Contact Lens & Anterior Eye最新文献

{"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}

{"title":"Diagnostic accuracy in dry eye: Insights into clinical and artificial intelligence limitations: Limitations of diagnostic accuracy in dry eye.","authors":"Germán Mejía-Salgado, William Rojas-Carabali, Carlos Cifuentes-González, María Andrea Bernal-Valencia, Paola Saboya-Galindo, Jaime Soto-Ariño, Valentina Dumar-Kerguelen, Guillermo Marroquín-Gómez, Martha Lucía Moreno-Pardo, Juliana Tirado-Ángel, Anat Galor, Alejandra de-la-Torre","doi":"10.1016/j.clae.2025.102509","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102509","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the agreement and performance of four large language models (LLMs)-ChatGPT-3.5, ChatGPT-4.0, Leny-ai, and MediSearch-in diagnosing and classifying Dry Eye Disease (DED), compared to clinician judgment and Dry Eye Workshop-II (DEWS-II) criteria.</p><p><strong>Methods: </strong>A standardized prompt incorporating retrospective clinical and symptomatic data from patients with suspected DED referred to a dry eye clinic was developed. LLMs were evaluated for diagnosis (DED vs. no DED) and classification (aqueous-deficient, evaporative, mixed-component). Agreement was assessed using Cohen's-kappa (Cκ) and Fleiss'-kappa (Fκ). Balanced accuracy, sensitivity, specificity, and F1 score were calculated.</p><p><strong>Results: </strong>Among 338 patients (78.6 % female, mean age 53.2 years), clinicians diagnosed DED in 300, and DEWS-II criteria identified 234. LLMs showed high agreement with clinicians for DED diagnosis (93 %-99 %, Cκ: 0.81-0.86). Subtype agreement was lower (aqueous-deficient: 0 %-18 %, evaporative: 4 %-80 %, mixed-component: 22 %-92 %; Fκ: -0.20 to -0.10). Diagnostic balanced accuracy was 48 %-56 %, with high sensitivity (93 %-99 %) but low specificity (0 %-16 %). Subtype balanced accuracy and F1 score ranged from 33 %-81 % 0 %-71 %, respectively. Compared to DEWS-II, agreement for DED diagnosis remained high (96 %-99 %) but with weaker Cκ (0.52-0.58). Subtype agreement was again low (aqueous-deficient: 0 %-20 %, evaporative: 9 %-68 %, mixed-component: 16 %-75 %; Fκ: -0.09 to -0.02). Diagnostic balanced accuracy was 49 %-56 %, sensitivity 97 %-99 %, and specificity 5 %-16 %. Subtype balanced accuracy ranged from 43 % to 56 %, F1 score 0-68.</p><p><strong>Conclusion: </strong>LLMs showed strong agreement and high sensitivity for DED diagnosis but limited specificity and poor subtype classification, mirroring clinical challenges and highlighting risks of overdiagnosis.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102509"},"PeriodicalIF":3.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070921","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":"Dehydration kinetics of soft contact lenses: The hidden impact of early wear.","authors":"Silvia Tavazzi, Anna Galli, Francesco Maspero, Giulia Carlotta Rizzo, Fabrizio Zeri, Erika Ponzini","doi":"10.1016/j.clae.2025.102512","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102512","url":null,"abstract":"<p><p>In contact lens (CL) wear, maintaining adequate CL hydration is essential to prevent ocular dryness and associated discomfort. In this context, dehydration of worn Etafilcon A and Kalifilcon A CLs hydrated by natural tears was monitored using an in-vitro gravimetric method. A kinetic model was applied to derive the water kinetics coefficient, which emerged as a reliable indicator of the on-eye hydration state and water diffusion mechanisms. A significant reduction in water content and a tendency from a polymer-hindered water diffusion toward free diffusion were observed after just five minutes of wear, suggesting a rapid initial adaptation to the ocular environment that alters the material resistance to water evaporation. After two hours of wear, a similar effect was evident in approximately half of the samples investigated, indicating that a new hydration equilibrium may eventually be reached over time.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102512"},"PeriodicalIF":3.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066077","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":"Reliability and readability of online patient information for contact lens wearers.","authors":"Genis Cardona, Carla Vega","doi":"10.1016/j.clae.2025.102513","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102513","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the reliability and readability of online patient information regarding contact lens (CL) wear and maintenance, given that many users may employ these resources to supplement or replace professional advice.</p><p><strong>Methods: </strong>Ten frequently asked questions (FAQs) concerning CL wear and maintenance were formulated based on clinical experience and literature search. Each FAQ was used to query Google, and the first 20 eligible websites were analysed, yielding a final sample of 200 websites. Reliability was assessed using the short version of the Ensuring Quality Information for Patients (EQIP) tool, while readability was evaluated through the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL) tests. Websites were classified by country of origin and source type. Non-parametric group contrast and variable correlation analyses were conducted.