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Peer-reviewed articles

2017

Ngo,W., Srinivasan,S., Keech,A., Keir,N., Jones,L. Self versus examiner administration of the Ocular Surface Disease Index©. Journal of Optometry 2017;10,1:34-42. [ Show Abstract ]

Purpose To compare the difference in Ocular Surface Disease Index© (OSDI) scores when participants were given the OSDI to complete on their own (self-guided, SG), versus under the guidance of the examiner (examiner-guided, EG). Methods 100 participants enrolled in this prospective two-visit study (fifty under-45 years old, 38F/12M; and fifty 45 years-and-older, 42F/8M). Participants who scored =1 on the Subjective Evaluation of Symptoms of Dryness (SESoD) were included in this study. Participants completed the OSDI SG during the first visit. Participants returned the next day and repeated the OSDI, but with EG (with standardized instructions). Participants were under deception and believed that they were comparing the OSDI to the SESoD. Results The mean OSDI score of the SG and EG administration was 32.0 ± 17.3 and 33.8 ± 19.6 respectively (p > 0.05) with 95% limits of agreement between -20.6 and +24.2. The correlation between SG and EG administration was Spearman's r = 0.81, p 0.05) for both the under-45 group, and 45-and-older group. The 95% limits of agreement for the under-45 group were smaller than the 45-and-older group (under-45: [-15.5, +13.1,], 45-and-older: [-23.3, +32.2]). A significant difference was found between 8 of the 12 questions items (all p = 0.01). However, the mean difference for each was <0.6 and was not considered to be clinically significant. Conclusion There was no clinically significant difference in OSDI score between SG and EG administration, however having instructions provided with EG administration affected variability of scores in the older group more than the younger group. © 2016 Spanish General Council of Optometry

Ngo,W., Srinivasan,S., Houtman,D., Jones,L. The relief of dry eye signs and symptoms using a combination of lubricants, lid hygiene and ocular nutraceuticals. Journal of Optometry 2017;10,1:26-33. [ Show Abstract ]

Purpose To determine the combined effect of TheraTears® Lubricant Eye Drops, TheraTears® SteriLid Eyelid Cleanser, and TheraTears® Nutrition on dry eye signs and symptoms. Methods This prospective study enrolled 28 dry eye participants. Participants were instructed to use the Lubricant Eye Drops at least 2–4× a day, SteriLid 1–2× a day, and Nutrition 3 gel caps once a day. Participants were followed up at baseline, 1 month and 3 months. Outcome variables were the Ocular Surface Disease Index (OSDI), Symptom Assessment iN Dry Eye (SANDE) questionnaire, non-invasive tear break-up time (NIBUT), osmolarity, number of meibomian glands blocked (#MG blocked), meibum quality, eyelid margin features, Schirmer's test, tear film lipid layer thickness (LLT), meniscus height, corneal and conjunctival staining. Results Twenty participants (mean age = 43, from 23 to 66, 17F, 3M) completed the study. Participants reported having used, on average, the Lubricant Eye Drop 2.4×/day, the SteriLid 1.1×/day, and the Nutrition 3 gel caps 1×/day. There was a significant change over time (p < 0.05) for OSDI (-21.2 points), SANDE (-32.4 points), NIBUT (+0.43 s), eyelid margin features (-1.1 grade), meibum quality (-1.0 grade), and #MG blocked (-4.0 glands). Conclusion By using a combination of TheraTears® Lubricant Eye Drop, SteriLid, and Nutrition, patients experience significant relief in both dry eye symptoms and signs. © 2016 Spanish General Council of Optometry

Regmi,S. C., Samsom,M. L., Heynen,M. L., Jay,G. D., Sullivan,B. D., Srinivasan,S., Caffery,B., Jones,L., Schmidt,T. A. Degradation of proteoglycan 4/lubricin by cathepsin S: Potential mechanism for diminished ocular surface lubrication in Sjögren's syndrome. Experimental eye research 2017;1611-9. [ Show Abstract ]

Sjögren's syndrome (SS) is an autoimmune disease affecting the lacrimal and salivary glands with hallmark clinical symptoms of dry eye and dry mouth. Recently, markedly increased cathepsin S (CTSS) activity has been observed in the tears of SS patients. Proteoglycan 4 (PRG4), also known as lubricin, is an effective boundary lubricant that is naturally present on the ocular surface. While PRG4 is susceptible to proteolytic digestion, the potential effect of CTSS on PRG4 remains unknown. The objective of this study was to assess the ability of CTSS to enzymatically degrade purified PRG4, and PRG4 naturally present in human tears, and alter ocular surface boundary lubricating properties. To assess the potential time course and dose-dependency of PRG4 digestion by CTSS, full-length recombinant human PRG4 (rhPRG4) was incubated at 37 °C with or without CTSS in an enzymatic digestion buffer. Digestion of PRG4 by CTSS was also examined within normal human tear samples, both with and without supplementation by rhPRG4. Finally, digestion of endogenous PRG4 by CTSS, and the effect of a CTSS inhibitor, was examined in SS tears on Schirmer strips. Digestion products were separated on 3–8% SDS-PAGE and visualized by protein staining and western blotting. The boundary lubricating ability of rhPRG4 samples was assessed using an in vitro human eyelid-cornea friction test. Finally, SDS-PAGE protein stain bands resulting from rhPRG4 digestion were submitted for tandem mass spectrometry analysis to confirm their identity as PRG4 and identify non-tryptic cleavage sites. CTSS digested rhPRG4 in a time and dose dependent manner. CTSS digestion of rhPRG4 at 1% (where % is the mass ratio of CTSS to rhPRG4) resulted in a time dependent decrease in the full-length, ~460 kDa, monomeric rhPRG4 band, and an appearance of lower MW fragments. After 20 h, no full-length rhPRG4 was observed. Furthermore, with an increased relative enzyme concentration of 3%, no protein bands were observed after 2 h, indicating complete digestion of rhPRG4. Western blotting demonstrated PRG4 is present in normal human tears, and that rhPRG4, tears, and tears supplemented with rhPRG4 incubated with 3–9% CTSS demonstrated decreased intensity of high MW PRG4 bands, indicative of partial degradation by CTSS. Similarly, western blotting of PRG4 in SS tears incubated with CTSS demonstrated decreased intensity of high MW PRG4 bands, which was reversed in the presence of the CTSS inhibitor. CTSS treatment of rhPRG4 resulted in an increased friction coefficient, compared to untreated controls. Lastly, the lower MW bands were confirmed to be PRG4 fragments by tandem mass spectrometry, and 6 non-tryptic cleavage sites were identified. rhPRG4 is susceptible to proteolytic digestion by CTSS, both alone and in human tears, which results in diminished ocular surface boundary lubricating ability. Moreover, endogenous PRG4 is susceptible to proteolytic digestion by CTSS, both in normal and SS tears. Given the elevated activity of CTSS in SS tears, and the role intact PRG4 plays in ocular surface health and lubrication, degradation of PRG4 by CTSS is a potential mechanism for diminished ocular surface lubrication in SS. Collectively these results suggest that tear supplementation of PRG4 may be beneficial for SS patients. © 2017 Elsevier Ltd

