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Jennifer Swingle Fogt, Madison Roth, Hope Patterson Gardner Ohio State University College of Optometry, Columbus, OH, USACorrespondence: Jennifer Swingle Fogt, The Ohio State University College of Optometry, 338 West 10th Avenue, Columbus, OH, 43210-1280, USA, Tel +1 614-292-0882, Email Fogt.78@osu.eduAbstract: Compliance with contact lens care is important for successful contact lens wear and for minimizing the risk of complications related to lens wear. There are many components of overall lens care guidelines that may potentially be disregarded, forgotten, or misunderstood. Literature has reported copious data on rates of poor compliance for separate lens care recommendations. Knowing the areas of contact lens care where lens wearers perform poorly is helpful when creating strategies for improving patient education. As science evolves and new best-practices are determined, eye care providers must be engaged in educating new lens wearers and reeducating existing wearers. It is vital to make wearers mindful of proper lens care and why proper lens care should be important to them. Various educational strategies can help practitioners to communicate with their patients more effectively. The purpose of this narrative review is to discuss studies of noncompliance with contact lens wear; consequences of these noncompliant behaviors; and studies of lens care education which were found with a literature search. The resulting discussion also includes strategies to improve compliance with patient contact lens wear.Keywords: contact lenses, compliance, education, lens care

Jennifer Swingle Fogt, Nidhi Satiani, Katherine M Bickle, Gina Wesley, Kimberly Patton College of Optometry, The Ohio State University, Columbus, OH, USACorrespondence: Jennifer Swingle Fogt, The Ohio State University College of Optometry, 338 West 10th Avenue, Columbus, OH, 43210-1280, USA, Tel +1 614-292-0882, Email Fogt.78@osu.eduIntroduction: Patients expect to have excellent vision and comfort when wearing soft contact lenses. The purpose of this study was to compare the wear experiences of participants with astigmatism when wearing a daily disposable soft toric lens to an established, commonly used reusable toric lens.Methods: In this crossover study, habitual soft toric lens wearers were fit with a daily replacement soft toric lens (delefilcon A) and a reusable, 1-month replacement soft toric lens (comfilcon A) in a randomized order. After 30 days of wear, Visual analog scale (VAS) surveys were used to assess wear experience, including vision and comfort, for overall wear and end-of-day wear. Scores were compared statistically with mixed-effects linear models. Participants also responded to questions about convenience, ease of use, and satisfaction with both lenses and preference questions based upon comfort, vision, and overall performance.Results: Fifty-nine participants completed the multi-site crossover study. VAS scores [mean(std dev)] for overall quality of vision for the delefilcon A [80.4(16.4)] and comfilcon A [66.8(27.7)] lenses were statistically significant (P=0.002). The difference in the mean overall comfort scores for the delefilcon A lenses [71.6(26.3)] and comfilcon A lenses [63.2(28.9)] was 8.4, which exceeds the establish criteria for clinical significance, although not statistically significant (P=0.08). Overall satisfaction scores were 68.8(26.9) for the delefilcon A and 59.7(30.3) for the comfilcon A lenses (P=0.08). Both lenses provided mean binocular visual acuities better than 20/20 Snellen equivalent. Over half of the participants preferred the delefilcon A lenses based upon comfort, vision, and overall performance. Convenience, ease of use, and satisfaction all scored higher with delefilcon A lenses.Conclusion: The results of this study show that wear experience with delefilcon A lenses for astigmatism can meet or exceed that of comfilcon A toric lenses while also providing healthy, daily disposable lens wear.Keywords: soft contact lenses, astigmatism, toric contact lenses, comfort, experience

Jennifer Swingle Fogt, Kimberly Patton College of Optometry, The Ohio State University, Columbus, OH, USACorrespondence: Jennifer Swingle Fogt, College of Optometry, The Ohio State University, 338 W 10th Ave, Columbus, OH, 43210, USA, Tel +1 614 292 0882, Email Fogt.78@osu.eduObjective: The purpose of this study was to assess the wear experience of participants while wearing a toric daily disposable contact lens with water surface technology over long days of lens wear.Methods: Existing soft toric contact lens wearers were fit with the daily disposable study lenses. Participants assessed their initial comfort, vision, and satisfaction with the lenses by visual analog scale (VAS) survey. After a successful 1-week follow-up visit, participants were scheduled for 5 survey days, in which surveys were deployed to their smartphones for immediate assessments of comfort and quality of vision on a 1– 10 scale at 10, 12, 14, and 16 hours of lens wear on 5 subsequent weeknights. The final study visit assessed visual acuity, and overall lens wear experience surveys were completed with VAS surveys. The overall median and interquartile (IQR) range of all surveys were calculated.Results: Thirty bilateral toric lens wearers completed the study. Median (IQR) initial impression VAS scores were 97(12) for quality of vision, 100(9) for comfort, and 96(10) for satisfaction. Median evening surveys resulted in comfort scores of 10(1) at 10 hours, 9(2) at 12 hours, 9(2) at 14 hours, and 8(2) at 16 hours of wear. Median evening surveys resulted in quality of vision scores of 10(1) at 10 hours, 10(2) at 12 hours, 9(2) at 14 hours, and 9(3) at 16 hours of wear. VAS scores for overall experience were 97(9) for comfort, 95(13) for vision, and 8(31) for dryness. End-of-day VAS scores were 93(21) for comfort, 90(15) for vision, and 21(38) for dryness. Mean (±standard deviation) OU LogMAR visual acuity with the study lenses was − 0.19(0.06).Conclusion: Surveys of wear experience resulted in high scores for comfort and vision over the course of a long day of wear with the daily disposable study lenses in this population of patients with astigmatism.Keywords: soft contact lenses, daily disposable, end-of-day, comfort, vision

