The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc 

About: The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc is an academic journal. The journal publishes majorly in the area(s): Contact lens & Lens (optics). It has an ISSN identifier of 0733-8902. Over the lifetime, 727 publications have been published receiving 15035 citations.

Lid-wiper epitheliopathy and dry-eye symptoms in contact lens wearers.

Abstract: Purpose To evaluate whether dry-eye symptoms are associated with epitheliopathy of that portion of the upper eyelid marginal conjunctiva-the lid wiper-that wipes the ocular, or contact lens surface, during blinking Methods Subjects were divided into two groups based on the presence or absence of dry-eye symptoms The lid wiper of asymptomatic (n=75) and symptomatic (n=30) soft contact lens wearers was examined, following the instillation of fluorescein and rose bengal dyes Lid-wiper staining was graded zero to 3 Results Eighty percent of the symptomatic subjects displayed lid-wiper staining compared to 13% of the asymptomatic subjects The difference in staining between the two groups was significant (P<00001) Of the symptomatic subjects, 20% showed no staining; 266%, grade 1 staining; 366%, grade 2; and 166% showed grade 3 staining Of the asymptomatic subjects, 87% exhibited no staining; 9%, grade 1 staining; 3%, grade 2; and 1% showed grade 3 staining Conclusions This study describes a new clinical condition, lid-wiper epitheliopathy, an alteration of the epithelium of that portion of the marginal conjunctiva of the upper eyelid that wipes the ocular surface, diagnosed by staining with fluorescein and rose bengal dyes

Physiologic changes of the cornea with contact lens wear.

Abstract: Purpose This article reviews the corneal changes resulting from the hypoxia that occurs during sleep and specifically during contact lens wear. Methods Discussion includes a literature review and observations regarding the changes to the corneal epithelium, stroma, and endothelium that take place during sleep and wearing of contact lenses made from different materials. Results Hypoxia and hypercapnia cause significant changes to the corneal epithelium, stroma, and endothelium. Some of these changes can also be seen following the sleep cycle. Epithelial changes include decreased metabolic rate, morphologic changes, microcysts, changes in junctional integrity, decreased corneal sensation, and pannus formation. Stromal changes include stromal edema, stromal acidosis, neovascularization, and changes in corneal shape and, ultimately, corneal thinning. Endothelial changes include bleb formation, polymegethism, changes in endothelial cell density, and possible changes in endothelial function. Conclusions There are multiple and significant corneal changes resulting from hypoxia and hypercapnia. These changes vary with the specific lens style. The high-oxygen-permeable contact lenses recently introduced may overcome some of these problems.

Confocal microscopy of the living eye.

Abstract: Confocal microscopy is an imaging paradigm that allows optical sectioning of almost any material with increased axial and lateral spatial resolution and better image contrast. We have applied this technology to the study of the living eye of cats, albino rabbits, and humans. The technique allows in vivo, noninvasive, real time images of the eye at magnifications (630x) which allow resolution of anatomical detail at the cellular level. In this paper we report details of our current instrument techniques and some of our results. The past development, present state-of-the-art, and projected future advances and applications of this novel microscopy are discussed. Preliminary observations are reported for all layers of the cornea, the limbus, and wound-healing responses in single animals.

Gram-negative bacteria can induce contact lens related acute red eye (CLARE) responses.

Abstract: Purpose : Twelve volunteers participated in a study designed to measure the overnight corneal edema response with a variety of hydrogel contact lenses. During the study four subjects (5 eyes) experienced a contact lens related acute red eye (CLARE) reaction, which manifested as severe ocular pain, photophobia, corneal infiltration, and conjunctival hyperemia. An additional five subjects (7 eyes) developed corneal infiltrates only. Twelve eyes (of 9 subjects) showed no response. Methods and Results : Upon microbiological examination of the contact lenses and storage solutions, gram-negative bacteria were isolated in large amounts. The bacteria were identified as Serratia marcescens, Pseudomonas putida, and Pseudomonas aeruginosa. Significantly greater numbers of bacteria were isolated from contact lenses of subjects who experienced CLARE than from the other subjects (P = 0.005) and from the contact lenses of subjects who experienced an adverse reaction (CLARE or infiltrates) than from the other subjects (P < 0.001). The contaminating bacteria are thought to have been introduced to the lens storage vials as a result of lens handling and subsequent failure to disinfect lenses. Conclusions : This study draws attention to the possible contribution of contaminated lenses and storage cases in contact lens related acute inflammation and specifically implicates gram-negative bacteria, in particular Pseudomonas spp. and Serratia spp., in the inducement of acute inflammatory reactions such as CLARE.