Contact Lens & Anterior Eye RSS feed: Articles in Press. Contact Lens & Anterior Eye is a research-based journal covering all aspects of contact lens theory and practice, including original articles on invention and innovations, as well as the regular features of: Case Reports; Literary Reviews; Editorials; Instrumentation and Techniques and Dates of Professional Meetings. To order this journal online, visit http://intl.elsevierhealth.com/journals/clae http://www.contactlensjournal.com//inpress?rss=yesElsevier Inc.en © 2011 British Contact Lens Association. Published by Elsevier Inc. All rights reserved. Contact Lens & Anterior Eye1367-04842012-01-03 © 2011 British Contact Lens Association. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.contactlensjournal.com/article/PIIS1367048411001603/abstract?rss=yesAbstract: Introduction: The lens coloboma results from a segmental defective or absent development of the zonules. It is usually unilateral and bilateral cases are rare. These eyes are at greater risk of complications during cataract surgery due to ocular malformations. In addition the capsular bag requires stabilization using modified capsule tension ring, capsular tension segment or capsular anchor.Methods: Lens extraction is indicated for cataract or subluxation if visual function is sufficiently compromised. We report our surgical experience in a patient with bilateral isolated lens coloboma by performing manual small incision cataract surgery (MSICS) in left eye and phacoemulsification in right eye.Results: The nuclear rotation was hampered because of the lack of zonules and presence of lens coloboma. MSICS was converted to the intracapsular technique in left eye, though breaking the nucleus into pieces during phacoemulsification in right eye enabled its mobilization and successful completion with implantation of modified capsule tension ring.Conclusions: A patient with lens subluxation and lens coloboma is better managed by phacoemulsification as compared to the MSICS.Manual small incision cataract surgery for subluxated cataract with lens coloboma - Corrected ProofRuchi Goel, Saurabh Kamal, Bhawna Khurana, Sushil Kumar, K.P.S. Malik, Sonam Angmo Bodh, Malvika Singh10.1016/j.clae.2011.12.001Contact Lens & Anterior Eye (2012)2012-01-03Contact Lens & Anterior Eye2012-01-03CASE REPORThttp://www.contactlensjournal.com/article/PIIS1367048411001548/abstract?rss=yesAbstract: Purpose: To establish guidelines for contact lens wearers’ hand hygiene practices which achieve a balance between minimising risk of infection and reasonable expectations on the ability of patients to follow them.Methods: Evidence has been obtained from publications via PubMed, Advanced Medline Search, Cochrane Reviews, Google Scholar and using the key words hand hygiene, washing and contact lens.Results: Guidelines for effective hand washing and the bother involved vary according to the level of hygiene required. High levels of non-compliance with hand hygiene practices, even among healthcare workers, gives an indication of how important the level of bother involved when following guidelines can be in contributing to non-compliance.Conclusions: Better patient education to improve hand washing techniques as well as patient attitudes toward hand hygiene are needed to reduce high non-compliance levels. Better hand hygiene techniques and higher frequency of their application give the prospect of reduced risk of infection and of any discomfort that arises from increased lens and ocular bioburden. In order that adoption rates might be maximised, the guidelines which have been distilled from this review attempt to strike a balance between technique redundancy and the associated higher levels of hygiene achieved and the possibility that the perception of too much bother involved could reduce participation rates. The guidelines have been expanded by the inclusion of suggested explanatory information in the expectation that helping patients to understand why the recommendations are made will have the effect of increasing their adoption.Hand hygiene prior to contact lens handling is problematical - Corrected ProofCharles W. McMonnies10.1016/j.clae.2011.11.003Contact Lens & Anterior Eye (2011)2011-12-26Contact Lens & Anterior Eye2011-12-26REVIEWhttp://www.contactlensjournal.com/article/PIIS136704841100155X/abstract?rss=yesAbstract: Aim: The aim of this study was to assess the impact of hand washing regimes on lipid transference to contact lenses. The presence of lipids on contact lenses can affect visual acuity and enhance spoilation. Additionally, they may even mediate and foster microbial transfer and serve as a marker of potential dermal contamination.Methods and materials: A social hand wash and the Royal College of Nursing (RCN) hand wash were investigated. A ‘no-wash regime’ was used as control. The transfer of lipids from the hand was assessed by Thin Layer Chromatography (TLC). Lipid transference to the contact lenses was studied through fluorescence spectroscopy (FS).Results: Iodine staining, for presence of lipids, on TLC plates indicated the ‘no-wash regime’ score averaged at 3.4±0.8, the social wash averaged at 2.2±0.9 and the RCN averaged at 1.2±0.3 on a scale of 1–4. The FS of lipids on contact lenses for ‘no washing’ presented an average of 28.47±10.54 fluorescence units (FU), the social wash presented an average of 13.52±11.12FU and the RCN wash presented a much lower average 6.47±4.26FU.Conclusions: This work demonstrates how the method used for washing the hands can affect the concentration of lipids, and the transfer of these lipids onto contact lenses. A regime of hand washing for contact lens users should be standardised to help reduce potentially transferable species present on the hands.The significance of hand wash compliance on the transfer of dermal lipids in contact lens wear - Corrected ProofDarren Campbell, Aisling Mann, Olivia Hunt, Lívia J.R. Santos10.1016/j.clae.2011.11.004Contact Lens & Anterior Eye (2011)2011-12-19Contact Lens & Anterior Eye2011-12-19http://www.contactlensjournal.com/article/PIIS1367048411001524/abstract?rss=yesThis letter to the editor outlines some of my concerns regarding the recently published paper: Hickson-Curran S, et al. Patient attitudes and behavior regarding hygiene and replacement of soft contact lenses and storage cases. Contact Lens Anterior Eye (2011), doi:10.1016/j.clae.2010.12.005. Details of the parts of the paper that I have concerns with are listed below.S. Hickson-Curran, et al. “Patient attitudes and behavior regarding hygiene and replacement of soft contact lenses and storage cases” [Contact Lens Anterior Eye (2011), doi:10.1016/j.clae.2010.12.005] - Corrected ProofKenneth A. Polse10.1016/j.clae.2011.11.001Contact Lens & Anterior Eye (2011)2011-12-02Contact Lens & Anterior Eye2011-12-02LETTER TO THE EDITORhttp://www.contactlensjournal.com/article/PIIS1367048411001512/abstract?rss=yesAbstract: Sjogren's syndrome is an autoimmune disease that commonly presents to the ophthalmologist as a dry eye disease. We report an unusual presentation of a case of Sjogren's syndrome. A 33-year-old man presented with lid swelling, pseudomembraneous conjunctivitis with central corneal epithelial defect and history of limb weakness for past 2 years. There was progressive enlargement of the epithelial defect and conjunctival-scleral necrosis developed during follow-up. Evaluation for underlying connective tissue disorder was positive for SS-B/La antibody and, the rheumatoid factor, anti nuclear antibody, anti neutrophil cytoplasmic antibody titres were negative. Patient was diagnosed as a case of Primary Sjogren's syndrome. Resolution of the conjunctival-scleral necrosis occurred following treatment with combination of cyclosporine and prednisolone. Paramedian tarsorrhaphy was performed to promote healing of the corneal epithelium. The corneal epithelium healed, conjunctival-scleral necrosis resolved completely and the visual acuity improved to 6/36 in the right eye after 3 months of immunosuppressive therapy. The immunosuppressive therapy was discontinued after completion of 6 months of treatment. After 6 months follow-up of stopping immunosuppressive therapy, the ocular and systemic condition is