Michael G. Harris

Vision and task performance with monovision and diffractive bifocal contact lenses

We measured vision and task performance on 26 presbyopes, ages 46 to 65 years, fitted with diffractive bifocal contact lenses (BFCL) and monovision contact lenses (MVCL). Distance contact lenses combined with reading spectacles (DCL) served as the control condition. Twenty subjects completed the 6-week study. All subjects wore BFCL and MVCL daily for a period of 3 weeks each. Performance times for three near tasks were 6 to 8% longer with BFCL compared with DCL and 2 to 6% longer for MVCL compared with DCL. There were significant reductions in distance visual acuity with BFCL (0.4 to 1.5 Snellen lines) and MVCL (0.5 to 0.8 Snellen lines) compared to DCL. At the conclusion of the study, given a choice between BFCL and MVCL, 2 of the 20 subjects chose to continue wearing BFCL, whereas 18 of the 20 subjects chose MVCL. Our results show greater visual compromise and decreased task performance with BFCL and MVCL compared to DCL and greater patient preference for MVCL

Refractive index of the cornea as a function of its thickness.

ABSTRACT This paper analyzes the relationship between corneal thickness and corneal refractive index. A refractive index change of the cornea when it thickens within the clinically observed range does not lead to a significant error in the corneal thickness measurement made by pachometry.

Ultraviolet transmittance of contact lenses

Chronic and acute exposure to ultraviolet (UV) radiation has been shown to have deleterious effects on all layers of the human eye. As a consequence, appropriate protective measures have been advocated with respect to exposure to this form of radiation. Among suggested actions are spending less time in the sun and wearing protective visual aids such as those containing UV-absorbing materials when exposed to sunlight. To investigate the protective ability of currently available contact lens materials we measured the transmittance characteristics of 11 different types of soft and rigid contact lenses in the UV and visible range from 280 to 500 nm with a Zeiss model DM4 Dual Beam Spectrophotometer. Our findings indicate that lenses not treated with UV absorbers transmitted most of the UV radiation. Lenses containing UV absorbers provided excellent UV protection and transmitted significantly less UV radiation than the untreated lenses (Students t-test with Bonferonis correction, N = 10, p < 0.001). Based on our findings, we recommend that contact lenses with UV absorbers be considered as a viable option for providing UV protection, especially for aphakic patients, patients taking photosensitizing pharmaceutical agents, and those patients who spend a great deal of time outdoors.

in Vivo Dehydration of Disposable (acuvue) Contact Lenses

The in vivo dehydration of the Acuvue disposable contact lens was measured in six subjects using a contact lens refractometer. On average, the lenses dehydrated 6.2 ± 1.9% after 20 min and 10.2 ± 3.9% after 6 h of wear. The magnitude of dehydration is greater than has been reported for other hydrogel lens types of similar water content. This information may assist practitioners in the interpretation of clinical signs pertaining to lens behavior and associated patient symptoms.

Task and visual performance with concentric bifocal contact lenses.

We evaluated the effects of concentric simultaneous vision bifocal contact lenses on task performance, visual acuity, and stereopsis. Forty extensively screened presbyopes were fitted with CIBA Spectrum centernear bifocal contact lenses (BCL) and with distant contact lenses combined with reading spectacles (DCL) which served as the control. Thirty-two subjects completed the 8-week study. At dispensing and after 8 weeks of regular BCL wear, performance times with BCL were significantly greater than with DCL for all three near tasks. BCL generally resulted in more errors per trial. Visual acuities with BCL were reduced significantly by 0.8 to 1.4 acuity lines compared to DCL. Stereopsis was reduced significantly by 32 to 36 sec arc with BCL compared to DCL at both measurement sessions. It is likely that the decreased task performance with the simultaneous vision BCL is caused by the decreased visual acuity with these lenses. Nonetheless, 27 patients (58.7% of those selected to be fitted; 67.5% of those who were fitted) chose to wear the BCL on a regular basis at the study conclusion. Thus, even though BCL reduced task and visual performance, thoroughly screened and properly fitted presbyopic patients can become satisfied BCL wearers. However, the reduced task and visual performance with BCL should be considered when evaluating prospective BCL candidates.

