Jones L, Morgan P. Redefining contact lens prescribing: An evidence-based framework British Contact Lens Association Meeting, Birmingham, UK, Jun 5, 2025

Jones, L., Craig, J. P., Markoulli, M., Karpecki, P,. Akpek, E. K., Basu, S., Bitton, E., Chen, W., Dhaliwal, D. K., Dogru, M., Gomes, J. A. P., Koehler, M., Mehta, J. S., Perez, V. L., Stapleton, F., Sullivan, D. A., Tauber, J., Tong, L.,Travé-Huarte, S., Wolffsohn, J. S., Alves, M., Baudouin, C., Downie, L., Giannaccare, G., Horwath-Winter, J., Liu, Z., Koh, S., Messmer,E., Otero, E., Villani, E., Watson, S., Yoon, K. C. TFOS DEWS III Management and Therapy Report American Journal of Ophthalmology 2025;Online ahead of print [ Show Abstract ]

This report provides an evidence-based review of current strategies to manage dry eye disease (DED). First-line management focuses on methods to replenish, conserve and stimulate the tear film, with an emphasis on ocular supplements, which remain the cornerstone of DED treatment. Meibomian gland dysfunction, a primary contributor to DED, is typically treated with warm compresses and a wide variety of in-office treatments, including device-driven technologies to warm the eyelids, intense pulsed light therapy, low-level light therapy and other new and emerging technologies. Lid hygiene treatments include lid wipes, anti-Demodex therapies, blepharoexfoliation and topical antibiotics.

DED caused by certain etiological drivers can benefit from anti-inflammatory therapies, including corticosteroids, T-cell immunomodulatory topical drugs and a wide variety of pharmacological agents, in addition to biologic tear substitutes such as autologous serum and platelet-rich plasma. Emerging therapies, such as neuromodulation via nasal neurostimulation and novel pharmacological treatments offer potential future options. Advanced options, including amniotic membrane grafts and complex surgical methods, provide options for severe or refractory cases. Lifestyle modifications, including optimized blinking, dietary supplementation and environmental adjustments, play a crucial role in long-term management. Patient education and adherence to treatment regimens remain essential for sustained symptom relief.

The TFOS DEWS III prescribing algorithm provides an evidence-based framework to offer guidance to clinicians in selecting relevant interventions based on disease etiology that aim to provide targeted management of the subtype of DED that an individual is experiencing.

Jones,D., Chow,A., Fadel,D., Gonzalez Meijome,J.M., Grzybowski,A., Kollbaum,P., Loughman,J. Wolffsohn,J. IMI—Instrumentation for Myopia Management Investigative Ophthalmology & Visual Science 2025;66(9):Article 7 [ Show Abstract ]

The rising prevalence of myopia has underscored the importance of early diagnosis and effective management strategies to control its progression and to prevent complications. Advancements in instrumentation enable clinicians to provide individualized evidence-based care for patients. Instrumentation for myopia control encompasses a wide range of technologies designed to assess refractive error, biometric parameters, including axial length, accommodative responses, as well as detailed assessment of ocular health. These tools offer clinicians the ability to move beyond traditional clinical techniques, providing more accurate, detailed, and repeatable measurements critical for the detection and monitoring of myopia progression. This allows for a personalized approach to treatment planning, enabling the selection and optimization of myopia control interventions. Furthermore, advanced imaging and real-time data visualization support patient education by fostering understanding, which may improve adherence to treatment plans. By adopting these technologies, clinicians can address the complexities of myopia management, deliver precise and effective care, and contribute to global efforts to curb the myopia epidemic. The integration of advanced instrumentation into clinical practice encourages early intervention and management strategies for patients at risk of becoming myopic (pre-myopia), as well as improving patient outcomes for myopic patients.

Kapadia,W., Nikhil,V., Ning,Q., Pei,Z., Phan,C.-M., Haines,L., Jones,L., Ren,C. A novel microfluidic viscometer for measuring viscosity of ultrasmall volumes of Newtonian and non-Newtonian liquids Journal of Micromechanics and Microengineering 2025;35(5):Article number 055005 [ Show Abstract ]

Viscosity is a critical fluid property that significantly influences fluid behavior and performance across various systems. Most commercial viscometers require relatively large sample volumes (on the order of milliliters), which restricts their utility in scenarios where only limited sample volumes are available. For instance, human tear fluid—essential for developing effective treatment strategies—is scarce (typically on microliters), especially in individuals with dry eye disease. To address this limitation, we present a novel microfluidic viscometer platform capable of measuring the viscosity of ultra-small volumes (i.e. ∼10 μl) of Newtonian and non-Newtonian fluids. The working principle is based on the Hagen-Poiseuille equation, incorporating the Weissenberg-Rabinowitsch-Mooney correction for slit-flow, and employs an optically transparent microfluidic chip integrated with supporting devices including a syringe pump, manifold, camera, and differential pressure transducer. Preliminary validation was conducted using glycerol solutions, artificial tears, and tear samples from dry and healthy eyes. This microfluidic viscometer holds promise for measuring the shear viscosity of small volumes of biofluid samples (e.g. synovial fluid, cerebrospinal fluid, tear films) or pharmaceuticals (e.g. monoclonal antibodies, ophthalmic drug delivery products) by developing surface coating materials appropriate for specific samples.