stable.Unusual presentation of a case of Sjogren's syndrome with neurological and ocular manifestation - Corrected ProofNaina R. Bamrolia, Ritu Arora, Usha Yadava10.1016/j.clae.2011.10.002Contact Lens & Anterior Eye (2011)2011-11-18Contact Lens & Anterior Eye2011-11-18CASE REPORThttp://www.contactlensjournal.com/article/PIIS1367048411001238/abstract?rss=yesAbstract: Purpose: To establish if sodium fluorescein (SFL) dye accumulation within intercellular spaces on the ocular surface contributes to the appearance of superficial punctate corneal staining.Methods: Thirteen subjects bilaterally wore PureVision™ lenses that had been pre-soaked in ReNu MultiPlus® multipurpose solution. After 1h of lens wear, corneal staining with SFL was assessed using a standard slit-lamp technique. Participants who presented with bilateral, corneal staining were selected for further evaluation. A randomly selected eye was rinsed with saline three times. Fellow eyes (control) received no rinsing. After each rinse, the appearance of SFL staining was recorded without any further instillation of the dye. To eliminate any confounding effects of staining due to residual fluorescein in the tear menisci, corneal staining was induced in freshly excised, isolated, rabbit eyes by topical administration of 0.001% PHMB and staining, rinsing and grading were performed as above.Results: Nine out of 13 subjects presented with bilateral diffuse corneal staining (mean grade±SD: 2.4±0.7). The mean staining grades in test and control eyes respectively after each of the three rinses were (1) 2.41±0.41, 2.25±0.69 (p=0.9); (2) 2.34±0.79, 2.1±0.83 (p=0.8); and (3) 1.71±0.65, 1.60±0.79 (p=0.6) there was no significant reduction in staining with rinsing (p>0.05) and no difference was observed between test and control eyes at any sampling-point. Similar observations made in ex vivo rabbit eyes replicated these results.Conclusions: Pooling or accumulation of SFL solution within intercellular spaces does not appear to contribute to the appearance of superficial micropunctate corneal staining.Mechanisms of superficial micropunctate corneal staining with sodium fluorescein: The contribution of pooling - Corrected ProofKalika L. Bandamwar, Qian Garrett, Eric B. Papas10.1016/j.clae.2011.08.008Contact Lens & Anterior Eye (2011)2011-09-14Contact Lens & Anterior Eye2011-09-14SHORT COMMUNICATIONhttp://www.contactlensjournal.com/article/PIIS1367048411001068/abstract?rss=yesAbstract: Purpose: Meibography is reported to be important in Meibomian Gland Dysfunction (MGD) evaluation. Our purpose was to investigate the usefulness of a standard infra-red video security camera in meibography.Methods: Meibographs were taken of the right lower lid of 17 subjects (female 10; age=44.3years ±13.3 SD), randomly selected from the patient pool of Horst Riede GmbH, Weinheim, Germany. Meibomian glands (MG) were photographed by an near adapted infra-red video security camera and extend of MG loss (MGL) was measured by digital image analyzes. Lipid-layer and non-invasive break-up time (NIBUT) was measured by tearscope, dry eye symptoms were evaluated by the Ocular Surface Disease Index (OSDI). Correlations between MGL scores and ocular signs, tearfilm and symptoms were analyzed by Pearsons, differences between gender by U-test. The ability of MGL to predict dry eye symptoms was evaluated by area under the receiver operative characteristic curve (AUC).Results: MGL scores were significantly correlated to lipid-layer pattern (r=−0.68, p=0.001) NIBUT (−0.46, 0.032) OSDI (0.89, 0.001) and age (0.61, 0.005). MGL was significantly larger in female (p=0.001). AUC of MGL was 95.8% (p=0.001; sensitivity=88.9%; specificity=87.5%; threshold=32.3%).Conclusions: MGL is a predictive test of dry eye symptoms. The analyzed significant correlation between MGL and tearfilm and dry eye symptoms indicates the usefulness of the non-contact IR meibograph (PNCM).Non-contact meibography: Keep it simple but effective - Corrected ProofH. Pult, B.H. Riede-Pult10.1016/j.clae.2011.08.003Contact Lens & Anterior Eye (2011)2011-09-01Contact Lens & Anterior Eye2011-09-01