Real world registry data on contact lens wear in patients with dry eye disease

Abstract

Purpose : To describe real-world ocular surface clinical characteristics of contact lens wearers (CLW) presenting with symptoms of dry eye disease (DED).

Methods : Data collected by clinicians in routine clinical practice and entered into a prospectively designed, observational, web-based clinical outcomes registry, the Save Sight Dry Eye Registry (SSDER), was used. Of 382 patients on the registry the data from the 23 who wore contact lenses within 1-month of the index visit were analysed. Dry eye subtype was classified by the treating clinician as evaporative, aqueous deficient, mixed and/or corneal neuropathic pain. The Patient Health Questionnaire-4 (PHQ-4) was used to screen for anxiety and depression. Index visit data, including demographic information, pre-visit DED treatment, DED diagnosis, OSDI, OCI and PHQ-4 scores, and right eye conjunctival hyperaemia, tear breakup time (TBUT), ocular surface staining score and meibomian gland dropout were reported.

Results : Twenty-three patients (6% of 382 SSDER patients) of mean age 42±17 years (range 14–79 years; 91.3% female; 69.6% White/Caucasian and 30.4% Asian) had a history of recent CLW. Twelve patients reported prior treatment for DED, most commonly topical lubricants (69.4%) and cyclosporin (8.7%). Most patients (95.7%) had evaporative DED. The mean OSDI score was 31.3±20.0 (range 2.1–70.8), comprising 14.2% normal scores, 35.6% mild, 7.1% moderate, and 42.7% severe DED. Mean OCI scores for the frequency and intensity of eye discomfort were 29.3±6.7 (range 16–41) and 29.3±6.3 (16–39), respectively; the overall mean OCI score was 37.5±9.7 (21–59). Twenty-two percent of patients had mild to severe symptoms of anxiety and depression. Mean TBUT was 6.2±4.1 (range 2–14) seconds. Most patients had mild (73.9%) to moderate (13.0%) meibomian gland dropout, and mild (73.9%), moderate (4.3%) or severe (4.3%) conjunctival hyperaemia. Ocular surface staining was graded as none (26.1%), minimal (43.5%), mild (21.7%), moderate (4.3%) and severe (4.3%).

Conclusions : Contact lens wearers on our real-world registry had mainly evaporative dry eye disease and meibomian gland disease. They had symptoms of dry eye, anxiety and depression. A larger sample is required to explore the natural history and response to treatment.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.