Abdi,B., Mofidfar,M., Hassanpout,F., Cilingir,E. K., Kalajahi,S., Milani,P. K., Ghanbarzadeh,M., Fadel,D., Barnett,M., Ta,C. N., Leblanc,R. M., Chauhan,A., Abbasi,F. Therapeutic contact lenses for the treatment of corneal and ocular surface diseases: Advances in extended and targeted drug delivery International Journal of Pharmaceutics 2023;638(May):122740 [ Show Abstract ]

The eye is one of the most important organs in the human body providing critical information on the environment. Many corneal diseases can lead to vision loss affecting the lives of people around the world. Ophthalmic drug delivery has always been a major challenge in the medical sciences. Since traditional methods are less efficient (∼5%) at delivering drugs to ocular tissues, contact lenses have generated growing interest in ocular drug delivery due to their potential to enhance drug bioavailability in ocular tissues. The main techniques used to achieve sustained release are discussed in this review, including soaking in drug solutions, incorporating drug into multilayered contact lenses, use of vitamin E barriers, molecular imprinting, nanoparticles, micelles and liposomes. The most clinically relevant results on different eye pathologies are presented. In addition, this review summarizes the benefits of contact lenses over eye drops, strategies for incorporating drugs into lenses to achieve sustained release, results of in vitro and in vivo studies, and recent advances in the commercialization of therapeutic contact lenses for allergic conjunctivitis.

Akbari,E., Imani,R., Shokrollahi,P., Keshel,S. H. Corneal sustained delivery of hyaluronic acid from nanofiber-containing ring-implanted contact lens Journal of Biomaterials Application 2023;37(6):992-1006 [ Show Abstract ]

Dry eye syndrome, as a persist corneal epithelial defect (PED), is an inconvenient ocular disorder that is generally treated by high-dosage, conventional eye drops. Addressing low efficacy and rather restricted bioavailability of the conventional eye drops, drug-eluting contact lenses (CLs) are widely used as alternatives in ophthalmic drug delivery applications. In the present study, a nanofiber-containing ring implant poly (vinyl alcohol) (PVA) hydrogel is designed as a carrier for hyaluronic acid (HA) delivery. hyaluronic acid is physically encapsulated in a nanofiber-containing ring-shaped hydrogel with a 2 mm width that is implanted in the final CLs hydrogel. The designed CL has 59% porosity, 275% swelling ratio and undergoes no weight loss at physiological conditions in14 days. In-vitro release studies were performed on the CLs with and without nanofibers. The results showed that nanofiber incorporation in the designed CL was highly influential in decreasing burst release and supported sustained release of HA over 14 days. In addition, nanofiber incorporation in the designed system strengthened the lens, and the young modulus of the PVA hydrogel increased from 6 to 10 kPa. Cell viability study also revealed no cell cytotoxicity and cell attachment. Overall, the study demonstrated the effective role of nanofibers in the physical strengthening of the CL. Also, the designed system holds promise as a potential candidate for HA delivery over an extended period for treating dry eye syndrome.

Bitton E, Craig J, Jones L. Rapid Fire: Dry Eye in 2023 American Academy of Optometry, New Orleans, October 13, 2023 [ Show Abstract ]

Symptoms related to ocular surface disease, which includes dry eye disease (DED), are the main drivers of patient consultations. This rapid-fire lecture will focus on three main themes concerning DED, namely a brief overview of the definition, classification and diagnosis of DED from the TFOS DEWS II; innovations in management technologies; and the projected pharmaceutical pipeline for DED.

Bitton,E., Jones,D., Wittich,W. Financial Inequities in Optometric Education in Canada: A Comparison of Two Optometry Programs Optometry and Vision Science 2023;100(11):785-793 [ Show Abstract ]

Significance: The advancing age of the population will require increased access to eyecare services to manage eye diseases and vision correction. Optometric education requires a sound financial plan to manage student debt. This study evaluates the financial inequalities of optometric programs in Canada, and how this may impact the provision of eyecare professionals.