2016

Dantam,J., McCanna,D. J., Subbaraman,L. N., Papinski,D., Lakkis,C., Mirza,A., Berntsen,D. A., Morgan,P., Nichols,J. J., Jones,L. W., Mathew,J. H., Cox,S. M., Bickle,K. M., Powell,D. R., Cox,J., Miller,W. L., Wallace-Tucker,A., Charrier,S., Chen,Y. -J, Cardenas,L., Huerta,S., Dionne,K., Maldonado-Codina,C., Plowright,A. J., Howarth,G. F., Chatterjee,N., Smith,S., Dumbleton,K., Schulze,M., Moezzi,A., Luensmann,D., Ngo,W., Paquette,L., Srinivasan,S., Varikooty,J., Johnson,J., Simpson,M., Voss,L., R Microbial contamination of contact lens storage cases during daily wear use. Optometry and Vision Science 2016;93,8:925-932. [ Show Abstract ]

Purpose. To evaluate contact lens (CL) storage case contamination when used with four different CL care solutions during daily wear of three different CL materials. Methods. A parallel, prospective, bilateral, randomized clinical trial (n = 38) was conducted. Subjects were randomly assigned to use one of three CL materials (etafilcon A, senofilcon A, or galyfilcon A) on a daily wear basis. Subsequently, each subject randomly used one of four different CL care solutions (Biotrue, OPTI-FREE PureMoist, RevitaLens OcuTec, and CLEAR CARE) for 2 weeks, along with their respective storage cases. After every 2-week period, their storage cases were collected and the right and left wells of each storage case were randomized for two procedures: (1) microbial enumeration by swabbing the storage case surface and (2) evaluation of biofilm formation (multipurpose solution cases only) using a crystal violet staining assay. Results. More than 80% of storage cases were contaminated when used in conjunction with the four CL care solutions, irrespective of the CL material worn. Storage cases maintained with CLEAR CARE (mean Log colony forming units (CFU)/ well ± SD, 2.0 ± 1.0) revealed significantly (p < 0.001) greater levels of contamination, compared to those maintained with Biotrue (1.3 ± 0.8) and RevitaLens OcuTec (1.2 ± 0.8). Predominantly, storage cases were contaminated with Gram-positive bacteria (= 80%). There were significant differences (p = 0.013) for the levels of Gram-negative bacteria recovered from the storage cases maintained with different CL care solutions. Storage cases maintained withOPTI-FREE PureMoist (0.526 ± 0.629) showed significantly higher biofilm formation (p = 0.028) compared to those maintained with Biotrue (0.263 ± 0.197). Conclusions. Levels of contamination ranged from 0 to 6.4 Log CFU/storage case well, which varied significantly (p < 0.001) between different CL care solutions, and storage case contamination was not modulated by CL materials. © Copyright 2016 American Academy of Optometry.

Berntsen,D. A., Hickson-Curran,S. B., Jones,L. W., Mathew,J. H., Maldonado-Codina,C., Morgan,P. B., Schulze,M. M., Nichols,J. J., Cox,S. M., Bickle,K. M., Powell,D. R., Cox,J., Miller,W. L., Wallace-Tucker,A., Charrier,S., Chen,Y. -J, Cardenas,L., Huerta,S., Dionne,K., Plowright,A. J., Howarth,G. F., Chatterjee,N., Mirza,A., Smith,S., Dumbleton,K., Moezzi,A. M., Luensmann,D., Ngo,W., Paquette,L., Srinivasan,S., Varikooty,J., Johnson,J., Simpson,M., Voss,L., Ryan,L., Careless,N., Smith,A., Subbar Subjective comfort and physiology with modern contact lens care products. Optometry and Vision Science 2016;93,8:809-819. [ Show Abstract ]

Purpose. To compare subjective comfort and ocular physiology with three multipurpose solutions (MPSs) to that of a peroxide-based system with three different soft contact lens materials. Methods. Habitual soft contact lens wearers (n = 236) were enrolled at three sites and completed a washout period with no contact lens solution for =4 days. Subjects were randomly assigned to one of three lens types: etafilcon A, galyfilcon A, or senofilcon A. A new lens of the assigned type was worn for 10 to 14 days each while using one of four care solutions, in random order (A - polyaminopropyl biguanide + polyquaternium, B - POLYQUAD + Aldox, C - alexidine + polyquaternium-1, and D - hydrogen peroxide) with a washout period (=4 days) between each solution. After each care solution, biomicroscopy was performed and subjective comfort was assessed using the Contact Lens User Experience (CLUE) questionnaire and other instruments including comfortable wear time (CWT). Linear mixed models were used for analysis. Comfort and biomicroscopy signs with each MPS were compared to that of the peroxide solution. Results. Subjective CLUE Comfort score across all lens types with each MPS was not significantly different than with the peroxide solution (p = 0.98). There were no differences in CWT between each MPS and the peroxide solution for any lens type (range of differences: -0.8 to 0.8 h; all p = 0.13). Six MPS/material combinations had no clinically meaningful change in corneal staining versus peroxide (<0.5 units); three combinations could increase staining by up to 0.57 units. Staining was

Schulze,M. -M, Srinivasan,S., Hickson-Curran,S. B., Berntsen,D. A., Howarth,G. F., Toubouti,Y., Morgan,P., Nichols,J. J., Jones,L. W., Mathew,J. H., Cox,S. M., Bickle,K. M., Powell,D. R., Cox,J., Miller,W. L., Wallace-Tucker,A., Charrier,S., Chen,Y. -J, Cardenas,L., Huerta,S., Dionne,K., Maldonado-Codina,C., Plowright,A. J., Chatterjee,N., Mirza,A., Smith,S., Dumbleton,K., Moezzi,A. M., Luensmann,D., Ngo,W., Paquette,L., Varikooty,J., Johnson,J., Simpson,M., Voss,L., Ryan,L., Careless,N., Smith, Lid wiper epitheliopathy in soft contact lens wearers. Optometry and Vision Science 2016;93,8:943-954. [ Show Abstract ]