Lourenco Nogueira,C., Boegel,S.J., Shukla,M., Ngo,W., Hui,A., Jones,L., Aucoin,M. Antiviral activity of contact lens care solutions and rub-and-rinse regimen against adenovirus Optometry and Vision Science 2025;102(3):156-166 [ Show Abstract ]

SIGNIFICANCE
Although human adenoviruses are the leading cause of acute viral conjunctivitis, there is a lack of data surrounding the efficacy of contact lens care products against these viruses.

PURPOSE
This study investigates the antiviral activity of several commercially available contact lens care solutions against human adenovirus type 5 (Ad5).

METHODS
Six contact lens care solutions (Biotrue, Boston Simplus, OPTI-FREE Puremoist, Clear Care, cleadew, and cleadew GP) were investigated. Quantitative suspensions tests were conducted on Ad5 solutions after interaction with the different contact lens care solutions for 4 or 6 hours. For the hydrogen peroxide solution (Clear Care), interaction times of 0, 2, 4, and 6 hours prior to neutralization were also investigated. Finally, the impact of rubbing and rinsing of Ad5 contaminated contact lenses with the solutions was studied.

RESULTS
Solutions based on povidone-iodine demonstrated a more than 3-log reduction in virus after 4 and 6 hours of incubation. In contrast, hydrogen peroxide only demonstrated a 0.52-log reduction after 6 hours of incubation. Increasing the contact time with hydrogen peroxide increased Ad5 inactivation, with a 2.18-log reduction after 6 hours of incubation with the solution prior to neutralization. Nonoxidative systems did not demonstrate a significant log reduction after 4 hours of incubation. However, rubbing and rinsing of contact lenses using the nonoxidative systems reduced the virus counts from contaminated contact lenses to below the limit of quantification.

CONCLUSIONS
Povidone-iodine solutions have a significant effect on reducing the viability of Ad5. Hydrogen peroxide care solutions are effective only if unneutralized contact time is increased. Nonoxidative systems can be effective in combating contaminated lenses only with the addition of a rub-and-rinse step.

Luensmann D, Kaiser Maharjan E. AOA 2025: Coverage of ametropia with a planned replacement soft contact lens portfolio Optometry Times 2025, Jun 27:

Luensmann D, Woods J, Jones L. Coverage of ametropia with a planned replacement soft contact lens portfolio AOA Optometry's Meeting, Minneapolis, USA, Jun 27, 2025 [ Show Abstract ]

BACKGROUND: Soft lens power ranges are often broad for spherical prescriptions, but there is typically less coverage for astigmatic prescriptions, particularly with multifocal lenses. This unequal coverage within a lens brand may mean refitting previously successful lens wearers with a different brand when they need a toric or multifocal correction. This could increase chair time and requires adaptation to a different lens fit, which could negatively impact lens comfort and/or handling and therefore patient satisfaction. This analysis reviewed the coverage of a specific planned replacement portfolio.

METHODS: In a secondary analysis, prescription data of 101,973 optometric clinic patients aged 14-70 years were evaluated: 59,631 female and 42,342 male . The prescriptions available in a planned replacement portfolio spanning spherical and toric prescriptions were evaluated to calculate the coverage in non-presbyopic and presbyopic age groups.

RESULTS: In the non-presbyopic group (age 14-39; n=47,195) and presbyopic group (age 40-70; n=54,778), astigmatism of at least -0.75DC was present in 39% and 44% of eyes respectively.
Spherical corrections are acceptable for eyes with no more than 0.50DC astigmatism. If a lens brand is available in single-vision prescriptions +6.00 to -12.00D and multifocal prescriptions +6.00 to -10.00D, they would cover 99.9% and 99.7% of eyes respectively.

Toric corrections are warranted for eyes with astigmatism of at least -0.75DC, and if a lens brand is available in single vision: sphere +6.00 to -9.00D and up to -2.75DC in all axes, and multifocal: sphere +4.00 to -6.00D and up to -1.75DC in all axes, plus up to -2.75DC in axes 90±20 and 180±20, these ranges would cover 95.3% and 92.3% of astigmatic eyes in the respective age groups.
This results in a total coverage of 97.3% across all age groups and prescriptions. In contrast, if the toric multifocal option was not available, the total brand coverage reduced to 78.3%.

CONCLUSION: This analysis demonstrates that robust coverage was achieved for both presbyopic and non-presbyopic populations in this planned replacement portfolio. Such high coverage helps facilitate a smooth transition and adaptation for practitioners and patients when needing to switch from single vision spherical lenses to toric and/or multifocal lenses.