</p><p><strong>Results: </strong>The median EQIP score was 68.0 % (range 29.0 %-90.0 %), with 30.0 % of websites providing high-quality content (≥75 %). Websites from encyclopaedias and medical centres/hospitals scored higher in reliability compared to commercial and practitioner sources (p < 0.05). Readability was generally poor, with mean FRES and FKGL values of 55.8 ± 11.3 and 9.9 ± 2.3, respectively, exceeding recommended reading levels. Unexplained technical jargon was found in 59.5 % of websites. Encyclopaedias demonstrated better readability scores than news centres (p = 0.036). A weak but significant inverse correlation was found between EQIP and FRES scores (rho = -0.215; p = 0.002), indicating that higher reliability was associated with slightly better readability.</p><p><strong>Conclusion: </strong>Overall, online patient information regarding CL wear and maintenance evidenced moderately high reliability but insufficient readability. Contact lens wearers may find this information difficult to understand, leading to poor compliance and potential ocular complications. Given the critical role of online resources in patient education, eye care professionals should guide patients towards reliable, comprehensible websites and consider modern communication strategies to enhance compliance and safety in CL wear.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102513"},"PeriodicalIF":3.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066143","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":"Proteomic analysis of tear fluid: Comparative short-term effects of scleral lenses and rigid corneal lenses wear in ametropic healthy adults.","authors":"Zhe Zhang, Li Zeng, Qihua Le, Yanze Yu, Jiaqi Zhou, Feng Xue, Xingtao Zhou, Jiaxu Hong, Zhi Chen","doi":"10.1016/j.clae.2025.102507","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102507","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the effect of scleral lenses (SLs) on the ocular surface of healthy individuals and explore potential molecular changes in the tear fluid reservoir associated with this form of contact lens.</p><p><strong>Methods: </strong>Forty-one healthy Chinese subjects were enrolled in the prospective study and assigned to wear SLs or rigid corneal lenses (RCL), and their ocular surface was evaluated at various time points over one month period. Hyperemia, tear film stability, and molecular changes in tear fluid were assessed. Tandem mass tagging proteomics analysis was used to identify differentially expressed proteins in tears after wearing different lenses.</p><p><strong>Results: </strong>There were no statistically significant differences observed in in the hyperemia index of the nasal and temporal ciliary vessel areas, as well as the nasal and temporal conjunctival vessel areas between groups. The difference in tear film stability between the two groups was not statistically significant. However, proteomic analysis of tear samples revealed 397 differentially expressed proteins in the SLs group, including pro-inflammatory markers such as interleukins. Pathway analysis identified upregulation of inflammation-related pathways.</p><p><strong>Conclusions: </strong>SLs wear does not significantly impact hyperemia and tear film stability compared to RCL. Nevertheless, at the molecular level, there is evidence showing an underlying inflammatory response. These findings require continued research to elucidate the clinical implications of these molecular changes and to guide SLs fitting.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102507"},"PeriodicalIF":3.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041868","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":"Impact of orthokeratology lens decentration on axial length growth in Chinese myopic children: A meta-analysis.","authors":"Yi-Ming Guo, Jiaqi Wang, Jiejing Bi, Juan Huang, Junhan Wei, Yijin Han, Lu Ye","doi":"10.1016/j.clae.2025.102493","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102493","url":null,"abstract":"<p><strong>Background: </strong>Orthokeratology (OK) lenses have become a prevalent intervention for myopia control. However, lens decentration, a frequent complication, may influence the efficacy of myopia control. The aim of this study was to systematically assess the impact of OK lens decentration on axial length growth (ALG) in Chinese myopic children through a meta-analysis.</p><p><strong>Methods: </strong>We conducted a meta-analysis to evaluate the effect of OK lens decentration on ALG in myopic children. Relevant studies were identified through comprehensive searches in databases, including PubMed, Embase, and the Cochrane Library, for publications from 2000 to 2024. The primary outcome was the standardized mean difference (SMD) in ALG between the centered and decentered lens groups. Heterogeneity was assessed using the Cochrane Q test and I² statistics, while publication bias was examined using funnel plots and visual inspection.