Young,G., Veys,J., Pritchard,N., Coleman,S. A multi-centre study of lapsed contact lens wearers Ophthalmic and Physiological Optics 2002;22(6):516-527 [ Show Abstract ]

Purpose: Discontinuation from contact lens wear has been identified as a contributing factor in the lack of growth of contact lens use in Europe. The purpose of this study was to determine the proportion of lapsed contact lens wearers that can be refitted successfully with contact lenses and to evaluate the reasons for discontinuation from contact lens wear. Methods: This was a multi-site clinical study involving 15 UK investigators and 236 lapsed contact lens wearers who had previously tried contact lenses and discontinued. The reasons for discontinuation were assessed by subjects, who were then refitted with contact lenses. Investigators subsequently evaluated factors associated with their initial discontinuation. Short-term success was defined as the successful completion of 1 month of contact lens wear with absence of complications that would prevent further wear. Subjects were interviewed by telephone 6 months after being refitted to determine whether they were still wearing contact lenses. Those who were not wearing lenses were questioned about the reasons for discontinuation and their likelihood of resuming lens wear. Results: A majority of subjects (51%) cited discomfort as the principal reason for having previously given up contact lens wear. Problems with vision were the second most common reason (13%), either with reading (6%) or general vision (7%). The most common type of discomfort was dryness (40%). In almost all cases (97%), the investigator's assessment of the reasons for discontinuation agreed with the subject's own assessment but investigators also cited product-related and practitioner-related factors as contributing to previous failure. The short-term success rate for refitting lapsed wearers was found to be 77% (CI: 70-82%). The highest short-term success rates were for 2-weekly/monthly soft spherical lenses (91%) and daily disposable lenses (89%). Lower success rates were found for soft toric (69%) and soft bifocal (53%) lenses. At the 6-month stage, 73% of those who continued in lenses after the 1-month visit were still wearing contact lenses and a further 18% indicated that they were either 'very likely' or 'likely' to resume lens wear. Conclusions: A high proportion of lapsed contact lens wearers can be successfully refitted with contact lenses. The prime reason for previous discontinuation from contact lenses is discomfort and, in particular, dryness-related discomfort. In many cases, previous contact lens failure is product or practitioner-related rather than because of patient-specific problems. Once refitted with contact lenses, lapsed wearers cite vision problems rather than discomfort as the most common reason for discontinuing. This finding suggests that recent advances in contact lens material, design, replacement frequencies and care systems have improved the prospects for avoiding lens-related discomfort and for continuing contact lens wear. © 2002 The College of Optometrists.

Zaidi,A., Seo,J., McCanna,D.J., Mahil,A., Jones,L. Molecular biology of two common ophthalmic viruses: Relevance to clinical practice Optometry in Practice 2023;24(1): [ Show Abstract ]

Due to the coronavirus pandemic, viruses have suddenly become a prominent topic of discussion. As such, it
is important to understand the life cycle and, ultimately, the process of inactivating viruses. To inactivate them
it is important to block the mechanisms that they use to induce infection. Due to their ability to survive on
various surfaces, appropriate cleaning practices to prevent viral spread and contamination of medical devices,
practice equipment and surfaces are paramount. Depending on the type of virus and genome configurations,
various mechanisms are used to induce a viral infection. Understanding the susceptibility of the viral outer
coating is crucial to preventing viral spread, whether through droplet transmission or while on surfaces (fomite
transmission). Knowledge of how viral receptors and proteins interact to facilitate the recognition, attachment
and entry of a virus into the host cell is vital for an understanding of how disinfectants and antivirals can be
effective. Viral replication, transcription and translation are also major targets of antivirals. This paper will
review the physiology of two major ophthalmic viruses: adenovirus and herpes simplex.