Luensmann D, Woods J, Jones L. ePoster: Coverage of ametropia with a planned replacement soft contact lens portfolio AOA Optometry's Meeting, ePoster, May 29, 2025 [ Show Abstract ]

BACKGROUND: Soft lens power ranges are often broad for spherical prescriptions, but there is typically less coverage for astigmatic prescriptions, particularly with multifocal lenses. This unequal coverage within a lens brand may mean refitting previously successful lens wearers with a different brand when they need a toric or multifocal correction. This could increase chair time and requires adaptation to a different lens fit, which could negatively impact lens comfort and/or handling and therefore patient satisfaction. This analysis reviewed the coverage of a specific planned replacement portfolio.

METHODS: In a secondary analysis, prescription data of 101,973 optometric clinic patients aged 14-70 years were evaluated: 59,631 female and 42,342 male . The prescriptions available in a planned replacement portfolio spanning spherical and toric prescriptions were evaluated to calculate the coverage in non-presbyopic and presbyopic age groups.

RESULTS: In the non-presbyopic group (age 14-39; n=47,195) and presbyopic group (age 40-70; n=54,778), astigmatism of at least -0.75DC was present in 39% and 44% of eyes respectively.
Spherical corrections are acceptable for eyes with no more than 0.50DC astigmatism. If a lens brand is available in single-vision prescriptions +6.00 to -12.00D and multifocal prescriptions +6.00 to -10.00D, they would cover 99.9% and 99.7% of eyes respectively.

Toric corrections are warranted for eyes with astigmatism of at least -0.75DC, and if a lens brand is available in single vision: sphere +6.00 to -9.00D and up to -2.75DC in all axes, and multifocal: sphere +4.00 to -6.00D and up to -1.75DC in all axes, plus up to -2.75DC in axes 90±20 and 180±20, these ranges would cover 95.3% and 92.3% of astigmatic eyes in the respective age groups.
This results in a total coverage of 97.3% across all age groups and prescriptions. In contrast, if the toric multifocal option was not available, the total brand coverage reduced to 78.3%.

CONCLUSION: This analysis demonstrates that robust coverage was achieved for both presbyopic and non-presbyopic populations in this planned replacement portfolio. Such high coverage helps facilitate a smooth transition and adaptation for practitioners and patients when needing to switch from single vision spherical lenses to toric and/or multifocal lenses.

Michaud L, Jones D, Chow A.. Myopia Revisited: A Practical Learning Session with Panel Discussion Ontario Association of Optometrists, Symposium, March 29, 2025

Ngo,W., Nagaarudkumaran,N., Huynh,C. B. Refrigeration reduces instillation discomfort of a 0.09% cyclosporine A solution Optometry and Vision Science 2025;102(1):14-19 [ Show Abstract ]

Significance: Topical cyclosporine A (CsA) for the treatment of dry eye disease is often associated with instillation discomfort, which may negatively influence patient adherence to therapy. This study found that refrigerating topical CsA reduced instillation discomfort compared with instillation of warm CsA. Thus, refrigerating CsA prior to instillation may improve patient experience when using CsA to manage dry eye disease.

Purpose: This study aimed to quantify instillation discomfort associated with cold or warm instillation of a 0.09% CsA.

Methods: Forty participants with symptomatic aqueous deficient dry eye were enrolled. A drop of cold (4°C) CsA was instilled in one eye, and a drop of warm (23°C) CsA was instilled in the other eye. The order and eye receiving the cold drop were randomized. Participants rated the discomfort of each eye (0, no discomfort; 10, maximal discomfort) prior to drop instillation, immediately post-instillation, and at each subsequent minute for 10 minutes. Area under the curve was used to quantify cumulative discomfort.

Results: Forty participants (39.6 ± 18.9 years old, 82% female) completed the study. A majority of participants (n = 24, 60%) experienced reduced cumulative discomfort with cold CsA, whereas the remainder experienced minimal difference (n = 10, 25%) or increased cumulative discomfort (n = 6, 15%). For those with reduced discomfort (n = 24), cumulative discomfort associated with cold instillation (median, 11.5 [2.2, 20.0]) was significantly lower (p<0.01) than cumulative discomfort associated with warm instillation (median, 17.5 [11.2, 32.2]). Cold instillation was associated with a median reduction of 1 discomfort point immediately post-instillation and at all subsequent time points (all p≤0.04, but not significant at t = 10), compared with warm instillation.

Conclusions: Up to 60% of participants found that cold instillation of CsA solution induced less discomfort than warm instillation, lasting up to 9 minutes post-instillation. In contrast, although 15% of participants found reduced discomfort with warm instillation, the magnitude of discomfort associated with warm instillation was not significantly different than cold instillation.

