Contact Lens Spectrum


Document #159





(p. 18) Point/Counterpoint: The Clinical Impact of Corneal Staining


Solution-induced Corneal Staining Does Matter, By Lyndon Jones, PhD, FCOptom, FAAO


1.†††††††† Korb DR, Korb JM: Corneal staining prior to contact lens wearing. J Am Optom Assoc 1970; 41;3: 228-32.

2.††††††††††† Josephson JE, Caffery BE: Corneal staining characteristics after sequential instillations of fluorescein. Optom Vis Sci 1992; 69;7: 570-573.

3.††††††††††† Schwallie JD, McKenney CD, Long WD, Jr., McNeil A: Corneal staining patterns in normal non-contact lens wearers. Optom Vis Sci 1997; 74;2: 92-8.

4.†††††††† Snyder C: Solution interaction with the ocular surface: The significance in making the grade. Clin Refract Optom 2005; 16;5: 134 - 140.

5.†††††††† Levy B: Superficial corneal "staining"- clinical observation and risk assessment. Eye Contact Lens 2007; 33;4: 165-6.

6.†††††††† Ward KW: Superficial punctate fluorescein staining of the ocular surface. Optom Vis Sci 2008; 85;1: 8-16.

7.†††††††† Soni PS, Horner DG, Ross J: Ocular response to lens care systems in adolescent soft contact lens wearers. Optom Vis Sci 1996; 73;2: 70-85.

8.†††††††† Jones L, Jones D, Houlford M: Clinical comparison of three polyhexanide-preserved multi-purpose contact lens solutions. Cont Lens Anterior Eye 1997; 20;1: 23-30.

9.†††††††† Cho P, Lui T, Kee C: Soft contact lens care systems and corneal staining in Hong Kong-Chinese. Cont Lens Anterior Eye 1998; 21;2: 47-53.

10.†††††† Jones L, MacDougall N, Sorbara LG: Asymptomatic corneal staining associated with the use of balafilcon silicone-hydrogel contact lenses disinfected with a polyaminopropyl biguanide-preserved care regimen. Optom Vis Sci 2002; 79;12: 753-761.

11.†††††† Lebow KA, Schachet JL: Evaluation of corneal staining and patient preference with use of three multi-purpose solutions and two brands of soft contact lenses. Eye Contact Lens 2003; 29;4: 213-20.

12.††††††††††† Pritchard N, Young G, Coleman S, Hunt C: Subjective and objective measures of corneal staining related to multipurpose care systems. Cont Lens Anterior Eye 2003; 26;1: 3-9.

13.†††††† Amos C: A clinical comparison of two soft lens care systems used with silicone hydrogel contact lenses. Optician 2004; 227;5933: 16 - 20.

14.††††††††††† Stiegemeier MJ, Cedrone R, Evans D, Friederichs G, Holle D, Jenkins W, Lutzi D, Roberson R, Schenker H, White E, Zigler L: Clinical performance of 'no rub' multi-purpose solutions. Cont Lens Anterior Eye 2004; 27;2: 65-74.

15.††††††††††† Garofalo RJ, Dassanayake N, Carey C, Stein J, Stone R, David R: Corneal staining and subjective symptoms with multipurpose solutions as a function of time. Eye Contact Lens 2005; 31;4: 166 - 174.

16.††††††††††† Stiegemeier MJ, Friederichs GJ, Hughes JL, Larsen S, Movic W, Potter WB: Clinical evaluation of a new multi-purpose disinfecting solution in symptomatic contact lens wearers. Cont Lens Anterior Eye 2006; 29;3: 143-51.

17.††††††††††† Andrasko G, Ryen K: A series of evaluations of MPS and silicone hydrogel lens combinations. Rev Cornea and Contact Lenses 2007;March: 36 - 42.

18.†††††† Zigler L, Cedrone R, Evans D, Helbert-Green C, Shah T: Clinical evaluation of silicone hydrogel lens wear with a new multipurpose disinfection care product. Eye Contact Lens 2007; 33;5: 236-43.

