Issue 71 of Contact Lens Update Now Available

WATERLOO, ONTARIO, May 1, 2023—Addressing the rapidly-evolving importance of biometry in myopia management, the Centre for Ocular Research & Education (CORE) has dedicated Issue 71 of Contact Lens Update to the topic. Four international experts offer timely, clinically-relevant perspectives that eye care professionals can employ in their practices for equipment selection, axial length assessment, and outcomes interpretation. The latest edition and all past issues are available for free at ContactLensUpdate.com.

“With global myopia prevalence estimated to reach 50% by the year 2050, more effectively controlling and managing the disease has captured the attention of the optometry and ophthalmology communities like few other issues,” said CORE Director Lyndon Jones. “This issue of Contact Lens Update is designed to help our clinical peers better understand several aspects of biometry and axial length, in a succinct format that can be read in a matter of minutes.”

Debbie Jones, clinical professor at the University of Waterloo School of Optometry & Vision Science and lead clinical scientist at CORE, authors the opening editorial. She summarizes several multifunction instruments that are becoming mainstays in clinical settings, each capable of supplying a wealth of information to support management of young myopic patients.

The feature article from Marielle Reidy, a pediatric optometrist and a PhD candidate conducting myopia research at the Ohio State University, discusses the results of a study assessing the potential of ocular biometrics and uncorrected visual acuity for detecting myopia. She writes that “some biometric measures taken under noncycloplegic conditions can serve as useful screening tools for myopia detection, when cycloplegic refractive assessment is not possible. Axial length, the AL/CR ratio, or the AL/CR ratio in combination with UCVA can all detect myopia with good success.”

Gareth Lingham, an orthoptist and postdoctoral fellow at the Centre for Eye Research Ireland, shares results from his poster first presented at the Association for Research in Vision and Ophthalmology (ARVO) 2022 annual meeting. This study assessed the performance of a machine learning-based algorithm in estimating axial length by using age, sex, spherical refractive error, astigmatism and corneal radius of curvature data. The outcomes highlight the potential for new technologies to be employed when biometry is unavailable.

Also included in this issue is a clinical insight by Jason Compton, owner of Compton Eye Associates in the New York City area and assistant adjunct faculty of the SUNY College of Optometry. His downloadable practitioner resource provides a useful overview of the benefits of optical biometry over ultrasound for measuring axial length.

Published six times per year, Contact Lens Update provides a global platform for unbiased clinical insights based in current research. Since 2011, each issue has provided dependable and up-to-date ocular health information for more than 60,000 leading eye care professionals.

In addition to a complete archive of back issues, ContactLensUpdate.com offers a resource library that provides no-cost professional tools, patient resources, images and video. It also houses complimentary technical training videos produced by International Association of Contact Lens Educators, plus an industry glossary. Industry professionals can access the latest issue directly from ContactLensUpdate.com or quickly sign up for email receipt of future issues.

The publication receives support from the educational arms of Alcon, CooperVision, and Johnson & Johnson Vision.

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About the Centre for Ocular Research & Education (CORE)
The Centre for Ocular Research & Education (CORE) was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

MEDIA CONTACTS
Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA, FAAO
McDougall Communications for CORE
aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.545.1815

WATERLOO, ONTARIO, April 25, 2023—The Centre for Ocular Research & Education (CORE) has received the Public Education Award from the Ontario Association of Optometrists (OAO), which honors members for outstanding contributions in public education and awareness campaigns and activities. CORE was specifically recognized for promoting eye health and safety, including providing scientifically-sound information to consumers during the pandemic and efforts to slow the progression of myopia through myopia control methods.

“The real heroes behind this honor are the people of CORE, practitioners with whom we partner, and sponsors who have contributed to our professional and public education platforms over the past several decades. It’s wonderful to see their work and the impact acknowledged,” said Lyndon Jones, CORE’s director.

At the start of the COVID-19 pandemic, CORE led the world’s first global response to  misinformation about contact lens wear, setting the entire industry on a path to recovery. In only 30 days, CORE replaced falsehoods with facts for both consumers and eye care professionals, with its guidance appearing in more than 6,000 media outlets across 55 countries.

