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.

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;Online ahead of print [ 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.

Jones,L., Efron,N., Bandamwar,K., Barnett,M., Jacobs,D. S., Jalbert,I., Pult,H., Rhee,M. K., Sheardown,H., Shovlin,J. P., Stahl,U., Sranila,A., Tan,J. Tavazzi,S., Ucakhan,O. O., Willcox,M. D. P., Downie,L. TFOS lifestyle: Impact of contact lenses on the ocular surface Ocular Surface 2023;Online ahead of print [ Show Abstract ]

Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviours (e.g., using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic has impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.

Stapleton,F., Abad,J. C., Barabino,S., Burnett,A., Iyer,G., Lekhanont,K., Li,T., Liu,Y., Navas,A., Obinwanne,C. J., Qureshi,R., Roshandel,D., Sahin,A., Shih,K., Tichenor,A., Jones,L. TFOS lifestyle: Impact of societal challenges on the ocular surface Ocular Surface 2023;28(April):165-199 [ Show Abstract ]

Societal factors associated with ocular surface diseases were mapped using a framework to characterize the relationship between the individual, their health and environment. The impact of the COVID-19 pandemic and mitigating factors on ocular surface diseases were considered in a systematic review. Age and sex effects were generally well-characterized for inflammatory, infectious, autoimmune and trauma-related conditions. Sex and gender, through biological, socio-economic, and cultural factors impact the prevalence and severity of disease, access to, and use of, care. Genetic factors, race, smoking and co-morbidities are generally well characterized, with interdependencies with geographical, employment and socioeconomic factors. Living and working conditions include employment, education, water and sanitation, poverty and socioeconomic class. Employment type and hobbies are associated with eye trauma and burns. Regional, global socio-economic, cultural and environmental conditions, include remoteness, geography, seasonality, availability of and access to services. Violence associated with war, acid attacks and domestic violence are associated with traumatic injuries. The impacts of conflict, pandemic and climate are exacerbated by decreased food security, access to health services and workers. Digital technology can impact diseases through physical and mental health effects and access to health information and services. The COVID-19 pandemic and related mitigating strategies are mostly associated with an increased risk of developing new or worsening existing ocular surface diseases. Societal factors impact the type and severity of ocular surface diseases, although there is considerable interdependence between factors. The overlay of the digital environment, natural disasters, conflict and the pandemic have modified access to services in some regions.

Sullivan,D., da Costa,A. X., Del Duca,E., Doll,T., Grupcheva,C. N., Lazreg,S., Liu,S-H., McGee,S. R., Murthy,R., Narang,P., Ng,A. Y., Nistico,S., O'Dell,L., Roos,J., Shen,J., Markoulli,M. TFOS lifestyle: Impact of cosmetics on the ocular surface Ocular Surface 2023;29(July):77-130 [ Show Abstract ]

In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.

Woods,C., Naroo,S., Zeri,F., Bakkar,M., Barodawala,F., Evans,V., Fadel,D., Kalikivayi,L., Lira,M., Maseedupally,V., Trave Huarte,S., Eperjesi,F. Evidence for commonly used teaching, learning and assessment methods in contact lens clinical skills education Contact Lens Anterior Eye 2023;Online ahead of print [ Show Abstract ]

Introduction
Evidence based practice is now an important part of healthcare education. The aim of this narrative literature review was to determine what evidence exists on the efficacy of commonly used teaching and learning and assessment methods in the realm of contact lens skills education (CLE) in order to provide insights into best practice. A summary of the global regulation and provision of postgraduate learning and continuing professional development in CLE is included.

Method
An expert panel of educators was recruited and completed a literature review of current evidence of teaching and learning and assessment methods in healthcare training, with an emphasis on health care, general optometry and CLE.

Results
No direct evidence of benefit of teaching and learning and assessment methods in CLE were found. There was evidence for the benefit of some teaching and learning and assessment methods in other disciplines that could be transferable to CLE and could help students meet the intended learning outcomes. There was evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; clinical teaching and learning, flipped classrooms, clinical skills videos and clerkships. For assessment these methods were; essays, case presentations, objective structured clinical examinations, self-assessment and formative assessment. There was no evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; journal clubs and case discussions. Nor was any evidence found for the following assessment methods; multiple-choice questions, oral examinations, objective structured practical examinations, holistic assessment, and summative assessment.

Conclusion
Investigation into the efficacy of common teaching and learning and assessment methods in CLE are required and would be beneficial for the entire community of contact lens educators, and other disciplines that wish to adapt this approach of evidence-based teaching.