Jennifer Swingle Fogt, Kimberly Patton College of Optometry, The Ohio State University, Columbus, OH, USACorrespondence: Jennifer Swingle Fogt, The Ohio State University College of Optometry, 338 W 10th Ave, Columbus, OH, 43210, USA, Tel +1 614 292 0882, Email Fogt.78@osu.eduObjective: The purpose of this study was to assess the wear experience of silicone hydrogel daily disposable contact lenses with water surface technology over a long day of lens wear.Methods: Thirty-five soft contact lens wearers were refit with the daily disposable study lenses and participants scored their initial impressions of comfort, vision and satisfaction using a visual analog scale (VAS). Participants used their smart phones to complete surveys of comfort and vision on a scale of 1– 10 at 10, 12, 14, and 16 hours of lens wear on 5 weeknights. A participant score for each time point was calculated by averaging the evening responses. End of study VAS surveys of symptoms were also completed.Results: Median (Interquartile Range) VAS initial impression scores were 99.00 (12.00) for quality of vision, 98.00 (16.00) for comfort, and 100.00 (13.00) for satisfaction. The end of study surveys found end of day median VAS scores of 87.00 (19.00) for end of day quality of vision and 75.00 (24.50) for end of day comfort. The median score for overall quality of vision was 93.00 (14.00) and for overall comfort was 93.00 (16.50). The median score for end of day dryness was 37.00 (55.00) and overall dryness was 13.00 (34.00).Conclusion: The daily disposable lenses with water surface treatment used in this study maintained high median scores for comfort and quality of vision for up to 16 hours of wear.Keywords: daily disposable contact lenses, water surface contact lenses, comfort, end of day comfort, long wear time

Ryan Rutschilling, Jennifer Swingle Fogt College of Optometry, The Ohio State University, Columbus, OH, USACorrespondence: Jennifer Swingle Fogt, College of Optometry, The Ohio State University, 338 W. 10th Ave, Columbus, OH, 43210, USA, Tel +1 614 292 0882, Email Fogt.78@osu.eduPurpose: The health benefits of silicone hydrogel lens materials and a daily replacement modality have been demonstrated in previous studies; however, existing planned replacement lens wearers may resist changing to a new lens replacement schedule. The purpose of this study is to evaluate the wear experience of satisfied planned replacement silicone hydrogel wearers when refit into a silicone hydrogel daily disposable lens.Patients and Methods: In this open-label, non-comparison study, satisfied wearers of two week planned replacement contact lenses were evaluated for inclusion criteria and refit with optimized prescriptions in their habitual lenses. At a follow-up visit one week later, participants were refit with the study daily disposable lenses and completed visual analog scale (VAS) surveys of initial quality of vision, comfort, and satisfaction. Participants returned for a final visit after two weeks of wearing the study daily disposable lenses. At the final visit, VAS surveys for both overall and end of day (EOD) vision, comfort, and dryness were completed. Overall median and interquartile range (IQR) were assessed for all surveys in the study.Results: Thirty individuals completed the study (29.1 ± 7.8 years old; 19 female). Median (IQR) results for the initial impression VAS surveys were 92.50(11.75) for quality of vision, 92.50(18.00) for comfort, and 93.00(18.00) for satisfaction. Final VAS survey results revealed median scores of 87.50(25.00) for EOD quality of vision and 82.50(51.25) for EOD comfort. The median overall quality of vision was 91.00(17.00) and overall comfort was 93.00(28.50). Median (IQR) overall dryness was 28.50(49.00) and median EOD dryness was 30.50(64.25).Conclusion: The findings of this study suggest that providers can successfully refit satisfied wearers of early generation silicone hydrogel planned replacement lenses into a new generation silicone hydrogel daily disposable lens while maintaining satisfaction.Keywords: soft contact lens, vision, comfort, wear experience

