Cornea, Contact Lenses, and Tears

This month, Optometry and Vision Science (OVS) publishes a number of articles on contact lenses, cornea, and tears. In fact, more than one-half of the 16 articles are on this topic. In essence, we have a “mini” Feature Issue. Our lead article deals with the intriguing idea that orthokeratology can be used to create monovision for presbyopes by producing one myopic eye. The authors showed that, as with younger patients, orthokeratology is effective within a week and it reverses to baseline corneal curvature within 1 week cessation of overnight contact lens wear. No doubt that there will be some controversy and comments, but the authors address a most interesting concept and provide results that show the viability of such an approach. There will be some considerable public media response on this article, so clinicians may want to be prepared to answer patient questions—the media can report in such glowing “breakthrough” terms that are bound to peak patient interest! Three articles look at contact lens approaches to correcting keratoconus. They are common in the sense that they are focused on the possibilities and advantages of both personalized and template approaches to correcting optical aberrations of keratoconus with contact lenses, and in the approach to diagnosis in the third article. The first article reports customized correction of higher order aberrations into a scleral lens. It produces substantial visual acuity improvement in advanced keratotonic eyes to provide patients who have abnormally aberrated corneas with nearly a normal level of optical and visual quality. In the second, the authors feel, using 110 keratotonic eyes to develop templates for the subgroups, that the relatively common high-order aberrations in keratoconus can be characterized in subgroups that will allow feasible correction for these subgroups. In the third, the authors report that Placido image–based new corneal irregularity indices can be used as an effective tool for detection of early keratoconic and keratoconus-suspect eyes. Two articles deal with contact lens wear and comfort: one emphasizes the importance of the lens care and the other the impact of care compliance. In the first, the authors use data from seven prospective clinical trials involving 283 subjects. They report that a planned replacement silicone hydrogel contact lens, when worn on a daily disposable basis, reduces corneal surface adverse events and offers better ocular comfort compared with when it is reused with various lens care systems. In the second, perhaps not surprisingly, the authors are able to document that the interval between eye examinations is longer for patients who are less compliant with manufacturer-recommended replacement frequency. Three articles deal with tears and tear osmolarity. These range from tear sampling techniques, variability across patients in tear osmolarity with different commercially available eyedrops, and a method of measuring evaporation rates, respectively. In the first, our authors validate in situ tear osmolarity measurements by comparing the TearLab instrument with a traditional vapor pressure osmometer. On-eye measurements were repeatable and showed good agreement with vapor pressure measurements. In the second, each of 20 consecutive patients with moderate dry eye had one of two commercial eyedrops in the right eye and the other in the left eye. They report that the hypo-osmotic drops with sodium hyaluronate reduced tear osmolarity at a greater and more sustained rate, although both were effective. In the third article, our authors demonstrated repeatability for a new method to measure tear evaporation based on infrared thermography. This month marks the final deadline (April 1, 2013) for submission of articles for a Feature Issue on myopia. Optometry and Vision Science creates an update on myopia about every other year, given the ongoing intensity of research efforts on this topic. The six guest editors are internationally renowned, and they are expecting to put together a first-rate Feature Issue to be published in September or October this year. The interest in myopia research remains high, especially as the research raises more and more interest in the prevention and progress of myopia (see Call for Papers topics in this issue of OVS). Next month, OVS features a Clinical Perspective, “Optical Control of Myopia Has Come of Age—Or Has It?,” by two authors active in clinical care and research. It raises the kind of issues that clinicians will be interested in and calls for a more aggressive clinical approach and needed clinical trials to further validate those approaches. That same month, another top optometry journal, Optometry and Physiological Optics, will publish a feature issue on myopia. Later in the year, the journal Experimental Eye Research will also publish its own feature issue on the topic and an International Conference is scheduled for August in Berkeley, California. Finally, this month, the membership will receive a very brief four-question e-mail survey on OVS. It is a follow-up of a survey done a year ago, then again just 6 months ago in September/October. This month, the focus is on readership digital access to the journal and the extent of the OVS iPad App penetration with members OVS reading habits. Do please take the 1 to 2 minutes needed to respond to the survey. It is most helpful in enabling the editors to bring you an ever-improving journal. We have plenty to interest you in this month’s OVS! Tony Adams Editor in Chief Optometry and Vision Science