• Journal of Korean Ophthalmic Optics Society
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• v.20 no.2
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• pp.125-131
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• 2015

Purpose: The effect of pigmentation in circle contact lens on lens wearers' tear film stability was investigated in this study. Methods: Non-invasive tear film break-up times of 54 normal eyes before and after lens wearing in twenties and the portion of first tear breakup were measured. The frontal and back surface roughness of circle contact lens was further observed with a scanning electron microscope. The clear lens which was made of hilafilcon B and circle contact lenses which were made of hilafilcon B, polymacon and copolymer of HEMA NVP were tested. Results: Non-invasive tear film breakup time was significantly reduced compared with it before lens wearing. In some case, statistically significant difference in tear film breakup time was also observed between circle contact lenses. The tear file break-up was usually early started in lower than upper portion, and in temporal than nasal portion although there was variation in the lens material. The tear film break-up of circle contact lenses made of hilafilcon B was more commonly observed in peripheral portion(pigmented area) compared with clear contact lens made of same material. Conclusions: The present study revealed that the stability of tear film was affected by wearing circle contact lens and the result seems to be used as the basis for the problem solving that can occur due to the pigmentation when wearing circle contact lens.

• Journal of Korean Ophthalmic Optics Society
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• v.15 no.4
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• pp.339-346
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• 2010

Purpose: The study was performed to compare the difference of non-invasive tear break-up time (NIBUT) with alignment or steep fitting of soft contact lens in normal and dry eyes. Methods: Total 40 eyes (aged 20~30 years) were classified to the normal (n=20) or dry eye group (n=20) by the diagnosis methods for dry eyes and worn soft contact lens (polymacon material) with alignment or steep fitting. NIBUTs of lens wearers were separately measured at the points of before wearing, immediately after wearing and after stabilization of tear film. Results: With alignment fitting, averaged NIBUT in the dry eye group after stabilization of tear film was not significantly different from that of the normal eye group. However, averaged NIBUTs in the normal and dry eyes had significant difference when measured immediately after lens wearing. However, the number of eyes having NIBUT less than 4.0 second was 30% higher compared to the number of normal eyes with steep fitting when measured immediately after wearing. Some shorten NIBUT in dry eyes with steep fitting was also shown after stabilization of tear film. Conclusions: These results suggest that wearing soft contact lens in dry eyes differently affect tear film compared to normal eyes. Thus, dry eyes need more advertent fitting for contact lens wearing because of unstable tear film.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.1
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• pp.11-21
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• 2016

Purpose: The aim of this study was to analyze the difference in tear film stability according to the wearing time when wearing clear and circle soft contact lens(circle lens) made of same material. Methods: The clear and circle contact lenses of hilafilcon B and nelfilcon A materials were respectively applied on the subjects classified as normal and dry eyes depending on their tear volume, and their tear film stability was investigated by measuring the non-invasive tear film break-up times, lens centration and the first appearing area of tear breakup after 30 mins and 6 hrs of lens wearing. Results: Non-invasive tear film breakup time significantly reduced with increase of the wearing time for normal and dry eyes when wearing clear and circle contact lenses. The starting ratio of tear film break-up was higher at the peripheral area of clear and circle lenses in all two different materials, and higher at the peripheral area of dry eyes than normal eyes. Starting ratio of tear film break-up was higher at the peripheral area of nelfilcon A lenses compared with hilafilcon B lenses, however, its change with the increase of wearing time showed a different aspect. The number of tear film break-up per unit area when wearing circle lenses of nelfilcon A increased at the central area with the wearing time while its number was higher at the peripheral area when wearing circle lenses of hilafilcon B. The centration of clear lenses made of two materials was closer to pupil compared to circle lenses with the increase of wearing time, however, a larger decentration was shown in dry eyes compared with normal eyes. Conclusions: The research revealed that an effect on tear film stability may be changed by clear lenses as well as circle lenses with coloring process according to the increase of wearing time, and the factors affecting on tear film stability may also vary depending on lens materials. Thus, the appropriate lenses should be selected by the consideration of lens material as well as coloring method/dyes according to the wearers' habit such as daily wearing time and wearing period when trying to wear clear and circle lenses.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.1
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• pp.15-20
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• 2008