Months later, CORE was instrumental in raising practitioner and public awareness of mask-associated dry eye. Through a series of papers and columns, easy-to-grasp infographics, and media interviews in more than 2,500 news outlets on six continents, the initiative drove global understanding of the cause and simple actions to mitigate onset. In tandem, CORE collaborated with The Conversation Canada to publish a story about not neglecting eye care as the pandemic continued—reaching millions of consumers in Canada, the U.S., and English- and French-speaking overseas countries.

More recently, CORE pivoted from pandemic-related public education to two of the most discussed topics in eye health—childhood myopia and dry eye. CORE’s work helped inform parents and encouraged them to seek comprehensive eye exams for their children. Additionally, the CORE team helped bring attention to the challenge through employers, who in many cases are positioned to influence action through benefits plans. On the dry eye front, CORE collaborated again with The Conversation to share information and discuss the crucial role of optometrists in helping deliver sustained relief.

In any given year, CORE delivers countless in-person and virtual lectures, papers and posters, and produces a bi-monthly, 60,000-subscriber Contact Lens Update magazine—all of which contribute to furthering the practice of optometry worldwide.

The Ontario Association of Optometrists represents over 1,700 optometrists across the province. It is dedicated to helping members provide the highest standard of eye health and vision care for Ontarians while driving the profession of optometry forward.

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About the Centre for Ocular Research & Education (CORE)
The Centre for Ocular Research & Education (CORE) was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

MEDIA CONTACTS:
Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA, McDougall Communications for CORE
aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.545.1815

Latest Innovations Offer Widespread Applications for Development of
Drug Delivery Systems, Biodegradable Contact Lenses, and Pharmaceuticals

WATERLOO, Ontario, April 18, 2023—Scientists from the Centre for Ocular Research & Education (CORE) are poised to unveil multiple advancements in 3D printing next week during the ARVO 2023 Annual Meeting in New Orleans. These innovations have widespread applications, with the potential to accelerate development of drug delivery systems, biodegradable contact lenses, and pharmaceuticals.

“Our multidisciplinary team has created one of the most sophisticated 3D printing environments for ocular research in the world,” said Alex Hui, OD, PhD, FAAO, head of Biosciences at CORE. “This investment in people and technologies is opening doors for new discoveries, product validation, and clinical insights, with so many implications for enhancing vision.”

CORE’s scientific poster presentations at ARVO span several interlinked aspects of three-dimensional modeling. Three related works focus on a new, CORE-developed method to rapidly fabricate PDMS (polydimethyl siloxane) microfluidic chips at a low cost and with high throughput. These chips are used to test ocular cellular responses to various conditions, formulations, and materials. Researchers were able to incorporate human corneal epithelial cells (HCECs), which showed strong adherence, metabolic activity, and growth capability, indicating the viability of chip-based cell biological studies.

CORE also fabricated a PDMS microfluidic chip for evaluating contact lens-based drug release. ARVO organizers have designated “Fabrication of a Microfluidic Chip for Ophthalmic Drug Delivery Studies Using 3D Printing” (Ramasamy M., et al.) as a scientific highlight for the entire conference.

Another CORE program to be shared in New Orleans developed a biodegradable bioink for fabricating ophthalmic devices. A novel gelatin methacrylate (GelMA)-centric formulation was used with a commercial masked-stereolithography (mSLA) 3D printer, with the resulting material assessed for degradation. Investigators also fabricated a contact lens from the same material, without requiring any support structures during printing.

In a quest to better evaluate ocular drug delivery, CORE scientists designed a soft hydrogel eye model, including an upper and lower eyelid, a frontal surface to mimic the cornea and sclera, and an internal chamber to mimic the interior of the eye. The eyeball and the lower eyelid were 3D bioprinted, then fit to a CORE-created in vitro OcuBlink device for automated blinking and tear collection. The outcomes supported the method for testing that more closely mimics a human ocular system, especially for drug absorption through the cornea.

The Association for Research in Vision and Ophthalmology (ARVO) is the largest and most respected eye and vision research organization in the world. Its members include nearly 10,000 researchers from more than 75 countries. The ARVO 2023 Annual Meeting runs from April 23–27, and attracts thousands of attendees from academic, industry, and clinical settings.