Jennifer Swingle Fogt The Ohio State University College of Optometry, Columbus, OH, USACorrespondence: Jennifer Swingle FogtThe Ohio State University College of Optometry, 338 West 10th Avenue, Columbus, OH, 43210-1280, USATel +1 614-292-0882Email Fogt.78@osu.eduAbstract: Midday fogging is a common problem in scleral lens wear, as particles accumulate in the tear reservoir between the posterior surface of the lens and the front of the ocular surface during wear. As particulate waste collects, symptoms of blurred vision and discomfort arise, typically leading patients to remove their lenses for cleaning, refilling with fresh solution, and reinsertion into the eye. The appearance of the particulate can vary, likely due to different causes for midday fogging. Studies which attempted to identify the particulate have given some insight into some of the causes, but larger studies are needed to identify this debris. Research on lens solutions used for filling the lens reservoir and of various aspects of scleral lens fits have also begun to culminate in the concept that midday fogging may ultimately be related to inflammation. Since scleral lens wearers can have varied and multiple sources of inflammation, strategies in minimizing midday fogging can differ between patients.Keywords: midday fogging, scleral lenses, interrupted scleral lens wear, turbidity, post-lens tear reservoir

Jennifer S Fogt,1 Nick Fogt,1 P Ewen King-Smith,1 Haixia Liu,2 Joseph T Barr1 1Ohio State University College of Optometry, Columbus, OH, USA; 2Allergan Plc, Irvine, CA, USACorrespondence: Jennifer S FogtThe Ohio State University College of Optometry, 338 West 10th Avenue, Columbus, OH 43210-1280, USATel +1 614-292-0882Email Fogt.78@osu.eduPurpose: To determine if an eye drop containing omega-3 fatty acids (Refresh Optive MEGA-3®, Allergan plc, Dublin, Ireland) increases the lipid layer thickness (LLT) of the tear film versus a non-emollient eye drop (Refresh Optive, Allergan plc).Methods: Patients (≥30 years) with baseline LLT ≤75 nm completed the Current Symptoms Survey (CSS – a visual analog survey of dry eye symptoms), and LLT was measured pre- and post-instillation (15 and 60 mins) of their randomly assigned treatment. After washout, patients were tested with the other treatment. Primary endpoint: change in LLT from baseline. Secondary endpoint: CSS results.Results: Of 21 patients enrolled, 19 completed the study. With the omega-3–containing eye drop, the mean (standard deviation) LLT increase from baseline at 15 mins was statistically significant in the overall field (8.8 [11.5] nm; P

Jennifer S Fogt, Lisa A Jones-Jordan, Joseph T Barr The Ohio State University College of Optometry, Columbus, OH, USA Introduction: New designs of eye wash stations have been developed in which the direction of water flow from the fountain has been reversed, with two water streams originating nasally in both eyes and flowing toward the temporal side of each eye. No study has been done to determine the ideal direction of water flow coming from the eye wash in relation to the eye. Materials and methods: Ophthalmic eye examinations were conducted before and after the use of two eye wash stations with opposite water flow directionality. Fluorescein was instilled in both eyes before using an eye wash to measure the effectiveness of the water flow. Subjects were surveyed upon their experiences using the eye washes. Conclusion: Ophthalmic examination found no significant difference in the efficacy of the eye washes with nasal-to-temporal water flow when compared to temporal-to-nasal water flow direction. Keywords: eye wash, ocular burn, cornea, water flow

Jennifer S Fogt,1 Matthew J Kowalski,1 P Ewen King-Smith,1 Alice T Epitropolous,2 Andrew J Hendershot,2 Carrie Lembach,2 John Paul Maszczak,1 Lisa A Jones-Jordan,1 Joseph T Barr1 1The Ohio State University College of Optometry, 2The Ohio State University Department of Ophthalmology, Columbus, OH, USA Purpose: The aim of this study was to evaluate the efficacy of a lipid containing emollient eye drop, Soothe XP, which was reformulated in 2014 with a more stable preservative and buffer system, compared to a control, non-emollient, eye drop (Systane Ultra) in improving lipid layer thickness (LLT) in subjects with dry eye due to meibomian gland dysfunction (MGD).Patients and methods: This prospective single-center, open-label, cross-over, examiner masked-study enrolled subjects aged 30–75 years with lipid-deficient dry eye and a clinical diagnosis of MGD as determined by a slit lamp examination, an evaluation of meibomian gland drop out with meibography, and a standard patient evaluation of eye dryness questionnaire of >5. Eligibility was then determined by a LLT of