Purpose: To study on the confidence of dry eye diagnosis methods which need to prescribe contact lens. Methods: Non-invasive tear film break-up time (NIBUT) and tear film break-up time (TBUT) were measured in forty healthy subjects in their 20s, and then the subjects were classified into normal eye and dry eye. The results of McMonnies questionnaire, tear prism height measurement, Hardtack test, blink rate measurement and Schirmer test were compared with the results of NIBUT and TBUT. Results: The results of NIBUT and TBUT were as follows; 20 subjects had normal eyes, 10 subjects had dry eyes in both NIBUT and TBUT, and 10 subjects showed different results. In McMonnies questionnaire, the score of normal eye group averaged 8.2 and that of dry eye group averaged 18.5, which showed statistically significant difference. Furthermore, 100% of normal eye group classified by the results of NIBUT and TBUT corresponded with the result of McMonnies questionnaire and 90% of dry eye group showed the correspondence. Tear prism height of normal eye group averaged 0.32 mm and that of dry eye group averaged 0.23 mm, which were significantly different. Hardtack test, blink rate measurement and Schirmer test without local anesthesia showed no statistically significant difference between normal eye group and dry eye group. Conclusions: On dry eye diagnosis methods, the results of McMonnies questionnaire and tear prism height measurement had close correlation with the results of NIBUT and TBUT.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.4
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• pp.445-454
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• 2015

Purpose: The present study was aimed to investigate the effect of tear volume on a change of axial rotation according to wearing time of toric soft contact lens and gaze directions. Method: Toric soft contact lenses with double thin zone design applied on 62 eyes. Then, changes in non invasive tear film break-up time and the rotational direction/amount of lens when changing gaze direction were respectively measured after 15 minutes and 6 hours of lens wear. Results: Lens rotation to temporal direction was more found when changing gaze direction after lens wear. However, its rotation was varied according to wearing time and the subjects' tear volume. Furthermore, the frequency of lens rotation to temporal direction was higher in dry eyes compared with normal eyes at nearly all gaze directions after 15 minutes and 6 hour of lens wear. The rotational amount of lens was generally greater in dry eyes after 15 minutes of lens wear. However, its difference between normal eyes and dry eyes was not great after 6 hours of lens wear. Conclusion: The present study revealed that axial rotation of toric soft contact lens was varied according to the wearer's tear volume and lens rotational patterns at the initial, and extending periods of lens wear were different. The change in rotational pattern of toric soft contact lens from these results means the possibility of visual change after extending lens wear, and the identification of its correlation with tear volume suggests the necessity of considering factors for choosing appropriate toric soft contact lens.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.1
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• pp.27-35
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• 2013

Purpose: The present study was conducted to investigate the changes in the physical properties of RGP lenses induced by the polishing during the process of RGP lens manufacturing, and further evaluate the differences in the actual wearer's comfort and the tear film break-up time caused by these changes. Methods: RGP lenses (fluorosilicone acrylate material) were divided into 4 groups by the different lens-polishing time like 0, 25, 50 and 100 seconds and the thickness, the surface roughness and the wetting angle of those lenses were compared. Furthermore, the comfortability of the lens wear was surveyed after applying these lenses on the subject's eyes with normal tear volume and the non-invasive tear break-up time of the wearers was measured. Results: The central thickness of 4 RGP lenses made of different lens-polishing time was not significantly different however, the lens surface was changed smoother after polishing to be confirmed by scanning electron microscopy. The wetting angle of the RGP lens significantly decreased in accordance with the increase of polishing time. Thus, the difference of approximately $16^{\circ}$ between 0 second and 100 seconds-polishing was statistically significant. The actual wearing feeling of RGP lens was tended to improve in accordance with the increase of the lens wettability however, it was not proportional improvement. The non-invasive tear break-up time of the lens wearers showed different aspect compared with the changes in lens wettability and the actual feeling of RGP lens wear. Conclusions: In this study, better lens wettability, thinner lens thickness, and/or improved lens surface induced by physical stimuli in the process of RGP lens manufacturing was not well-correlated with the increase of actual subjective/objective satisfaction in RGP lens wear. Thus, the consideration of physical properties of the lens as well as the lens wearers' physiological factors in the process of RGP lens manufacturing may be suggested.

