Contact Lens & Anterior Eye最新文献

{"title":"Letter to the editor.","authors":"","doi":"10.1016/j.clae.2025.102518","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102518","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102518"},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact lens discomfort and associated conditions: Definitions and disambiguation relative to dry eye disease.","authors":"Eric B Papas","doi":"10.1016/j.clae.2025.102520","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102520","url":null,"abstract":"<p><p>Terminology used in relation to contact lens discomfort, and its associated conditions has proliferated, leading to confusion and misuse. This short article demonstrates that the lexicon can be reduced to four terms, which are sufficient to describe the field. These are contact lens discomfort (CLD), contact lens associated dry eye (CLADE), contact lens induced dry eye (CLIDE) and dry eye disease (DED). Definitions for these conditions are clarified and their diagnostic pathways described. Exclusive use of these defined terms is recommended to avoid future misunderstanding, simplify clinical differential diagnosis, maximise treatment efficacy and facilitate the interpretation of research outputs by promoting characterisation of homogenous study groups.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102520"},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized evaluation of orthokeratology lens fitting status assisted by deep learning algorithm.","authors":"Wenting Song, Yong Zhang, Chuan Wan, Ming Liu, Shuai Wang, Hang Yin, Min Xue, Hongbiao Pan, Lei Shi","doi":"10.1016/j.clae.2025.102519","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102519","url":null,"abstract":"<p><strong>Objective: </strong>Aims to develop a standardized evaluation method based on the YOLOv8n object detection algorithm, with the goal of quantitatively assessing the displacement of orthokeratology lenses (OK_lenses) and objectively evaluating their fitting status under fluorescein staining conditions.</p><p><strong>Methods: </strong>117 videos documenting of the fluorescein sodium staining fitting process of OK_lenses, were analyzed alongside corresponding ophthalmic examination results. Key frames were extracted from these videos, annotated, and compiled into a local dataset. A YOLOv8n object detection algorithm model was constructed to automatically identify the visible iris and OK_lenses. The lens displacement was calculated based on the distance between the center points of these two targets and the horizontal visible iris diameter (HVID). Model performance was evaluated using Accuracy, Recall, and F1-score metrics, while consistency was assessed via the Kappa consistency test and compared with traditional manual assessment results.</p><p><strong>Results: </strong>Achieved automatic calculation of OK_lens displacement in fluorescein-stained images and analysis of their fitting status through the application of the YOLOv8n object detection algorithm. For iris and lens detection, the model yielded accuracy, recall, and F1-score values of 97.6 %, 98.8 %, 98.2 % and 98.4 %, 98.9 %, 98.6 %, respectively. In terms of fitting status assessment, the accuracy of the three prediction results of this model compared with the gold standard was 88.6 %, 91.4 % and 88.6 % respectively, the average accuracy rate was 89.5 %, and all Kappa values were > 0.80, showing a high consistency with the gold standard.</p><p><strong>Conclusion: </strong>The YOLOv8n object detection algorithm model demonstrates strong concordance with the gold standard and high accuracy, validating its robust replication of the gold standard's evaluation logic. By enabling the objective, quantitative analysis of lens displacement in fluorescein-stained images, this highly stable and objective model could serve as a standardized tool to complement traditional manual evaluations. It offers considerable value for improving assessment efficiency of physicians lacking fitting experience and reducing subjective bias during fitting procedures. Notably, this study may not improve efficiency for experienced fitting physicians, as the steps and time required for fitting may not be significantly reduced. To further verify its generalization ability, future studies should expand the sample size and incorporate multi-center data for comprehensive validation to support its transition toward clinical standardization.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102519"},"PeriodicalIF":3.7,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between relative peripheral refraction and axial length elongation in myopic children wearing orthokeratology lenses using a novel wide-angle multispectral refraction topographer.","authors":"Mandantuoya, Mingxin Ao, Yu Zhang","doi":"10.1016/j.clae.2025.102517","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102517","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the peripheral retinal relative defocus in myopic children wearing orthokeratology (OK) lenses and evaluate its relationship with the efficacy of myopia control.