19.††††††††††† Andrasko G: Solution-induced staining and comfort during lens wear. Contact Lens Spectrum 2008; 23;9: 33-35.

20.††††††††††† Andrasko G, Ryen K: Corneal staining and comfort observed with traditional and silicone hydrogel lenses and multipurpose solution combinations. Optometry 2008; 79;8: 444-54.

21.††††††††††† Dumbleton K, Keir N, Moezzi A, Feng Y, Jones L, Fonn D: Objective and subjective responses in patients refitted to daily-wear silicone hydrogel contact lenses. Optom Vis Sci 2006; 83;10: 758-68.

22.†††††† Amos C: Performance of a new multipurpose solution used with silicone hydrogels. Optician 2004; 227;5945: 18-22.

23.††††††††††† Santodomingo-Rubido J: The comparative clinical performance of a new polyhexamethylene biguanide- vs a polyquad-based contact lens care regime with two silicone hydrogel contact lenses. Ophthalmic Physiol Opt 2007; 27;2: 168-73.

24.†††††† Miller MB, Dillehay S: Multipurpose solution use with silicone hydrogel contact lenses. Contact Lens Spectrum 2007; 22;5: 33 - 40.

25.††††††††††† Andrasko G, Ryen K, Garofalo RJ, Lemp J: Compatibility of silicone hydrogel lenses with multi-purpose solutions. Invest Ophthalmol Vis Sci 2006; ARVO abstracts;E-abstract 2392.

26.††††††††††† Andrasko G: 2006.

27.†††††† Carnt N, Willcox M, Evans V, Naduvilath T, Tilia D, Papas E, Sweeney D, Holden B: Corneal staining: The IER matrix study. Contact Lens Spectrum 2007; 22;9: 38 - 43.

28.†††††† Carnt N, Evans V, Holden B, Naduvilath T, Tilia D, Papas E, Willcox M: IER matrix update: adding another silicone hydrogel. Contact Lens Spectrum 2008; 23;3: 28 - 35.

29.†††††† Dillehay S, Long B, Cutter GR: A statistical analysis of the staining grid. Contact Lens Spectrum 2007; 22;11: 41 - 47.

30.†††††† Levy B, Orsborn G: Clinical risks: Myths and truths. Contact Lens Spectrum 2008; 23;1: 42 - 46.

31.†††††† Jones L, Dumbleton K, Bayer S, Fonn D: Clinical performance and corneal staining associated with silicone hydrogels used on a daily wear basis. Abstract - AAO Meeting, Hawaii, Apr 2004.

32.†††††† Carnt N, Jalbert I, Stretton S, Naduvilath T, Papas E: Solution toxicity in soft contact lens daily wear is associated with corneal inflammation. Optom Vis Sci 2007; 84;4: 309-15.

33.†††††† Papas EB, Carnt N, Willcox MD, Holden BA: Complications associated with care product use during silicone daily wear of hydrogel contact lens. Eye Contact Lens 2007; 33;6 Pt 2: 392-3; discussion 399-400.


Putting Solution-Induced Staining Into Perspective, By Philip B. Morgan, PhD, MCOptom, FAAO, FBCLA, & Carole Maldonado-Codina, PhD, MCOptom, FAAO


