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Peer-reviewed articles


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;Online ahead of print [ Show Abstract ]

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.

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.

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.

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.


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 ]

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.

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.

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%).

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.


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.


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.


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.


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.


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.


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.


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


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 p<0.05). There were no statistical differences (all p>0.05) 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.


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, p< 0.001) whereas there were no changes in the placebo group (baseline: 4.8 ± 0.8, 3 months: 4.8 ± 0.6, p=0.948). At baseline, the mean OSDI score of all participants was 52.2±16.5, with no significant difference between groups. There was a statistically significant improvement in OSDI score at 3 months for both groups (treatment 13.4 point reduction, p=0.003; placebo 7.8 point reduction, p=0.022). Those participants with the most severe OSDI scores (>50) 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.


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 p<0.001). When subjects’ data was divided according to their habitual lens modality groups (60 H-DD wearers and 60 re-useable wearers), there were also no comfort differences between the study lenses, either across time, or at insertion and 8hrs (all p>0.05). 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


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


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 ]


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 ]


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 ]


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


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


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


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


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


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


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


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

Continuing Education Presentations


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


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


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


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


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


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


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


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


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