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Peer-reviewed articles


Walsh,K., Jones,L. The use of preservatives in dry eye drops Clinical Ophthalmology 2019;13:1409-1425 [ Show Abstract ]

Topical ocular preparations are widely recommended by health care professionals, or chosen by patients, to help manage dry eye disease (DED). The chronic and progressive nature of DED may result in the administration of topical products several times a day, over a period of many years. Given DED is a condition that by definition affects the ocular surface, it is important to understand how the repeated use of eye drops may impact the ocular surface, influence clinical signs, affect symptoms, and impact the overall disease process of dry eye. The component in topical preparations with the greatest potential to adversely affect the ocular surface is the preservative. This paper reviews the literature in relation to the use of preservatives in formulations for dry eye. The ocular effects of benzalkonium chloride (BAK) are summarised and compared to the performance of alternative preservatives and preservative-free formulations. Use of preserved and preservative-free drops in relation to the management of varying stages of DED is discussed.


Luensmann,D., Schaeffer,J. L., Rumney,N. J., Stanberry,A., Walsh,K., Jones,L. Spectacle prescriptions review to determine prevalence of ametropia and coverage of frequent replacement soft toric contact lenses Contact Lens and Anterior Eye 2018;41(5):412-420 [ Show Abstract ]

Purpose: To determine the prevalence of ametropia and astigmatism in a clinic population and to estimate the coverage of frequent replacement soft toric lenses. Methods: A review of patient files was conducted at three clinical sites. Prescription data collected between January 2014 and March 2017 in a patient cohort 14 to 70 years of age inclusive were analyzed to determine prevalence of ametropia and astigmatism. The percent coverage of frequent replacement soft toric contact lenses has further been estimated using different ranges for sphere, cylinder and axis availability. Results: In total 101,973 patients were included in the analysis of which 69.5% were considered myopic, 26.9% hyperopic and 3.5% emmetropic as determined by the eye with the larger absolute value of the spherical equivalent refraction. Astigmatism in at least one eye was found in 87.2% of the population, with 37.0% of the patients exhibiting astigmatism of at least −1.00DC in at least one eye. With-the-rule astigmatism was most prevalent in the 14 to 20 year-olds (53.0%), while against-the-rule astigmatism was most prevalent in the 41 to 70 year-olds (50.7%). For astigmatic eyes with a cylinder of at least −0.75DC (n = 83,540; 41% of all eyes), the coverage with toric soft lenses varied greatly depending on parameter availability and ranged between 30.7% (sphere: Plano to −3.00D, cylinder: up to −1.75DC, axes: 90 ± 10° and 180 ± 10°) and 96.4% (sphere: + 6.00D to −10.00D, cylinders: up to −2.75DC, 18 axes). Conclusion: Currently available frequent replacement soft toric contact lenses provide coverage for up to 96.4% of potential patients.

Scientific Presentations


Nakhla N, Killeen RM, de Waal D, Haines L, Srinivasan S, Sivak A, Walsh K, Pantazi F. Enhancing Eye Care Through Interprofessional Collaboration – A joint pharmacist-optometrist initiative Lifelong Learning in Pharmacy conference. Brisbane, Australia, 2018

Nakhla N, Killeen RM, de Waal D, Haines L, Srinivasan S, Sivak A, Walsh K, Pantazi F. Enhancing Eye Care Through Interprofessional Collaboration – A joint pharmacist-optometrist initiative Association of Faculties of Pharmacy of Canada conference. Ottawa, ON, Canada, 2018

Sivak A, Srinivasan S, Walsh K, Haines L, MacIver S, Killeen R, Nakhla N, Jones L. Professional Collaboration for Patient-Centred Eye Care – A Continuing Education Program for Optometrists and Pharmacists American Academy of Optometry, San Antonio, USA, 2018 [ Show Abstract ][ PDF ]

SIGNIFICANCE: Collaboration between North American pharmacists and optometrists is inconsistent, despite overlapping goals and concerns relating to eye care.
PURPOSE: The Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science and School of Pharmacy at the University of Waterloo (UW) collaborated to address this gap in information sharing by developing a series of web-based multimedia continuing education modules directed at pharmacists, optometrists and optometric assistants. These modules were designed to highlight unique and overlapping spheres of knowledge in addition to providing guidance with respect to developing a plan for interprofessional collaboration.
METHODS: Content was developed through interprofessional discussion and by consulting emerging research, evidence-based guidelines and needs assessments, and was informed by the Canadian Interprofessional Health Collaborative competency framework. The UW Centre for Extended Learning provided guidance with respect to instructional design and usability. Content was reviewed by community-based optometrists and pharmacists as well as external content matter experts representing both professions. The modules were reviewed and accredited by the Council on Optometric Practitioner Education (COPE) and the Canadian Council on Continuing Education in Pharmacy (CCCEP).
RESULTS: The completed program includes four hours of content comprising four modules: (1) an overview of interprofessional collaboration, (2) contact lens care systems, (3) management of dry eye disease, and (4) contact lens red eye. Each module includes profession-specific perspectives, guidelines related to ocular needs and treatment options, and profession-specific roles in addressing patient needs. Modules also outline topic-specific opportunities for communication, collaboration and referral.
CONCLUSIONS: Opportunities for collaboration between optometrists and pharmacists are rich but largely unexplored within the confines of profession-specific “tunnel vision.” These CE modules aim to start a conversation about the ways in which optometrists and pharmacists can work together to enhance patient-focused care.

Continuing Education Presentations


Jones L, Walsh K. Sensitive to silicone? Understanding and managing the patient who presents with an adverse reaction to their silicone hydrogel contact lenses Global Specialty Lens Symposium, Las Vegas, Nevada, 2019


Jones L, Walsh K. Silicone hydrogel daily disposables Philadelphia, 2018

Jones L, Walsh K. Silicone hydrogel daily disposables Budapest, 2018

Jones L, Walsh K. 1 day silicone hydrogels: the best of both worlds? CooperVision Symposium, Budapest, Hungary, 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.

Professional Publications


Walsh K, Dantam J, Luensmann D. Contact Lens Wear and Its Disruption of the Tear Film Review of Cornea & Contact Lens 2019;May/June: 38-42.

Walsh K, Lenz Y, Behrens R. Get the support you need: Freely available information can complement basic contact lens practice Contact Lens Spectrum 2019;34, 9: 32-37


Jones L, Walsh K. The evolution of silicone hydrogel daily disposables Optician 2018, 4 May: 25-32

Walsh K. Myth 3: It is not worth correcting low astigmats with toric contact lenses ContactLensUpdate.com 2018

Walsh K. Myth or reality? ContactLensUpdate.com 2018

Walsh K, Srinivasan S, Jones L. Lid margin health: the forgotten part of contact lens discomfort? Optician 2018, 7 September: 28-32


Walsh K. Three days of the latest in education, innovation and best practice Optik 2017

Walsh K. Building a bigger basket with your contact lens wearers Optik 2017

Walsh K. The astigmat in contact lenses: their experience and your opportunity Optik 2017

Walsh K. Material protection: UV and contacts Optik 2017

Walsh K. Hurry up and fit them while they’re young Optik 2017

Walsh K. A glimpse of a future contact lens practice Optik 2017

Walsh K. Pupil diameter, working distance and illumination during habitual tasks. Implications for simultaneous vision contact lenses for presbyopia - An article review ContactLensUpdate.com 2017

Walsh K. Summary: Definition and classification report ContactLensUpdate.com 2017


Walsh K. Contact lens aftercare: an opportunity to deliver great customer experience Optik 2016

Walsh K. Not all contact lens deposits are bad Optik 2016