Purpose: The objective of this study was to compare the financial inequities in Optometric education in Canada from the 2020 graduating class.

Methods: A cross-sectional study assessed monetary variables related to the study of optometry in Canada, including academic and personal expenses, and overall debt and expenses related to the COVID-19 lockdown for the 2020 graduating class.

Results: 108 optometry students from the 2020 graduating classes of the University of Montreal and the University of Waterloo responded, with 68 (53 F:15 M, age 25.66, SD = 2.01) completing the study. Waterloo students spent more years in university (P < .001); had higher academic fees (P <.001); spent more on travelling to their family residence (P =.007) and received more provincial (P = .002) and federal (P <.001) loans than Montreal students. Overall debt prior to optometry was similar amongst students but differed (P <.001) at the end of their program, with Waterloo students having a higher debt burden.

Conclusions: There is a financial inequity in optometric education in Canada depending on the chosen program. Cumulative optometry student debt for the 2020 graduating class in Canada ranges from $CAN 0 to 189,000 with an average of $CAN 65,800 and a median of $CAN 50,000. The results of this study can assist financial, government agencies and future optometry students to better understand the financial burdens and establish a financial plan to study optometry in Canada, to respond to the growing eyecare needs of the public.

Caffery,B., Pucker,A., Chidi-Egboka,C., Obinwanne,C. J., Karkness,B., Carnt,N. A., Ng,A. Y. Lubricating drops for contact lens discomfort in adults Cochrane Database of Systematic Reviews 2023 (5):CD015751 [ Show Abstract ]

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To determine the efficacy and safety of lubricating drops for ocular discomfort associated with contact lens wear in adults.

Carrasquillo K, Fadel D. Fitting, evaluating, and troubleshooting the fit FitAcademy, Boston, USA, Sep 15, 2023

Chan V, Drolle E, Phan CM, Hui A, Shi C, Subbaraman L, Wu J, Jones L. Evaluating the activity of lysozyme deposited on contemporary reusable silicone hydrogel contact lenses using an in vitro eye model The Association for Research in Vision and Ophthalmology, New Orleans, LA, USA, 2023 [ Show Abstract ][ PDF ]

Purpose: To evaluate lysozyme activity (LA) on five contemporary reusable silicone hydrogel contact lens (CL)materials over their proposed wear period using an advanced in vitro blink model.

Methods: Five CL materials (lotrafilcon B, samfilcon A, comfilcon A, senofilcon A, and serafilcon A) were cycled daily for 16h on an eye model, followed by 8h of soaking in OPTI-FREE PureMoist, to mimic a typical wear cycle. An artificial tear solution containing physiologically representative proteins and lipids was delivered to the model at a rate of 1.2-2.1μl/min. The model includes an artificial eyelid that blinks at a rate of 6blinks/min, which was kept at room temperature and humidity above 50%. Serafilcon A and senofilcon A were tested over 14 days, whereas the other CLs were evaluated for 30 days. At specified time intervals, including after 1, 7, 14 and 30 days, CLs were removed from the model and lysozyme extracted using a solvent containing acetonitrile and trifluoroacetic acid. The LA from the extracts were then evaluated using a micrococcal absorbance assay.

Results: Overall, LA decreased over time, reaching non-detectable levels by day 30 (p<0.05). Serafilcon A (13.9 ± 7.8μg/lens), and samfilcon A (9.6 ± 2.3μg/lens), had the highest LA after 1 day, followed by comfilcon A (4.7 ± 1.8μg/lens), lotrafilcon B (3.3 ± 1.6μg/lens), and senofilcon A (2.2 ± 3.7μg/lens). By day 7, LA for the weekly replacement lens, serafilcon A, decreased to 0.5 ± 0.6μg/lens. By day 14, LA for the biweekly replacement lens, senofilcon A, decreased to 0.6 ± 0.7μg/lens. Lotrafilcon B, samfilcon A, and comfilcon A, all monthly replacement lenses, decreased in activity by day 30 (0.1 ± 0.2μg/lens, 0.5 ± 0.7μg/lens, 0.0 ±0.0μg/lens respectively).

