Background:Contact lenses are a cornerstone of vision correction for ametropia and can be of particular value for management of irregular astigmatism and corneal ectasia. Beyond objective measures of visual acuity and corneal health, patient-reported outcomes and vision-related quality of life (VR-QoL) have emerged as critical endpoints. This review aimed to synthesize evidence on VR-QoL outcomes with contact lenses. Methods:We conducted a narrative review of studies published between 2000 and 2025 on the influence of various contact lens modalities including soft conventional lenses, rigid gas-permeable (RGP) lenses, scleral and mini-scleral lenses, orthokeratology, and specialty designs on VR-QoL across myopia, keratoconus, dry-eye disease, and other conditions. Descriptive tables were developed for all identified studies, and a synthesis of the impact of contact lenses on VR-QoL findings is presented. Evidence for VR-QoL measurement and instrumentation, special considerations for pediatric/adolescent populations, and barriers/limitations to sustained contact lens wear were also appraised. Results:VR-QoL evaluations using validated instruments demonstrate favorable findings with contact lenses. VR-QoL gains with contact lenses are more favorable compared with spectacle correction, particularly in appearance, activities, peer perception, and psychological domains. In keratoconus, RGP and scleral lenses dramatically improve NEI-VFQ-25 composite scores, even in cases of advanced disease. Barriers to sustained wear of contact lenses mostly relate to lens discomfort and dry eye due to ocular surface complications, although studies in patients with ocular surface disease/dry eye still derive VR-QoL benefits with contact lenses. There is a lack of head-to-head trials for certain modalities (eg, an absence of studies directly comparing multifocal contact lenses to spectacles for fall rates). Conclusion:Contact lenses provide significant and clinically meaningful gains in VR-QoL among adult and pediatric patients with refractive error, keratoconus, ocular surface disease or dry eye, and other indications. The VR-QoL benefits of contact lenses may exceed those achieved with spectacles.

BACKGROUND:Lid wiper epitheliopathy (LWE) is a marker of an abnormal lid/cornea interaction. This study proposes an automated Hue-Value grading algorithm of LWE staining following manual selection of the region of interest. METHODS:Images of LWE staining were processed using Hue and Value from HSV (Hue-Saturation-Value) color space with a custom MATLAB program. Thirty-one images were successfully analyzed. Examiners analyzed images in random order twice, separated by more than a week. Bland Altman and Intraclass Correlation Coefficients (ICC) were performed. RESULTS:There was no difference (p > 0.05) between upper (UL) and lower (LL) eyelids for LWE height (UL: 0.12 ± 0.12 mm, LL: 0.12 ± 0.07 mm), width (UL: 10.70 ± 3.84 mm, LL: 10.26 ± 3.49 mm), or area (UL: 2.85 ± 2.67 mm2, LL: 2.63 ± 1.71 mm2). There was no between examiner difference for all eyelid LWE height or area (p > 0.05), but a difference in LWE width (0.16 mm; p = 0.031). ICC for LWE height, width and area were 0.996 (95% CI: 0.993 to 0.998), 0.997 (95% CI: 0.992 to 0.998) and 0.999 (95% CI: 0.998 to 0.999). There was no between examiner difference for height or area (p > 0.05) for UL, but a difference in LWE width (0.28 mm; p = 0.026). ICC for height, width and area were 0.999 (95% CI: 0.996 to 1.00), 0.995 (95% CI: 0.982 to 0.999) and 1.00 (95% CI: 0.999 to 1.00). There was no difference in LWE height, width or area for LL (all p > 0.05). ICC were 0.991 (95% CI: 0.973 to 0.997) for height, 0.998 (95% CI: 0.995 to 0.999) for width and 0.997 (95% CI: 0.990 to 0.999) for area. CONCLUSIONS:This novel method results in highly repeatable interexaminer measures of LWE staining after general lid region delineation. Small differences in LWE width were observed between examiners.