• Journal of Korean Ophthalmic Optics Society
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• v.5 no.2
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• pp.91-98
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• 2000

To investigate the distribution of dry eye and to accept diagnosis methods of dry eye in ophthalmic shop, this study was performed on 81 persons(male : 49, female : 32). 1. We divided two group for diagnosing dry eye by dry eye screening questionnaire : one was dry eye symptom group(49.3%) and the other was non-dry eye symptom group(50.7%). 2. Non-invasive break-up time(NIBUT) which was measured by using Tear $scope^{(R)}$ (Killer. co)was longer than invasive break-up time(IBUT). 3. A blink rate in dry eye symptom group(10%) was measured lesser than 10 cycle/min, in non-dry eye symptom group(14.9%). 4. In shirmer test there were lesser than 10mm/5min in dry eye symptom group(67.5%), in non-dry eye symptom group(39%). 5. Cornea and conjunctival staining by rose bengal represented Mild 25%, medium 36.25%, extreme 38.75% in dry eye symptom group. Non-dry eye symptom group was showed Mild 19.51%, medium 14.63%, extreme 12.19%. 6. These results showed that the patient showed dry eye symptom in 3 items of eye examination was 22.5%, 4 items 25%, 5 items 30%, 6 items 15%.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.1
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• pp.31-42
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• 2014

Purpose: The present study was conducted to investigate the effect of the physical properties of RGP lens induced by lens polishing on the actual wearer's subjective comfort, the tear film break-up time and the blinking rate as a follow-up study that revealed the relationship between the lens physical properties during lens manufacturing and lens wearer's factors. Methods: RGP lenses made from the three different polishing conditions (25, 50 and 100 seconds) were applied on 28 eyes of 17 subjects, aged 20 to 29 years, without any known disease and surgical history in the eyes. While the subjects were asked to wear the RGP lenses longer than a week, the questionnaire for the comfortability was administered everyday. Subjective and objective tear break-up time and blinking rate of the wearers were further measured. Results: The wearer's subjective comfortability showed some difference in the type of discomfort and satisfaction score according to the polishing status when wearing RGP lenses made from different polishing conditions longer than a week, and a bigger difference in satisfaction score induced by polishing condition was especially shown in experienced RGP lens wearer rather than un-experienced wearer. In the case of RGP lens wearer compared with the ones without the wearing experience, as the wearing time increased subjective and objective tear break-up time were increased and the blinking rate was decreased. However, subjective and objective tear break-up time were tended to decrease with even longer wearing time when wearing the RGP lens made from the polishment for 100 seconds. Conclusions: These results confirmed that the optimization of physical properties of the lens may not give the same effect on the wearer's subjective and objective symptoms and other factors when actual wearing. From the results, it can suggest that the success rate of RGP lens wear may be changed by physiological factors such as the stabilization of wearer's tear film, comfortability and lens wearing experience when wearing RGP lens based on 'The manufacturing standard for soft contact lens/hard contact lens' provided by Korea Food and Drug Administration.

• Journal of Korean Ophthalmic Optics Society
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• v.9 no.2
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• pp.333-343
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• 2004

Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.191-201
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• 2016

Purpose: In the present study, the effect of artificial tears with different ingredients on tear film stability and subjective symptoms of dry eyes in the early stage of soft contact lenses wear was investigated. Methods: The three kinds of artificial tears and saline solution were respectively applied onto 50 dry eyes which wore soft contact lenses made of etafilcon A. Then, non-invasive tear film break-up time (NIBUT) was measured at every five minutes for 30 minutes right after the instillation of artificial tears, and the changes in blink rate and subjective symptoms were estimated after 30 minutes from the instillations. Results: All three kinds of artificial tears increased NIBUT larger than saline. The effect of increasing NIBUT immediately after the instillation of artificial tears was the largest when the artificial tear containing viscosity enhancer was used. The duration time of the effect was the longest when the artificial tear having both surfactant and viscosity enhancer was applied. The blink rate was not significantly changed when both artificial tears and saline solution were instilled. Subjective symptoms were significantly improved by the instillation of both artificial tears and saline solution and dryness, irritation, tiredness, stiffness, dazzling were improved by the use of most solutions. However, the subjective symptoms were rebounded to the level before the instillation of artificial tears after 30 minute-instillation. Conclusions: It was revealed that both artificial tears and saline solution could improve the subjective symptoms of dry eye in the early stage of soft contac lenses however, the effect of these solutions on the tear film stability was different according to the components. From the results, it is suggested that the proper selection of artificial tears is necessary for the improvement of dry eye symptoms at the early stage of soft contact lenses wear in dry eye.