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Review

Ocular surface microvascular response and its relation to contact lens fitting and ocular comfort: an update of recent research

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Pages 661-671 | Received 04 Dec 2020, Accepted 07 Jan 2021, Published online: 05 Mar 2021
 

ABSTRACT

This review examines vascular responses in the ocular surface to contact lens wear and its relation to lens fitting characteristics and contact lens-related discomfort. A search of PubMed was performed to find original research in English, within the past 10 years, that studied the ocular surface, including lid-wiper vascular responses to the lens. The interaction between the lens and ocular surface triggers vascular responses, impacting the lens fitting and contact lens-related discomfort. Contact lens-related discomfort is a multifactorial event, which is affected by lens characteristics. Overall, contact lenses with low modulus and a relatively tight fit produce significant ocular comfort. If an appropriate lens fit is achieved, lens fitting characteristics may not play a critical role in contact lens-related discomfort. On the other hand, the pathogenic and vascular changes of lid-wiper vascular responses appear to play an essential role in developing contact lens-related discomfort, in concert with reactions of the cornea (compression and staining) and conjunctiva (indentation and staining). Robust evaluation of lid-wiper changes at the cellular and microvascular level may hold the key to better understanding the mechanism of contact lens-related discomfort and reveal strategies for eliminating lid wiper epitheliopathy and improving ocular comfort in contact lens wearers.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by research grants from NIH Center Grant [P30 EY014801] and a grant from the Research to Prevent Blindness (RPB).

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