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Soft Contact Lens-Related Dryness with and without Clinical Signs

Young, Graeme; Chalmers, Robin; Napier, Leslie; Kern, Jami; Hunt, Chris; Dumbleton, Kathryn

doi: 10.1097/OPX.0b013e3182640af8
Original Articles

Purpose. To report demographics, wearing patterns, and symptoms from soft contact lens (SCL) wearers with significant SCL-related dryness symptoms with and without significant ocular signs of dryness.

Methods. In a multicenter, prospective observational clinical trial, symptomatic SCL wearers reported significant SCL-related dryness via self-administered questionnaire of frequency and intensity of dryness after a dry eye (DE) examination. DE etiology was assigned post hoc by an expert panel, and those with and without significant DE-related signs were analyzed by univariate logistic regression. Possible DE etiologies were aqueous tear deficiency, SCL-induced tear instability, meibomian gland dysfunction, or “other.” Wearers without signs that qualified for any DE etiology were designated as No DE Signs (NDES).

Results. Of the 226 SCL symptomatic wearers examined, 23% were without signs, 30% had aqueous tear deficiency, 25% had SCL-induced tear instability, 14% had meibomian gland dysfunction, and 8% had “other” diagnoses. The NDES wearers had significantly longer pre-lens break-up time (9.8 vs. 6.6 s, p < 0.0001), better lens wetting (3.4 vs. 2.4 0 to 4 scale, p < 0.0001), lower levels of film deposits on lenses (0.45 vs. 0.92, 0 to 4 scale, p < 0.0001), and of most slit lamp signs. The NDES wearers were significantly more likely to be male (36% vs.19%, p = 0.013), were less likely to have deteriorating comfort during the day (81% vs. 97%, p = 0.001), reported longer average hours of comfortable wear (11 ± 3 vs. 9 ± 4 h, p = 0.014), had older contact lenses (18 ± 14 vs. 13 ± 12 days, p = 0.029), and greater intensity of photophobia early and late in the day (p = 0.043 and 0.021).

Conclusions. Symptoms of dryness in SCL wearers stem from a variety of underlying causes. However, nearly one-quarter of these symptomatic SCL wearers appear to be free of signs of dryness. The effective management of CL-related dryness requires a comprehensive range of clinical assessments and the use of a diverse range of management strategies.

*PhD, FCOptom, FAAO

OD, FAAO

PhD

§PhD, MBA

MSc

MSc, MCOptom, FAAO

Visioncare Research Ltd, Farnham, United Kingdom (GY, CH), Clinical Trial Consultant, Atlanta, Georgia (RC), Alcon Research, Fort Worth, Texas (LN, JK), and Centre for Contact Lens Research, University of Waterloo, Waterloo, Ontario, Canada (KD).

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.optvissci.com).

Received December 19, 2011; accepted April 26, 2012.

Robin L. Chalmers 2097 East Lake Rd Atlanta, GA e-mail: chalmers2097@gmail.com

© 2012 American Academy of Optometry