Perez, V. L., Chen, W., Craig, J. P., Dogru, M., Jones, L., Stapleton, F., Wolffsohn, J. S., Sullivan, D. A. TFOS DEWS III Editorial American Journal of Ophthalmology 2025;Online ahead of print [ Show Abstract ]

The Tear Film & Ocular Surface Society (TFOS), a non-profit organization, was created to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Since its incorporation in 2000, TFOS has launched numerous global initiatives. Perhaps the best-known are the TFOS Workshops, especially those related to dry eye disease (DED). DED afflicts hundreds of millions of people worldwide, is a leading cause of patient visits to eye care practitioners, and, if moderate or severe, is associated with significant pain, role limitations, low vitality and poor general health.

Phan C, Walther H, Ho B, Jones L. Development of a novel in vitro blink model for measuring prelens non-invasive break-up time
The Association for Research in Vision and Ophthalmology Annual Meeting, Salt Lake City, May 8, 2025 [ Show Abstract ]

Purpose
To develop an in vitro blink model for measuring prelens non-invasive break-up time of contact lenses with a keratograph.

Methods
The model was designed using CAD (computer-aided design) software and fabricated using a combination of 3D printing, CNC (computer numerical control) machining, and molding processes. The base structure of the eyeball was 3D-printed, and the front surface of the eyeball was cast using acrylic resin mixed with graphite powder in an ultrasmooth polydimethylsiloxane (PDMS) mould. The lower eyelid was designed to hold the eyeball and the lower tear meniscus. The base structure of the eyelid was 3D-printed using flexible resin (Flex 50A) on the FormLabs 3B (Formlabs Inc., Somerville, MA, USA), and then moulded into its final shape with polyvinyl alcohol. The blink speed of the model was set to 150 mm s-1 for both opening and closing. The model’s ability to generate a stable tear film over a contact lens (senofilcon A) was validated using non-invasive keratographic break-up time (NIKBUT) with the OCULUS Keratograph 5M. 20 µL of phosphate-buffered saline (PBS) is added to the upper eyelid using a pipette, and the model is allowed to equilibrate for three blinks before each measurement.

Results
The resulting eyeball is black in the central corneal region, providing the necessary contrast to reflect the concentric rings projected by the keratograph. During each blink, the hydrogel in the upper eyelid comes into contact with the lower tear meniscus and evenly distributes the tear fluid across the eyeball during the upward motion of the blink. Without a contact lens, the tear film breaks immediately over the hydrophobic acrylic surface of the eyeball. The NIKBUT for senofilcon A ranged from approximately 5 to 7 seconds, aligning with clinical observations. The model also includes a fluid reservoir located in the lower eyelid, used to rehydrate the hydrogel. Additionally, two inlets can be attached to the lower eyelid to control fluid flow into and out of the model.

Conclusions
The developed blink model consistently forms a tear film over a contact lens during the upward blink motion, using the lower tear meniscus as the fluid source.

Phan,C-M., Hui,A., Shi,X., Zheng,Y., Subbaraman,L., Wu,J., Jones,L. The Impact of Comfort Eluting Agents and Replacement Frequency on Enhancing Contact Lens Performance Clinical Ophthalmology 2025;19(March 12):857-873 [ Show Abstract ]

This review explores the development and clinical implications of soft contact lenses designed to elute comfort agents, emphasizing their role in enhancing user experience and ocular health. As discomfort remains one of the primary reasons for discontinuation of lens wear, this concept aims to address this challenge by gradually releasing these agents over their period of use. This review also explores the effectiveness, safety, and user satisfaction associated with frequent replacement schedules of these lenses. Clinical trials demonstrate that lenses with eluting comfort agents significantly reduce dryness and irritation, leading to improved wear-time and overall comfort. The findings suggest that frequent replacement not only enhances lens hygiene but also maximizes the therapeutic benefits of the eluted agents, promoting a healthier ocular environment. The implications for practice highlight a shift towards more patient-centered approaches in contact lens design and management, aiming to improve adherence and satisfaction among users. This research paves the way for future innovations in contact lens technology, focusing on personalized solutions that cater to individual comfort needs.

Phan,C. M., Wulff,D., Thacker,M., Hui,A. Drug releasing contact lenses and their application to disease presentations
Clinical and Experimental Optometry 2025;Online ahead of print [ Show Abstract ]

Eye drops, the most common method for anterior segment treatment, face challenges of inefficiency, with less than 7% instilled drugs typically reaching target tissues of interest. The advent of contact lens drug delivery systems offers a paradigm shift, enhancing drug residence time and bioavailability on the ocular surface. This review focuses on the considerations and challenges in developing contact lenses for drug delivery, particularly for managing four categories of ocular diseases: anterior segment infections, dry eye disease, ocular allergies, and glaucoma. Each disease category requires tailored therapeutic approaches, and the technical intricacies of drug-releasing contact lenses must address concerns related to lens properties, drug release duration, and safety. The aim of this review is to provide insights into the therapeutic needs of ocular diseases and offer a comprehensive overview of the progress made in this innovative approach. The emergence of a commercially available ketotifen fumarate-releasing lens serves as a testament to the feasibility and potential benefits of this innovative approach, paving the way for further refinement and targeted applications in ocular therapeutics.