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About the Centre for Ocular Research & Education (CORE)
The Centre for Ocular Research & Education (CORE) – formerly known as the Centre for Contact Lens Research – was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

Media Contacts
Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA, FAAO
McDougall Communications for CORE
aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.434.2150

Issue 70 of Contact Lens Update Now Available

WATERLOO, ONTARIO, March 8, 2023—Adding context to recent technological advances to combat dry eye disease, the Centre for Ocular Research & Education (CORE) has published a series of clinically-relevant perspectives from four international experts via Issue 70 of Contact Lens Update.

The authors examine several in-office procedures, as well as a clinical case report that demonstrates their usefulness when treating contact lens discomfort caused by dry eye. The latest edition and all past issues are available for free at ContactLensUpdate.com.

“With the ever-increasing burden of dry eye disease, eye care professionals must stay abreast of cutting-edge therapies available to their practices and patients,” said CORE Director Lyndon Jones. “This issue of Contact Lens Update arms clinicians with relevant information needed to adopt and successfully implement these technologies.”                                                                             

Jennifer Craig, professor in Ophthalmology at the University of Auckland in New Zealand, authors the opening editorial. She provides a comprehensive, evidence-based overview of the various technologies and instruments that are available for dry eye disease treatment.  

The feature article from Leslie O’Dell, medical director for Optometry America, York, PA, discusses the results of a comprehensive review paper examining eyelid warming devices. The article outlines the evidence for the efficacy of these devices and their place in therapy.

Karl G. Stonecipher, medical director of Laser Defined Vision, professor of Ophthalmology at University of North Carolina and clinical adjunct professor of Ophthalmology at Tulane University, shares insights from his poster first presented at the American Society of Cataract and Refractive Surgery annual meeting. This study showed that the use of intense pulsed light or low-level light therapy was beneficial in patients with severe meibomian gland disfunction who had failed treatment with topical and systemic medications.

Also included in this issue is a clinical insight by Selina McGee, owner of BeSpoke Vision and adjunct assistant professor at the Northeastern State University College of Optometry. This case report outlines the complete assessment and successful treatment of a patient experiencing contact lens discomfort due to dry eye disease.

Published six times per year, Contact Lens Update provides a global platform for unbiased clinical insights based in current research. Since 2011, each issue has provided dependable and up-to-date ocular health information for more than 60,000 leading eye care professionals.

In addition to a complete archive of back issues, ContactLensUpdate.com offers a resource library that provides no-cost professional tools, patient resources, images and video. It also houses complimentary technical training videos produced by International Association of Contact Lens Educators, plus an industry glossary. Industry professionals can access the latest issue directly from ContactLensUpdate.com or quickly sign up for email receipt of future issues.

The publication receives support from the educational arms of Alcon, CooperVision, and Johnson & Johnson Vision.

# # #

About the Centre for Ocular Research & Education (CORE)
The Centre for Ocular Research & Education (CORE) was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

MEDIA CONTACTS
Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA, FAAO
McDougall Communications for CORE
aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.545.1815

Novel Investigation Method Overcomes Traditional Limitations, Shows Minimal Protein Impact and High Efficacy of Cleaning Solutions

WATERLOO, Ontario, February 13, 2023—Scientists at the Centre for Ocular Research & Education (CORE) have applied a novel method to answer a long-held question: how much protein is really deposited on rigid gas permeable (RGP) contact lenses? Historically, RGP protein deposits have been difficult to measure because of test sensitivity limitations.

To overcome that challenge, the CORE Biosciences group undertook a unique approach, incorporating radiolabeled lysozyme into an artificial tear solution then determining on-lens protein sensitively through radioactive counts. While CORE had used the technique for soft contact lens deposition studies in the past, this was a first for RGPs.

Seven common RGP lens materials were soaked in the radioactive artificial tear solution for 16 hours, followed by eight hours of exposure to a 3% one-step hydrogen peroxide (OSP) care solution to investigate cleaning ability.