Monovision contact lens wear and occupational task performance

ABSTRACT The effects of monovision (MV) contact lens wear on the performance of occupational‐type nearpoint tasks was evaluated on 18 presbyopic subjects (ages 44 to 67 years) by comparing MV performance (MV condition) to that with distance contact lenses with reading glasses (BV condition). Each subject had correctable distance visual acuity of 6/6 (20/20) in each eye, at least 60 sec arc of near stereopsis, good ocular health, and no previous MV experience. Time performance and error performance for 3 nearpoint occupational tasks (pointers and straws, card filing, and letter editing) were measured with the MV correction and BV correction. Measurements were taken at dispensing and at 2 weeks and 8 weeks after dispensing. Subjects were instructed to wear the MV soft spherical contact lenses at least 8 h per day. We measured BV time performance to be better than MV time performance by 2.8 to 5.7% and also measured an increased number of errors with MV.

Corneal curvature and refractive error changes associated with wearing hydrogel contact lenses.

&NA; To determine if there are corneal curvature and refractive error changes associated with hydrogel lens wear, 27 patients wearing F series Bausch & Lomb SOFLENSTM contact lenses were examined regularly for nine months. During the first month of lens wear, a mean corneal steepening of 0.23 DK ±0.18 and an increase in with‐the‐rule toricity were found, which persisted during the following eight months of wear. A mean increase in myopia of 0.35 DS ±0.211 DS was found after nine months of lens wear for five randomly selected patients. This amount of change was statistically significant and was highly correlated with the observed corneal steepening. Their lenses were removed after nine months of lens wear. Both corneal changes and the increase in myopia persisted during the 14 days after lens removal. If long term studies with larger samples show similar results, the effect of hydrogel lenses on corneal curvature and refractive error will have to be considered in the decision to fit this type of lens.

In-office microwave disinfection of soft contact lenses

We evaluated the effectiveness of an in-office microwave disinfection procedure which allowed for the disinfection of up to 40 soft contact lenses at one time. Ciba AOSept cases filled with sterile unpreserved saline were contaminated with one of six FDA test challenge microorganisms at a concentration of approximately 10(3) colony forming units per milliliter (CFU/ml). Twenty cases were placed on the rotating plate of a standard 2450 MHz 650 W microwave oven in a 10-cm diameter circle. The cases were exposed to high intensity microwave irradiation for periods of 0 to 15 min. None of the 6 microorganisms evaluated survived 2 min or longer of microwave exposure. Our findings indicated that microwave irradiation can be a convenient, rapid, and effective method of disinfecting a number of soft contact lenses at one time and thus adaptable as an in-office soft contact lens disinfection procedure.

Contanct lens adaptation: osmotic theory.

ABSTRACT Corneal thickness changes were measured and used as an index of the effect of contact lenses on normal corneal physiology to study the contact lens adaptation process and to evaluate fitting relationships. The adaptation process may be accounted for on the basis of the decrease in tearing which accompanies neural adaptation of the receptors in the lid margins to stimulation by a contact lens and which produces a more normal tear tonicity.

Transmittance of tinted and UV-blocking disposable contact lenses

PURPOSE Tinted and ultraviolet (UV)-blocking disposable contact lenses have become increasingly popular over the last decade. Wearers of UV-blocking contact lenses could benefit greatly by protecting their eyes from potential UV radiation damage. A Uvikon 930 dual beam spectrophotometer was used to measure three enhancement-tinted lenses (royal blue, evergreen, and aqua), two types of UV-blocking lenses, and two types of non-UV-blocking lenses. Enhancement-tinted lenses did show a decrease in transmittance at certain wavelengths on the visible spectrum, but they did not reduce the transmittance of UV radiation to the extent of the UV-blocking lenses designed specifically for this purpose.