ABSTRACT
Purpose: The purpose of this study was to analyze the differences in corneal sensory nerve functionality in young asymptomatic (CL-A) and symptomatic (CL-S) contact lens (CL) users. Methods: CL wearers (23.8 ± 1.0 years, n = 31) were classified as CL-S with an Ocular Surface Disease Index (OSDI) ≥ 13 (n = 14) or CL-A. Users of eye glasses (EG; 24.5 ± 0.8 years, n = 29) with OSDI < 13 participated as controls. The sensations evoked by mechanical, chemical (gas esthesiometer), and cold (4°C saline drops) stimuli were measured using the Visual Analogue Scales (VASs). Moreover, tear volume, tear break up time (TBUT), blinking frequency (BF), and ocular surface temperature (OST; IR thermography) were also measured. Results: Mechanical and chemical stimuli produced similar scores in the CL-A and EG participants, although the CL-A subjects referred to stronger irritation (p < 0.05). Likewise, the VAS intensity in response to cold stimuli did not differ between CL-A and EG subjects, while the ability to detect cold was significantly worse in CL-S users (p < 0.05). CL-A users had a similar tear volume, a higher BF (p < 0.01) and shorter TBUT (p < 0.001) to EG wearers, and blinking and TBUT were also altered significantly in CL-S users (p < 0.01). Interestingly, the OST was significantly lower in CL-A users (p < 0.05) than in EG wearers, but not in CL-S users. Conclusions: Using CLs modifies corneal sensitivity, blinking and tearing in young volunteers. Even if they have yet to develop clinical signs of inflammation, they display changes in corneal sensitivity consistent with the sensitization of corneal nociceptors and the inhibition cold thermoreceptors, phenomena that occur under inflammatory conditions. The differences in corneal sensitivity and OST between CL-A and CL-S users could reflect the extent of nerve damage and inflammation at the ocular surface.
Subject(s)
Contact Lenses, Hydrophilic , Contact Lenses , Dry Eye Syndromes , Lacrimal Apparatus Diseases , Humans , Cornea/physiology , Blinking , Tears , Inflammation , Contact Lenses, Hydrophilic/adverse effects , Dry Eye Syndromes/etiologyABSTRACT
Dry eye disease (DED) is difficult to detect in young contact lens (CL) wearers, who usually have no signs, mild symptoms and an ocular surface disease index (OSDI) below the DED diagnosis values (OSDI ≥ 13). We investigate if some of the 12 OSDI questions (OSDI Aocular symptoms; OSDI Bvision-related functionality; OSDI Cenvironmental triggers) contribute the most to classify young CL as symptomatic. TBUT and tear volume are also measured. Age, gender and refraction error-matched eye glasses (EG) wearers participated as the control. CL and EG data were compared with t-test and z-test. Confusion matrices and logistic correlation analyses were performed to define the contribution of each OSDI question to classify symptomatic subjects. OSDI classified symptomatic CL better than the tear volume or TBUT values. In CL, only OSDI B and C values were significantly higher in symptomatic vs. asymptomatic subjects (p < 0.001), while values of all twelve OSDI questions were significantly higher in symptomatic vs. asymptomatic EG (p < 0.05−0.001). All OSDI questions contribute equally to identify symptomatic EG, while only OSDI B questions on daily life visual functions are significant to classify symptomatic CL wearers at risk to develop DED or at a subclinical stage. CL wearers scoring ≥ 2 on the OSDI B questions should be considered for preventive treatments, even if their clinical sings are scarce or absent.
ABSTRACT
Objetivos: recoger y analizar las técnicas que usan los terapeutas ocupacionales en el tratamiento de la heminegligencia, para posteriormente comprobar si en la práctica clínica se utilizan técnicas con evidencia científica. Métodos: la realización de este estudio se ha llevado a cabo a través de una encuesta, la cual se ha difundido desde varios Colegios Oficiales de Terapeutas Ocupacionales. Resultados: se obtuvieron 85 respuestas y la técnica que mejor resultado proporcionó en el tratamiento de la heminegligencia es Entrenamiento en Actividades de la Vida Diaria. Aunque esta técnica de buenos resultados en la práctica clínica no tiene una evidencia sólida. La técnica que más evidencia tiene actualmente en el tratamiento de la heminegligencia es la Adaptación de Prismas. Conclusiones: se necesita investigar más desde Terapia Ocupacional para basar nuestra práctica clínica en la evidencia científica y poder obtener buenos resultados en la rehabilitación de la heminegligencia visuoespacial. (AU)
Objective: to collect and analyse the techniques used by occupational therapists in the treatment of visuospatial hemineglect, in order to subsequently check whether techniques with scientific evidence are used in clinical practice. Methods: this study has been carried out by means of a survey, which has been disseminated by several Official Associations of Occupational Therapists. Results: 85 responses were obtained and the technique that provided the best results in the treatment of hemineglect is Training in Activities of Daily Living. Although this technique has good results in clinical practice, there is no solid evidence. The technique that currently has the most evidence in the treatment of hemineglect is Prism Adaptation. Conclusions: more research is needed from Occupational Therapy to base our clinical practice on scientific evidence and to obtain good results in the rehabilitation of visuospatial hemineglect. (AU)