Investigators determined the deposits were minimal, ranging from 1.2 ± 0.2 μg to 3.2 ± 0.7 μg per lens without use of a cleaning solution. Moreover, the OSP solution significantly reduced the amount of radioactive lysozyme present on the majority of RGPs after 30 alternating incubating and cleaning cycles when compared to using phosphate buffered saline, with measurements of remaining lysozyme on cleaned lenses ranging from 1.3 ± 0.1 μg to 2.5 ± 0.1 μg per lens.

“Renewed interest in RGP lenses around the world, sparked by the rise in their use for myopia management, has subsequently increased the desire for more advanced research. CORE has built a reputation for discovering new ways to precisely assess ophthalmic devices and pharmaceuticals, and this radiolabeling technique has strong potential for other applications,” said Alex Hui, OD, PhD, FAAO, head of Biosciences at CORE.

CORE’s multidisciplinary Biosciences team investigates fundamental research questions relating to the ocular surface and biomaterials, particularly contact lenses. Last year, CORE expanded its specialty contact lens focus to also include design optimization for orthokeratology, scleral lens physiological performance, and the impact of scleral lenses on ocular surface disease and dry eye management.

The work was first presented as a scientific poster, The impact of RGP care solutions on ISO measured lens parameters and the protein deposition on RGP lenses when managed with a hydrogen peroxide care solution, Hui, et al., at the 2023 Global Specialty Lens Symposium. CooperVision provided study funding support.

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About the Centre for Ocular Research & Education (CORE) The Centre for Ocular Research & Education (CORE) – formerly known as the Centre for Contact Lens Research – was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

Media Contacts Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA, FAAO McDougall Communications for CORE aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.434.2150

Topics Span Drug Delivery, Dry Eye, Microbiology, Myopia Control, MGD and More

WATERLOO, Ontario, January 16, 2023—Ahead of the first global eye care conference of the year, the Centre for Ocular Research & Education (CORE) has announced its “Top 10 of 2022” publications list, designating works of significant value to clinicians, researchers, educators, and manufacturers. The papers were selected from 26 peer-reviewed manuscripts covering clinical studies, laboratory studies, and reviews developed by the organization over the past 12 months.

“The entire CORE team, our collaborators, and sponsors continue to advance multiple dimensions of ocular science at a record pace, helping peers in the optometry and ophthalmology communities provide the best possible patient care,” says CORE Director Lyndon Jones, PhD, DSc, FCOptom, FAAO. “The sheer volume of these high-caliber studies can be overwhelming at times. That’s why we have selected 10 publications that represent essential knowledge for today’s eye care professionals.”

Papers making the “Top 10” for 2022 (in the order in which they were published) include:

1. Effect of a Novel Omega-3 and Omega-6 Fatty Acid Supplement on Dry Eye Disease: A 3-month Randomized Controlled Trial. Optom Vis Sci 2022; 99;1: 67-75. Ng A, et al.

Fatty acid supplementation has been discussed as a potential means to help patients with a variety of disorders due to their reported anti-inflammatory effects. Supplementation of patients with omega-3 and omega-6 fatty acids has thus been advocated for patients who have dry eye due to recognition of the inflammatory processes involved with that disease, however whether this has an impact on the signs and symptoms of dry eye has not been conclusively demonstrated. In this study, CORE’s expertise in conducting clinical trials was leveraged to be able to demonstrate that supplementation with a novel combination of omega-3 and omega-6 fatty acids is able to significantly improve symptoms in severely symptomatic dry eye patients compared to placebo controls. Importantly, it also demonstrated that it required three months of this supplementation to start to take effect. This information will be useful to clinicians looking for additional means to help their symptomatic dry eye patients. https://doi.org/10.1097/opx.0000000000001826

2. Testing drug release from medicated contact lenses: The missing link to predict in vivo performance. J Control Release 2022; 343 672-702. Pereira-da-Mota A, et al.