Purpose: This study describes efficiency of diagnostic, image-based, and impression-based fitting methods by eye care providers who prescribe scleral lenses (SL) for patients with keratoconus., Methods: An electronic survey was distributed to eye care providers with an interest in SL fitting. Demographic data including practice modality, country of residence, and fitting volume were collected. Efficiency of each fitting method (diagnostic, image, and impression-guided) was queried including time required for initial evaluation, number of lenses ordered, and number of office visits required. Practitioners with access to image and impression-based technology were also asked time required to acquire data and to estimate the percentage of time a lens could be manufactured from the initial images or impressions., Results: 423 practitioners who prescribe SL for patients with keratoconus reported completing a median [IQR] 100 [280] SL fittings. There was no difference in the median time required for initial evaluation (30 min; p = 0.5) or median number of lenses ordered during the fitting process (2 lenses; p = 0.2) between diagnostic, image-based, or impression-based SL fitting methods. Median time to acquire initial images was 10 [7] minutes and 15 [10] minutes to obtain impressions. Images obtained were adequate to order an initial lens 80 [45]% of the time while initial impressions were adequate 90 [40]%., Conclusion: In this study, practitioner-reported efficiency of SL fitting was similar between diagnostic, image-based and impression-based methods for patients with keratoconus., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

We investigated the effect of 0.6 MeV proton irradiation on the superconducting and normal-state properties of thin-film YBa2Cu3O7-δ superconductors. A thin-film YBCO superconductor (≈567 nm thick) was subject to a series of proton irradiations with a total fluence of 7.6×1016 p/cm2. Upon irradiation, Tc was drastically decreased from 89.3 K towards zero with a corresponding increase in the normal-state resistivity above Tc. This increase in resistivity, which indicates an increase in defects inside the thin-film sample, can be converted to the dimensionless scattering rate. We found that the relation between Tc and the dimensionless scattering rate obtained during proton irradiation approximates the generalized d-wave Abrikosov-Gor'kov theory better than the previous results obtained from electron irradiations. This is an unexpected result, since the electron irradiation is known to be most effective to suppress superconductivity over other heavier ion irradiations such as proton irradiation. In comparison with the previous irradiation studies, we found that the result can be explained by two facts. First, the dominant defects created by 0.6 MeV protons can be point-like when the implantation depth is much longer than the sample thickness. Second, the presence of defects on all element sites is important to effectively suppress Tc., Competing Interests: The authors declare no conflicts of interest.

Background and Objective: This study determined whether practitioners specializing in keratoconus (KC) adhere to published guidelines for disease management and to what extent comorbid conditions of dry eye, contact lens tolerance, and psychological consequences of KC are formally assessed as part of long-term management., Materials and Methods: This cross-sectional study used an IRB-approved, Internet-based, REDCap platform. Descriptive statistics are presented., Results: A total of 222 participants qualified for participation. Most 134 (60%) followed young and unstable patients every 6 months and less frequent follow-up examinations for patients with stable findings, with 142 (64%) recommending annual examinations. Scleral lenses were the preferred optical correction method (36%), followed by corneal gas permeable lenses (21%). A total of 118 (55%, n=216) participants recommend crosslinking to any patient with documented disease progression regardless of age. Fewer than 25% of patients were referred for surgical correction of KC. Half of respondents, 114 (51%), reported testing for tear film dysfunction, while 108 (49%) never tested. No participants used a depression screening instrument., Conclusion: Practitioners managing patients with KC largely adhere to current consensus recommendations. This survey identified several potentially high-impact, low-cost improvements to current practice patterns, including screening for dry eye and depression., Competing Interests: CONFLICTS OF INTEREST AND SOURCES OF FUNDING Schornack M: None Nau A: Sight Sciences (Paid Consultant), Vital Tears (advisory board), Optometry Times (speaker) Harthan J: Paid consultant for the following: Allergan, Essilor, Euclid, International Keratoconus Academy, Johnson & Johnson Vision, Metro Optics, Visioneering Technologies, Inc. Research for Bausch+Lomb, Kala Pharmaceuticals, Ocular Therapeutix, Metro Optics Fogt JS: Nevakar (research grant), Bausch & Lomb (research grant), Eyenovia (research grant), Alcon (research grant), Cooper Vision (research grant), Interojo (research grant), Envision Biomedical (paid consultant), Tear Optix (Paid consultant) Nau, C: none Shorter, E: Johnson & Johnson (research grant), Synergeyes (research grant), Art Optical (research grant), Boston Sight (paid lecturer), Oculus (paid lecturer)

Although optometric programs have incorporated scleral lens (SL) education into their curricula, actual student experiences with SL fitting varies widely. This survey study describes the SL fitting and training experiences of graduating optometry students in US schools and colleges. Participants (323) were fourth-year students preparing to graduate in 2020 (19% response rate). Students appeared to have insufficient SL fitting practice, the median number of SL evaluations completed before graduation was 5 (range 0-110) and 63% reported less than 10 fits. Students with an interest in fitting SLs may wish to pursue additional training opportunities, such as residency, to acquire further experience before achieving sufficient proficiency with SLs.