Purpose. To evaluate lid wiper epitheliopathy (LWE) in soft contact lens (SCL) wearers on initial presentation and after using various SCL and solution combinations. Methods. LWE was assessed in 253 habitual SCL wearers who attended a screening visit at one of three study sites. LWE was assessed using lissamine green and sodium fluorescein dyes (Korb scale); a final LWE grade was calculated as the averaged LWE grade of the two dyes. Eligible habitual wearers continued into the four study periods, during which they wore one of three SCL types (etafilcon A, galyfilcon A, or senofilcon A) while using each of four care solutions for 10 to 14 days in randomized order. Statistical analyses were performed using linear mixed models, testing for differences in LWE for subject characteristics and between three multipurpose (MPS) test solutions (BioTrue, OPTI-FREE PureMoist, RevitaLens OcuTec) compared to a hydrogen peroxide (Clear Care) control solution. Results. LWE was present in 85% of habitual SCL wearers. LWE was not different for age (p = 0.28), sex (p = 0.99), race (p = 0.34), and comfort (p = 0.38) and not correlated with refractive error (r = 0.07). LWE was lower in habitual senofilcon A wearers (least-squares (LS) mean ± SE = 0.82 ± 0.19) compared to wearers of lotrafilcon B (1.34 ± 0.20; p < 0.02), comfilcon A (1.41 ± 0.21; p < 0.01), and other (1.18 ± 0.16; p < 0.03). Two hundred three participants completed all four study solutions with their assigned lens type; LWE was not different between the MPSs compared to the peroxide control solution across lens materials, except for less LWE for BioTrue (0.88 ± 0.17) versus Clear Care for participants wearing galyfilcon A (1.11 ± 0.18; p < 0.01). Conclusions. On initial presentation, LWE was present in 85% of habitual wearers and found to be independent of age, sex, race, comfort, and refractive error but dependent on habitual SCL type. There were no clinically meaningful differences in LWE between the MPSs and hydrogen peroxide solution for the three lens types studied. © Copyright 2016 American Academy of Optometry.

Cox,S. M., Berntsen,D. A., Chatterjee,N., Hickson-Curran,S. B., Jones,L. W., Moezzi,A. M., Morgan,P. B., Nichols,J. J., Mathew,J. H., Bickle,K. M., Powell,D. R., Cox,J., Miller,W. L., Wallace-Tucker,A., Charrier,S., Chen,Y. -J, Cardenas,L., Huerta,S., Dionne,K., Maldonado-Codina,C., Plowright,A. J., Howarth,G. F., Mirza,A., Smith,S., Dumbleton,K., Schulze,M., Luensmann,D., Ngo,W., Paquette,L., Srinivasan,S., Varikooty,J., Johnson,J., Simpson,M., Voss,L., Ryan,L., Careless,N., Smith,A., Subbarama Eyelid margin and meibomian gland characteristics and symptoms in lens wearers. Optometry and Vision Science 2016;93,8:901-908. [ Show Abstract ]

Purpose. To describe the lid margin characteristics of contact lens wearers and relate them to comfort during lens wear. Methods. Three study sites enrolled habitual contact lens wearers. Subjects completed the Comfort domain of the Contact Lens User Experience (CLUE) questionnaire, and each eye was graded for the presence of mucocutaneous junction (MCJ) displacement, lid margin irregularity, and lid margin vascularity. Examiners counted the number of meibomian gland (MG) orifices in the central centimeter of the lower eyelid and the number of those that showed pouting/plugging and vascular invasion. MG expressibility was graded according to the Shimazaki schema. Subjects were grouped based on presence/ absence of each characteristic, total number of orifices (=5 vs. 0). Descriptive statistics are reported. A linear model was used to assess the fixed effect of each characteristic on combined CLUE score and each CLUE statement, if the effect on combined CLUE score showed p < 0.10. Results. The study included 203 subjects (67.5% female) with mean age (±SD) of 30.3 ± 9.6 years. The most commonly observed characteristics were orifice pouting/plugging, compromised MG expressibility, and lid margin vascularity (35.0, 30.3, and 20.4%, respectively). MCJ displacement and MG expressibility had an effect on the combined CLUE score such that individual CLUE statements were analyzed (p = 0.01 and p = 0.06, respectively). MCJ displacement had an effect on comfort upon insertion (p = 0.01), comfort after 5 minutes (p = 0.03), end-of-day comfort (p = 0.01), and ability to maintain ocular moisture (p = 0.030). MG expressibility had a significant effect on general comfort (p = 0.01), comfort throughout the day (p = 0.02), and the ability to maintain ocular moisture (p = 0.02). Conclusions. MCJ displacement and MG expressibility have an effect on contact lens comfort. © Copyright 2016 American Academy of Optometry.

Omali,N. B., Heynen,M., Subbaraman,L. N., Papinski,D., Lakkis,C., Smith,S. L., Morgan,P. B., Berntsen,D. A., Nichols,J. J., Jones,L. W., Mathew,J. H., Cox,S. M., Bickle,K. M., Powell,D. R., Cox,J., Miller,W. L., Wallace-Tucker,A., Charrier,S., Chen,Y. -J, Cardenas,L., Huerta,S., Dionne,K., Maldonado-Codina,C., Plowright,A. J., Howarth,G. F., Chatterjee,N., Mirza,A., Dumbleton,K., Schulze,M., Moezzi,A. M., Luensmann,D., Ngo,W., Paquette,L., Srinivasan,S., Varikooty,J., Johnson,J., Simpson,M., Vos Impact of lens care solutions on protein deposition on soft contact lenses. Optometry and Vision Science 2016;93,8:963-972. [ Show Abstract ]

Purpose. To evaluate the effect of four contemporary lens care solutions on total protein, total lysozyme, and active lysozyme extracted from three contact lens materials. Methods. Adapted contact lens wearers were recruited at three sites, and all subjects were randomly assigned to daily wear of either etafilcon A, galyfilcon A, or senofilcon A for 2 weeks. Four lens care solutions (Biotrue, OPTI-FREE PureMoist, RevitaLens OcuTec, and ClearCare) were used by each subject in random order with a new pair of lenses after a washout period between solutions of at least 4 days. After 2 weeks of daily wear, contact lenses were collected for analysis. Proteins were extracted from a subset of contact lenses (n = 568) and total protein, total lysozyme, and lysozyme activity were quantified using a modified Bradford assay, an enzyme-linked immunosorbent assay, and a micrococcal assay, respectively. Results. Higher levels of total protein were extracted from etafilcon A when used with Biotrue compared to other solutions (p = 0.0001). There were higher levels of total lysozyme extracted from galyfilcon A lenses when used with PureMoist than with Biotrue or Clear Care (p < 0.006). Higher total lysozyme was extracted from senofilcon A when used with RevitaLens OcuTec compared to Biotrue (p = 0.002). Lower lysozyme activity was recovered from senofilcon A lenses with RevitaLens OcuTec when compared to all other care solutions (all p < 0.004). When Biotrue, PureMoist, or RevitaLens OcuTec were used, higher total lysozyme was extracted from galyfilcon A compared to senofilcon A(p < 0.01). When RevitaLens OcuTec was used, higher levels of active lysozyme were extracted from galyfilcon A compared to senofilcon A (p = 0.02). Conclusions. The ability of lens care solutions to remove protein from lenses varies depending upon the care solution composition and also the polymeric make-up of the contact lens material. © Copyright 2016 American Academy of Optometry.