The concept of using contact lenses (CL) as drug delivery devices has been proposed for over five decades. CL offer a wide variety of advantages over drop-use for delivering drugs to the eye, as drops rapidly drain from the ocular surface and patient compliance remains poor. However, this concept remains difficult due to numerous scientific, technological, and regulatory challenges. One main difficulty is the setting of release rate specifications for each drug, since at present there are no standardized in vitro release models that can appropriately predict the performance of drug-eluting CL once placed onto the eye. This review looked at methods to predict in eye performance from lab-based models and what factors are important to develop better models and avoid animal studies. https://doi.org/10.1016/j.jconrel.2022.02.014

3. Long-term Effect of Dual-focus Contact Lenses on Myopia Progression in Children: A 6-year Multicenter Clinical Trial. Optom Vis Sci 2022; 99;3: 204-212. Chamberlain P, et al.

CORE was the largest clinical site in this international six-year study evaluating the effect of CooperVision MiSight 1 day lenses on myopia progression. The initial three-years of the study followed a conventional randomized clinical trial model with a control group (wearing Proclear 1 day) matched to a group wearing the lenses under investigation (MiSight 1 day). At the three-year mark all participants were invited to continue in the study for an additional three years, all wearing MiSight 1 day. This paper outlines the results from the six-year data. Participants who initially wore the control lens showed a slowing of their myopia progression after wearing MiSight 1 day for three years (compared to myopia progression in the first three years). For participants who wore MiSight 1 day lenses throughout the six years, the slowing of myopia progression observed in the initial three years continued in the subsequent three years. https://doi.org/10.1097/opx.0000000000001873

4. Exploring the factors which impact overall satisfaction with single vision contact lenses. Cont Lens Anterior Eye 2022; 45;5: Guthrie S, et al.

Subjective ratings of comfort and vision are two of the most impactful measures of contact lens success. However, this work shows that dissatisfaction with ease of handling for application can be enough to lower satisfaction in all areas. In addition, a patient’s habitual lens-wearing experience is an important influencer on their perceptions. Consequently, practitioners should not underestimate the effect of a negative lens-handling experience on overall lens-wearing success. https://doi.org/10.1016/j.clae.2022.101579

5. The impact of contact lenses on meibomian gland morphology. Ocul Surf 2022; 24 148-155. Osae, E.A., et al.

Despite years of experience with contact lenses, controversy remains as to whether contact lenses adversely impact the meibomian glands (MG). This review summarized the present body of evidence, suggesting that contact lens wear is associated with alterations in MG morphology and qualitative changes in MG secretion. Key factors such as duration of contact lens wear, contact lens type, edge design, and material modulus are discussed in relation to the extent of MG morphological changes, the quality of MG secretion and other ocular surface parameters. https://doi.org/10.1016/j.jtos.2022.04.001

6. Antiviral Activity of Contemporary Contact Lens Care Solutions against Two Human Seasonal Coronavirus Strains. Pathogens 2022; 11;4: 472. Lourenco Nogueira C, et al.

In the early phases of the COVID-19 pandemic, the routes of infection that the virus could take to infect humans was under debate, with a theoretical concern of transmission through the eye. Ocular devices, including contact lenses, thus came under scrutiny as potential vectors for the virus and the effectiveness of virus removal when they were cleaned and disinfected was put into question. This paper investigated the antiviral activity of various contact lens disinfecting solutions against two seasonal coronaviruses in the same family as SARS-CoV-19. It found that oxidative solutions based on hydrogen peroxide or povidone iodine were effective against the viruses, while multipurpose solutions had little to no antiviral activity. A follow up study however demonstrated that inclusion of a rub and rise step effectively removed the vast majority of the viruses, suggesting that even multipurpose solutions are effective against viral contamination if used as directed. https://doi.org/10.3390/pathogens11040472

7. The impact of a rub and rinse regimen on removal of human coronaviruses from contemporary contact lens materials. Cont Lens Anterior Eye 2022; 45;6: 101719. Lourenco Nogueira C, et al.

This study assessed the impact of a rub and rinse step to remove two coronavirus strains from a wide variety of soft and rigid contact lens (CL) materials using several CL disinfection solutions. The results showed that human coronavirus contamination can be easily removed from CL surfaces. Although CL care products based on oxidative systems (hydrogen peroxide and povidone-iodine) efficiently removed virus contamination from all CL surfaces without the need for a rub and rinse step, a full regimen including rub and rinse steps is crucial when using CL care products based on non-oxidative systems. https://doi.org/10.1016/j.clae.2022.101719

8. Short-term tolerability of commercial eyelid cleansers: A randomised crossover study. Cont Lens Anterior Eye 2022; 45;6: Craig J, et al.