Phan,C.-M., Ho,B., Hui,A., Walther,H., Zhen,Y., Subbaraman,L., Shi,X., Wu,J., Jones,L. Evaluating the initial and end-of-day wettability of contemporary daily disposable contact lenses using various in vitro methods Optometry and Vision Science 2025;102(5):375-381 [ Show Abstract ]

SIGNIFICANCE:
Contact lens wettability is potentially correlated with friction, which is linked to lens comfort. However, measuring wettability can be highly variable. This study assessed wettability using three techniques for a more accurate profile.

PURPOSE:
To evaluate the wettability of contemporary daily disposable contact lenses after 16 hours on an in vitro model using the sessile drop, captive bubble, and a novel in vitro noninvasive keratograph breakup time (NIKBUT) method.

METHODS:
The wettability of six contemporary silicone hydrogel contact lens materials (verofilcon A, delefilcon A, senofilcon A, kalifilcon A, stenfilcon A, and somofilcon A) and two conventional hydrogel materials (nesofilcon A and etafilcon A) were evaluated using an in vitro blink model at t = 0 and 16 hours. The blink rates of the eye model were 20 blinks per minute. Sessile drop and captive bubble angles were analyzed using the Optical Contact Analyzer. NIKBUT was assessed on a blink model in combination with the OCULUS Keratograph 5M.

RESULTS:
There were no significant differences in wettability for any lens types between 0 and 16 hours when assessed using the captive bubble or NIKBUT methods (p>0.05). For the sessile drop method, verofilcon A had the lowest contact angle values (36.5 ± 2.9°), and all lenses except for etafilcon A had similar wettability after 16 hours. All the lenses had similar wettability when assessed using the captive bubble method, suggesting that they had similar wettability under optimal wetting conditions. For NIKBUT, delefilcon A had the longest NIKBUT values (9.0 ± 1.0 s) after 16 hours.

CONCLUSIONS:
The sessile drop technique produced the most measurable differences in wettability between different lens types, whereas the captive bubble technique was not able to provide any measurable differences between lenses. NIKBUT measurements may provide a better measure of on-eye wettability, but variability in the results using the current eye model still needs to be addressed in future studies for improved repeatability. Although the contact lenses showed different contact angles and NIKBUT results, their in vitro wettability did not significantly change over the 16 hours of simulated wear in terms of the captive bubble or NIKBUT values.

Richards,J., Jaskulski,M., Woods,J., Guthrie,S., Kollbaum,P. Optical characterisation and vision quality assessment of two myopia control contact lenses Ophthalmic and Physiological Optics 2025;Online ahead of print [ Show Abstract ]

Purpose
This investigation examined the image and vision quality of two commercially available daily disposable myopia control soft contact lenses.

Methods
Wavefront errors were measured with an SHS Ophthalmic aberrometer for two myopia control soft contact lenses: a coaxially designed dual-focus lens (omafilcon A, CooperVision MiSight® 1 day, MS1d) and a design employing multiple add powers that included non-coaxial optics in annular add zones (senofilcon A, Johnson & Johnson Vision ACUVUE® Abiliti™ 1-Day, AB). Geometric optics ray tracing generated point-spread functions and wave optics were used to compare modulation transfer functions (MTFs) and simulated letter images. Twenty-six myopic children completed a randomised, non-dispensing, contralateral double-masked clinical trial. After 1 h of wear, right and left eye visual acuity (VA), subjective vision quality and lens preference (Likert) were assessed while viewing monocularly.

Results
The lens containing non-coaxial optics employed a small central zone with approximately +10.00 D of added power and two annular rings with a power gradient typical of non-coaxial optics. The coaxial design contained a centre zone with a distance correction and two annular zones with a fixed add power of approximately +2.00 D. MTFs and simulated images were better with small pupils, which was most noticeable with the coaxial design. Distance VA was -0.02 ± 0.04 with MS1d and 0.09 ± 0.08 with AB, p < 0.01. The majority of participants (77%) reported a preference for one lens; 54% preferred the MS1d and 23% preferred the AB lens.

Conclusions
Myopia control contact lenses employing coaxial or a mixture of coaxial and non-coaxial optics both reduced retinal image contrast but successfully imaged high spatial frequencies and provided high quality of vision. Image and vision quality were slightly superior in the lens employing coaxial optics alone.

Schulze,M., Guthrie,S., Ho,B., Woods,J., Jones,L. A Clinical Evaluation of Lifitegrast Ophthalmic Solution 5% in Symptomatic Contact Lens Wearers Clinical Ophthalmology 2025;19(August):3033-3049 [ Show Abstract ]

Purpose: To evaluate the effectiveness of lifitegrast ophthalmic solution 5% in alleviating end-of-day dryness and discomfort in symptomatic contact lens (CL) wearers.