Conclusions: Deposition of biologically active lysozyme has been proposed to be an important factor for biocompatible CL wear. A decline in activity over time as the deposited protein becomes denatured may impact overall CL performance and has been linked to reduced comfort. LA decreases over time and reaches near zero for all lens types by the end of their proposed wearing period, confirming that they should be replaced within their specified replacement intervals. Compared to simple in vitro vial models, using an advanced blink model for CL deposition testing aims to provide more physiologically relevant results prior to clinical testing.

Craig J, Jones L, Wolffsohn J. The Dry Eye Wheel – A better way to tackle dry eye 4th World Congress of Optometry O=MEGA23, Melbourne, Sep 8, 2023

Craig,J. P., Alves,M., Wolffsohn,J., Downie,L. E., Efron,N., Galor,A., Gomes,J. A. P., Jones,L., Markoulli,M., Stapleton,F., Starr,C. E., Gallant Sullivan,A., Willcox,M. D. P., Sullivan,D. A. TFOS lifestyle report introduction: A lifestyle epidemic – Ocular surface disease Ocular Surface 2023;28(April):304-309 [ Show Abstract ]

Lifestyle defines how a person lives. While the way we live can impact our environment, thed environment can influence the way we live, and both can affect our health. The ocular surface, and in particular the tear film, is susceptible to modifications due to its external (e.g. environmental conditions, lifestyle and societal challenges, and the digital environment), applied (e.g. contact lens wear and cosmetics) or internal (e.g. nutrition, and elective medications and procedures) environments. Consequently, it is critical for clinicians to understand the impact of lifestyle choices on the ocular surface so that they can communicate with their patients to optimise their health and, wherever possible, institute preventative steps to mitigate potential health risk factors.

To increase awareness of the potential impacts of lifestyle choices on ocular surface health, the Tear Film & Ocular Surface Society (TFOS) launched the TFOS Workshop entitled “A Lifestyle Epidemic: Ocular Surface Disease.” Consistent with prior TFOS Workshops [[1], [2], [3], [4]], the aim was to review existing literature, to identify gaps in knowledge and to propose future directions for research, with the long-term goal of improving the lives of individuals affected by ocular surface disease around the world.

Under the leadership of the Workshop Chair Jennifer Craig, Vice Chair Monica Alves, and Organizer David Sullivan, a Steering Committee was formed (Table 1) to plan and execute this TFOS Lifestyle Workshop. The Steering Committee was committed to an evidence-based approach and a process of open communication, dialogue and transparency, to achieve a consensus concerning the relationship(s) between lifestyle factors and their impact on ocular surface disease.

Craig,J., Alves,M., Wolffsohn,J., Downie,L., Efron,N., Galor,A., Gomes,J., Jones,L., Markoulli,M., Stapleton,F., Starr,C., Sullivan,A., Willcox,M., Sullivan,D TFOS Lifestyle Report Executive Summary: A Lifestyle Epidemic - Ocular Surface Disease Ocular Surface 2023;30(October):240-253 [ Show Abstract ]

The Tear Film & Ocular Surface Society (TFOS) Workshop entitled ‘A Lifestyle Epidemic: Ocular Surface Disease’ was a global initiative undertaken to establish the direct and indirect impacts of everyday lifestyle choices and challenges on ocular surface health. This article presents an executive summary of the evidence-based conclusions and recommendations of the 10-part TFOS Lifestyle Workshop report. Lifestyle factors described within the report include contact lenses, cosmetics, digital environment, elective medications and procedures, environmental conditions, lifestyle challenges, nutrition, and societal challenges. For each topic area, the current literature was summarized and appraised in a narrative-style review and the answer to a key topic-specific question was sought using systematic review methodology. The TFOS Lifestyle Workshop report was published in its entirety in the April 2023 and July 2023 issues of The Ocular Surface journal. Links to downloadable versions of the document and supplementary material, including report translations, are available on the TFOS website: http://www.TearFilm.org.

