Contact Lens Spectrum

THE INVENTORS of contact lenses would hardly believe the progress that has been made in the last 50 years or so. With advanced materials—orthokeratology to slow myopia, the reemergence of scleral lenses, and more—our profession continues to push the envelope with new technologies while balancing the health of the eye. As we look toward the next 50 years, it is exciting to imagine the possibilities ahead.

AS WE CONTINUE THIS YEAR'S celebration of Contact Lens Spectrum’s 40th anniversary, this month we are reminded of the “Event of the Year,” which we have published since the late 1990s. To commemorate those events, we asked for your feedback on which were the most remarkable over the decades. It was clear that myopia came out on top. From the first US Food and Drug Administration approval of a contact lens to orthokeratology to spectacles, readers are absolutely excited about all things myopia.

HIGHER-ORDER ABERRATIONS (HOAs) have been known to affect optical systems since Kepler and Galileo developed their telescopes in the early 1600s.1 Over the next few centuries, the understanding of how light courses through optical systems was continuously refined; however, aberration detection and quantification were not available. In the early 1900s, Hartmann developed a plate that was used to help eliminate aberrations from telescopes.

For many patients and practitioners alike, the word “multifocal” can trigger a bit of hesitation. In my experience, concerns about chair time, adaptation issues, and inconsistent vision are rooted in outdated perceptions shaped by earlier generations of lenses and overshadow the many benefits that multifocal contact lenses can offer patients who have presbyopia. Multifocal options have come a long way from where they started.

This educational activity consists of a written article and 20 study questions. The participant should, in order, read the Activity Description at the beginning of this activity, read the material, answer all questions in the post test, and then complete the Activity Evaluation/Credit Request form. To receive credit for this activity, please follow the instructions provided below in the section titled To Obtain CE Credit. This educational activity should take a maximum of 2 hours to complete.

STABLE REFRACTION doesn’t always mean stable myopia. This has never been truer than when monitoring orthokeratology (ortho-k). The nature of ortho-k leads to variations in refractive data that are a moving target (dependent on factors such as wear time and what time of day). Axial length represents an objective measurement of eye length from the anterior cornea to the fovea. A small amount of normal physiologic growth reflects coordinated enlargement of the globe, including equatorial expansion.

A 27-year-old female presented for a contact lens evaluation. She had a known history of keratoconus managed with scleral lenses. She reported decreased vision and reduced comfort with her current lenses, which were 3 years old. Her last comprehensive eye examination had also been approximately 3 years prior at another clinic. Best-corrected vision with her habitual scleral lenses was 20/60 OD and 20/50 OS. Slit lamp evaluation revealed minimal to no central fluorescein pooling.

OFFERING SPECIALTY contact lenses in a practice requires interaction with the laboratories that manufacture them, so practitioners must feel comfortable with the crucial step of ordering. Lens ordering is most effective when a practitioner learns the “language” of specialty lenses, confidently communicates clinical observations to the laboratory, and fully utilizes available ordering resources. Developing a structured system for lens ordering can make the entire process smoother.

OCULAR SURFACE DISEASE and inflammatory dry eye are common in patients of all age groups and can significantly affect a patient’s overall daily functioning and quality of life.1 Daily activities such as reading, working on the computer, or even being outdoors can be debilitating due to persistent pain, photophobia, fluctuating vision, or foreign body sensation, which often accompany dry eye disease.1 These patients have often tried numerous conventional therapies such as over the counter and...

THE TEAR FILM & OCULAR SURFACE Society (TFOS) Dry Eye Workshop (DEWS) III report redefined dry eye disease (DED) as “a multifactorial, symptomatic disease characterized by a loss of homeostasis of the tear film and/or ocular surface, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities are etiological factors” (Perez et al, 2025). Consistent with the previous TFOS DEWS report, symptoms and signs are used to diagnose DED.