Growing evidence has shown that lid infestation with the ocular mite Demodex is involved in the development of dry eye disease, meibomian gland dysfunction, chalazion and contact lens dropout. This study looked at the short-term tolerability of five commercially available anti-demodectic eyelid cleansers in 30 healthy non-contact lens wearers. The results highlighted varying levels of comfort and satisfaction with the different treatments, with some resulting in tear film instability, conjunctival hyperaemia and ocular surface staining on application. Awareness of these possible adverse effects will help clinicians set realistic patient expectations and encourage better compliance in their use of lid hygiene therapies for the treatment of Demodex blepharitis. https://doi.org/10.1016/j.clae.2022.101733

9. Magnitude of astigmatism – A comparison between eyes. Cont Lens Anterior Eye 2022; 45;5: 101510. Luensmann D, et al.

Astigmatism is a refractive error that typically sits more on the sideline of attention even though it is the most common refractive error, being rivaled by myopia only in certain ethnicities. A large cohort of 101,973 clinic patients was included in this retrospective chart review to determine the symmetry of astigmatism between eyes. In this cohort 87.2% of patients exhibited some level of astigmatism in at least one eye. Taking the astigmatic patients alone, it became apparent that one in four exhibited astigmatism of at least −0.75DC in one eye only, while the other eye required a lower correction. The power symmetry was high between eyes for low astigmatic corrections; for patients who had −1.00DC in the right eye, 80.8% of them had a similar prescription (± 0.50DC) in the left eye. However, symmetry was reduced with higher astigmatism; for patients with astigmatism of −4.00DC in the right eye, only 40.6% exhibited a similar level (± 0.50DC) of astigmatism in the other eye. https://doi.org/10.1016/j.clae.2021.101510

10. Temporal Change in Pro-Inflammatory Cytokine Expression from Immortalized Human Corneal Epithelial Cells Exposed to Hyperosmotic Stress. Curr Eye Res 2022; 47;11: 1488-1495. Nagaarudkumaran N, et al.

Hyperosmolarity, or an increase in concentrations of salts and other dissolved particles in a solution, has been identified as a key contributor to the development of dry eye disease. The mechanisms through which an increase in osmolarity affects cells on the ocular surface is however still under investigation. Leveraging CORE’s expertise in cell culture, this study investigated the impact of hyperosmolar stress on corneal epithelial cells to produce biomarkers indicate inflammation as well as their metabolic activity. It found that exposure to hyperosmolar environments caused decreased cell metabolism within six hours, and provided insight into the types of changes in the measured inflammatory biomarkers at this point as well. This will provide valuable insight into the timing of when cells should be assessed for effects of hyperosmolarity as well as what inflammatory biomarkers to target for new therapies. https://doi.org/10.1080/02713683.2022.2125531

CORE offers a searchable database of its more than 2,600 peer-reviewed papers, professional articles, continuing education presentations, and scientific presentations dating back to the early 1980s. That resource is available at https://core.uwaterloo.ca/publications/.

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About the Centre for Ocular Research & Education (CORE)
The Centre for Ocular Research & Education (CORE) – formerly known as the Centre for Contact Lens Research – was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

MEDIA CONTACTS
Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA, FAAO
McDougall Communications for CORE
aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.434.2150

Widespread use of face masks has been determined essential to combat COVID-19’s spread, yet is giving rise to a new phenomenon: increased reports of dry, uncomfortable eyes. Experts from the Centre for Ocular Research & Education (CORE) are advising eye care professionals (ECPs) on how to recognize mask-associated dry eye (MADE) and methods to mitigate the condition.

Reports of MADE have circulated since early summer and a recent review¹ concluded that eye dryness and irritation from mask wear may become a problem for a large percentage of the population.

“Face masks are crucial in the fight against COVID-19, and ECPs are well-positioned to provide patients with advice on appropriate wear in order to maximize eye comfort,” said Dr. Lyndon Jones, director of CORE. “Asking patients about their mask-wearing experiences and providing a few helpful tips takes little time and can make a substantial difference.”