  1. Jones L, MacDougall N, and Sorbara LG. Asymptomatic corneal staining associated with the use of balafilcon silicone-hydrogel contact lenses disinfected with a polyaminopropyl biguanide-preserved care regimen. Optom Vis Sci 2002; 79: 753-761.
  2. Andrasko GJ and Ryen KA. A Series of Evaluations of MPS and Silicone Hydrogel Lens Combinations. Review of Cornea and Contact Lenses; March 2007.
  3. Carnt N, Willcox MDP, Evans DJ, Naduvilath T, Tilia D, Papas E, Sweeney DF, and Holden BA. Corneal Staining: The IER Matrix Study. Contact Lens Spectrum; September 2007.
  4. Poggio EC, Glynn RJ, Schein OD, et al. The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses. N Engl J Med. 1989;321:779-83.
  5. Cheng KH, Leung SL, Hoekman HW, et al. Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet. 1999;354:181-5.
  6. Morgan PB, Efron N, Hill EA, Raynor MK, Whiting MA, Tullo AB. Incidence of keratitis of varying severity among contact lens wearers. Br J Ophthalmol. 2005;89:430-6.
  7. Stapleton, F. et al. The Incidence of Contact Lens-Related Microbial Keratitis in Australia. Ophthalmology (2008).
  8. Dart, J. K., Radford, C. F., Minassian, D., Verma, S. & Stapleton, F. Risk Factors for Microbial Keratitis with Contemporary Contact Lenses A Case-Control Study. Ophthalmology (2008).
  9. Radford, C. F., Minassian, D. C. & Dart, J. K. G. Acanthamoeba keratitis in England and Wales: Incidence, outcome, and risk factors. British Journal of Ophthalmology 86, 536-542 (2002).
  10. Fleiszig SM. The Glenn A. Fry award lecture 2005. The pathogenesis of contact lens-related keratitis. Optom Vis Sci 2006; 83: 866-73.




(p. 21) Prescribing for Astigmatism: Toric Soft Lenses and the Eyelids, Timothy B. Edrington, OD, MS, FAAO


Young G, Hunt C, Covey M. Clinical evaluation of factors influencing toric soft contact lens fit. Optometry and Vision Science 2002;79(1):11-19


Hanks AJ. The watermelon seed principle. Contact Lens Forum 1983;8(9):31-35



(p. 24) Contact Lens Materials: Donít Compromise with Your Teenagers, by Kathy Dumbleton, MSc, MCOptom, FAAO, & Lyndon Jones, PhD, FCOptom, FAAO


1.††††††††††† Hamano H, Watanabe K, et al.: A study of the complications induced by conventional and disposable contact lenses. CLAO J 1994; 20;2:103-108.

2.†††††††† Nason RJ, Boshnick EL, et al.: Multisite comparison of contact lens modalities. Daily disposable wear vs. conventional daily wear in successful contact lens wearers. J Am Optom Assoc 1994; 65;11:774-780.

3.†††††††† Jones L, Jones D, et al.: Subjective responses of 100 consecutive patients to daily disposables. Optician 1996; 211;5536:28-32.

4.††††††††††† Solomon OD, Freeman MI, et al.: A 3-year prospective study of the clinical performance of daily disposable contact lenses compared with frequent replacement and conventional daily wear contact lenses. CLAO J 1996; 22;4:250-257.

5.††††††††††† Suchecki JK, Ehlers WH, et al.: A comparison of contact lens-related complications in various daily wear modalities. CLAO J 2000; 26;4:204-213.

6.†††††††† Veys J, French K: Health benefits of daily disposable contact lenses. Optician 2006; 231;6049:16 - 20.

7.††††††††††† Morgan PB, Efron N, et al.: Incidence of keratitis of varying severity among contact lens wearers. Br J Ophthalmol 2005; 89;4:430-436.

8.††††††††††† Hingorani M, Christie C, et al.: Ulcerative keratitis in a person wearing daily disposable contact lenses. Br J Ophthalmol 1995; 79;12:1138.

9.††††††††††† Woodruff SA, Dart JK: Acanthamoeba keratitis occurring with daily disposable contact lens wear. Br J Ophthalmol 1999; 83;9:1088-1089.

10.†††††† Choi DM, Goldstein MH, et al.: Fungal keratitis in a daily disposable soft contact lens wearer. CLAO J 2001; 27;2:111-112.

11.†††††† Su DH, Chan TK, et al.: Infectious keratitis associated with daily disposable contact lenses. Eye Contact Lens 2003; 29;3:185-186.

12.††††††††††† Niyadurupola N, Illingworth CD: Acanthamoeba keratitis associated with misuse of daily disposable contact lenses. Cont Lens Anterior Eye 2006.