Patients and Methods: This was an open-label study in symptomatic CL wearers with ratings of ≥ 40 for end-of-day dryness on a visual analog scale (VAS; 0– 100 scale; 100 worst). Participants wore their habitual CLs and instilled lifitegrast twice daily for 12 weeks with lenses removed. The performance of lifitegrast was assessed by comparing VAS 0– 100 ratings (100=worst) at 2, 6 and 12 weeks for end-of-day dryness and discomfort and Contact Lens Dry Eye Questionnaire-8 (CEQ-8) scores to baseline levels. Tear samples were collected at all visits to measure 10 different tear cytokines.

Results: Forty participants (33F, mean age 30.8± 12.1 years, 65% daily disposable CL users) completed the study. There were no serious adverse events. Median (range) visual analog scale ratings for end-of-day dryness (Baseline: 76 (19– 99); 2-weeks: 43 (0– 95); 6-weeks: 26 (0– 94); 12-weeks: 15 (0– 98)) and discomfort (Baseline: 70 (10– 97); 2-weeks: 45 (0– 95); 6-weeks: 25 (0– 84); 12-weeks 11 (0– 96)) both significantly improved over time (all p< 0.01). At baseline, 100% of participants rated dryness ≥ 40, which dropped to 17% at 12 weeks. Baseline CLDEQ-8 scores of 22 (12– 31) had significantly decreased to 11 (1– 26) at 12 weeks. Comfortable CL wear time increased significantly from 6± 2 hours at baseline to 9± 3 hours at 6 and 12 weeks (all p< 0.01). Cytokine levels did not change over time.

Conclusion: Lifitegrast significantly improved end-of-day dryness, end-of-day discomfort, CLDEQ-8 scores and comfortable CL wear time within 2 weeks of use.

Sedaghat,A. Shokrolahi,F., Yeganeh,H., Shokrollahi,P, Hosseini,S. Injectable gellan gum hydrogel with PLGA-LDH microspheres for controlled alendronate release and bone regeneration International Journal of Biological Macromolecules 2025;321, Part 1(September):Article 146092 [ Show Abstract ]

Injectable Gellan Gum-Gelatin hydrogel (GG/gelatin hydrogel) with PLGA-LDH composite microspheres (Gel-PMA) was developed for controlled alendronate (ALN) release and enhanced bone regeneration. Manganese-Zinc Layered Double Hydroxide (LDH) nanoparticles (∼142 nm) were synthesized, loaded with ALN (ALN-LDH, about 25 %), and encapsulated in poly (d,l-lactide-co-glycolide) (PLGA) microspheres (∼120 μm) via a solid-in-oil-in-water (S/O/W) double-emulsion technique. Microspheres (10 wt%) were incorporated into a GG/gelatin hydrogel and crosslinked with CaCl₂. Physicochemical and morphological analyses confirmed successful fabrication of LDH, ALN-LDH, ALN-LDH-loaded PLGA microspheres, and composite hydrogels. Mechanical testing showed that incorporating PLGA microspheres increased compressive strength from 30 to 170 kPa.

Gel-PMA enabled sustained ALN release (∼95 % in 28 days), significantly improving ALN cumulative released amount (drug availability) over previous studies. Gel-PMA also exhibited excellent biocompatibility (>90 % cell viability). In vitro studies demonstrated osteogenic potential of Gel-PMA through increased ALP activity (0.0062 to 0.022 μmol/min/mg), calcium deposition (0.0125 to 0.022 μg/μl), and Alizarin Red staining over 28 days. ARS and MT assays, alongside upregulated ALP, Col I, and OCN gene expression, further confirmed osteogenic differentiation. These findings highlight Gel-PMA as a promising injectable scaffold for bone tissue engineering, offering controlled drug release, enhanced mechanical properties, and superior osteogenic potential.

Shokrollahi P, Garg P, Hui A, Phan,C, Jones,L. PVA-Based Hydrogel Inserts for Atropine Delivery for Myopia Treatment The Association for Research in Vision and Ophthalmology Annual Meeting, Salt Lake City, May 4, 2025 [ Show Abstract ]

Purpose
Myopia progression is a global problem, with 50% of the world’s population predicted to be myopic by 2050. This project aimed to develop atropine (ATR)-releasing ocular inserts based on polyvinyl alcohol (PVA) hydrogels for the treatment of myopia, which could be complementary to other myopia control methods, such as spectacles or contact lenses.