Abstract: The benefits of scleral lens (SL) wear have been described in cross-sectional and retrospective studies; however, the frequency of complications associated with SL wear has not, to the best of our knowledge, been determined. From a survey of SL practitioners, we estimated the period prevalence over 1 year of corneal complications that required SL wearers to discontinue lens wear. In a sample of 72,605 wearers, SL wear was discontinued for the following complications: corneal edema, 1.2%; corneal neovascularization, 0.53%; microbial keratitis, 0.45%; and limbal stem cell deficiency, 0.20%. This study design allowed for calculation of period prevalence of these complications rather than complication incidence rates. Information presented in this report may be useful in clinical decision-making and for future study design., (Copyright © 2022 Contact Lens Association of Ophthalmologists.)

Objectives: To report current trends in scleral contact lens prescription and management, including lens designs prescribed, care products recommended, and procedures performed during routine scleral lens (SL) evaluation., Methods: An online survey was designed by the Scleral Lenses in Current Ophthalmic Practice Evaluation study team and administered to eye care practitioners attending a specialty contact lens meeting. The survey was available from November 8, 2019, through March 31, 2020. Participants' demographic data were collected, along with information on lens diameters, landing zone (LZ) designs, recommended care products, and components of routine SL evaluation., Results: In total, 715 participants responded to at least one of the survey items of interest. Most lenses prescribed (63%) were 16 mm or more in diameter. Lenses with toric LZs were the most frequently prescribed (48%), followed by spherical (40%), quadrant-specific (8%), and impression-based or image-based designs (3%). Most participants (61%) recommended hydrogen peroxide products for lens care. Nonpreserved saline in a single-use vial was most frequently recommended to fill the bowl of the lens before application. Intraocular pressure was measured during SL evaluation by 45% of participants; 38% of participants routinely measured corneal thickness., Conclusions: Practitioners increasingly are prescribing SLs with advanced LZ designs. Most practitioners recommend hydrogen peroxide-based disinfection systems and single-use vials of nonpreserved saline for lens care and application. Because differences in components of routine SL evaluations were reported, clinicians may benefit from reaching a consensus on essential components of SL evaluation., Competing Interests: J. Harthan: consulting for Allergan, Essilor of America, Euclid Systems Corp, International Keratoconus Academy, Metro Optics, Visioneering Technologies Inc., Bausch + Lomb Inc., Kala Pharmaceuticals, Ocular Therapeutix Inc. E. Shorter: research grant from Johnson & Johnson. Consulting: BostonSight. J. Fogt: research funding from Nevakar Inc., EyeNovia Inc., Alcon, Innovega Inc., Contamac US Inc., Bausch + Lomb. Consulting for Alcon and Contamac US Inc. A. Nau: paid lecturer for Eye Eco. Consulting for Oyster Point Pharma Inc.The remaining authors have no conflicts of interest to disclose., (Copyright © 2022 Contact Lens Association of Ophthalmologists.)

Objectives: To describe prescribing patterns of therapeutic scleral lenses (SLs) in the management of corneal irregularity and ocular surface disease among practitioners who prescribe SLs., Methods: Participants ranked treatment options for corneal irregularity and ocular surface disease in the order they would generally consider using them in an electronic survey. Median rank score for each option is reported, along with the percentage of participants assigning first place ranking to each option. The percentage of participants assigning first, second, or third place ranking to each option is also reported., Results: Seven hundred and seventy-eight practitioners participated. Scleral lenses are most frequently considered as the first choice for the management of corneal irregularity based on overall median rank, followed by corneal rigid lenses (rigid gas-permeable [RGPs]). Scleral lenses were the first choice of 42% of participants, followed by RGPs (20%). For ocular surface disease, lubricant drops are most frequently used first, followed by meibomian gland expression, topical cyclosporine or lifitegrast, topical steroids, punctal plugs, and SLs, respectively. Lubricant drops were the first therapeutic option considered for ocular surface disease by 63% of participants and 45% ranked SLs as their sixth, seventh or eighth treatment based on median overall rank., Conclusions: Scleral lenses were identified as the first option for management of corneal irregularity more frequently than RGPs. Scleral lenses are considered for management of ocular surface disease before surgical intervention but after meibomian gland expression, punctal occlusion, and topical medical therapy are attempted., (Copyright © 2022 Contact Lens Association of Ophthalmologists.)