13.†††††† Dart JKG, Radford CF, et al.: Risk factors for microbial keratitis with contemporary contact lenses. Ophthalmol 2008; 115;10: 1647-1654.

14.††††††††††† Hamano H, Maeda N, et al.: Corneal thickness change induced by dozing while wearing hydrogel and silicone hydrogel lenses. Eye Contact Lens 2008; 34;1:56-60.

15.††††††††††† Bergmanson JP, Sheldon TM: Ultraviolet radiation revisited. CLAO J 1997; 23;3:196-204.

16.†††††† Ono M: Studies on ultraviolet radiation and health effects: ocular exposure to ultraviolet radiation. Dev Ophthalmol 2002; 35 32-39.

17.†††††† Cohen S: Educating patients about ultraviolet radiation. Contact Lens Spectrum 2008; 23;8:34 - 39.

18.†††††† Kwok LS, Kuznetsov VA, et al.: Prevention of the adverse photic effects of peripheral light-focusing using UV-blocking contact lenses. Invest Ophthalmol Vis Sci 2003; 44;4:1501-1507.

19.†††††† Walsh JE, Bergmanson JP, et al.: Can UV radiation-blocking soft contact lenses attenuate UV radiation to safe levels during summer months in the southern United States? Eye Contact Lens 2003; 29;1 Suppl:S174-179; discussion S190-171, S192-174.

20.†††††† Kwok LS, Daszynski DC, et al.: Peripheral light focusing as a potential mechanism for phakic dysphotopsia and lens phototoxicity. Ophthalmic Physiol Opt 2004; 24;2:119-129.

21.†††††† Moore L, Ferreira JT: Ultraviolet (UV) transmittance characteristics of daily disposable and silicone hydrogel contact lenses. Cont Lens Anterior Eye 2006; 29;3:115-122.




(p. 33) No-Fee CE: Ocular and Refractive Considerations for the Aging Eye, By Kathryn Richdale, OD, MS, FAAO


Atchison DA. New thinking about presbyopia. Clin Exp Optom 2008;91:205-6.

Atchison DA, Markwell EL, Kasthurirangan S, Pope JM, Smith G, Swann PG. Age-related changes in optical and biometric characteristics of emmetropic eyes. J Vis 2008;8:29.

Back A. Factors influencing success and failure in monovision. ICLC 1995;22:167-71.

Benjamin WJ, Borish IM. Borish's clinical refraction. Philadelphia: W.B. Saunders; 2006.

Bennett ES. Contact lens correction of presbyopia. Clin Exp Optom 2008;91:265-78.

Bullimore M, Mitchell GL, Jones L, Reuter KS. Factors affecting the accommodative response in an adult myopic population. Optom Vis Sci 2007;84:E-abstract 070082.

Dubbelman M, Sicam VA, Van der Heijde GL. The shape of the anterior and posterior surface of the aging human cornea. Vision Res 2006;46:993-1001.

Dubbelman M, Van der Heijde GL. The shape of the aging human lens: curvature, equivalent refractive index and the lens paradox. Vision Res 2001;41:1867-77.

Dubbelman M, Van der Heijde GL, Weeber HA, Vrensen GF. Changes in the internal structure of the human crystalline lens with age and accommodation. Vision Res 2003;43:2363-75.

du Toit R, Ferreira JT, Nel ZJ. Visual and nonvisual variables implicated in monovision wear. Optom Vis Sci 75:119-25.

Eye Diseases Prevalence Research Group. The Prevalence of Refractive Errors Among Adults in the United States, Western Europe, and Australia. Arch Ophthalmol 2004;122:495-505.

Faragher RG, Mulholland B, Tuft SJ, Sandeman S, Khaw PT. Aging and the cornea. Br J Ophthalmol 1997;81:814-7.

Farnsworth PN, Shyne SE. Anterior zonular shifts with age. Exp Eye Res 1979;28:291-7.

Glasser A. Restoration of accommodation: surgical options for correction of presbyopia. Clin Exp Optom 2008;91:279-95.