Methods
PVA was dissolved in water at 80°C to prepare a 10% (w/v) solution. The solution was divided into two parts. ATR was added to one part to give 0.6% (w/v) concentration, and the other part acted as a control. Both groups were transferred to a silicon mold (5.5mm diameter, 0.2mm height, ~100µl) and subjected to six freeze-thaw cycles, alternating between freezing at -20°C for 16 hours and thawing at room temperature for 8 hours
Mechanical properties were studied via a compression test (TA instruments, Hamilton, USA), and the morphology was assessed using scanning electron microscopy (Quanta FEG 250, FEI, USA). The release of atropine was then measured in 1mL of phosphate-buffered saline every 30 minutes for 6 hours.

Results
SEM analysis revealed a highly interconnected porous structure and a narrow pore size distribution (12±8µm, Figure 1A). The hydrogels displayed about 0.86 kPa compression modulus and 21.81 kPA compression strength at 30% strain (Figure 1B) and withstood 5 compression cycles with minimal changes in modulus. The discs released about 25% of the initial ATR loaded (~600 µg) in the first 30 min and about 50% in 1 hour. Nearly, 100% of the cargo was released in 3.5 hours (Figure 1C). The release profile followed first-order kinetics (R2 = 0.9628).

Conclusions
The open pore network of the discs can accommodate water and improve the elastic soft “feel” of the insert, while being structurally robust and easy to handle. This hydrogel insert based on PVA, a polymer with FDA approval for biomedical applications, can support the gradual release of ATR up to 3.5 hours and helps avoid the side effects of 1% ATR eye drops, while providing a similar cumulative concentration of the drug to the eye. Future studies will focus on optimizing parameters to extend the release duration.

Shokrollahi,P., Garg,P., Wulff,D., Hui,Al., Phan,C-M., Jones,L. Vat Photopolymerization 3D Printing Optimization: Analysis of Print Conditions and Print Quality for Complex Geometries and Ocular Applications International Journal of Pharmaceutics 2025;668(January):Article 124999 [ Show Abstract ]

Abstract: 3D printing, also known as additive manufacturing, continues to reshape manufacturing paradigms in healthcare by providing customized on-demand object fabrication. However, stereolithography-based 3D printers encounter a conflict between optimizing printing parameters, requiring more time, and print efficiency, requiring less time. Moreover, commonly used metrics to assess shape fidelity of 3D printed hydrogel materials like ‘circularity’ and ‘printability’ are limited by the soft nature of hydrogels, that can cause irregularities in their boundary. To unlock the full potential of 3D printing of biomaterials, it is also necessary to understand correlation between printing parameters and ink properties. In this work, a method based on curing depth, overcuring (cumulative cure), and print thickness was developed, which enables a time-efficient and reliable determination of printing conditions for complex geometries using gelatin methacrylate hydrogel biomaterial ink. We also examined the impact of printing direction on the print quality in terms of object/print thickness and aspect ratio. Moreover, the effects of dye concentration, exposure time, and layer thickness on print quality were evaluated, with discussions focused on the correlation between print dimension to layer thickness. Further evaluation was achieved by successfully printing bioinspired corneal stroma-like scaffold and delicate structures like a contact lens and a model eyeball, substantially expanding the scope of this method in producing high-quality prints with intricate details. We also demonstrate the effectiveness of ‘Feret ratio,’ another measure of object shape, in assessing the shape fidelity of different prints. Overall, the results highlight the practical potential of this method in enhancing the speed and reliability of the 3D printing processes involving complex geometries using a low-cost 3D printers.

Stapleton,F., Argüeso,P., Asbell,P., Azar,D., Bosworth,C., Chen,W., Ciolino,J., Craig,J., Gallar,J., Galor,A., Gomes,J. A. P., Jalbert,I., Jie,Y., Jones,L., Konomi,K., Liu,Y., Merayo-Lloves,J., Oliveira,F. R., Perez Quinones,V. A., Rocha,E. M., Sullivan,B. D., Sullivan,D. A., Vehof,J., Vitale,S., Willcox,M., Wolffsohn,J., Dogru,M. TFOS DEWS III Digest Report American Journal of Ophthalmology 2025;Online ahead of print [ Show Abstract ]

This digest summarises the interdisciplinary research in dry eye disease (DED) published since the 2017 TFOS DEWS II reports. It comprises seven topics including Sex, Gender, and Hormones, Epidemiology, Pathophysiology, Tear Film, Pain and Sensation, Iatrogenic and Clinical Trial Design and explores how each of these inform diagnostic methodology, disease subtype and management of DED.

Sex- and gender-related differences significantly influence the ocular surface due to hormones, sex chromosomes, sex-specific autosomal factors, epigenetics, care-seeking behaviors, and service utilization. Epidemiological data reveal that DED prevalence varies by age and sex, influenced by diagnostic criteria and the multifactorial nature of the disease. New risk factors for DED include environmental, iatrogenic, systemic diseases and lifestyle domains.

Pathophysiological distinctions between Aqueous Deficient Dry Eye (ADDE) and Evaporative Dry Eye (EDE) have been clarified. EDE is characterized by a muted inflammatory response at the ocular surface, meibomian gland dysfunction and conceivably phenotypic changes in corneal epithelial cells. There is an expanding role for metabolic, hormonal, physical, neural and cellular stresses, including hyperosmolarity, mitochondrial stress, and neurogenic inflammation.

