- Email: [email protected]
Tear film parameters in challenging environments
Abstracts / Contact Lens & Anterior Eye 35S (2012) e33–e50
Tear film parameters in challenging environments Sheila Rae ∗ , Gurpal Flora Anglia Ruskin University, UK E-mail address: [email protected] (S. Rae). Purpose: Despite advances in materials, discomfort and dryness symptoms are still frequently reported as reasons for dissatisfaction with or discontinuation of soft contact lens wear. Such symptoms are frequently reported in lens wearers and non-wearers in challenging environments. The effect over time of two challenging environments on tear film stability and quantity was tested. Method: Tear film parameters were assessed over a 60 min period in a custom built walk-in environmental chamber (Weiss Gallenkamp, UK) which controls temperature (◦ C) and relative humidity (%RH) independently. Environments tested were: (i) ‘indoor office’ at 21C and 30% RH; (ii) ‘aircraft cabin’ at 21C and 10%RH. Tear film stability was assessed using non-invasive reflected grid observation scored in seconds as time to first distortion of the grid pattern. Tear film quantity was assessed by tear meniscus height measured in mm using on-screen callipers (Ionico) from captured digital slit lamp images. Phenol red threads were scored in mm of wetted strip in 15 s. Ten subjects participated with the two environments tested on different days. Results: Tear film stability significantly reduced following 55 min in ‘indoor office’ (p = .018) but not for ‘aircraft cabin’ (p = .110). Tear meniscus height decreased significantly following 15 min in ‘aircraft cabin’ (p = .028) but no significant change was found for ‘indoor office’. Phenol red thread tests gave no significant change in results for either environment. Conclusions: Both tear film stability and quantity were progressively adversely affected over time by low humidity environments. Strategies to increase humidity or reduce evaporation are required to offset effects on the tear film. FRIDAY MAY 25, 2012 CONFERENCE SESSION 13: CET SPOTLIGHT: THE OPPORTUNITY WITH AND FOR YOUNG WEARERS, HALL 4, 15:00–17:30 ACCREDITED FOR 1 CL CET – DISPENSING OPTICIANS/CONTACT LENS SPECIALISTS/OPTOMETRISTS COPE 34166-CL CET Spotlight: The opportunity with and for young wearers
http://dx.doi.org/10.1016/j.clae.2012.10.028 CHAIR: DR JEFF WALLINE Simon Donne 1,∗ , Bruce J.W. Evans 2 , Carol Lakkis 3 , Sarah Morgan 4 1
Simon Donne Opticians, UK Institute of Optometry, London, UK 3 JJVCI, UK 4 Staff Development Consultant, Manchester, UK E-mail address: [email protected] (S. Donne). 2
Fitting children can be rewarding in addition to generating patients for life and being an excellent source of referrals. There is also evidence of the positive life-changing effects that lens wear has on young people, so in addition to the practice and revenue building opportunities, fitting children also provides professional satisfaction. This session will summarise how to communicate effectively with young wearers and their parents, and the potential benefits of fitting children to both patient and practitioner. It will also address the potential issue of non-compliance in the younger wearer, and latest thinking on myopia control will be reviewed, including success with a range of lens options and environmental factors. The
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session will conclude by looking at the opportunities for practice growth with fitting these younger patients. http://dx.doi.org/10.1016/j.clae.2012.10.029 Introduction Jeff Walline (Chair) Communicating lens wear for children – bothsides of the equation Sarah Morgan Fitting younger wearers? It’s child’s play Professor Bruce Evans Are young wearers less compliant? Dr Carol Lakkis Contact lens myopia control Dr Jeff Walline How young wearers can improve practice profitability Simon Donne FRIDAY MAY 25, 2012 CONFERENCE SESSION 14: BCLA SEMINAR: DRY EYE TOOLkIT, HALL 5, 09:00–13:00 ACCREDITED FOR 2 CL CET – DISPENSING OPTICIANS/CONTACT LENS SPECIALISTS/OPTOMETRISTS
http://dx.doi.org/10.1016/j.clae.2012.10.030 Dry eye toolkit—Best practice approach Caroline Christie 1,∗ , Bo Lauenborg Boptom 2 , Teifi James 3 , Jennifer Craig 4 1
CooperVision, UK Kontaklinse Instituttet, Aarhus, Denmark 3 Calderdale Royal Hospital, Halifax, West Yorkshire, UK 4 University of Auckland, New Zealand E-mail address: [email protected] (C. Christie). 2
CHAIR: DR GRAEME YOUNG Type “Dry Eye” into Google search engine, result >½ million hits ranging from comprehensive overviews of signs & symptoms, diagnosis and management to chat rooms, support groups and blogs. Companies manufacturing pharmaceuticals, over-the-counter artificial tears and other treatment devices have entire Web sites dedicated to dry eye. The session will show it is well within the clinical competencies of ECPs to manage “dry eye”, in most instances patients do not require referral to the GP/ophthalmologist. Many practitioners see patients for no more than 20–30 min when collecting contact lenses or 30 min over an entire year, in the case of annual eye examinations. How can they possibly expect to correctly identify a patient’s problem and confidently recommend a management approach? Often recommendations are not followed through, leading to similar or even increased symptoms by the next appointment. Sound familiar? The patient journey in the form of a – “dry eye work-up” – will be outlined as a means not only to improve detection & management of dry eye but as monitoring tool for subsequent outcomes on advice and therapies. Best practice, in ways to educate patients to ensure they remember key messages and comply to enhance outcomes will be discussed. The concept of a dedicated member of staff, “the optical hygienist” trained in dealing with dry eye management; insertion of the actual drops, lid hygiene techniques and associated products as well as frequently asked questions (FAQs) is a major asset in time man-