Despite years of experience with contact lenses, controversy remains as to whether contact lenses adversely impact the meibomian glands (MG). This review summarizes the present body of evidence, showing that contact lens wear is associated with alterations in MG morphology (up to 80% higher gland atrophy compared to non-wearers) and qualitative changes in MG secretion. Key factors such as duration of contact lens wear, contact lens type (e.g., soft vs. rigid), edge design, and material modulus of elasticity are discussed in relation to the extent of MG morphological changes, the quality of MG secretion and other ocular surface parameters. Longitudinal studies of sufficient statistical power are needed to better understand how contact lens wear affects the MG, risk factors, and the clinical sequelae of these changes.

Despite decades of experience with hematopoietic stem cell transplantation, we are still faced with the delicate equipoise of achieving stable ocular health post-transplantation. This is because ocular graft-versus-host disease (oGvHD) following hematopoietic stem cell transplantation frequently occurs (≥50%) among transplant patients. To date, our understanding of the pathophysiology of oGvHD especially the involvement of the meibomian gland is still limited as a result of a lack of suitable preclinical models among other. Herein, the current state of the etiology and, pathophysiology of oGvHD based on existing pre-clinical models are reviewed. The need for additional pre-clinical models and knowledge about the involvement of the meibomian glands in oGvHD are emphasized.

Aim: To compare differences in clinical dry eye features and meibomian gland health status between dry eye patients from rural and urban populations in Ghana. Methods: We examined 211 (rural=109, urban=102) participants with subjective dry eye symptoms. Tear film break-up time (TBUT), Schirmer's test and ocular surface staining (OSS) were assessed. Symptoms were evaluated using the SPEED II questionnaire. Meibomian glands (MG) in the right eye upper (UL) and lower lids (LL) were imaged using a custom meibographer. MG area was determined by intensity threshold segmentation using Image J software. MG loss (MGL) was also graded based on Pult's grading scheme. Mann-Whitney, Spearman correlation, chi-square and odds analyses were performed; p<0.05 was considered significant. Results: Rural participants showed greater SPEED scores, reduced TBUT, and lower Schirmer scores, p<0.05. The proportion of rural participants with MGL were significantly more (82.3%) than urban participants (63.3%), p<0.05. They also showed greater MGL than urban participants, p<0.05. Chi-square test revealed significantly different meiboscale distributions (UL: chi(2)=13.58, LL: chi(2)=15.29) between the groups, p<0.05. Overall significant relationships were observed between MGL and age [r(s)=0.61], OSS [r(s)=0.35], TBUT [r(s)=-0.52], and Schirmer scores [r(s)=-0.40], p<0.05. Conclusion: The data suggest that the participants from the rural population have worse dry eye and meibomian gland health status than those from the urban population. The significant relationships between the various clinical variables suggest important links between MGD and DED. Subtle differences in the everyday working and living environment could likely account for the differences in the severity of DED and MGD between the two groups. And considering the increased pattern of urbanization, industrialization and modernization and the related environmental effects in Africa, future longitudinal studies on specific environmental risk factors or mediators of DED and MGD are necessary to ascertain the MGD and DED situation in Ghana and Africa at large

Background: Dyslipidemia may be linked to meibomian gland dysfunction (MGD) and altered meibum lipid composition. The purpose was to determine if plasma and meibum cholesteryl esters (CE), triglycerides (TG), ceramides (Cer) and sphingomyelins (SM) change in a mouse model of diet-induced obesity where mice develop dyslipidemia. Methods: Male C57/BL6 mice (8/group, age = 6 wks) were fed a normal (ND; 15% kcal fat) or an obesogenic high-fat diet (HFD; 42% kcal fat) for 10 wks. Tear production was measured and meibography was performed. Body and epididymal adipose tissue (eAT) weights were determined. Nano-ESI-MS/MS and LC-ESI-MS/MS were used to detect CE, TG, Cer and SM species. Data were analyzed by principal component analysis, Pearson’s correlation and unpaired t-tests adjusted for multiple comparisons; significance set at p ≤ 0.05. Results: Compared to ND mice, HFD mice gained more weight and showed heavier eAT and dyslipidemia with higher levels of plasma CE, TG, Cer and SM. HFD mice had hypertrophic meibomian glands, increased levels of lipid species acylated by saturated fatty acids in plasma and meibum and excessive tear production. Conclusions: The majority of meibum lipid species with saturated fatty acids increased with HFD feeding with evidence of meibomian gland hypertrophy and excessive tearing. The dyslipidemia is associated with altered meibum composition, a key feature of MGD.

Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and loss of ocular surface homeostasis. Increasingly, several observational clinical studies suggest that dyslipidemia (elevated blood cholesterol, triglyceride or lipoprotein levels) can initiate the development of MGD. However, conclusive evidence is lacking, and an experimental approach using a suitable model is necessary to interrogate the relationship between dyslipidemia and MGD. This systematic review discusses current knowledge on the associations between dyslipidemia and MGD. We briefly introduce a diet-induced obesity model where mice develop dyslipidemia, which can serve as a potential tool for investigating the effects of dyslipidemia on the meibomian gland. Finally, the utility of lipidomics to examine the link between dyslipidemia and MGD is considered.

The study aimed at determining the commonest ocular conditions among basic school children and their prevalence in the Sunyani Municipality, Ghana.The study also sought to assess the level of awareness of school teachers on ocular conditions affecting the school children.A total of 400 students and 50 teachers were randomly selected from 5 different basic schools in the Sunyani Municipality.Data was collected through vision screening of the school children and in-depth questionnaires for school teachers.The Statistical Package for the Social Sciences (SPSS) version 20.0 was used for data analysis.Out of the 400 participants, 227 (57%) were females and 173 (43%) were females.The prevalence of ocular conditions detected was 51.25%.Refractive errors accounted for 25.25% with hyperopia being the highest (18.5%), followed by astigmatism (4.5%) and myopia being the least prevalent (2.5%).The prevalence of ocular pathologies among the pupils screened was 26.0% with the commonest condition being allergic conjunctivitis (18.5%).Only one pupil (0.1%) suffered from low vision while none was blind in both eyes.The prevalence of ocular conditions amongst the school children was very high and the rate of eye clinic attendance was also low among them.These findings warrant pragmatic intervention to alleviate the burden of ocular conditions among the school children.

Meibomian Gland Dysfunction (MGD) is a leading cause of evaporative Dry Eye Disease (DED). This makes non-invasive meibography an important procedure in the clinical evaluation of DED patients. Our purpose was to conduct a lead-off investigation focused on the practicality of performing meibography in a developing country, with limited access to complex ophthalmic imaging systems, using a custom meibographer, as a step to future comparative studies on meibomian glands and DED in Africa.

Dry eye disease (DED) is an increasingly significant clinical problem in developing countries and/or emerging economies. Existing studies on DED conducted in these areas have largely reported on associations between DED and infectious disease (trachoma) and malnutrition (hypovitaminosis A), but current trends of industrialization, urbanization, and modernization in these areas could result in a shift to other forms of DED. Herein, we review the epidemiology of DED in these geographic areas, highlighting potential causes and risk factors of DED while presenting information on diagnostic tools and algorithms and insight into some treatment modalities of DED that could prove useful to clinicians and investigators in these regions.

The aim of the study was to report postoperative corneal and surgically induced astigmatism (SIA) in patients with preoperative against-the-rule (ATR) astigmatism who underwent superior approach manual small incision cataract surgery (MSICS). 58 eyes of 58 cataract patients with preoperative ATR astigmatism were involved in this study. All patients had operable cataracts and underwent superior approach MSICS. Keratometric (K) readings were taken prior to surgery and at 12 weeks after surgery. Centroid values of SIA, preoperative astigmatism, and postoperative astigmatism were calculated using Cartesian coordinates based analysis. Wilcoxon signed rank test was used to compute statistical significance between mean preoperative and postoperative corneal astigmatism. Cohen’s d was used as effect size measure. Centroid values of 1.42 D × 179, 2.48 D × 0, and 1.07 D × 1 were recorded, respectively, for preoperative astigmatism, postoperative astigmatism, and SIA. Wilcoxon signed rank test indicated that mean ± SD postoperative corneal astigmatism (2.80±1.40 D) was statistically significantly greater than preoperative corneal astigmatism (1.49±1.34 D), Z=-6.263, p<0.0001. A high Cohen’s d of 1.32 was found. Our results suggest statistical and clinically significant greater postoperative corneal astigmatism than preoperative corneal astigmatism for ATR astigmatism cataract patients who underwent superior approach MSICS.