</p><p><strong>Methods: </strong>Wide-angle (150° field of view) relative peripheral refraction and axial length measurements were conducted in 48 children wearing OK lenses. Key peripheral refraction parameters included minimum defocus distance, defocus ring outer diameter, defocus ring inner diameter, defocus ring width, and retinal relative defocus values (RDVs). Pearson correlation analysis was used to evaluate the associations between axial elongation rate and these parameters. Multiple regression analysis was constructed to predict axial elongation, mainly based on the parameters of peripheral retinal defocus.</p><p><strong>Results: </strong>Peripheral myopic defocus was observed in children wearing OK lenses. Axial elongation rate showed a negative correlation with defocus ring outer diameter (R = -0.388, P < 0.01) and defocus ring width (R = -0.503, P < 0.01), while it was positively correlated with minimum defocus distance (R = 0.383, P < 0.01) and defocus ring inner diameter (R = 0.309, P < 0.01). RDV-53, RDV-45, RDV-(30-45), RDV-(45-53), RDV-N, and RDV-I also showed significant positive correlations with axial elongation rate (P < 0.01). Age, baseline axial length, defocus ring width, minimum defocus distance, and RDV-(45-53) were five predictors in the multivariable prediction model.</p><p><strong>Conclusion: </strong>Wearing OK lenses induced peripheral myopic defocus. Larger defocus ring width, closer defocus ring to the macular zone and greater relative peripheral myopic defocus were associated with less axial elongation. Peripheral defocus parameters combined with age and baseline axial length could predict axial elongation to some extent.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102517"},"PeriodicalIF":3.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of baseline characteristics on subjective improvement of dry eye after intense pulsed light therapy.","authors":"Miriam Carrillo-Pulido, Sonia Ortiz-Peregrina, María Dolores López Pérez, Antonio Cano-Ortiz, Timoteo González-Cruces","doi":"10.1016/j.clae.2025.102514","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102514","url":null,"abstract":"<p><strong>Purpose: </strong>To identify baseline clinical signs and symptoms associated with response to intense pulsed light (IPL) combined with meibomian gland expression in dry eye disease (DED), and to develop machine learning (ML) models for individualized outcome prediction.</p><p><strong>Methods: </strong>This retrospective study analyzed 100 eyes from 100 DED patients (aged 58.6 ± 13.4 years) treated with IPL and meibomian gland expression. Baseline parameters assessed with the Antares system included meibomian gland loss (MGL), tear meniscus height (TMH), non-invasive tear break-up time (NIBUT), conjunctival hyperemia, and Ocular Surface Disease Index (OSDI). Patients were stratified by change in OSDI after treatment (ΔOSDI): Class 1 (no improvement), Class 2 (mild improvement), and Class 3 (clear improvement). Several ML models were trained to predict ΔOSDI from baseline parameters.</p><p><strong>Results: </strong>IPL significantly improved both symptoms and signs. OSDI decreased from 44.65 ± 18.3 to 28.47 ± 19.3 (p < 0.001), NIBUT increased from 4.5 ± 3.2 to 7.5 ± 6.5 s (p < 0.001), and TMH and conjunctival hyperemia also improved (p < 0.001), while MGL and BCVA remained stable. Greater improvement was observed in patients with higher baseline OSDI (p = 0.001). The XGBoost algorithm achieved the highest predictive performance (AUC-ROC = 0.77), with OSDI and NIBUT as the strongest predictors based on SHAP analysis.</p><p><strong>Conclusions: </strong>IPL combined with meibomian gland expression improves symptoms and signs in DED, particularly in patients with more severe baseline symptoms. Baseline OSDI and NIBUT were the strongest predictors of response. ML models demonstrated moderate accuracy, supporting their potential role in personalized DED treatment strategies.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102514"},"PeriodicalIF":3.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of ambient illuminance and mobile phone screen brightness on tear film stability, visual fatigue, and blink patterns during reading.","authors":"Meng Lin, Xinkai Zheng, Charong He, Meng Li, Fan Lu, Liang Hu","doi":"10.1016/j.clae.2025.102515","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102515","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impacts of different ambient illuminance and screen brightness conditions on tear film stability, visual fatigue, and blink patterns during mobile phone reading.</p><p><strong>Methods: </strong>This prospective study involved 30 young subjects who completed 4 experiments based on ambient illuminance and screen brightness: Group 1: bright room, bright screen; Group 2: dark room, dark screen; Group 3: bright room, dark screen; Group 4: dark room, bright screen. Participants completed a 30-minute mobile phone reading task in each experiment. Tear film stability indicators, including fluorescein tear break-up time (FTBUT), noninvasive tear breakup time, tear meniscus height, and lipid layer thickness, were measured before and after reading. During reading, an infrared camera recorded blink-related parameters. Subjective questionnaires assessed comfort and visual fatigue.</p><p><strong>Results: </strong>After the reading task, the FTBUT of each group significantly decreased (all P < 0.05). Notably, all tear film stability indicators significantly changed in Group 4. The incomplete blink rate in all the groups tended to increase over time (all P < 0.05). Among the four groups, Group 4 had a significantly greater incomplete blink rate and partial blink ratio (P < 0.05), along with a greater subjective fatigue score, than did Group 1 (P < 0.01). The frequency of incomplete blinks (r = 0.29, P = 0.03) was positively correlated with the visual fatigue score.