</p><p><strong>Results: </strong>A total of nine retrospective studies, encompassing 1503 participants aged 8-15 years, met the inclusion criteria. Six studies with 12-month data were included in the primary analysis, showing a significant reduction in ALG in the decentered group (SMD = -0.45, 95 % CI: -0.66 to -0.24, p < 0.0001), with moderate heterogeneity (I² = 59.1 %). Subgroup analyses by publication year and sample size revealed temporal and methodological variations, with studies from earlier years showing more pronounced reductions in ALG. Sensitivity analysis confirmed the robustness of the results, with slight variations in the pooled effect size. At 24 months, three studies demonstrated a significant reduction in ALG (SMD = -0.46, 95 % CI: -0.68 to -0.24, p < 0.0001), with negligible heterogeneity (I² = 0 %). Potential publication bias was suggested by the funnel plot, particularly due to one outlier study.</p><p><strong>Conclusion: </strong>OK lens decentration significantly reduces ALG in myopic children, indicating its potential efficacy in myopia control. However, moderate heterogeneity was observed, which may be attributed to variations in study designs and sample characteristics. Further research with larger sample sizes and extended follow-up periods is necessary to validate these findings.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102493"},"PeriodicalIF":3.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034362","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":"Depression, anxiety, stress, and dry eye disease among Gazan undergraduate health sciences and nursing students: a structural equation modeling study.","authors":"Mohammed Aljarousha, Mohd Zulfaezal Che Azemin, Indang Ariati Ariffin, Mohammed Abdelfatah Alhoot, Abdelraouf A Elmanama, Hatem H Alsaqqa, Yousef Aljeesh, Mohd Zaki Awg Isa, Mia Yang Ang, Waleed M Alghamdi, Hussam Abdeljabar Ahmad Mizher, Emad I H Shaqoura","doi":"10.1016/j.clae.2025.102504","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102504","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate associations between dry eye disease (DED) symptoms and psychological distress (depression, anxiety, stress) among undergraduate health sciences and nursing students in the Gaza Strip during the 2023-2025 conflict period.</p><p><strong>Methods: </strong>A cross-sectional study used convenience sampling via WhatsApp and face-to-face interviews between 4 February and 29 April 2025. Participants completed a demographic form, the Arabic Ocular Surface Disease Index (OSDI), and the Arabic Depression Anxiety Stress Scale-8 (DASS-8). Analyses included descriptive statistics, group comparisons, correlations, and structural equation modeling (SEM) with interaction terms; sex was included as a covariate, and academic year was examined as an exploratory moderator of distress-symptom associations.</p><p><strong>Results: </strong>Data from 282 students (190 female, 92 male) were analyzed. OSDI scores were skewed upward (median 25.0, IQR 16.67-33.33). Using OSDI > 12, symptomatic DED prevalence was 87.9 %. OSDI correlated with depression (r = 0.37), anxiety (r = 0.44), and stress (r = 0.56), all p < 0.001. SEM indicated a stronger unique association for stress and a smaller, significant association for depression; moderation by academic year was not statistically significant. The classifier achieved good discrimination for symptomatic status (AUC = 0.829).</p><p><strong>Conclusion: </strong>Among Gazan health sciences and nursing students, DED symptoms were common and associated with psychological distress-particularly stress and, to a lesser extent, depression. Sex and academic year did not show robust effects. Findings support considering mental health within DED management for students in conflict settings.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102504"},"PeriodicalIF":3.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031041","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":"Are scleral lenses underutilized? A call for greater awareness among healthcare professionals.","authors":"Maria K Walker","doi":"10.1016/j.clae.2025.102496","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102496","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102496"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006796","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":"Diagnostic criteria for meibomian gland dysfunction: A prospective registry-based external validation analysis.","authors":"Michael T M Wang, Jordan M Cooper, Catherine J Jennings, Barry Power, James S Wolffsohn, Jennifer P Craig","doi":"10.1016/j.clae.2025.102487","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102487","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102487"},"PeriodicalIF":3.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975856","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":"Letter to the editor RE \"Improved control efficacy of a novel aspherical orthokeratology lens compared with the traditional three-zone spherical lens in a single-blind randomized clinical trial\".","authors":"Dr Parth Aphale, Himanshu Shekhar, Shashank Dokania","doi":"10.1016/j.clae.2025.102495","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102495","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102495"},"PeriodicalIF":3.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975944","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}