To investigate which of two tunnel incision forms (frown versus straight) in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients' cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05); frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05). Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher's exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05).

Results: Overall, 53% of the sunglasses acquired from roadside vendors failed to meet the AOA UVA -protection standard while all of the sunglasses from optical shops met the standard. Mean UVA was 100% in optical shop sunglasses and 77.23% in roadside vendor sunglasses. Most common purchase locations were from roadside vendors (65.5%) and fashion stores/boutique (21.3%). Participants’ main reasons for wearing sunglasses included glare reduction (38.3%) and fashion (30.8%). Price (41.5%) was the most important factor considered when buying sunglasses whiles 1.25% indicated amount of UV protection as the most important factor. Conclusion: More than half of sunglasses sold by roadside vendors did not meet the AOA standard. Most of our study respondents did not consider UV protection when buying sunglasses.

Mathews Journal of Ophthalmology Ocular Morbidity Among Sawmill Workers in the Kumasi Metropolis Emmanuel Boateng Baafi1, Clement Afari1, David Ben Kumah1, Benjamin Brifa Bempong1, Eugene Appenteng Osae1. 1Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Corresponding Author: Emmanuel Boateng Baafi, Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, Tel: +233 54 643 6608; Email: ebbaafi2014@gmail.com

Objectives To determine the prevalence of common ocular conditions among small scale miners in the Ashanti region of Ghana. Material and Methods A crosssectional study across three conveniently chosen mining communities was carried out. Two hundred (200) miners were purposively sampled. History taken from participants included participants” demographics, ocular and occupational history. Ocular examination included ophthalmoscopy and visual acuity. Diagnoses were made on the presence of a condition(s) in either or both eyes. The Statistical Package for Social Sciences (SPSS) version 17.0 was used to analyze data collected. Descriptive statistics and Pearson’s Chi Square test were employed. Results Overall, 160 respondents were examined. The overall prevalence of eye diseases was 83.0%. Conjunctivitis had the highest prevalence (40.0%) followed by dry eye (9.4%), pinguecula (8.1%), pterygium (7.5%) and cataract (5.6%).Refractive errors recorded10%. Conclusions The study revealed a high ocular morbidity rate (83.0%).Uptake of regular eye examination and eye health education are recommended for these miners since they are exposed to several risk factors which play important roles in ocular morbidity.

Our aim was to evaluate the influence of visual impairment on the quality of life of patients reporting at the low vision centre of the Eastern Regional Hospital in Koforidua.The World Health Organization Quality Of Life (WHOQOL-Bref) which assesses quality of life in four main domains was administered to two hundred and ninety four (294) patients who visited the low vision centre of the Eastern Regional Hospital, for various eye services.Additional information on patient demographics and their visual acuities were obtained.The mean quality of life scores were determined for the visually and non-visually impaired.86(29.3%) of the participants were visually impaired (presenting vision worse than 6/18).A significant difference in mean age was realized between subjects who were visually impaired (53.7 ± 18.4) (mean ± SD) and subjects who were not visually impaired (34.3 ± 13.1) (p = 0.001).The visually impaired participants had a lower quality of life scores in all four domains of quality of life naming, environmental, physical, social and psychological with 7.5% unadjusted reduction in overall quality of life.Visual impairment is associated with significant reduction in different quality of life domains for this population.Quality of life is poorer with increasing severity of visual impairment.