Dataset Information

Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training.

ABSTRACT: Biofeedback training has been used to access autonomically-controlled body functions through visual or acoustic signals to manage conditions like anxiety and hyperactivity. Here we examined the use of auditory biofeedback to improve accommodative responses to near visual stimuli in patients wearing single vision (SV) and multifocal soft contact lenses (MFCL). MFCLs are one evidence-based treatment shown to be effective in slowing myopia progression in children. However, previous research found that the positive addition relaxed accommodation at near, possibly reducing the therapeutic benefit. Accommodation accuracy was examined in 18 emmetropes and 19 myopes while wearing SVCLs and MFCLs (centre-distance). Short periods of auditory biofeedback training to improve the response (reduce the lag of accommodation) was performed and accommodation re-assessed while patients wore the SVCLs and MFCLs. Significantly larger accommodative lags were measured with MFCLs compared to SV. Biofeedback training effectively reduced the lag by ?0.3D in individuals of both groups with SVCL and MFCL wear. The training was more effective in myopes wearing their habitual SVCLs. This study shows that accommodation can be changed with short biofeedback training independent of the refractive state. With this proof-of-concept, we hypothesize that biofeedback training in myopic children wearing MFCLs might improve the treatment effectiveness.

SUBMITTER: Wagner S

PROVIDER: S-EPMC7081315 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training.

Wagner Sandra S Schaeffel Frank F Troilo David D

Scientific reports 20200319 1

Biofeedback training has been used to access autonomically-controlled body functions through visual or acoustic signals to manage conditions like anxiety and hyperactivity. Here we examined the use of auditory biofeedback to improve accommodative responses to near visual stimuli in patients wearing single vision (SV) and multifocal soft contact lenses (MFCL). MFCLs are one evidence-based treatment shown to be effective in slowing myopia progression in children. However, previous research found t ...[more]

PMID: 32193512

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Project description:ObjectiveThe purpose of this study was to evaluate the wear experience of satisfied wearers of a particular reusable toric soft contact lens when refit into a water surface technology daily disposable toric soft contact lens.Methods30 participants completed the study over three visits. At the first visit, subjects were refit into with their habitual reusable toric soft contact lens (comfilcon A) to maximize fit and vision. Subjects returned after one week and were then refit into the study daily disposable soft contact lenses (verofilcon A) and completed surveys of their initial impressions of comfort, vision, and satisfaction. Participants wore the study lenses for two weeks, and then returned for their final visit to complete a vision and ocular health check. At the final visit, subjects also completed surveys to rate their overall and end-of-day comfort, quality of vision, stability of vision, and dryness using a visual analog scale (VAS). Participants also answered questions about their wear experience with the lenses. Overall median and interquartile range (IQR) of all data and surveys was calculated.ResultsInitial impressions of the study lenses revealed a median (IQR) score of 85 (28) for vision, 91 (25) for comfort, and 87 (21) for satisfaction. Overall VAS scores after two weeks of wear found median scores of 93 (16) for quality of vision, 88 (28) for stability of vision, and 91 (20) for comfort. End-of-day median scores were 82(27) for quality of vision, 90 (35) for stability of vision, and 80 (38) for comfort. Overall dryness scores were 20(45) and end-of-day dryness was 39 (46). Median(IQR) binocular logMAR visual acuity with the study lenses was -0.16(0.1). Median rotation of the lenses was 0(4.3) degrees.ConclusionParticipants wearing the daily disposable study lenses for astigmatism gave high scores in vision and comfort both at initial fitting and after two weeks of lens wear. Results showed that satisfied wearers of comfilcon A reusable toric soft contact lenses can be successfully refit with verofilcon A daily disposable contact lenses.

Project description:IntroductionSoft contact lens wearers are often prescribed the same lens material and modality for multiple years if patients express satisfaction and no significant problems with lens fit or ocular health are noted upon evaluation. Despite their satisfaction, it is possible that other lenses exist that could provide additional health or convenience benefits and still provide satisfied lens wear experience.MethodsIn this study, wearers of a specific monthly replacement lens brand (comfilcon A) were recruited for an open-label study. The habitual contact lens prescription was optimized for 2 weeks of wear and participants confirmed that they were satisfied with their habitual lenses before being refit with daily disposable lenses (verofilcon A). Participants responded to visual analog scale (VAS) survey about their initial impressions of the lenses. After 2 weeks of lens wear, participants completed a final study visit and completed surveys about lens wear experiences with the daily disposable study lenses.ResultsFifteen male and 15 female participants completed the study. Median (IQR) binocular LogMAR visual acuity was -0.20(0.12), which is equivalent to 10/12.5 Snellen acuity. Initial impression surveys revealed median (interquartile range) of 92.5(22.3) for quality of vision; 95.0(19.3) for comfort; and 91.5(19.3) for satisfaction. At the final visit, median scores for EOD quality of vision was 86.5(24.0); EOD comfort was 84.5(30.3), and EOD dryness 25.5(47.0). Median overall VAS scores were 92.5(16.0) for vision; 88.0(18.3) for comfort, and 17.5(25.8) for dryness. Median satisfaction with the study lenses was scored 9(2.8) on a 1-10 scale.ConclusionsIn this study, satisfied wearers of comfilcon A reusable lens were refit with Verofilcon A daily disposable lenses and showed high satisfaction scores with the new lenses, showing that refitting these patients can allow patients to have lenses with more frequent replacement and maintain satisfaction with daily lens wear.

Project description:PurposeMicrobial contamination of contact lenses is associated with corneal infection and inflammation. This study determined the microbiological, clinical, and demographic factors that are associated with bacterial contamination of a silicone hydrogel contact lens when worn for continuous wear (CW).MethodsTwo hundred five healthy subjects were enrolled in the Longitudinal Analysis of Silicone Hydrogel Contact Lens Study and were fitted with lotrafilcon A lenses for monthly CW and followed for 1 year. Lenses were aseptically removed after 1 week and 4 months of wear and cultured using an agar sandwich technique. Lids and conjunctiva were routinely cultured at baseline and after 1 week and 4 months of CW. Lenses and ocular sites were considered to have substantial microbial bioburden when they harbored pathogenic organisms or high levels of commensal organisms. Univariate and multivariate logistic regression analyses were conducted to examine whether substantial conjunctival or lid bioburden, subject demographics, lens-wearing history, symptoms, and biomicroscopic signs were associated with lens bioburden.ResultsAbout one third (32.4%) of subjects had substantial bacterial bioburden in either eye across multiple visits. Over half (53.2%) and about one tenth (11.7%) of subjects had substantial lid and conjunctival bioburden, respectively, and 11.2% discontinued because of discomfort. The adjusted odds ratios (and 95% confidence intervals) for presence of substantial lens bioburden were 2.49 (1.17-5.30), 4.24 (1.45-12.40), and 4.11 (1.17-14.46) for substantial lid bioburden, substantial conjunctival bioburden, and lens discomfort, respectively.ConclusionsBacterial contamination of silicone hydrogel contact lenses is common during CW. Substantial lens bioburden is associated with discomfort precluding successful CW. The presence of substantial lid and conjunctival bioburden is associated with a 2.5-fold and more than fourfold greater risk of substantial lens bioburden and is likely the major route of contamination.

Dataset Information

Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training.

Publications

Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training.

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