</p><p><strong>Conclusions: </strong>Reading in a dark environment with a bright screen led to the most significant instability of the tear film, visual fatigue, and changes in blink patterns. Therefore, it is advisable to avoid reading under such conditions.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102515"},"PeriodicalIF":3.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of different methods to image the tear film before and during contact lens wear.","authors":"Srikanth Dumpati, Mukesh Kumar, Ajay Kumar Vijay, Jacqueline Tan, Mark Willcox","doi":"10.1016/j.clae.2025.102511","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102511","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the repeatability and compare non-invasive tear breakup time (NIBUT) and tear film lipid layer thickness (TFLLT) measurements obtained using subjective (Keeler Tearscope-Plus) and objective (Oculus Keratograph 5M and LipiView II Interferometer) instruments before and during soft contact lens (CL) wear.</p><p><strong>Methods: </strong>This prospective, randomised, double-masked, crossover study involved ten healthy participants who wore two types of daily disposable soft CLs: hydrogel and silicone hydrogel. NIBUT and TFLLT were assessed under pre cornea (before lens insertion) and pre lens (over the lens) conditions. NIBUT was measured using Tearscope-Plus and the Oculus Keratograph 5M, while TFLLT was assessed with Tearscope-Plus and the LifpiView II Interferometer. Repeatability was evaluated using repeated-measures ANOVA within-subject standard deviation (Sw), coefficient of repeatability (CR), and intraclass correlation coefficient (ICC). Correlation between instruments was assessed using Spearman coefficients, while agreement was evaluated using Bland-Altman analysis.</p><p><strong>Results: </strong>NIBUT measured with the Tearscope-Plus demonstrated good to excellent repeatability (ICC: 0.84-0.96). TFLLT measured with the LipiView II Interferometer showed excellent repeatability (ICC: 0.92-0.96). The Oculus Keratograph 5M showed moderate to good repeatability for NIBUT (ICC: 0.67-0.85). No significant correlations were observed between NIBUT measurements from the Tearscope-Plus and Oculus Keratograph 5M (r range: 0.02-0.30; p > 0.05). In contrast, strong correlations were observed between TFLLT measurements from the Tearscope-Plus and LipiView II Interferometer in pre cornea (r = 0.72, p < 0.01) and pre hydrogel (r = 0.74, p = 0.02) conditions, with a moderate, non-significant correlation in the pre silicone hydrogel condition (r = 0.51, p = 0.13). Bland-Altman analysis revealed wide limits of agreement between instruments, indicating substantial measurements variability.</p><p><strong>Conclusion: </strong>Tearscope-Plus and LipiView II Interferometer demonstrated high repeatability for NIBUT and TFLLT, respectively. However, the Tearscope-Plus overestimated both NIBUT and TFLLT values compared to objective instruments, indicating that these instruments should not be used interchangeably in clinical practice or research.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102511"},"PeriodicalIF":3.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMI-global trends in myopia management attitudes and strategies in clinical practice - A nine-year review.","authors":"Yasmin Whayeb, James S Wolffsohn, Nicola S Logan, Jacinto Santodomingo-Rubido","doi":"10.1016/j.clae.2025.102492","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102492","url":null,"abstract":"<p><strong>Purpose: </strong>Surveys in 2015, 2019, and 2022 identified a high level of eye care practitioner activity and concern about pediatric myopia, reflected by an uptake of appropriate control techniques. This research provided updated information, examining global trends from 2015 to 2024.</p><p><strong>Methods: </strong>A self-administered, internet-based questionnaire was distributed in 18 languages to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy, prescribing of available strategies and barriers to adoption. Responses were compared with data from previous surveys.</p><p><strong>Results: </strong>A total of 2,993 practitioners responded in 2024. From 2015 to 2024, practitioner concern had increased in all continents besides Australasia (all p < 0.05), being consistently highest in Asia (8.4 ± 1.8 to 8.6 ± 1.9, respectively). Practitioner activity level had increased markedly in every continent (all p < 0.001), with the greatest change in North America (4.7 ± 3.0 to 7.1 ± 2.6, respectively). Perceived efficacy of soft contact lenses approved for myopia control more than doubled since 2015 (24.4 ± 25.0 % to 52.2 ± 24.0 %, p < 0.001). Combination therapy and orthokeratology were perceived to be the most efficacious interventions, yet single vision spectacles were the most prescribed option. However, the frequency of prescribing single vision spectacles had decreased since 2015 (by -11.1 %, p < 0.001). Globally, cost to the patient remained practitioners' primary reason for not prescribing myopia interventions.