2015

Hagedorn,S., Drolle,E., Lorentz,H., Srinivasan,S., Leonenko,Z., Jones,L. Atomic force microscopy and Langmuir-Blodgett monolayer technique to assess contact lens deposits and human meibum extracts. Journal of Optometry 2015;8,3:187-199. [ Show Abstract ]

Purpose The purpose of this exploratory study was to investigate the differences in meibomian gland secretions, contact lens (CL) lipid extracts, and CL surface topography between participants with and without meibomian gland dysfunction (MGD). Methods Meibum study: Meibum was collected from all participants and studied via Langmuir-Blodgett (LB) deposition with subsequent Atomic Force Microscopy (AFM) visualization and surface roughness analysis. CL Study: Participants with and without MGD wore both etafilcon A and balafilcon A CLs in two different phases. CL lipid deposits were extracted and analyzed using pressure-area isotherms with the LB trough and CL surface topographies and roughness values were visualized using AFM. Results Meibum study: Non-MGD participant meibum samples showed larger, circular aggregates with lower surface roughness, whereas meibum samples from participants with MGD showed more lipid aggregates, greater size variability and higher surface roughness. CL Study: Worn CLs from participants with MGD had a few large tear film deposits with lower surface roughness, whereas non-MGD participant-worn lenses had many small lens deposits with higher surface roughness. Balafilcon A pore depths were shallower in MGD participant worn lenses when compared to non-MGD participant lenses. Isotherms of CL lipid extracts from MGD and non-MGD participants showed a seamless rise in surface pressure as area decreased; however, extracts from the two different lens materials produced different isotherms. Conclusions MGD and non-MGD participant-worn CL deposition were found to differ in type, amount, and pattern of lens deposits. Lipids from MGD participants deposited irregularly whereas lipids from non-MGD participants showed more uniformity. © 2014 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Srinivasan,S., Otchere,H., Yu,M., Yang,J., Luensmann,D., Jones,L. Impact of cosmetics on the surface properties of silicone hydrogel contact lenses. Eye and Contact Lens 2015;41,4:228-235. [ Show Abstract ]

Purpose: This study evaluated the impact of various cosmetics on the surface properties of silicone hydrogel (SiHy) contact lens materials. Methods: In this in vitro experiment, 7 SiHy contact lens materials were coated with 1 of 9 cosmetics, including common hand creams (3), eye makeup removers (3), and mascaras (3). Dark-field microscopy images were taken to determine pixel brightness (PB) after cosmetic exposure, which describes the visible surface deposition (n=6 for each lens type), with a higher PB indicating increased deposition. The sessile drop technique was used to determine the advancing contact angle (CA). Measurements were repeated for both methods after a single peroxide-based cleaning cycle. Results: Pixel brightness was significantly higher for mascara-coated lenses compared with the other cosmetic products (P,0.01). The peroxide-based lens care solution removed most deposits from the nonwaterproof mascara for 4 lens types, whereas deposits remained relatively unchanged for 1 waterproof mascara (P.0.05). Hand creams and makeup remover had minimal impact on PB. Changes in CA measurements after cosmetic application were highly lens dependent. Hand creams caused primarily a decrease in CA for 5 of the 7 lens types, whereas 1 of the waterproof mascaras caused a significant increase of 30 to 50° for 3 lens types. Conclusion: Some mascara-lens combinations resulted in increased CA and PB, which could have an impact on in vivo lens performance. Nonwaterproof mascara was mostly removed after a cleaning cycle. Further research is needed to understand the clinical implications for SiHy lens wearers using cosmetics. © 2015 Contact Lens Association of Opthalmologists, Inc.

Luensmann,D., Yu,M., Yang,J., Srinivasan,S., Jones,L. Impact of cosmetics on the physical dimension and optical performance of silicone hydrogel contact lenses. Eye and Contact Lens 2015;41,4:218-227. [ Show Abstract ]

Objectives: To evaluate the impact of cosmetics on silicone hydrogel (SiHy) contact lens shape, lens power, and optical performance. Methods: In this in vitro experiment, 7 SiHy materials were coated with 9 marketed brands of cosmetics, including hand creams (HCs) (3), eye makeup removers (MRs) (3), and mascaras (3). Diameter, sagittal depth, and base curve were determined using the Chiltern (Optimec Limited), whereas lens power and optical performance were assessed using the Contest Plus (Rotlex). Six replicates were used for each lens and cosmetic combination.Measurements were repeated after a cleaning cycle using a one-step hydrogen peroxide solution. Results: Makeup removers had the greatest impact on diameter, sagittal depth, and base curve, resulting in changes of up to 0.5, 0.15, and 0.77 mm, respectively. The HCs and mascaras had little impact on these parameters; however, differences were observed between lens types. Optical performance was reduced with all mascaras, and a decrease of greater than 2 units on a 0 to 10 scale (10=uniform power distribution) was seen for 5 lens types exposed to waterproof mascara (P0.05). Lens cleaning resulted in some recovery of the lens parameters, and efficiency varied between cosmetics. Conclusion: Some eye MRs and waterproof mascaras changed the shape and optical performance of some SiHy lenses. Further research is needed to understand the clinical implications for SiHy lens wearers using cosmetics. © 2015 Contact Lens Association of Opthalmologists, Inc.

Pucker,A. D., Jones-Jordan,L. A., Li,W., Kwan,J. T., Lin,M. C., Sickenberger,W., Marx,S., Srinivasan,S., Jones,L. W. Associations with meibomian gland atrophy in daily contact lens wearers. Optometry and Vision Science 2015;92,9:e206-e213. [ Show Abstract ]

Purpose To determine associations for contact lenses (CLs) and meibomian gland atrophy in a matched-pair study. Methods Contact lens wearers (case) and age- and sex-matched non-contact lens (NCL) wearers with no history of CL use (control) were recruited for a multicenter study. All subjects were administered the Ocular Surface Disease Index questionnaire and a comprehensive battery of clinical tests (e.g., tear breakup time, bulbar and limbal redness, meibography, etc.) were performed. Upper and lower eyelid meibomian gland atrophy were graded with both digital meibography (percent gland atrophy) and visual meiboscore methods. Conditional logistic regression analyses were then used to determine relationships among CL use, meibomian gland atrophy, and ocular surface signs and symptoms. Results A total of 70 matched pairs were analyzed. The mean (±SD) age of the CL group was 30.6 (±12.4) years, and that of the NCL group was 30.1 (±12.2) years. The subjects were 63% female. The association between CL wear and meiboscore was not significant univariately, but the best-fitting multivariate regression model showed that higher meiboscores were associated with being a CL wearer (odds ratio [OR], 2.45) in a model that included eyelid margin erythema (OR, 0.25) and lissamine green staining (OR, 1.25). Percent gland atrophy was not associated with CL wear in regression analysis (p = 0.31). Conclusions This study determined inconclusive associations with CLs and meibomian gland atrophy. This study also provided a comprehensive assessment of differences between CL and NCL wearers. © 2015 American Academy of Optometry.