MADE: What, Why and Who’s at Risk?

Masks significantly reduce the outward spread of air. However, exhaled air still needs to disperse; when a mask sits loosely against the face the likely route is upwards. This forces a stream of air over the surface of the eye, creating conditions that accelerate tear film evaporation, leading to dry spots on the ocular surface and discomfort.

In addition to worsening symptoms in patients with pre-existing dry eye disease, MADE can affect a wide-spectrum of others: the elderly who typically have a poorer quality tear film, contact lens wearers, and masked people working extended hours in air-conditioned settings and/or while using digital screens.

Beyond discomfort, MADE may encourage people to rub their eyes for temporary relief—raising the possibility of unwashed hands being brought to the face. In turn, this increases the likelihood of coronavirus infection through the mouth, nose, and to a lesser extent, the eye.

Guidance for Practitioners

CORE suggests that ECPs consider incorporating three MADE-related actions into their examination lane protocols:

1. Consider the role of the face mask if there are worsening symptoms and signs in patients with confirmed dry eye disease, or if patients report dry, uncomfortable eyes or variable vision for the first time.
2. Routinely ask all patients how their eyes feel while wearing a mask, since many may not think to volunteer their experiences or associate their symptoms with mask use.
3. Provide advice on alleviating the symptoms, including using a new CORE-developed infographic to help show how a few simple steps can likely provide relief and minimize reoccurrence.

Tips for Patients

As illustrated in its new MADE infographic (available for download from COVIDEyeFacts.org), CORE recommends that mask wearers experiencing dry eye symptoms try straight-forward solutions:

1. Ensure that a mask is worn appropriately, particularly with spectacles or sunglasses. A carefully taped top edge that does not interfere with blinking may help.
2. Apply lubricating drops, asking their ECP for recommendations.
3. Limit time in air-conditioned environments and take regular breaks from digital devices.

CORE experts are also been quick to state that people should first check with their eye care practitioner for advice and to rule out other cases—a good approach with any new eye-related concern.

Don’t Ditch the Mask

Dr. Jones is adamant that bringing more attention to MADE should not be used to support anti-mask wearing sentiments.

“Responsibly wearing a mask, even when having to contend with eye dryness, is a critical part of overcoming the global pandemic. The good news is that we understand MADE and can address it—an opportunity for ECPs to further communicate their knowledge and ongoing value to patients at a time when sound, scientific guidance is needed more than ever,” he noted.

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About the Centre for Ocular Research & Education (CORE)

The Centre for Ocular Research & Education (CORE) – formerly known as the Centre for Contact Lens Research – was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

MEDIA CONTACTS:
Aimee J. Lewis or Mike McDougall, APR, Fellow PRSA
McDougall Communications for CORE
aimee@mcdougallpr.com +1.585.414.9838  |  mike@mcdougallpr.com +1.585.434.2150

1. Moshirfar, M., West, W.B. & Marx, D.P. Face Mask-Associated Ocular Irritation and Dryness. Ophthalmol Ther 9, 397–400 (2020). https://doi.org/10.1007/s40123-020-00282-6

As bottles of soap are flying off the shelves and hand sanitizer is in short supply since the global spread of Novel Coronavirus COVID-19, people are paying more attention to hand washing practices. While there is no suggestion of an association between COVID-19 and safe contact lens wear, for the millions of lens wearers worldwide, the increased focus on hand washing is a welcome message.

A recent literature review from Professor Emeritus Desmond Fonn and the Centre for Ocular Research & Education (CORE) reports that proper hand hygiene is especially important for people who use contact lenses. The peer-reviewed study, published in Contact Lens and Anterior Eye, draws attention to how hand washing habits could affect the development of contact lens related microbial keratitis, which can be severe and sight-threatening, and corneal inflammatory events.

“Everyone is suddenly Googling handwashing techniques with the spread of COVID-19,” said Lyndon Jones, PhD, DSc, FCOptom, FAAO, FBCLA, the paper’s co-author and director of CORE. “Clearly this is sensible advice to help reduce the risk of transferring the virus, however, outside of the current crisis, focus on good hand washing techniques should be mandatory for contact lens wearers too. With the amount of information available on this topic right now, it is timely to remind lens wearers of just how much the simple act of thorough hand washing can reduce their risk of lens-related complications occurring.”

