Wolffsohn,J., Travé-Huarte,S., Stapleton,F,, Downie,L.E., Schulze,M., Guthrie,S., Stahl,U., Wang,M., Craig,J. Relative importance of tear homeostatic signs for the diagnosis of dry eye disease The Ocular Surface 2025;36(April):151-155 [ Show Abstract ]

Aim: Disease misdiagnosis is more likely if standardised diagnostic criteria are not used. This study systematically examined the effect on diagnosing dry eye disease (DED), when tests for evaluating tear film homeostasis were included or excluded from a multi-test protocol.

Method: For 1,427 participants across five sites, data for the full suite of diagnostic tests defined in the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) Diagnostic Methodology report algorithm were evaluated; diagnostic sensitivity was calculated when individual signs were removed, and when different combinations of signs were required.

Results: Evaluating just one of the three TFOS DEWS II homeostatic signs resulted in between 12.3 % and 36.2 % of patients who met the DED diagnostic criteria not being assigned this diagnosis. While comprehensive ocular surface staining evaluation, comprising of corneal, conjunctival and lid margin staining, in combination with symptoms had the highest sensitivity (87.7 %) of the three markers, the sensitivity dropped to 44.6 % if only corneal staining was evaluated. Omitting either non-invasive tear breakup time or tear osmolarity each dropped the sensitivity by <5 %. The prevalence of DED was substantially reduced if a diagnosis required symptoms and two of the three signs to be present (by 43.7 %–61.2 %) and by 65.9 % if all three signs indicating a loss of tear film homeostasis were required. The outcomes of the analysis did not change significantly across differing severities of DED symptoms.

Conclusions: The TFOS DEWS II diagnostic algorithm of symptoms plus assessing for a tear film (non-invasive tear breakup time or tear osmolarity) and ocular surface sign can be considered a robust and appropriate approach for DED diagnosis.

Wong,K.Y.. Fast Forward to the Future: Aptamer-Functionalized Contact Lenses Contact Lens Spectrum 2025;40, July/August:

Wong,S., Woods,J., Schulze,M., Fadel,D., Stahl,U., Jones,L. Performance of Delefilcon A Daily Disposable Contact Lenses in a Group of Digital Device Users Clinical Ophthalmology 2025;19(July):2439-2452 [ Show Abstract ]

Purpose: To assess the performance of delefilcon A daily disposable contact lenses (CL) in lens wearers who reported heavy digital device use.

Patients and Methods: This prospective study involved lens wearers who used digital devices ≥ 8 hours per day. Delefilcon A CL were dispensed for 2-weeks, to be worn ≥ 5 days/week, ≥ 13 hours/day, using digital devices as normal. At-home questionnaires rating comfort, dryness, and clarity of vision (0– 100 scale, 100=best) were completed on Days 1, 7, and 14± 1 upon insertion, after 8 hours of device use, and before removal. At the Day 14 visit, participants rated overall comfort, dryness, and vision (0– 100 scale) and completed a 5-point Likert-type scale questionnaire.

Results: Thirty-five participants were eligible, 32 completed (27 females; age: 25.3± 6.3 years). Median at-home ratings for comfort, dryness, and vision were ≥ 85, with no difference between days (all p≥ 0.09). Ratings decreased throughout the day (p≤ 0.005), except comfort (Day 7) and vision (Days 1 and 7), where ratings before removal were similar to 8 hours of device use (p≥ 0.014). After 2-weeks, median (range) overall ratings for comfort, dryness, and vision were 96 (70– 100), 93 (50– 100), and 95 (75– 100), respectively. Most agreed the CL performed well, providing good comfort (91%) and vision all-day-long (94%), and did not have dryness with device use (69%). When devices were used ≥ 8 hours, most felt the CL performed well (84%), were satisfied with comfort (88%) and vision (88%), did not experience eye strain (81%), eye fatigue (66%), or episodes of blurred vision (75%).

Conclusion: Delefilcon A lenses provided high satisfaction levels among lens wearers who spent a significant portion of their day using digital devices. Participants rated the CL highly for comfort and vision throughout the day, with most reporting no issues with dryness, eye strain, or blurred vision while wearing lenses and using digital devices.

Woods J, Luensmann D, Guthrie S, Vega J, Richdale K. Do objective and subjective outcomes align when evaluating multifocal soft lens performance? British Contact Lens Association Meeting, Birmingham, UK, Jun 5 to 7, 2025 [ Show Abstract ]

Purpose:
The success of multifocal soft lenses (MF) can differ depending on whether objective or subjective evaluations are considered. This study compared vision results for in-practice acuity and subjective feedback after participants had worn two different MF designs for 1-month.

Methods:
This prospective, participant-masked, randomised, cross-over, daily-wear study involved habitual MF wearers at 5 sites. Study lenses were monthly replacement, silicone hydrogel: comfilcon A (comMF) and lehfilcon A (lehMF). After 1-month wearing each lens, high-contrast logMAR distance, intermediate and near acuities were measured, and participants rated their experience using 0-100 visual-analogue scales, 4-point agreement questions and 5-point preference Likert scales.