Ngo,W., Caffery,B., Srinivasan,S., Jones,L. W. Effect of lid debridement-scaling in sjögren syndrome dry eye. Optometry and Vision Science 2015;92,9:e316-e320. [ Show Abstract ]

Purpose To evaluate the effect of lid debridement-scaling (LDS) on dry eye signs and symptoms in subjects with Sjögren syndrome (SS). Methods This prospective randomized controlled study enrolled 14 female subjects with SS. Seven subjects were randomized into the treatment group where they were selected to receive LDS; the remainder did not receive LDS and served as control subjects. Lid debridement-scaling was conducted using a stainless steel golf club spud (Hilco Wilson Ophthalmics, Plainville, MA) on both the upper and lower eyelids of both eyes. Outcome variables were assessed before LDS and again 1 month later. The outcome variables were the Ocular Surface Disease Index (OSDI), Symptom Assessment iN Dry Eye (SANDE) visual analog scores, ocular staining (SICCA OSS [Sjögren's International Collaborative Clinical Alliance Ocular Staining Score]), fluorescein tear breakup time (FLBUT), meibomian gland score (MGS), meibomian gland yielding liquid secretions (MGYLS) score, and line of Marx's (LOM) position. Results Thirteen subjects completed the study. Data from only the right eye were analyzed. For the control group (n = 6; mean [±SD] age, 62.3 [±11.6] years), the pre-LDS, post-LDS, and significance level (pre-LDS mean [±SD] vs. post-LDS mean [±SD]; p value) were as follows: OSDI (58.3 [±22.1] vs. 48.3 [±29.0]; p = 0.051), SANDE (77.4 [±22.1] vs. 89.6 [±32.6]; p = 0.20), SICCA OSS (7.0 [±4.5] vs. 8.2 [±3.5]; p = 0.25), MGS (1.3 [±1.5] vs. 1.0 [±0.9]; p = 0.75), MGYLS (0.3 [±0.5] vs. 0.0 [±0.0]; p = 0.50), FLBUT (2.99 [±1.54] vs. 2.85 [±1.79]; p = 0.63), and LOM (2.0 [±0.0] vs. 2.0 [±0.0]; p = n/a). For the treatment group (n = 7; mean [±SD] age, 58.0 [±8.1] years), the pre-LDS, post-LDS, and significance level were as follows: OSDI (63.2 [±13.3] vs. 46.9 [±19.4]; p = 0.04), SANDE (72.6 [±17.1] vs. 77.0 [±28.0]; p = 0.54), SICCA OSS (6.6 [±2.9] vs. 5.0 [±3.9]; p = 0.02), MGS (1.0 [±1.2] vs. 3.1 [±1.7]; p = 0.01), MGYLS (0.0 [±0.0] vs. 0.6 [±1.0]; p = 0.50), FLBUT (3.13 [±0.81] vs. 3.45 [±1.03]; p = 0.53), and LOM (0.9 [±0.9] vs. 1.0 [±1.0]; p = 1.00). Conclusions This pilot study showed that LDS improved symptoms, ocular staining, and meibomian gland function for the group that received LDS. This indicates that LDS can aid in the management of SS dry eye. © 2015 American Academy of Optometry.

2014

Ngo,W., Srinivasan,S., Schulze,M., Jones,L. Repeatability of grading meibomian gland dropout using two infrared systems. Optometry and Vision Science 2014;91,6:658-667. [ Show Abstract ]

PURPOSE: To determine the interobserver and intraobserver repeatability in using the OCULUS Keratograph 4 (K4) and 5M (K5M) to grade meibomian gland (MG) dropout using meibography grading scales. METHODS: The inferior and superior eyelids of 40 participants (35 women, 5 men; mean age = 32 years) were imaged three times each on both instruments. The images were split into one training and two study sets; the latter were graded (four-point meibography scale) by two observers on two separate occasions (24 hours apart) to determine repeatability. Semiobjective quantification of percentage MG dropout was conducted using ImageJ on K4 and K5M images. A finer seven-point meibography scale was used to grade a separate set of K5M images. RESULTS: For the four-point scale, interobserver mean difference (MD) (±SD) was 0.08 (±0.55) on day 1 and 0.13 (±0.50) on day 2, and the concordance correlation coefficient (CCC) was 0.79 and 0.81 on days 1 and 2, respectively. Intraobserver MD (±SD) was 0.04 (±0.54), CCC = 0.79 for observer 1; intraobserver MD (±SD) was -0.09 (±0.60), CCC = 0.74 for observer 2. For the seven-point scale, interobserver MD (±SD) was 0.05 (±0.45), CCC = 0.89 on day 1, and interobserver MD (±SD) was 0.01 (±0.41), CCC = 0.91 on day 2. Intraobserver MD (±SD) was -0.10 (±0.35), CCC = 0.93 for observer 1, and intraobserver MD (±SD) was -0.06 (±0.30), CCC = 0.95 for observer 2. Percentage dropout measured between the K4 and K5M images showed lack of agreement, with 21.8% coefficient of repeatability. There was no significant correlation (r 0.05) between meibography score and clinical signs (corneal staining, gland expressibility, telangiectasia, vascularity, lash loss); however, there was a high correlation (r = 0.77; p < 0.05) between meibography score with percentage dropout. CONCLUSIONS: Observers graded from -1 to +1 grade units between and within themselves for a four-point scale, 95% of the time. Although the interobserver and intraobserver repeatability of the K4 and K5M were very similar, a high rate of disagreement in percentage dropout between K4 and K5M images suggests that the two instruments cannot be interchanged. Meibomian gland dropout scores did not correlate significantly with clinical signs. Using a finer scale may be beneficial for detecting change.

2013

Papas,E. B., Ciolino,J. B., Jacobs,D., Miller,W. S., Pult,H., Sahin,A., Srinivasan,S., Tauber,J., Wolffsohn,J. S., Nelson,J. D. The TFOS International Workshop on Contact Lens Discomfort: Report of the management and therapy subcommittee. Investigative Ophthalmology and Visual Science 2013;54,11:TFOS183-TFOS203.

Ngo,W., Srinivasan,S., Jones,L. Historical overview of imaging the meibomian glands. Journal of Optometry 2013;6,1:1-8. [ Show Abstract ]

Growing knowledge of the role of the meibomian glands in dry eye disease and contact lens discomfort has resulted in a surge of interest in visualizing these glands within the eyelids. This manuscript provides an overview of the many different visualization methods that have evolved over the past 30-40 years. Some of the visualization methods covered in this review include lid transillumination, video and non-contact meibography, and imaging methods employing confocal microscopy, optical coherence tomography and ultrasound. This review has also highlighted all the studies to date that have employed meibography as part of their methods. An overview of the available meibography dropout grading systems will also be provided. © 2012 Spanish General Council of Optometry.

