To begin to address this problem, we review existing, published grading scales in an integrated fashion, highlighting their differences and similarities to emphasize common themes and the methods and elements that are important in creating a standardized scale.
The Food and Drug Administration (FDA) and other international regulatory agencies rely on ocular surface staining as a primary endpoint for new drug approvals, so that absence of a “gold standard” scale may affect approval of new drug treatments.
However, despite common usage, a universally accepted “gold standard” grading scale does not exist for corneal and conjunctival staining, which can impact the ability to diagnose and monitor ocular surface conditions such as dry eye. Vital dye staining has been used for over a century to assess the severity of ocular surface disease. The work cannot be changed in any way or used commercially without permission from the journal.
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Because of the high preponderance of dry eye amongst presbyopes, material selection is of importance and consideration should be given to the lens-ocular surface interaction.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. There was minimal upper corneal staining, and the degree was similar with the study and habitual lenses.Įtafilcon A material, worn under a daily disposable modality, was shown to reduce upper lid margin and limbal staining in presbyopic contact lens wearers of Asian descent compared with the wearers' own contact lenses. Limbal staining was also significantly less with the study contact lenses than with the participants' own contact lenses after 6 hr of wear (P=0.009).
Lid margin staining after 6 hr of wear of the study contact lenses was not different from that measured after 1 day without contact lenses (P=0.507). Lid margin staining was significantly lower with the study contact lenses (2.0☑.0 mm) than with the participants' own contact lenses (3.2☓.0 mm) after 6 hr of wear, representing a mean staining decrease of 38% (P=0.010). The photographs were masked according to study visit and the staining extent measured using proprietary software. Digital photographs of the upper lid margins, nasal and temporal conjunctiva, and superior cornea were taken after 6 hr of wear of the participants' habitual contact lenses, after 1 day without contact lens wear, and after 6 hr of wear of the study contact lenses at the end of the 1-month period. The habitual modalities of wear were 45% daily disposable and 55% planned replacement.
Twenty established presbyopic contact lens wearers (hydrogel n=5, none habitual wearers of etafilcon A lenses silicone hydrogel n=15) of Asian descent were refitted with etafilcon A multifocal daily disposable contact lenses (1-DAY ACUVUE MOIST MULTIFOCAL) for a period of 1 month of daily lens wear. The objective of this study was to quantify the mechanical effects of the study contact lenses on the ocular surface in a population of presbyopic contact lens wearers of Asian descent. Contact lens wearers of Asian descent may be predisposed to experience microtrauma of the ocular surface as a result a thinner post-lens tear film and higher eyelid tension, and these effects would be anticipated to be most marked in an older population.
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