, Woods C, Varikooty J, Jones L, Simpson T, Fonn D. A novel method of recording corneal staining that facilitates parametric analysis Optom Vis Sci 2006;83: E-Abstract 065236

2005

Woods C, Scott M, Woods J, Simpson T, Fonn . A novel method to create clinical grading scales Optom Vis Sci 2005;82: E-abstract 050040

Jabeen A, Luensmann D, Woods J, Hill J, Jones L. Evaluation of the Lag of accommodation with DOT spectacle lenses The Association for Research in Vision and Ophthalmology, New Orleans, LA, USA, April, [ Show Abstract ][ PDF ]

Purpose: Alteration in contrast have shown to impact the accommodative accuracy in myopes. This study investigated whether the Diffusion Optics Technology™ (DOT) spectacles that are
designed to reduce the contrast on peripheral retina, have an impact on the lag of accommodation (LOA) in emmetropic children after short-term wear.

Methods: This was a single visit, prospective, randomized, subject-masked study. Participants were eligible if they had ±1.00 diopters prescription or less and they had no history of previous myopia control treatment. The logMAR visual acuity was measured and ocular dominance was tested using the sighting method. Participants then wore a pair of plano DOT spectacles (not featuring a central clear zone) and standard plano spectacles (control) in a randomized order and, after 5 minutes adaptation to the lenses, ten open-field autorefraction measurements (Grand Seiko 5500) were taken for each eye, with the target at 6m and 40cm. Analysis was conducted on the mean auto-refraction to determine differences in LOA between lens types for the right eye and also for the dominant eye.

Results: A total of 30 participants (20 female:10 male) with a mean (± SD) age of 10.4 ± 2.8 years (range 7 to 17) completed the study. The mean ± SD LOA was 0.57 ± 0.39D for the right eye and 0.60 ± 0.40D for the dominant eye whilst wearing DOT spectacles and similarly, 0.62 ± 0.34D for the right eye and 0.68 ± 0.33D for the dominant eye while wearing control spectacles. Mann Whitney U test results indicated no statistically significant difference between DOT and control spectacles for the right eye data (p=0.64) or for the dominant eye data (p=0.25). Similarly, no difference was observed in the mean LOA when compared between males and females, and between the younger (6-11) and older (12-17) age groups for both right eye and dominant eye with DOT and control spectacles (all p>0.05).

Conclusion: DOT lenses have no significant effect on the lag of accommodation compared to single vision spectacles after short-term wear. The study counters the supposition that reduced contrast may influence accommodative accuracy.

Continuing Education Presentations

2023

Jones D, Woods J.. Workshop: Multi-function Instruments for Myopia management: A Review of Current Instruments and their Capabilities. British Contact Lens Association Clinical Conference & Exhibition, Manchester, Jun 10, 2023

Woods J. Maximizing Success with Soft Contact Lenses for Myopia Control THE Myopia Meeting, Toronto, Canada, Dec 2, 2023

2018

Jones D, Woods J. Controlling the myopia epidemic Fall CE Manitoba Association of Optometrists, 2018

Jones L, Woods J, Walsh K. Contact lens selection on trial Part 1: neophytes NCC, Veldhoven, Netherlands, 2018

Jones L, Woods J, Walsh K. Contact lens selection on trial Part 2: existing wearers NCC, Veldhoven, Netherlands, 2018

Walsh K, Jones L, Luensmann D, Woods J. Rapid Fire: Celebrating 20 Years of Silicone Hydrogels: The Past, Present and Future American Academy of Optometry, San Antonio, USA, 2018 [ Show Abstract ]

Using the analogy of a child growing up, four presenters cover the twenty-year timeline of silicone hydrogels (SiHys). How does the historical performance of this material inform both currently available lenses and future applications? Each part of the talk covers a specific period in the timeline since 1998: from infancy, through to elementary and high school years, balancing properties for comfortable daily wear and gaining increased understanding of interactions with the ocular surface and tear film. At age 20, SiHys have yet to graduate from college, leaving the last talk to share what the future may hold.