Srinivasan,S., Heynen,M. L., Martell,E., Ritter III,R., Jones,L., Senchyna,M. Quantification of MUCIN 1, cell surface associated and MUCIN16, cell surface associated proteins in tears and conjunctival epithelial cells collected from postmenopausal women. Molecular Vision 2013;19970-979. [ Show Abstract ]

Purpose: To quantify the expression of mucin 1, cell surface associated (MUC1) and mucin 16, cell surface associated (MUC16) proteins and messenger ribonucleic acid (mRNA) in a cohort of postmenopausal women (PMW), to explore the relationship between mucin expression, dry eye symptomology, and tear stability. Methods: Thirty-nine healthy PMW (>50 years of age) were enrolled in this study. No specific inclusion criteria were used to define dry eye; instead, a range of subjects were recruited based on responses to the Allergan Ocular Surface Disease Index (OSDI) questionnaire and tear stability measurements as assessed by non-invasive tear breakup time (NITBUT). Tears were collected from the inferior tear meniscus using a disposable glass capillary tube, and total RNA and total protein were isolated from conjunctival epithelial cells collected via impression cytology. Expression of membrane-bound and soluble MUC1 and MUC16 were quantified with western blotting, and expression of MUC1 and MUC16 mRNA was assessed with real-time PCR. Results: OSDI responses ranged from 0 to 60, and NITBUT ranged from 18.5 to 2.9 s. Only two statistically significant correlations were found: soluble MUC16 protein concentration and MUC16 mRNA expression with OSDI vision related (-0.47; p=0.01) and ocular symptom (0.39; p=0.02) subscores, respectively. Post hoc exploratory analysis on absolute expression values was performed on two subsets of subjects defined as asymptomatic (OSDI =6, n=12) and moderate to severe symptomatic (OSDI =20, n=12). The only significant difference between the two subgroups was a significant reduction in MUC16 mRNA expression found in the symptomatic dry eye group (1.52±1.19 versus 0.57±0.44; p=0.03). Conclusions: A broad exploration of mucin expression compared to either a sign (NITBUT) or symptoms of dry eye failed to reveal compelling evidence supporting a significant relationship, other than a potential association between MUC16 with specific symptoms. Furthermore, comparison of mucin protein and expression levels between the asymptomatic and moderate to severe symptomatic subgroups revealed only one significant difference, a reduction in MUC16 mRNA expression in the symptomatic subgroup. © 2013 Molecular Vision.

Srinivasan,S., Menzies,K. L., Sorbara,L., Jones,L. W. Imaging meibomian glands on a patient with chalazia in the upper and lower lids: A case report. Contact Lens and Anterior Eye 2013;36,4:199-203. [ Show Abstract ]

Aim: To describe the meibomian gland (MG) appearance in a case of eyelid chalazia, using a novel meibography method. Methods: A 29-year-old female of South Asian origin presented with mild swelling in the lower lid of the left eye. The patient also presented with a history of a recurrent chalazion in the upper lid of the same eye, which later progressed to an active chalazion. A chalazion also developed in the upper lid of the right eye. Meibography was performed using a novel Keratograph (Keratograph 4, OCULUS, Wetzlar, Germany) to evaluate the structure of the MG in the area affected by the chalazia. Results: The area of the recurrent chalazion in the upper left lid showed partial and/or complete MG loss. The active chalazia in the lower left lid and the upper right lid showed inflammation and MG drop out at the affected site. The inflammation was found to be reduced during the follow-up visits, however disappearance of MG very specific to the region of the chalazion was observed. Conclusion: The Keratograph 4 was able to image the MG structures clearly, allowing the clinician to monitor the progression of chalazia and the MG loss in the affected areas. © 2013 British Contact Lens Association.

2012

Leiske,D. L., Leiske,C. I., Leiske,D. R., Toney,M. F., Senchyna,M., Ketelson,H. A., Meadows,D. L., Srinivasan,S., Jones,L., Fuller,G. G. Temperature-induced transitions in the structure and interfacial rheology of human meibum. Biophysical journal 2012;102,2:369-376. [ Show Abstract ]

Meibomian lipids are the primary component of the lipid layer of the tear film. Composed primarily of a mixture of lipids, meibum exhibits a range of melt temperatures. Compositional changes that occur with disease may alter the temperature at which meibum melts. Here we explore how the mechanical properties and structure of meibum from healthy subjects depend on temperature. Interfacial films of meibum were highly viscoelastic at 17°C, but as the films were heated to 30°C the surface moduli decreased by more than two orders of magnitude. Brewster angle microscopy revealed the presence of micron-scale inhomogeneities in meibum films at higher temperatures. Crystalline structure was probed by small angle x-ray scattering of bulk meibum, which showed evidence of a majority crystalline structure in all samples with lamellar spacing of 49 that melted at 34°C. A minority structure was observed in some samples with d-spacing at 110 that persisted up to 40°C. The melting of crystalline phases accompanied by a reduction in interfacial viscosity and elasticity has implications in meibum behavior in the tear film. If the melt temperature of meibum was altered significantly from disease-induced compositional changes, the resultant change in viscosity could alter secretion of lipids from meibomian glands, or tear-film stabilization properties of the lipid layer. © 2012 Biophysical Society.

Leiske,D. L., Miller,C. E., Rosenfeld,L., Cerretani,C., Ayzner,A., Lin,B., Meron,M., Senchyna,M., Ketelson,H. A., Meadows,D., Srinivasan,S., Jones,L., Radke,C. J., Toney,M. F., Fuller,G. G. Molecular structure of interfacial human meibum films. Langmuir 2012;28,32:11858-11865. [ Show Abstract ]

Meibum is the primary component of the tear film lipid layer. Thought to play a role in tear film stabilization, understanding the physical properties of meibum and how they change with disease will be valuable in identifying dry eye treatment targets. Grazing incidence X-ray diffraction and X-ray reflectivity were applied to meibum films at an air-water interface to identify molecular organization. At room temperature, interfacial meibum films formed two coexisting scattering phases with rectangular lattices and next-nearest neighbor tilts, similar to the Ov phase previously identified in fatty acids. The intensity of the diffraction peaks increased with compression, although the lattice spacing and molecular tilt angle remained constant. Reflectivity measurements at surface pressures of 18 mN/m and above revealed multilayers with d-spacings of 50 Å, suggesting that vertical organization rather than lateral was predominantly affected by meibum-film compression. © 2012 American Chemical Society.