Dantam J, Ng QW. Truth or myth: There is no patient benefit to correcting low astigmatism with soft contact lenses Optician: https://www.opticianonline.net/content/features/truth-or-myth-there-is-no-patient-benefit-to-correcting-low-astigmatism-with-soft-contact-lenses 2023, December 1:

Efron,N., Morgan,P., Jones,L., Nichols,J. Who cites optometry journals? Journal of Optometry 2023;16(4):296-304 [ Show Abstract ]

Purpose
This work seeks to identify the most impactful journals, papers, authors, institutions, and countries that cite optometry journal articles.

Methods
The Scopus database was searched for papers citing at least one article published in any of the 18 optometry journals included in that database (i.e. ‘optometry articles’). The 10 most highly cited papers that cite optometry journal articles were determined from 82,830 papers found. A h-index for “optometry journal citations” (the hOJC-index) was derived for each entity in the categories of journals, papers, authors, institutions and countries to serve as a measure of impact.

Results
The hOJC-index of the body of papers citing optometry journal articles is 370. Papers citing optometry journal articles have themselves been cited 2,054,816 times. Investigative Ophthalmology & Visual Science (hOJC = 154) is the most impactful journal citing optometry articles and Optometry and Vision Science the most prolific (5310 papers). The most impactful paper citing optometry journal articles (5725 citations) was published in Journal of Clinical Epidemiology. Ophthalmologist Seang Mei Saw (hOJC = 69) is the most impactful author and optometrist Nathan Efron is the most prolific (288 papers). Harvard University (hOJC = 127) is the most impactful and UNSW Sydney is the most prolific institution (1761 papers). The United States is the most impactful and prolific nation (hOJC = 313; 28,485 papers).

Conclusions
Optometry journal articles are cited extensively by optometrists, ophthalmologists, and vision scientists world-wide, as well as authors from a broad spectrum of non-ophthalmic research domains. This work confirms the utility and influence of optometry journals.

Fadel D. Preventing and Managing Edema with Scleral Lenses Review of Cornea and Contact Lenses 2023, March/April: 18-21

Fadel D. Expert Panel Discussion FitAcademy, Boston, USA, Sep 16, 2023

Fadel D. Therapeutic Contact lenses. How to manage each individual case? IPEC Conference Contactologia Especializada. Buenos Aires, Argentina, Aug 3, 2023

Fadel D. Meet the experts: Which lens to apply in irregular corneas? IPEC Conference Contactologia Especializada. Buenos Aires, Argentina, Aug 3, 2023

Fadel D. Scleral lens design and calculation of parameters based on corneal topography. Workshop. IPEC Conference Contactologia Especializada. Buenos Aires, Argentina, Aug 3, 2023

Fadel D. Scleral lens complications and management. IPEC Conference Contactologia Especializada. Buenos Aires, Argentina, Aug 3, 2023

Fadel D. Take Control of Your Scleral Fitting International Congress of Scleral Contact (ICSC), Florida USA, Jul 28, 2023

Fadel D. Scleral Lenses Using WAVE Design Software: Once You Start, There’s no Going Back Global Specialty Lens Symposium, Las Vegas, Jan 20, 2023

Fadel D. Fast Forward to the Future: Envisaging the Future of Scleral Lenses Contact Lens Spectrum 2023;38, October: 46

Fadel D, Dutta D. Specialist Lens Cases British Contact Lens Association Clinical Conference & Exhibition, Manchester, Jun 10, 2023

Fadel D, Frogozo M. Optical Challenges When Fitting Scleral Lenses Global Specialty Lens Symposium, Las Vegas, Jan 21, 2023

Fadel D, jedlicka J, Gelles J, Sindt C. The Future of Contact Lens Fitting Global Specialty Lens Symposium, Las Vegas, Jan 20, 2023

Fadel D, Weshefsky T. Advanced Specialty Lens Designs Global Specialty Lens Symposium, Las Vegas, Jan 20, 2023