Purpose: To describe international scleral lens prescription and management practices across multiple practice types., Methods: For this cross-sectional study, scleral lens practitioners were asked to complete an electronic survey that requested information about a single scleral lens patient. Data collected included practitioner demographics (practice type, country, years of experience) and patient indications for scleral lens wear, fitting process, lens design, and care products., Results: Data were collected for 259 patients (419 eyes). Most participants (60%) practiced in the US, 75% worked primarily in community practice, and 58% claimed more than 5 years' experience fitting scleral lenses. Indications for scleral lens wear were corneal irregularity (87%), ocular surface disease (9%), and uncomplicated refractive error (4%). During the fitting process, the mean (SD) number of lenses ordered was 2.4 (1.6) (range, 1-16 lenses) during 3.8 (2.4) visits (range, 1-18 visits). Of patients, 62% used a daily surfactant cleaner, 47% used hydrogen peroxide disinfection, and 67% used single-use vials of nonpreserved saline. Mean lens diameter was 16.2 (1.1) mm (range, 11.8-23.0 mm). The landing zones were spherical (64%), toric (26%), quadrant-specific (7%), and custom (3%) designs. Optical power was spherical in 70%, toric in 27%, and higher-order aberration correcting in 3% of lenses. Only 5 lenses had multifocal optics., Conclusions: General consensus regarding prescribing patterns (lens design, wearing schedules, care products) between US vs non-US, community vs academic, and new vs established providers is reported in this study. Relatively low percentages of patients wearing lenses with advanced landing zones or optical designs suggest that these new options have not been widely adopted., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Financial disclosures: M. Schornack, C. Nau, D. Cao: None. E. Shorter: Research: Johnson and Johnson. A. Nau: Paid lecturer: EyeEcco; Consultant: Oyster Point Pharmaceuticals. J. Harthan: Consultant: Allergan, Essilor, Euclid, International Keratoconus Academy, Metro Optics, Visioneering Technologies, Inc; Research: Bausch and Lomb, Kala Pharmaceuticals, Ocular Therapeutix, Metro Optics. J. Fogt: Research: Alcon, Nevakar, Eyenovia, Qualis., (Copyright © 2021 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

Objectives: To assess dry eye symptoms associated with different contact lens modalities in patients with keratoconus using a dry eye questionnaire., Methods: An online survey was distributed by the National Keratoconus Foundation. The survey asked participants to report demographic characteristics, current optical correction, age at the time of diagnosis of keratoconus, and contact lens history. The 12-item Ocular Surface Disease Index (OSDI) questionnaire was also completed. Data from participants wearing the same contact lens modality bilaterally were analyzed., Results: The survey was completed by 197 individuals wearing the same contact lens modality bilaterally. The average age of participants at the time of the survey was 47.2±14.8 years (range: 15-87 years), and the average age at which keratoconus was diagnosed was 26.1±9.9 years (range: 8-55 years). The mean overall OSDI score of all participants was 40.2±22.8 (range: 0-100). There was no difference in the mean OSDI scores based on current contact lens modality type (F=1.79; n=187; P=0.13). Based on an OSDI score of 33 or higher, 90% of participants reported symptoms indicative of dry eye disease. Scleral lens wearers reported less discomfort on the individual items related to windy and low-humidity conditions., Conclusions: Individuals with keratoconus, irrespective of contact lens modality, report a high incidence of dry eye symptoms., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Contact Lens Association of Ophthalmologists.)

Purpose: Dry eye disease (DED) is often managed with over-the-counter eye drops. This study evaluated the diurnal effects of a single drop of two ocular lubricants (nanoemulsion vs. non-emollient) on tear film lipid layer thickness (LLT) and symptoms of ocular dryness. Subjects were also assessed after 1 month of nanoemulsion eye drop use., Methods: Part 1 was a cross-over comparison of a nanoemulsion and a non-emollient eye drop. LLT and dry eye symptoms were measured at baseline and at 15min, 1h, 2h, 4h and 6h after instillation of each drop. Part 2 was a 1-month observational study assessing LLT and symptoms after 30-day use of the nanoemulsion drop four times daily (qid)., Results: Total of 20 subjects completed the study (mean age=45.6±7.9, 15 female). Part 1 found a significant increase in average LLT 15min after nanoemulsion drop instillation in the overall and inferior third of the tear film for subjects with baseline LLT values <50nm. Average LLT values did not increase after use of the non-emollient. Symptoms of dryness improved up to 6h following instillation of both drops. Part 2 results found that using the nanoemulsion eye drop for 1 month improved symptoms reported on symptom surveys., Conclusion: Nanoemulsion eye drop use increased average LLT in subjects with low baseline levels. Statistically and clinically significant improvement in symptoms were found on symptom surveys after qid-use (four times a day) of the nanoemulsion drop. Results suggest that a nanoemulsion eye drop can benefit subjects with dry eye symptoms., (Copyright © 2020 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose: To estimate the prevalence of patient-reported midday fogging and to identify risk factors for midday fogging., Method: A multicenter, cross-sectional study was conducted with an electronic survey that was distributed to scleral lens practitioners. The survey asked them to describe their most recently examined established scleral lens patient. Respondents provided data about patient-reported midday fogging, patient demographic characteristics, indication for lens wear, lens-wearing schedule, lens design, and care products., Results: Of the 248 survey respondents who indicated whether their patients had midday fogging, 64 (25.8 %) had patients who self-reported such issues. Midday fogging was not associated with demographic characteristics (age, sex, race/ethnicity), indications for scleral lens wear, mean lens diameter (P = .30), haptic design (P = .29), use of a daily cleaner (P = .12), disinfection/storage solution used (P = .71), or filling solution (P = .65). Patients who reported midday fogging more commonly reported redness or irritation associated with scleral lens wear compared with those who did not experience midday fogging (P = .03)., Conclusions: Prevalence of midday fogging in this study was similar to previously reported rates. No specific lens design or care product was associated with patient-reported midday fogging. If inflammatory mediators are elevated in the postlens fluid reservoir of patients with midday fogging, as previously described, the redness or irritation associated with scleral lens wear suggests that ocular surface inflammation may be contributing to this phenomenon., (Copyright © 2020 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