</p><p><strong>Conclusions: </strong>More practitioners are prescribing appropriate control methods to children with lower degrees of myopia than identified previously. However, consistent hindrances need addressing, namely increased affordability and accessibility of effective control options.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102492"},"PeriodicalIF":3.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized contralateral eye study of myopia control between aspheric multifocal soft contact lens and orthokeratology in children.","authors":"Ruru Chen, Tianhui Chen, Weiwei Lu, Yue Li, Jiawei Li, Tiankun Li, Hengli Lian, Siping Chen, Colm McAlinden, Xiaoying Wang, Jinhai Huang","doi":"10.1016/j.clae.2025.102508","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102508","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare myopia progression in children wearing an aspheric multifocal contact lens and an orthokeratology (OrthoK) lens.</p><p><strong>Methods: </strong>A total of 65 participants, aged 9.70 ± 1.31 years, were fitted with an OrthoK lens in one randomly assigned eye and a multifocal soft contact lens in the contralateral eye for the first 6 months (period 1). Following this, contact lens wear was discontinued in both eyes for 1 month, after which the two lens-wearing methods were swapped between eyes and continued for another 6 months (period 2). Axial length (AL), spherical equivalent refraction (SER), central corneal thickness (CCT), and central choroidal thickness (CChT) were measured at the 0-, 6-, 7-, 13-, and 14-month visits. AL and SER were the primary outcome measures.</p><p><strong>Results: </strong>For the OrthoK and multifocal soft lens, AL elongation was 0.14 ± 0.11 mm and 0.23 ± 0.12 mm, respectively, after period 1. AL elongation for the OrthoK and multifocal lens was 0.12 ± 0.19 mm and 0.20 ± 0.13 mm, respectively, after period 2. The SER change for the OrthoK and multifocal lens was -0.20 ± 0.27 D and -0.33 ± 0.30 D after period 1 and -0.26 ± 0.40 D and -0.36 ± 0.46 D after period 2, respectively. No significant differences were observed between the two treatment groups (all P > 0.05).</p><p><strong>Conclusions: </strong>During the 14-month observation period, no statistically significant differences in myopia progression were found between the aspheric multifocal contact lens and the OrthoK lens. Further longitudinal observation is necessary to characterize the disparities in long-term myopia-control efficacy between the two intervention strategies.</p><p><strong>Trial registration: </strong>ChiCTR, ChiCTR2000041520. Registered 27 December 2020, https://www.chictr.org.cn/ChiCTR2000041520. Retrospectively registered.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102508"},"PeriodicalIF":3.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleral shell prostheses in patient care: A survey of eyecare clinicians in New Zealand.","authors":"Janice P Yeoman, Brian H Sloan, Keith R Pine, Robert J Jacobs, Stuti L Misra","doi":"10.1016/j.clae.2025.102510","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102510","url":null,"abstract":"<p><strong>Purpose: </strong>Research to guide scleral shell practice is sparse with minimal evidence-based information available about indications and contraindications for shell wear, or the ideal wear and maintenance regimes. New Zealand optometrists, ophthalmologists and ocular prosthetists were surveyed to gauge current understanding.</p><p><strong>Methods: </strong>Topics queried included practitioner specialisation, judgements on the suitability and success of shells for different presentations of non-functional disfigured eyes, shell wear and maintenance protocols, and management of complications.</p><p><strong>Results: </strong>Responses from 140 optometrists, 50 ophthalmologists and 8 ocular prosthetists were collected. Optometrists and ophthalmologists observed that patients with non-functional disfigured eyes had an ocular prosthesis significantly less often than anophthalmic patients (∼30 % vs >90 %). Judgements from optometrists and ophthalmologists about shell suitability for different clinical presentations were wide ranging and inconsistent. Judgements from ocular prosthetists highlighted globe volume, corneal sensitivity and corneal integrity as key factors determining shell wear success. Keratitis and discomfort with shell wear were of high concern to both optometrists and ophthalmologists. Optometrists and ocular prosthetists most frequently reported that shells should be disinfected daily with no overnight wear, while ophthalmologists provided heterogeneous recommendations.</p><p><strong>Conclusions: </strong>There are significant inconsistencies among and between ophthalmologists and optometrists in the provision, care and maintenance of scleral shells. Ocular prosthetists in New Zealand do not have the necessary scope of practice to care for patients' eye health once they have fabricated and fitted a scleral shell. The consequence of these combined factors is that people with blind disfigured eyes in New Zealand are sub-optimally managed. This survey provides a foundation for developing interdisciplinary consensus guidelines on scleral shell provision and maintenance in New Zealand.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102510"},"PeriodicalIF":3.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}