Scleral lenses (SLs) are large-diameter rigid contact lenses that are a mainstay treatment for eyes with corneal irregularities. In recent years, there has been increased interest in the role of managing dry eye disease (DED) with SLs, as many patients with DED have reported symptomatic relief with SL wear. The role of SLs for DED management when there are associated corneal irregularities is supported by individual case reports and studies. This has prompted practitioners to begin advocating using SLs in DED cases, even in the absence of associated corneal irregularities and other ocular surface diseases (OSDs). There have also been discussions on potentially placing SLs earlier in the treatment hierarchy of DED, where it currently sits at a more advanced level of intervention (Step 3) in the TFOS DEWS II Report. This review will present the currently available, albeit sparse, evidence that supports and suggests this practice, as well as ancillary evidence supporting the purported benefits of SL wear in DED. The advantages of SL wear, such as corneal healing, absence of tear evaporation and contact lens dehydration, and improved visual acuity with associated increased wear comfort, and how this will benefit DED patients will be explored. Conversely, the challenges associated with fitting SLs in DED patients, including increased midday fogging, poor wettability, and subjective patient satisfaction, will also be presented, as well as a discussion on the key considerations for SL fitting in this population. Overall, while more research is needed to support the use of SLs in DED patients without associated corneal irregularities and other forms of OSD, the use of these lenses may prove to have a potentially wider role given their reported ancillary benefits in these populations.

BACKGROUND: Previous studies have suggested that light rays may interact with contact lenses, potentially affecting their transmittance.
OBJECTIVE: This study aimed to investigate the effects of visible and ultraviolet (UV)-A light sources on the transmittance of some commercially available daily, weekly, and monthly contact lenses.
METHODS: Nine commercially available soft contact lenses were irradiated with a solar simulator, light-emitting diode (LED) source, laser source, and UV-A source. The average transmittance of the tested lenses before and after irradiation in the UV, visible, and infrared light wavelength ranges was determined using an Agilent UV-visible spectrophotometer, model 8453.
RESULTS: The results showed a partial or complete block of UV transmission at the UV-B region (300 nm) and the UV-A region (355 nm) by the Bio true daily contact lens, as well as the Acuvue Oasys, Avaira, and Biomedics 55 weekly lenses. At the visible region (555 nm), irradiation of the contact lenses by different light sources resulted in reduced light transmittance. At the infrared region (900 nm), the weekly and monthly contact lenses partially blocked infrared transmission, while the daily lenses showed either increased or decreased infrared transmission.
CONCLUSIONS: Solar and artificial lighting, as well as high-powered lasers, constitute a major concern on the contact lenses\' light transmission and optical properties. It is essential to develop soft contact lenses that have photoprotective properties while maintaining visible light transmittance.

Topical ophthalmic solutions (eye drops) are becoming increasingly popular in treating and preventing ocular diseases for their safety, noninvasiveness, and ease of handling. However, the static and dynamic barriers of eyes cause the extremely low bioavailability (<5%) of eye drops, making ocular therapy challenging. Thus, drug-eluting corneal contact lenses (DECLs) have been intensively investigated as a drug delivery device for their attractive properties, such as sustained drug release and improved bioavailability. In order to promote the clinical application of DECLs, multiple aspects, i.e., drug release and penetration, safety, and biocompatibility, of these drug delivery systems were thoroughly examined. In this review, we systematically discussed advances in DECLs, including types of preparation materials, drug-loading strategies, drug release mechanisms, strategies for penetrating ocular barriers, in vitro and in vivo drug delivery and penetration detection, safety, and biocompatibility validation methods, as well as challenges and future perspectives.

The wearable contact lens that continuously monitors intraocular pressure (IOP) facilitates prompt and early-state medical treatments of oculopathies such as glaucoma, postoperative myopia, etc. However, either taking drugs for pre-treatment or delaying the treatment process in the absence of a neural feedback component cannot realize accurate diagnosis or effective treatment. Herein, a neuroprosthetic contact lens enabled sensorimotor system is reported, which consists of a smart contact lens with Ti3C2Tx Wheatstone bridge structured IOP strain sensor, a Ti3C2Tx temperature sensor and an IOP point-of-care monitoring/display system. The point-of-care IOP monitoring and warning can be realized due to the high sensitivity of 12.52 mV mmHg-1 of the neuroprosthetic contact lens. In vivo experiments on rabbit eyes demonstrate the excellent wearability and biocompatibility of the neuroprosthetic contact lens. Further experiments on a living rate in vitro successfully mimic the biological sensorimotor loop. The leg twitching (larger or smaller angles) of the living rat was demonstrated under the command of motor cortex controlled by somatosensory cortex when the IOP is away from the normal range (higher or lower).

