According to the Tear Film and Ocular Surface Society report on contact lens discomfort (CLD), the only CL material-related factor that demonstrates correlation with CLD is coefficient of friction.6 However, until researchers agree upon an industry-standard methodology to measure friction of CL materials, this remains a difficult area to study. Other material-related factors, such as oxygen transmissibility, wettability, modulus and lens dehydration, only display weak links with CLD. Lens replacement frequency, lens design, thickness/bulk and edge configuration also show some relationship to CLD.5
Over the past few years, CL companies have debuted technologies aimed at developing lenses with surface and bulk properties that reduce discomfort. Some Silicone hydrogel (SiHy) materials even hope to address patient-related issues, such as digital eyestrain. This article reviews the latest SiHy materials that manufacturers hope will reduce patient discomfort as well as new CL materials and designs of other lens types.
Plaquenil (hydroxychloroquine, Sanofi-Aventis) has been used as anti-rheumatic drug therapy for conditions such as systemic lupus erythematosus and rheumatoid arthritis for years, despite its risk of irreversible macular toxicity. Historically, patients have been monitored using subjective measures such as visual field testing and objective findings during fundus examination, often leading to diagnosis of late-stage toxicity. However, it is crucial that clinicians identify the earliest signs of toxicity, as the risk of progressive vision loss extends even after discontinuation of Plaquenil. This is where new guidelines and advanced technology can help.
This article discusses the risks associated with Plaquenil therapy and the updated American Academy of Ophthalmology guidelines designed to help clinicians better detect and monitor macular toxicity associated with long-term Plaquenil use. Several diagnostic tools are key to detecting macular toxicity as early as possible to ensure discontinuation of the drug before adverse sequelae threaten patients’ vision.
When Lacie Truitt, OD, moved to Texas in April 2015 for her husband’s new job, she began looking for some fill-in optometry work.
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