Results:
59 participants completed; mean(SD) demographics: 53.2±6.7 years, -1.57±2.14 refractive spherical component, +1.86±0.46 near addition. Both lenses were worn >12 hours/day (p=0.96). Comfort was not different between lenses (all >80, p>0.05). High-contrast acuity was not different (p>0.05) between lenses for distance and intermediate, but near was 2.5 letters better with comMF (p<0.05). Also, more participants preferred comMF for vision for ‘digital device use’ and ‘near’ (both p0.05); no preferences favoured lehMF. While ratings for ‘overall satisfaction with vision’, ‘vision in dim/dark light conditions’, ‘consistent vision throughout the day’ and ‘crisp, clear vision overall’ showed no differences (all p>0.05), comMF was rated 9 points better for ‘crisp, clear vision when using digital devices’ (p<0.01). Differences favouring comMF were reported in all four near vision task agreement questions: when using ‘laptop’, ‘phone’, ‘reading’, ‘digital devices’) plus for ‘crisp vision at all distances’ (all p<0.05). No rating or agreement data favoured lehMF.

Conclusions:
Both lenses provided good overall performance. comMF demonstrated better near acuity which aligned with better subjective visual performance outcomes related to near-work and digital device use. These results support the value of including real-world experience and subjective feedback in multifocal fitting and evaluation.

Yamasaki,K., Nakagawa,H., Motohiro,C., Jones,L., Hui,A. The impact of a hyaluronic acid derivative-containing care system on the wettability of PEG-coated rigid lenses Contact Lens Anterior Eye 2025;Online ahead of print [ Show Abstract ]

Purpose: This study investigated how a contact lens care solution containing a hyaluronic acid derivative (HAD) impacts wettability of rigid lenses, with and without polyethylene glycol (PEG) surface coatings when tested in vitro.

Methods: The adsorption of fluorescently labelled HAD and hyaluronic acid (HA) on to PEG and non-PEG coated lenses was compared by fluorescence quantification. The impact of HAD on sessile drop wettability was investigated on PEG and non-PEG coated lenses, which were cycled 300 times between an artificial tear solution (ATS) for 16 h and 8 h in a HAD or non-HAD containing solution. PEG-coated lenses were also rubbed with two commercial solutions over 30 cycles, to observe the impact on wettability. The total amount of lysozyme deposited on PEG-coated lenses when using these solutions after 30 cycles were also compared. Finally, to quantify the maintenance of the PEG coating, the amount of silicon detected nanometres under the lens surface when using either solution was determined using X-ray photoelectron spectroscopy.

Results: Greater amounts of HAD adsorbed onto rigid lenses compared to HA. Use of a HAD-containing solution improved the wettability of non-PEG coated lenses, being similar to uncycled PEG-coated lenses after 21 cycles. The wettability of PEG-coated lenses was maintained with the HAD-containing solution, with less lysozyme deposition and similar levels of silicon detected as uncycled lenses. In contrast, the non-HAD containing solution decreased wettability over cycles, with PEG-coated lenses being similar to non-PEG coated lenses after 90 cycles. These lenses also experienced greater amounts of lysozyme deposition, and a greater amount of silicon detected below the lens surface.

Conclusions: Incorporation of HAD into a contact lens care solution has positive effects on wettability of both PEG and non-PEG coated rigid lenses. In contrast, using a non-HAD containing solution decreased wettability over time, even for PEG-coated lenses.

Zhang,H.Y., Xu,F.Y., Liu,K.K.K., Chan,Y.P., Chow,A., Jones,D., Lam,C.S.Y. Myopia Management in Hong Kong Journal of Clinical Medicine 2025;14(3):Article 698 [ Show Abstract ]

Objectives: We aimed to investigate how optometrists in Hong Kong are managing myopic and "pre-myopic" children.

Methods: Clinical files for children aged 6 to 10 years old who had eye examinations from 2017 to 2021 were retrospectively reviewed. Children were grouped by the initial spherical equivalent refractive error (SER) as myopes or pre-myopes. The demographic data, refractive error, and myopia management recommended by the optometrists were analyzed.

Results: A total of 1,318 children (859 myopes and 459 pre-myopes) from ten clinics in Hong Kong were included. Over 5 years, myopia management recommendations shifted significantly (p < 0.001). In 2017, only 18.4% of children were recommended to pursue myopia control (MC), increasing to 42.8% by 2021. The use of MC spectacle lenses increased from 7.3% in 2017 to 36.8% in 2021, becoming the most recommended option. Orthokeratology, MC contact lenses, and atropine remained stable at less than 5% over this period. Children recommended for MC approaches had significantly more myopia than those recommended single-vision lenses or monitoring (p < 0.05). Age of the first visit significantly correlated with SER change from the first visit to the next recommendation update for pre-myopes (r = 0.27, p = 0.013) but not for myopes.

Conclusions: From 2017 to 2021, myopia management patterns in Hong Kong shifted significantly, with more children being recommended for myopia control. MC spectacle lenses emerged as the most commonly recommended method. Younger pre-myopes at their first visit were more likely to have earlier management updates.