Advancements in tear film research recommend new approaches to understanding DED pathogenesis and identifying biomarkers, such as microRNAs. Ocular pain perception is linked to structural integrity of corneal nerves, functional capacities of neurons, and activity of the central and peripheral nervous systems. Iatrogenic DED can result from medications, contact lenses, and surgical procedures. Clinical trials now emphasize aligning design and endpoints with DED subtypes and therapeutic mechanisms, with new therapeutics and trial designs under consideration.

Walsh K, Vega J, Chisholm R, Cvarch B, Schwiegerling J, Luensmann D, Marullo R. Performance of two contact lens designs in a clinical setting and through computational optical modelling Global Specialty Lens Symposium, Las Vegas, Jan 17, 2025

Walsh,K., Jones,L., Morgan,P., Papas,E., Sulley,A. Topical review: Twenty-five years of silicone hydrogel soft contact lenses Optometry and Vision Science 2025;102(6):361-374 [ Show Abstract ]

SIGNIFICANCE:
The impact of silicone hydrogel (SiHy) contact lens materials on clinical contact lens practice and patient care over the past 25 years is reviewed, along with identifying areas for future innovation in material science and clinical practice to further improve outcomes for contact lens wearers.

A quarter of a century since the launch of SiHy contact lens materials, with many current eye care professionals having never practiced without them as an option, this literature review reflects how this significant change in soft lens material technology has impacted routine clinical contact lens practice and patient care. SiHy lenses now account for approximately 75% of all new daily wear soft lenses fitted and they are available in a wide variety of modalities, replacement frequencies, and designs, including daily disposable, torics, and multifocals. From the physical properties of SiHy materials and their adoption to their use in helping meet patient needs, conclusions can be made where historical clinical issues have been solved, and where innovation in material science and evolution in clinical practice are still required to deliver the best outcome for contact lens wearers. SiHy materials have largely eliminated hypoxia as a complication seen in contact lens clinical practice, and when used for daily wear, in particular as daily disposable lenses, they provide an exceptional option for vision correction that is minimally invasive, comfortable, and effective. This review helps with the understanding of how the eye care profession has adopted the use of these lenses over the last 25 years, and questions what comes next for these widely used family of materials and the opportunities that exist for them to continue contributing to patient satisfaction and to growing the contact lens market.

Weise K, Rhue B, Jones D, Khanal S.. Hot Topic Breakfast - The Future of Myopia Management: Perspectives from Leading Experts SECO International, Atlanta, Georgia, USA, Feb 28, 2025

Wolffsohn, J. S., Benítez-Del-Castillo, J., Loya-Garcia, D., Inomata, T., Iyar, G., Liang, L., Pult, H., Sabater, A., Starr, C., Vehof, J., Wang, M. T. M., Chen, W., Craig, J. P., Dogru, M., Perez Quinones, V. L., Stapleton, F., Sullivan, D. A., Jones, L., Arita, R., Belmonte, C., Chalmers, R. L., Galor, A, Ghosh, A., Labetoulle, M., Nichols, K. K., Pucker, A. D., Rocha, E, M., Sullivan, B., Versura, P., Willcox, M. D. P. TFOS DEWS III Diagnostic Methodology American Journal of Ophthalmology 2025;Online ahead of print [ Show Abstract ]

A standard approach to the diagnosis of dry eye disease across eye care practitioners is critical to reassuring the patient, providing consistency between practitioners and informing governments as to the true prevalence and resulting healthcare needs. The Tear Film & Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) III has reviewed the evidence-base since their previous reports published in 2017 and revised the definition to “Dry eye is a multifactorial, symptomatic disease characterized by a loss of homeostasis of the tear film and/or ocular surface, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities are etiological factors.” Key features from the definition include that dry eye disease is multifactorial, is a disease and not a syndrome and is always symptomatic. Differential diagnosis and ocular examination guidance is given along with the risk factors that should be discussed with the patient. The recommended screening questionnaire is the OSDI-6 with a cut-off score ≥4. A positive result together with a non-invasive breakup time 8mOsm/L) gives a diagnosis of dry eye. In addition, the ocular surface should be stained and positive symptomology together with >5 corneal fluorescein and/or >9 conjunctival lissamine green punctate spots and/or lid margin lissamine green staining of ≥2mm length & ≥25 %width also gives a diagnosis of dry eye. Subclassification was separated into tear film (lipid, aqueous and mucin/glycocalyx) and ocular surface and adnexa (anatomical misalignment, blink/lid closure, lid margin, neural dysfunction, ocular surface cell damage/disruption and primary inflammation/oxidative stress) components, with appropriate clinical tests and cut-offs provided to identify these etiological drivers in an individual, to inform appropriate management and therapy.