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Background and Objectives: Dry Eye Disease (DED) is a chronic condition characterised by tear film instability and ocular surface disruption, significantly impacting patients\' quality of life. This study aimed to provide top-level clinical evidence for the long-term efficacy of dehydrated amniotic membrane (dAM, Omnigen®) delivered via a specialised bandage contact lens (sBCL, OmniLenz) for managing moderate-to-severe DED. Materials and Methods: This randomised controlled trial (NCT04553432) involved 93 participants with moderate-to-severe DED, randomised to receive a 1-week bilateral treatment of either dAM (17 mm diameter with 6 mm central \'window\') applied under a sBCL or sBCL alone. Participants were assessed at baseline and followed up at 1, 3, and 6 months post-treatment. Outcomes included changes in symptomatology, tear film and ocular surface measurements, and in vivo confocal microscopy imaging of corneal nerve parameters and corneal dendritic cell (CDC) counts. Results: The dAM-sBCL group demonstrated a 65% reduction in OSDI scores at 6 months (p < 0.001), with 88% of participants showing improvement at 1 month. Corneal staining was significantly reduced in both groups. dAM-sBCL provided significant improvements in corneal nerve parameters at 1 month, with sustained positive trends at 3 months. Additionally, dAM-sBCL significantly reduced mature CDC counts, suggesting an anti-inflammatory effect. Conclusions: Treatment with dAM-sBCL for just 1 week significantly and rapidly improved dry eye symptoms as well as ocular surface signs for at least 3 months. It also enhanced corneal nerve health while reducing activated/mature corneal inflammatory cell numbers, presenting a safe and promising new treatment for moderate-to-severe DED.

The identification of new biomarkers of ocular diseases is nowadays of outmost importance both for early diagnosis and treatment. Epigenetics is a rapidly growing emerging area of research and its involvement in the pathophysiology of ocular disease and regulatory mechanisms is of undisputable importance for diagnostic purposes. Environmental changes may impact the ocular surface, and the knowledge of induced epigenetic changes might help to elucidate the mechanisms of ocular surface disorders. In this pilot study, we investigated the impact of extensive contact lens (CL) wearing on human corneal epithelium epigenetics. We performed ex vivo analysis of the expression of the miR-320 and miR-423-5p involved in the processes of cellular apoptosis and chronic inflammation. The human corneal epithelium was harvested from healthy patients before the photorefractive keratectomy (PRK). The patients were divided into two age- and sex-matched groups accordingly to CL wearing history with no CL wearers used as a control. The epithelium was stored frozen in dry ice at -80 °C and forwarded for miRNA extraction; afterwards, miRNA levels were detected using real-time PCR. Both miRNAs were highly expressed in CL wearers (p < 0.001), suggesting epigenetic modifications occurring in chronic ocular surface stress. These preliminary results show the relationships between selected miRNA expression and the chronic ocular surface stress associated with extensive CL use. MicroRNAs might be considered as biomarkers for the diagnosis of ocular surface conditions and the impact of environmental factors on ocular surface epigenetic. Furthermore, they might be considered as new therapeutic targets in ocular surface diseases.

BACKGROUND: This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in children and adults.
METHODS: A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event.
RESULTS: Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn.
CONCLUSIONS: OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.

Permanent engravings on contact lenses provide information about the manufacturing process and lens positioning when they are placed on the eye. The inspection of their morphological characteristics is important, since they can affect the user\'s comfort and deposit adhesion. Therefore, an inverted wavefront holoscope (a lensless microscope based on Gabor\'s principle of in-line digital holography) is explored for the characterization of the permanent marks of soft contact lenses. The device, based on an in-line transmission configuration, uses a partially coherent laser source to illuminate the soft contact lens placed in a cuvette filled with a saline solution for lens preservation. Holograms were recorded on a digital sensor and reconstructed by back propagation to the image plane based on the angular spectrum method. In addition, a phase-retrieval algorithm was used to enhance the quality of the recovered images. The instrument was experimentally validated through a calibration process in terms of spatial resolution and thickness estimation, showing values that perfectly agree with those that were theoretically expected. Finally, phase maps of different engravings for three commercial soft contact lenses were successfully reconstructed, validating the inverted wavefront holoscope as a potential instrument for the characterization of the permanent marks of soft contact lenses. To improve the final image quality of reconstructions, the geometry of lenses should be considered to avoid induced aberration effects.

Wearable devices are lightweight and portable devices worn directly on the body or integrated into the user\'s clothing or accessories. They are usually connected to the Internet and combined with various software applications to monitor the user\'s physical conditions. The latest research shows that wearable head devices, particularly those incorporating microfluidic technology, enable the monitoring of bodily fluids and physiological states. Here, we summarize the main forms, functions, and applications of head wearable devices through innovative researches in recent years. The main functions of wearable head devices are sensor monitoring, diagnosis, and even therapeutic interventions. Through this application, real-time monitoring of human physiological conditions and noninvasive treatment can be realized. Furthermore, microfluidics can realize real-time monitoring of body fluids and skin interstitial fluid, which is highly significant in medical diagnosis and has broad medical application prospects. However, despite the progress made, significant challenges persist in the integration of microfluidics into wearable devices at the current technological level. Herein, we focus on summarizing the cutting-edge applications of microfluidic contact lenses and offer insights into the burgeoning intersection between microfluidics and head-worn wearables, providing a glimpse into their future prospects.