Soft Contact Lens-Related Symptoms in North America and the United Kingdom.

PURPOSE: To characterize and compare the prevalence of soft contact lens-related (SCL) dryness symptoms in large populations of SCL wearers in North America (NAm) and the United Kingdom (UK). METHODS: SCL wearers from NAm (n = 1443) and UK (n = 932) sites completed self-administered questionnaires on SCL symptoms and wearing experiences. A categorization for contact lens-related dry eye (CL-DE) was applied that combined Contact Lens Dry Eye Questionnaire (CLDEQ) items on dryness frequency and intensity at the end of the day (CL-DE+ = constantly/frequently/sometimes plus intensity = 3-5, and CL-DE- = never/rarely plus intensity = 0-1, Marginal = all other ratings). Data were analyzed across regions and categories, with p-values <0.05 significant. RESULTS: Compared to UK wearers, those in NAm wore fewer toric and multifocal designs, and reported significantly longer average and comfortable wearing times (p < 0.001) but similar levels of general and end-of-day comfort. The prevalence of CL-DE+ differed between the UK and NAm: CL-DE+: 31 vs. 39%, Marginal CL-DE: 13 vs. 14%, and CL-DE-: 56 vs. 47%, p = 0.0001. Although daily disposable (DD) lenses were worn more commonly in the UK than NAm (33 vs. 10%, p < 0.0001), their use did not impact the overall prevalence of dryness symptoms. Between regions, NAm wearers reported significantly more frequent and intense end-of-day discomfort and dryness (p < 0.0001) and were significantly more likely to use treatments for CL-related symptoms yet experienced a lower degree of relief. CONCLUSIONS: SCL wearers in NAm reported longer hours of wear with significantly more symptoms of dryness and discomfort. NAm wearers used dryness treatments more often, but experienced less relief than UK wearers. In both regions, the CL-DE categorization was useful to predict poorer comfort, shorter comfortable wearing time, and increased use of treatments. These results highlight the need to benchmark SCL performance locally or regionally to understand and focus on the challenges to the lens wearing experience.

Soft contact lens-related dryness with and without clinical signs.

PURPOSE: To report demographics, wearing patterns, and symptoms from soft contact lens (SCL) wearers with significant SCL-related dryness symptoms with and without significant ocular signs of dryness. METHODS: In a multicenter, prospective observational clinical trial, symptomatic SCL wearers reported significant SCL-related dryness via self-administered questionnaire of frequency and intensity of dryness after a dry eye (DE) examination. DE etiology was assigned post hoc by an expert panel, and those with and without significant DE-related signs were analyzed by univariate logistic regression. Possible DE etiologies were aqueous tear deficiency, SCL-induced tear instability, meibomian gland dysfunction, or "other." Wearers without signs that qualified for any DE etiology were designated as No DE Signs (NDES). RESULTS: Of the 226 SCL symptomatic wearers examined, 23% were without signs, 30% had aqueous tear deficiency, 25% had SCL-induced tear instability, 14% had meibomian gland dysfunction, and 8% had "other" diagnoses. The NDES wearers had significantly longer pre-lens break-up time (9.8 vs. 6.6 s, p < 0.0001), better lens wetting (3.4 vs. 2.4 0 to 4 scale, p < 0.0001), lower levels of film deposits on lenses (0.45 vs. 0.92, 0 to 4 scale, p < 0.0001), and of most slit lamp signs. The NDES wearers were significantly more likely to be male (36% vs.19%, p = 0.013), were less likely to have deteriorating comfort during the day (81% vs. 97%, p = 0.001), reported longer average hours of comfortable wear (11 ± 3 vs. 9 ± 4 h, p = 0.014), had older contact lenses (18 ± 14 vs. 13 ± 12 days, p = 0.029), and greater intensity of photophobia early and late in the day (p = 0.043 and 0.021). CONCLUSIONS: Symptoms of dryness in SCL wearers stem from a variety of underlying causes. However, nearly one-quarter of these symptomatic SCL wearers appear to be free of signs of dryness. The effective management of CL-related dryness requires a comprehensive range of clinical assessments and the use of a diverse range of management strategies.

Characterizing contact lens-related dryness symptoms in a cross-section of UK soft lens wearers.

PURPOSE: To estimate the prevalence of and factors associated with contact lens-related dryness symptoms in a large population of soft contact lens patients in the UK. METHODS: Soft contact lens (CL) wearers (n=932) from 12 UK clinical sites were queried regarding CL history and wearing experience by a self-administered questionnaire. A new score using Contact Lens Dry Eye Questionnaire (CLDEQ) items was used where CL-related dry eye (CL-DE)=frequency of 'sometimes', 'frequently', or 'constantly' plus intensity 3-5; NoCL-DE=frequency of 'never' or 'rarely' and intensity 0-1; Marginal CL-DE, all other categories. Data were analyzed across categories, P-values <0.05 significant. RESULTS: The prevalence of CL-DE was: CL-DE=31%, Marginal CL-DE=13% and NoCL-DE=56%. Wearers with CL-DE had significantly lower typical comfort (CL-DE=7.0 ± 1.9; Marginal=7.6 ± 1.9; NoCL-Dry=8.7 ± 1.8, P<0.001), end-of-day comfort (CL-DE=4.9 ± 2.5; Marginal=6.1 ± 2.0; NoCL-DE=7.8 ± 2.1, P<0.001) and shorter comfortable wearing times in hours (CL-DE=9.1 ± 4.4; Marginal=9.8 ± 3.6; NoCL-DE=12.4 ± 5.1, P<0.001). Positive CL-DE status was significantly more likely among toric lens wearers (n=129) compared to spherical lens wearers (43% vs. 30%, P=0.04). Lens material class, lens care system and gender were not significantly related to CL-DE status. Of the CL-DE group, only 38% had been diagnosed with dry eye and 47% self-assessed as dry eye. Use of artificial tears, CLs for dryness, ointments/gels and warm compresses differed between groups according to CL-DE status (P<0.001, all comparisons). CONCLUSIONS: The survey provided useful data regarding the current status symptoms among UK soft CL wearers. The CL-DE score predicted patients' wearing experience; poorer comfort, shorter comfortable wearing time and increased use of treatments.