Woods J. Technology & contact lenses: looking into the future Fall CE Manitoba Association of Optometrists, 2018

Woods J. Challenging the contact lens recommendation Fall CE Manitoba Association of Optometrists, 2018

Woods J. Toric lenses CooperVision educational event, Toronto, Ontario, 2018

Woods J, Jones D. What went wrong? Fall CE Manitoba Association of Optometrists, 2018

2017

Woods J. One day disposables: Simplifying the choices OSI conference, Lake Louise, Alberta, Canada, 2017

2016

Woods J. One day disposables: Simplifying the choices CooperVision educational event, Markham, Ontario, 2016

Woods J. Why daily disposable lenses and which to choose? Ontario Association of Optometrists Northwestern District meeting, Thunder Bay, Ontario, 2016

Woods J. One day disposables: Simplifying the choices CooperVision educational event, Cambridge, Ontario, 2016

Professional Publications

2024

Woods J, Jong M. Truth or myth: Young children are less successful in contact lenses? Optician: https://www.opticianonline.net/content/features/truth-or-myth-young-children-are-less-successful-in-contact-lenses-answer-myth 2024, March 1:

2019

Jones L., Woods J., Walsh K., Luensmann D. Happy 20th, silicone hydrogels! Review of Cornea and Contact Lenses 2019, Jan/Feb: 12-13

Walsh K, Jones L, Woods J, Moody K. Evidence-based contact lens recommendation Contact Lens Spectrum 2019, Nov: 21-26

Woods J, Jones L. Lens care compliance Contact Lens Spectrum 2019;34, 4: 36-40

Woods J, Jones L. Patients should comply with the proper use of hydrogen peroxide and multipurpose solution care regimens Contact Lens Spectrum 2019;34, April: 38-42

2018

Jones D, Woods J. Maximize the opportunity for part-time contact lens wear Contact Lens Spectrum 2018;33, December: 12-13

Jones D, Woods J. Soft torics: Putting things straight Contact Lens Spectrum 2018;33, September: 12-13

Jones D, Woods J. Accommodating presbyopes: Who does it best? Contact Lens Spectrum 2018;33, June: 12-13

Jones D, Woods J. North America - Independence or not? Contact Lens Spectrum 2018;33, March: 14-15

Woods J. Myth 2: Fitting soft multifocal lenses is complex, takes up a lot of chair time and never meets patient needs ContactLensUpdate.com 2018

2015

Woods J. Conjunctival Responses to Contact Lens Wear Contact Lens Spectrum 2015;30, August: 34-36, 38

2013

Woods J, Woods C, Fonn D, Jones L. Potential acceptance of a daily disposable silicone hydrogel multifocal lens in emmetropic presbyopes Optom Vis Sci 2013;88: E-Abstract 135100

2009

Woods J, Woods C, Fonn D. Practical guide for fitting soft centre near design multifocal contact lenses Contact Lens Spectrum 2009

Woods J, Woods CA, Fonn D. Managing the emerging presbyopic contact lens wearer Optometry Today 2009;49, 12: 32-35

2007

Jones L, Dumbleton K, Woods J. A made-to-ofer silicone hydrogel lens Optician 2007;233, 6104: 45-47

Jones L, Dumbleton K, Woods J. Fitting a challenging case with a custom silicone hydrogel Contact Lens Spectrum 2007;22, 6: 17

Jones L, Dumbleton K, Woods J. Fitting and evaluating a custom silicone hydrogel lens Contact Lens Spectrum 2007;22, 4: 19

Jones L, Dumbleton K, Woods J. Introducing a made-to-order silicone hydrogel lens Contact Lens Spectrum 2007;22, 2: 23

Jones L, Dumbleton K, Woods J. A made to order silicone hydrogel lens Optician 2007;233, 6104: 45-47