Significance: Scleral lenses (SLs) are increasingly being considered as the initial correction for patients with keratoconus. In this study, keratoconus patients report higher levels of comfort and visual satisfaction with SL compared with corneal gas-permeable lenses (GPs)., Purpose: This study aimed to compare patient satisfaction and care burden associated with GP and SL for the management of keratoconus., Methods: An electronic survey was distributed by the National Keratoconus Foundation from October 2016 to March 2017. Age at diagnosis, initial and current treatment, lens complications, access to care, lens handling time, and annual out-of-pocket treatment costs were collected. Vision, lens comfort, and ease of use satisfaction were rated from 1 to 5., Results: A total of 422 responses were received, including 75 bilateral GP and 76 bilateral SL wearers. Scleral lens wearers had greater satisfaction with vision (3.2 ± 1.1 [SL] vs. 2.6 ± 1.1 [GP]; P < .001) and comfort (3.3 ± 1.0 [SL] vs. 2.2 ± 1.2 [GP]; P < .001) but similar ease of use satisfaction in both groups (2.8 ± 1.1 [SL] vs. 2.7 ± 1.1 [GP]; P < .90). Both groups reported issues with cloudy or foggy vision (GP, 63%; SL, 58%) and contact lens discomfort (GP, 77%; SL, 67%). Although GP wearers reported more issues with lens movement or loss (40 [GP] vs. 18% [SL]), they had fewer difficulties with halos (53 vs. 72% [SL]) and lens handling (40%) compared with SL wearers (63%). Gas-permeable lens (48%) and SL (45%) wearers spend 6 to 10 minutes daily handling their lenses. Sixty percent of GP wearers reported annual out-of-pocket cost expenses less than U.S.$1000, whereas only 41% of SL wearers reported the same., Conclusions: Scleral lens wearers with keratoconus report greater satisfaction with vision and comfort than do GP wearers, although both groups reported cloudy vision and lens discomfort.

In oncology, the "Warburg effect" describes the elevated production of energy by glycolysis in cancer cells. The ubiquitous and hypoxia-induced 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 (PFKFB3) plays a noteworthy role in the regulation of glycolysis by producing fructose-2,6-biphosphate (F-2,6-BP), a potent activator of the glycolysis rate-limiting phosphofructokinase PFK-1. Series of amides and sulfonamides derivatives based on a N-aryl 6-aminoquinoxaline scaffold were synthesized and tested for their inhibition of PFKFB3 in vitro in a biochemical assay as well as in HCT116 cells. The carboxamide series displayed satisfactory kinetic solubility and metabolic stability, and within this class, potent lead compounds with low nanomolar activity have been identified with a suitable profile for further in vivo evaluation., (Copyright © 2018. Published by Elsevier Ltd.)