The paper notes that in line with its ability to reduce the spread of disease, careful and thorough hand washing with soap and water followed by hand drying with unused paper towels should greatly reduce the transfer of microbial contamination from hands to the contact lens or eye. Clean hands plus use of daily disposables results in the lowest risk of contact lens-related complications. For wearers of reusable lenses there are additional guidelines on lens and case cleaning which can be downloaded for patient use from CORE’s Contact Lens Update educational resource.

Seeing is Believing

In 2018, CORE published a series of eye-popping photos that demonstrate the rapid growth of bacteria associated with mishandling contact lenses.  CORE researchers exposed new, clean contact lenses to both clean and unwashed hands. Unwashed hands were pressed into agar (Figure 2a), and also used to handle a new contact lens (Figure 2b). Scientists then repeated the procedure after following recommended handwashing practices, touching both the agar directly, along with applying and removing a contact lens (Figures 2c and 2d). The results clearly demonstrate the impact handling has on contact lenses. Samples that had been touched with unwashed hands showed significantly higher numbers of visible bacteria. By comparison, the contact lens touched with clean hands had only a minimal bacterial load.

“Contact lenses are a safe, highly effective form of vision correction used by millions of people worldwide, but ignoring good contact lens care can have a devastating effect on eye health and vision,” says CORE senior research associate Miriam Heynen, MSc, who conducted the experiment with laboratory research assistant Vivian Chan, BSc. “Taking care of your contact lenses with clean, dry hands is essential, a point that is clearly illustrated in the images shared here.”

Photos from the handling study are available for use by eye care professionals and contact lens wearers alike at https://core.uwaterloo.ca/news/seeing-is-believing-eye-popping-photos-show-why-good-contact-lens-hygiene-is-essential/

Dr. Jones concluded by saying “We understand the relevance of good hand washing practices for everyone in the current climate of COVID-19. Beyond the current heightened focus, it is also prudent to remind contact lens wearers of their ongoing need to conduct good hand hygiene prior to touching their lenses and eyes.”

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About the Centre for Ocular Research & Education (CORE)
The Centre for Ocular Research & Education (CORE) was established in 1988 at the University of Waterloo’s School of Optometry & Vision Science. Over the next three decades, the organization evolved from a three-person operation into a thriving hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Its uncompromising independence and results of the highest quality have been at the heart of many of the most prominent advances in eye health. Today, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. For more information, please visit core.uwaterloo.ca.

MEDIA CONTACT
Aimee J. Lewis
McDougall Communications for CORE
aimee@mcdougallpr.com or +1.585.414.9838

Evidence shows that there is a wide choice of preserved artificial tears which can be recommended within a larger treatment plan for mild to moderate dry eye disease.

According to researchers at the University of Waterloo, while preservative-free drops are best for severe dry eyes, they are not the only option to consider in the management of more mild stages of the disease.

“The preservative benzalkonium chloride (BAK) is known to irritate the surface of the eye and should be avoided in all dry eye patients, however, there is good evidence that alternatively preserved drops can be safely used in mild to moderate cases.” said Karen Walsh, a Clinical Scientist at Waterloo’s School of Optometry and Vision Science and the Centre for Ocular Research & Education. “Preservative-free drops can be more expensive, and many are packaged in single-dose containers that can be difficult for elderly patients to use.

“This study provides an important recommendation to eye care practitioners: they have more options for treating mild to moderate dry eye than they may think.”

As part of their research, Walsh and co-author Lyndon Jones, reviewed a range of studies including clinical trials and laboratory testing which showed that artificial tears containing alternative preservatives are significantly safer to the surface of the eye than BAK-preserved drops.

“It is important for patients with symptoms of dry eye to seek medical advice when choosing which drops are best. An examination with their eye care professional can diagnose the type and severity of dry eye, which will result in more effective treatment and ongoing management of the condition.” said Walsh.

This literature review, The use of preservatives in dry eye drops, authored by Walsh and Jones was recently published in the journal Clinical Ophthalmology.