Highlights
- •Ocular surface mucins were imaged using fluorescein-tagged wheat germ agglutinin dye and a custom imaging system.
- •Mucin density appeared greatest on the bulbar conjunctiva and lowest on the cornea.
- •Contact lens wear reduced F-WGA dye binding across the ocular surface, with the most marked effect at the cornea.
- •F-WGA associated fluorescence appeared reduced in the lid wiper region for symptomatic contact lens wearers.
- •F-WGA imaging is a key tool in furthering our understanding of contact lens discomfort and ocular surface disease.
Abstract
Purpose
Fluorescein-labelled wheat germ agglutinin (F-WGA) acts as a marker for ocular surface
mucins. This clinical study sought to investigate whether the degree of F-WGA fluorescence
observed at the ocular surface differed between symptomatic contact lens wearers,
asymptomatic contact lens wearers and non-contact lens wearers, using a novel imaging
system.
Methods
Twenty-five participants (10 symptomatic contact lens wearers, 10 asymptomatic contact
lens wearers and 5 non-contact lens wearers) attended a single study visit. Photographs
of the cornea, bulbar and tarsal conjunctiva were captured following application of
F-WGA solution.
Results
The imaging system captured high-resolution images of F-WGA fluorescence at the ocular
surface. The degree of fluorescence differed between the ocular surface regions (p < 0.001). A significant difference in fluorescence was observed between participant
groups for the cornea (p = 0.01), with both the symptomatic and asymptomatic contact lens wearers showing
lower fluorescence than the non-lens wearers. F-WGA associated fluorescence appeared
diminished in the lid wiper region of the symptomatic lens wearers, compared to the
asymptomatic group (p = 0.025).
Conclusion
The use of F-WGA as a clinical marker for ocular surface mucins allows an improved
understanding of their distribution across the ocular surface. Contact lens wear appears
to negatively impact mucin density across the ocular surface, with the most marked
effect on the cornea. F-WGA fluorescence appeared diminished in the lid wiper region
for the symptomatic contact lens wearing group, indicating that mechanical interaction
in this region may play a role in the aetiology of contact lens discomfort. Given
the ability of F-WGA to disclose mucin distribution across the ocular surface it is
likely to be a key clinical tool in furthering our understanding of (i) the aetiology
of contact lens related discomfort, (ii) contact lens designs/materials to minimise
interaction with the ocular surface and (iii) dry eye disease and other ocular surface
diseases.
Keywords
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Article info
Publication history
Published online: August 23, 2019
Accepted:
August 15,
2019
Received in revised form:
August 14,
2019
Received:
July 11,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of British Contact Lens Association. All rights reserved.