Purpose: To describe patient-specific outcomes of scleral lens wear utilizing a variety of lens designs across multiple practice settings as reported in an international practitioner survey., Methods: An electronic survey was administered to eye care providers who prescribe scleral lenses in which they were asked to describe their most recently examined established scleral lens patient. Data was collected on patient characteristics, lens designs, wearing schedules, care products, and visual and physiological outcomes of lens wear. Descriptive analysis of data was performed., Results: A total of 292 responses were received. Participants represented 26 countries. The most commonly reported indication for scleral lens wear was corneal irregularity (87%) followed by ocular surface disease (8%), refractive error (4%) and 1% with multiple indications. Visual acuity improved from 0.4 ± 0.4 (mean ± SD) to 0.1 ± 0.2 in eyes with corneal irregularity (p < 0.001), from 0.3 ± 0.3 to 0.1 ± 0.3 in eyes with ocular surface disease (p < 0.001), and from 0.1 ± 0.1 to 0.0± [0.1] in eye with refractive error (p = 0.01). Prior to scleral lens wear, corneal staining was present in 55% of patients; staining was present in only 35% of patients following scleral lens wear. The number of topical ophthalmic drops needed decreased from 1.7 ± 0.9 to 0.8 ± 0.8 in patients with corneal irregularity (p < 0.001) and from 3.5 ± 1.7 to 1.1 ± 1.0 in patients with ocular surface disease (p < 0.001). The number of drops used by patients with refractive error remained stable, with these patients using an average of 2.0 ± 1.0 drops prior to scleral lens wear and 1.7 ± 1.5 drops following scleral lens wear., Conclusions: Patients with corneal irregularity experienced the greatest improvement in visual acuity, but patients with ocular surface disease and refractive error also achieved better visual acuity with scleral lenses. Ocular surface condition improved in patients with both corneal irregularity and ocular surface disease; patients with ocular surface disease experienced the most dramatic improvement. Patients who wore scleral lenses to correct uncomplicated refractive error did not experience an improvement in signs or symptoms of ocular surface disease., (Copyright © 2018 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

Purpose: To describe prescriber reported scleral lens fitting and assessment strategies., Methods: The SCOPE (Scleral Lenses in Current Ophthalmic Practice Evaluation) study group designed and administered an IRB approved, electronic survey (REDCap) regarding current scleral lens fitting and assessment methods. The survey was distributed to attendees of the 2017 Global Specialty Lens Symposium., Results: 95 practitioners responded to the survey. Over half of the respondents, 58% (55/95) reported fitting scleral lenses for less than five years (new prescribers), and 42% (40/95) reported fitting scleral lenses for more than five years (experienced prescribers). There was a statistically significant difference between their initial use of technology (χ 2  = 21.117, p < 0.0005) in selection of a diagnostic lens. New prescribers consider base curve first (60%, 33/55), while experienced prescribers considered sagittal depth first (63%, 25/40) in their initial scleral lens selection. All of the experienced lens prescribers (100%, 39/39) reported estimating central clearance by comparing thickness of the post-lens tear reservoir to scleral lens thickness using a slit lamp beam at least some of the time, and 62% of new scleral lens prescribers (34/55; χ 2  = 19.175, p < 0.0005) reported doing so. All (100%, 40/40) experienced prescribers schedule scleral lens follow-ups at a specific time and assess conjunctival compression (100%, 40/40), conjunctival staining (100%, 39/39), and corneal staining (100%,40/40) after lens removal., Conclusions: Practitioners with varying backgrounds and experience have added sclerals to their lens inventories. However, definite guidelines for fitting have not been developed. The results of a survey are provided; demonstrating that among practitioners with greater than 5 years of scleral lens experience, a consensus has emerged for best practices. Strategies for lens evaluation, which may inform future efforts at generating scleral fitting standards are described., (Copyright © 2018 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

Energy and biomass production in cancer cells are largely supported by aerobic glycolysis in what is called the Warburg effect. The process is regulated by key enzymes, among which phosphofructokinase PFK-2 plays a significant role by producing fructose-2,6-biphosphate; the most potent activator of the glycolysis rate-limiting step performed by phosphofructokinase PFK-1. Herein, the synthesis, biological evaluation and structure-activity relationship of novel inhibitors of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 (PFKFB3), which is the ubiquitous and hypoxia-induced isoform of PFK-2, are reported. X-ray crystallography and docking were instrumental in the design and optimisation of a series of N-aryl 6-aminoquinoxalines. The most potent representative, N-(4-methanesulfonylpyridin-3-yl)-8-(3-methyl-1-benzothiophen-5-yl)quinoxalin-6-amine, displayed an IC 50 of 14 nm for the target and an IC 50 of 0.49 μm for fructose-2,6-biphosphate production in human colon carcinoma HCT116 cells. This work provides a new entry in the field of PFKFB3 inhibitors with potential for development in oncology., (© 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

A series of novel 2'-C-methylribonucleosides, involving 5-iodo and 5-alkynyl uridine analogues as well as related bicyclic furano- and pyrrolo[2,3-d]pyrimidinone compounds, has been synthesized and evaluated for their inhibitory effect on replication of the hepatitis C virus (HCV). The new nucleoside analogues did not show meaningful anti-HCV activity.

A series of novel derivatives of 2'-C-beta-methylcytidine, involving nucleosides modified in the "upper part" of the pyrimidine base (N(4)- and/or 5-position), has been synthesized and evaluated for their inhibitory effect on in vitro replication of the hepatitis C virus and the yellow fever virus (both Flaviviridae).