Srinivasan,S., Menzies,K., Sorbara,L., Jones,L. Infrared imaging of meibomian gland structure using a novel keratograph. Optometry and Vision Science 2012;89,5:788-794. [ Show Abstract ]

PURPOSE.: To examine the ability of a novel non-contact device (Keratograph 4) to image the meibomian gland (MG) structures and their morphological changes in the upper and lower eyelids. METHODS.: Thirty-seven participants (mean age 57.8 ± 8.5 years; 3 males and 34 females) completed the Ocular Surface Disease Index questionnaire to assess dryness symptoms. Meibum secretion quality score, number of blocked gland orifices, and meibum expressibility scores were assessed. The lower lid (LL) and upper lid (UL) of all subjects were everted and images of the MGs were taken using the Keratograph 4 (OCULUS). A MG dropout score (MGDS) due to complete or partial gland loss of both lids was obtained using a subjective 4-grade scoring system, and digital analysis of the images using ImageJ was performed. Presence of tortuosity and visible acinar changes of the MGs were also noted. RESULTS.: MGDS for both lids was significantly positively correlated with the Ocular Surface Disease Index score (r = 0.51; p < 0.05). The MGDS determined using the digital grading was also significantly positively correlated (UL: r = 0.68, p < 0.05; LL: r = 0.42, p < 0.05). The sum of the MGDS for both lids using the subjective grading scale was significantly different between the non-MGD and MGD group (1.3 ± 1.0 vs. 3.1 ± 1.1; p = 0.0004). MGDS assessment using the digital grading was significantly different between non-MGD (UL = 6%, LL = 8%) and MGD group (UL = 32%, LL = 42%; p = 0.001). Tortuous MG was observed only on the UL in 6% of the participants. Visible acinar changes were noted in 40% of the study participants. CONCLUSIONS.: Infrared meibography is now possible in a clinical setting using commercially available devices, and meibography can help determine differences in MG structure in subjects symptomatic of dry eye. Copyright © 2012 American Academy of Optometry.

Subbaraman,L. N., Glasier,M. -A, Varikooty,J., Srinivasan,S., Jones,L. Protein deposition and clinical symptoms in daily wear of etafilcon lenses. Optometry and Vision Science 2012;89,10:1450-1459. [ Show Abstract ]

Purpose.: To determine the relationship between clinical signs and symptoms and protein deposition over 8 h of wear of etafilcon A lenses in symptomatic and asymptomatic contact lens wearers. Methods.: Thirty adapted soft contact lens wearers (16 symptomatic and 14 asymptomatic) were fitted with etafilcon A lenses. In vivo wettability, non-invasive tear break-up time, and subjective symptoms (vision, comfort, and dryness) were assessed at baseline and after 2, 4, 6, and 8 h. After 2, 4, 6, and 8 h time points, lenses were collected, and total protein, total lysozyme, and active lysozyme deposition were assessed. Results.: There was a significant reduction (p = 0.032) in the non-invasive tear break-up time at 8 h in both groups. In the symptomatic group, there was a significant reduction in subjective comfort and dryness ratings at 6 and 8 h measurement with respect to baseline (p 94% at 8 h). Pearson's correlations between subjective symptoms and protein deposition showed poor correlations for total protein/lysozyme and any subjective factor (r 0.05), and only weak correlations between dryness and % active lysozyme (r = 0.3 to 0.5 for all time points). However, stronger correlations were found between active lysozyme and subjective comfort (r = 0.6 to 0.7; p < 0.001). Conclusions.: In addition to investigating total protein deposited on contact lenses, it is of significant clinical relevance to determine the conformational state of the deposited protein. Copyright © 2012 American Academy of Optometry.

2011

Heynen,M., Lorentz,H., Srinivasan,S., Jones,L. Quantification of non-polar lipid deposits on senofilcon A contact lenses. Optometry and Vision Science 2011;88,10:1172-1179.

2010

Srinivasan,S., Joyce,E., Boone,A., Simpson,T., Jones,L., Senchyna,M. Tear lipocalin and lysozyme concentrations in postmenopausal women. Ophthalmic and Physiological Optics 2010;30,3:257-266.

2008

Varikooty,J., Srinivasan,S., Jones,L. Atypical manifestation of upper lid margin staining in silicone hydrogel lens wearers with symptoms of dry eye. Contact Lens and Anterior Eye 2008;31,1:44-46. [ Show Abstract ]

Purpose: To report an atypical manifestation of upper lid margin staining (ULMS) that occurred in adapted silicone hydrogel (SH) contact lens wearers who complained of ocular surface dryness. Methods: Sequential staining with sodium fluorescein (FL) and lissamine green (LG) strips was performed in 38 SH lens wearers. The "wiper area" of the upper lid was examined with the slit lamp, at 8× and 12× magnifications. Results: Four out of 38 subjects (10.5%) showed fimbriated or "feathery" extensions from the superior margin of the subtarsal fold onto the upper tarsal plate. The extent of these feathery extensions varied between subjects, with a mean (±S.D.) length of 2 ± 0.8 mm. In all cases a broad band of staining with both FL and LG was demonstrated, which extended along the entire length of the lid margin. Conclusion: The staining patterns shown on the subjects' upper lid margins and tarsal plates suggest that ULMS may include more complex variants. The putative tissue damage revealed through the staining, points to a mechanism not simply restricted to the upper lid margin. © 2007 British Contact Lens Association.

2007

Srinivasan,S., Chan,C., Jones,L. Apparent time-dependent differences in inferior tear meniscus height in human subjects with mild dry eye symptoms. Clinical and Experimental Optometry 2007;90,5:345-350. [ Show Abstract ]

PURPOSE: The aim of the study was to track the volume of tears contained in the inferior tear meniscus over the course of the day in subjects with symptoms of mild dry eye and a control asymptomatic group. METHODS: Forty non-contact lens-wearing subjects (aged 27 +/- 6 years) were enrolled in this investigator-masked study. They were divided into 'dry eye' (DE) and 'non-dry eye' (NDE) individuals based on their responses to the Allergan Subjective Evaluation of Symptoms of Dryness (SESOD) questionnaire. Measurement of the tear meniscus height (TMH) was undertaken on the centre of the right eye at 9:00 am, noon, 3:00 pm, 6:00 pm and 9:00 pm on the lower lid using a non-contact, non-invasive optical coherence tomographer (OCT). The TMH was determined from scanned images using customised software. RESULTS: A monotonous and significant reduction in the central TMH occurred over the course of the day in both groups (p < 0.05), with the values constantly decreasing (NDE = 0.162 to 0.125 mm; DE = 0.154 to 0.121 mm). While the TMH values in the DE group were always lower than the NDE group, these were not significantly different at any time (p > 0.05). CONCLUSIONS: A diurnal reduction in tear volume, as assessed by evaluation of the inferior TMH, may be one of the reasons responsible for the common increase in end-of-day ocular dryness symptoms reported by many patients in clinical practice.