Glasser A. Restoration of accommodation. Curr Opin Ophthalmol 2006;17:12-8.

Glasser A. Accommodation: mechanism and measurement. Ophthalmol Clin North Am 2006;19:1-12.

Heys KR, Cram SL, Truscott RJ. Massive increase in the stiffness of the human lens nucleus with age: the basis for presbyopia? Mol Vis 2004;10:956-63.

Ho A, Erickson P, Manns F, Pham T, Parel JM. Theoretical analysis of accommodation amplitude and ametropia correction by varying refractive index in Phaco-Ersatz. Optom Vis Sci 2001;78:405-10.

Holden BA, Fricke TR, Ho SM, Wong R, Schlenther G, Cronje S, Burnett A, Papas E, Naidoo KS, Frick KD. Global vision impairment due to uncorrected presbyopia. Arch Ophthalmol 2008;126:1731-9.

Kasthurirangan S, Markwell EL, Atchison DA, Pope JM. In vivo study of changes in refractive index distribution in the human crystalline lens with age and accommodation. Invest Ophthalmol Vis Sci 2008;49:2531-40.

McDonnell PJ, Lee P, Spritzer K, Lindblad A, Hays RD. Associations of presbyopia with vision-targeted health-related quality of life. Arch Ophthalmol 2003;121:1577-81.

Millodot M. The influence of age onthe sensitivity of the cornea. Invest Ophthalmol Vis Sci 1977;16:240-2.

Moffat BA, Atchison DA, Pope JM. Explanation of the lens paradox. Optom Vis Sci 2002;79:148-50.

Pardue MT, Sivak JG. Age-related changes in human ciliary muscle. Optom Vis Sci 2000;77:204-10.

Richdale K, Mitchell GL, Zadnik K. Comparison of multifocal and monovision soft contact lens corrections in patients with low-astigmatic presbyopia. Optom Vis Sci 2006;83:266-73.

Richdale K, Sinnott LT, Skadahl E, Nichols JJ. Frequency of and factors associated with contact lens dissatisfaction and discontinuation. Cornea 2007a;26:168-74.

Salvi SM, Akhtar S, Currie Z. Ageing changes in the eye. Postgrad Med J 2006;82:581-7.

Tamm S, Tamm E, Rohen JW. Age-related changes of the human ciliary muscle. A quantitative morphometric study. Mech Ageing Dev 1992;62:209-21.

Van Haeringen NJ. Aging and the lacrimal system. Br J Ophthalmol 1997;81:824-6.

Van den Bosch W, Leenders I, Mulder P. Topographic anatomy of the eyelids, and the effect of sex and age. Br J Ophthalmol 1999;83:647-352.

Weale RA. On potential causes of presbyopia. Vision Res 1999;39:1263-72.

Weale RA. Epidemiology of refractive errors and presbyopia. Surv Ophthalmol 2003;48:515-43.



(p. 41) Corneal Topography: The Evolving Technology, By Michael Twa, OD, PhD


Alkhaldi 2003 - Enhancing the Standard Operating Range of a Placido Disk Videokeratoscope for Corneal Surface Estimation


Alonso-Caneiro 2008 - Estimating Corneal Surface Topography in Videokeratoscopy in the Presence of Strong Signal Interference


Applegate 2009 - Importance of fixation, pupil center, and referenc...[J Cataract Refract Surg. 2009]


Heart disease risk calculator -


Iskander 2005 - Evaluating tear film stability in the human eye with high-speed videokeratoscopy


Kollbaum 2008 - Detection of Corneal Irregularity With Automated Corneal Topography Indices -- Kollbaum et al. 49 (5): 1030 -- ARVO Meeting Abstracts


Mahmoud 2008 - CLMI: the cone location and magnitude index. [Cornea. 2008]


Twa 2005 - Optometry and Vision Science Volume 82(12) December 2005 p 1038-1046 Automated Decision Tree Classification of Corneal Shape.