Tear film parameters in challenging environments Sheila Rae ∗ , Gurpal Flora Anglia Ruskin University, UK E-mail address: [email protected] (S. Rae). Purpose: Despite advances in materials, discomfort and dryness symptoms are still frequently reported as reasons for dissatisfaction with or discontinuation of soft contact lens wear. Such symptoms are frequently reported in lens wearers and non-wearers in challenging environments. The effect over time of two challenging environments on tear film stability and quantity was tested. Method: Tear film parameters were assessed over a 60 min period in a custom built walk-in environmental chamber (Weiss Gallenkamp, UK) which controls temperature (◦ C) and relative humidity (%RH) independently. Environments tested were: (i) ‘indoor office’ at 21C and 30% RH; (ii) ‘aircraft cabin’ at 21C and 10%RH. Tear film stability was assessed using non-invasive reflected grid observation scored in seconds as time to first distortion of the grid pattern. Tear film quantity was assessed by tear meniscus height measured in mm using on-screen callipers (Ionico) from captured digital slit lamp images. Phenol red threads were scored in mm of wetted strip in 15 s. Ten subjects participated with the two environments tested on different days. Results: Tear film stability significantly reduced following 55 min in ‘indoor office’ (p = .018) but not for ‘aircraft cabin’ (p = .110). Tear meniscus height decreased significantly following 15 min in ‘aircraft cabin’ (p = .028) but no significant change was found for ‘indoor office’. Phenol red thread tests gave no significant change in results for either environment. Conclusions: Both tear film stability and quantity were progressively adversely affected over time by low humidity environments. Strategies to increase humidity or reduce evaporation are required to offset effects on the tear film. FRIDAY MAY 25, 2012 CONFERENCE SESSION 13: CET SPOTLIGHT: THE OPPORTUNITY WITH AND FOR YOUNG WEARERS, HALL 4, 15:00–17:30 ACCREDITED FOR 1 CL CET – DISPENSING OPTICIANS/CONTACT LENS SPECIALISTS/OPTOMETRISTS COPE 34166-CL CET Spotlight: The opportunity with and for young wearers
http://dx.doi.org/10.1016/j.clae.2012.10.028 CHAIR: DR JEFF WALLINE Simon Donne 1,∗ , Bruce J.W. Evans 2 , Carol Lakkis 3 , Sarah Morgan 4 1
Simon Donne Opticians, UK Institute of Optometry, London, UK 3 JJVCI, UK 4 Staff Development Consultant, Manchester, UK E-mail address: [email protected] (S. Donne). 2
Fitting children can be rewarding in addition to generating patients for life and being an excellent source of referrals. There is also evidence of the positive life-changing effects that lens wear has on young people, so in addition to the practice and revenue building opportunities, fitting children also provides professional satisfaction. This session will summarise how to communicate effectively with young wearers and their parents, and the potential benefits of fitting children to both patient and practitioner. It will also address the potential issue of non-compliance in the younger wearer, and latest thinking on myopia control will be reviewed, including success with a range of lens options and environmental factors. The
e41
session will conclude by looking at the opportunities for practice growth with fitting these younger patients. http://dx.doi.org/10.1016/j.clae.2012.10.029 Introduction Jeff Walline (Chair) Communicating lens wear for children – bothsides of the equation Sarah Morgan Fitting younger wearers? It’s child’s play Professor Bruce Evans Are young wearers less compliant? Dr Carol Lakkis Contact lens myopia control Dr Jeff Walline How young wearers can improve practice profitability Simon Donne FRIDAY MAY 25, 2012 CONFERENCE SESSION 14: BCLA SEMINAR: DRY EYE TOOLkIT, HALL 5, 09:00–13:00 ACCREDITED FOR 2 CL CET – DISPENSING OPTICIANS/CONTACT LENS SPECIALISTS/OPTOMETRISTS
http://dx.doi.org/10.1016/j.clae.2012.10.030 Dry eye toolkit—Best practice approach Caroline Christie 1,∗ , Bo Lauenborg Boptom 2 , Teifi James 3 , Jennifer Craig 4 1
CooperVision, UK Kontaklinse Instituttet, Aarhus, Denmark 3 Calderdale Royal Hospital, Halifax, West Yorkshire, UK 4 University of Auckland, New Zealand E-mail address: [email protected] (C. Christie). 2
CHAIR: DR GRAEME YOUNG Type “Dry Eye” into Google search engine, result >½ million hits ranging from comprehensive overviews of signs & symptoms, diagnosis and management to chat rooms, support groups and blogs. Companies manufacturing pharmaceuticals, over-the-counter artificial tears and other treatment devices have entire Web sites dedicated to dry eye. The session will show it is well within the clinical competencies of ECPs to manage “dry eye”, in most instances patients do not require referral to the GP/ophthalmologist. Many practitioners see patients for no more than 20–30 min when collecting contact lenses or 30 min over an entire year, in the case of annual eye examinations. How can they possibly expect to correctly identify a patient’s problem and confidently recommend a management approach? Often recommendations are not followed through, leading to similar or even increased symptoms by the next appointment. Sound familiar? The patient journey in the form of a – “dry eye work-up” – will be outlined as a means not only to improve detection & management of dry eye but as monitoring tool for subsequent outcomes on advice and therapies. Best practice, in ways to educate patients to ensure they remember key messages and comply to enhance outcomes will be discussed. The concept of a dedicated member of staff, “the optical hygienist” trained in dealing with dry eye management; insertion of the actual drops, lid hygiene techniques and associated products as well as frequently asked questions (FAQs) is a major asset in time man-