Srinivasan,S., Joyce,E., Jones,L. W. Tear osmolality and ferning patterns in postmenopausal women. Optometry and Vision Science 2007;84,7:588-592. [ Show Abstract ]

PURPOSE: To compare tear osmolality and ferning patterns in postmenopausal women (PMW) with and without dry eye symptoms. METHODS: Thirty-seven healthy PMW (>50 years of age), not on hormone replacement therapy, were categorized as being symptomatic or asymptomatic of dry eye based on their responses to an Allergan "Single-Item Score Dry Eye Questionnaire" (SIDEQ). They subsequently completed the Allergan "Ocular Surface Disease Index" (OSDI) questionnaire. Tear samples were collected from participants to evaluate osmolality and ferning patterns. A novel freezing point depression osmometer (Advanced Instruments Inc., Model 3100 Tear Osmometer), was used to measure the osmolality of the tear film. The tear ferning test was performed and evaluated for the quality of ferning based on the Rolando grading system. RESULTS: SIDEQ responses revealed 21 symptomatic and 16 asymptomatic participants. The OSDI total score was 6.5 +/- 5.9 for the non-dry-eyed (NDE) group and 25.7 +/- 12.4 for the dry-eyed (DE) group. The subscores for the DE group were significantly greater than the NDE group (p < 0.001). Osmolality values in DE individuals were significantly different from NDE (328.1 +/- 20.8 vs. 315.1 +/- 11.3 mOsm/kg; p = 0.02). Fifty percent of the DE participants showed type II ferning patterns and 29% of the DE participants showed type III ferning patterns, whereas the NDE participants showed either type I (44%) or II (66%) ferning patterns. There was a significant difference between the DE and NDE participants for the ferning patterns (p = 0.019). There was no significant correlation between tear osmolality and tear ferning (DE: r = 0.12; p > 0.05, NDE: r = -0.17; p > 0.05). CONCLUSIONS: Osmolality in mild and moderately DE PMW is higher than in NDE PMW and tear ferning is a rapid, simple, noninvasive laboratory procedure that indicates altered tear quality in PMW with symptoms of dry eye.

2005

Srinivasan,S., Joyce,E., Jones,L. W., Senchyna,M. Subconjunctival cyst-like formations following impression cytology. Contact Lens and Anterior Eye 2005;28,4:181-184. [ Show Abstract ]

Purpose: To report a case of an unusual adverse event subsequent to undertaking Conjunctival Impression Cytology (CIC). Methods: CIC was un dertaken on a 54-year-old healthy Caucasian female, using a 10 mm Millipore™ membrane on the bulbar conjunctiva. Prior to the CIC procedure, two drops of topical proparacaine (Alcaine®) were instilled and following the procedure two drops of artificial tears (GenTeal®) were administered. Results: The subject reported excessive bulbar conjunctival hyperaemia in the left eye 5 min postprocedure, with no marked pain or discomfort. Slitlamp biomicroscopic evaluation revealed several "bubbles" or cystic formations trapped underneath the conjunctival tissue, in association with moderate to severe bulbar conjunctival redness. These cysts began to regress fairly rapidly and completely disappeared within 1 h. Conclusion: CIC is a useful tool for studying the ocular surface; however, care should be taken while performing this mildly invasive procedure. This is the first report of bubble formation in the conjunctiva following CIC. Subjects should be advised about the short term redness and discomfort that could occur following CIC. © 2005 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Abstracts

2016

Ngo W, Jones L, Srinivasan S, Bitton E. Discomfort over Time Associated with various Ocular Demodex Treatment Products. Invest Ophthalmol Vis Sci 2016;57: E-abstract 2838. [ PDF ]

Ngo W, Srinivasan S, Jones L. Comparison of dry eye tests between symptomatic and asymptomatic age-matched females. Optom Vis Sci 2016;93: E-abstract 165089. [ PDF ]

2015

Ngo W, Caffery B, Srinivasan S, Jones L. Effect of Lid Debridement-Scaling on Dry Eye Signs and Symptoms in Sjogren’s Syndrome. Invest Ophthalmol Vis Sci 2015;56: E-abstract 2487. [ PDF ]

Srinivasan S, Ngo W, Jones L. The Relief of Dry Eye Signs and Symptoms Using a Combination of Lubricants, Lid Hygiene and Ocular Nutraceuticals. Invest Ophthalmol Vis Sci 2015;56: E-abstract 4465. [ PDF ]

Schulze M, Srinivasan S, Hickson-Curran S, Toubouti Y, Cox S, Mirza A, Nichols J, Morgan P, Jones L. Comparisons between Age, Gender, Lens Type and Lid Wiper Epitheliopathy with Soft Contact Lens Comfort. Invest Ophthalmol Vis Sci 2015;56: E-abstract 6069. [ PDF ]

Keir N, Srinivasan S, Ngo W, Chamberlain P, Feng W, Jones L, McNally J. Impact of time of day and length of wear on contact lens discomfort. Invest Ophthalmol Vis Sci 2015;56: E-abstract 6107.

Schulze M, Luensmann D, Ng AY, Panjwani F, Srinivasan S, Jones L. The relationship between the positioning of multifocal contact lens optics and satisfaction with vision. Optom Vis Sci 2015;92: E-abstract 155256. [ PDF ]

Ngo W, Srinivasan S, Jones L, Bitton E. Enhancement of Clinical Observation of Demodex Folliculorum. Optom Vis Sci 2015;92: E-abstract 155233. [ PDF ]

Ngo W, Srinivasan S, Jones L. The impact of an Eyelid Warming Device in the Management of Meibomian Gland Dysfunction. Optom Vis Sci 2015;92: E-abstract 150013.

2014

Srinivasan S, Schulze M, Hickson-Curran S, Berntsen D, Howarth G, Nichols J, Morgan P, Jones L. Comparison of upper lid margin staining with different soft contact lens materials and care product combinations. Invest Ophthalmol Vis Sci 2014;55: E-abstract 4673. [ PDF ]

Schulze M, Srinivasan S, Hickson-Curran S, Bemsten D, Howarth G, Nichols J, Morgan P, Jones L. Upper lid margin staining with different soft contact lenses and lens care solution combinations. BCLA Clinical Conference and Exhibition, 2014. [ PDF ]

Srinivasan S, Pucker A, Jones-Jordan L, Li W, Kwan J, Sickenberger W, Marx S, Lin M, Jones L. Meibomian Gland Atrophy Rate in Pre-presbyopic Contact Lens and Non-Contact Lens Wearers. Optom Vis Sci 2014;91: E-abstract 140081.

Ngo W, Srinivasan S, Feng Y, Keir N, Simpson T. Comparison of Two Sensory Panel Selection Strategies for Beginning and End of Day Lens Discomfort. Optom Vis Sci 2014;91: E-abstract 140089.

Pucker A, Kwan J, Jones-Jordan L, Jones L, Lin Meng, Marx S, Srinivasan S, Li W, Sickenberger W. Factors Associated with Meibomian Gland Atrophy in Daily Contact Lens Wearers. Optom Vis Sci 2014;91: E-abstract 140082.

2013

Srinivasan S, Menzies K, Jones L. Infra-red imaging of meibomian glands & evaluation of the lipid layer in Sjogren’s syndrome patients. Invest Ophthalmol Vis Sci 2013;54: E-Abstract 6012.

Srinivasan S, Menzies K, Jones L. Meibography and lipid layer evaluation in sjogern's syndrome patients. Contact Lens & Anterior Eye 2013;36,S2:e45.

Ngo W, Srinivasan S, Schulze M, Jones L. Inter- and intra-observer agreement using infrared meibography systems. Canadian Optometry Schools Research Conference, Waterloo, Canada, 2013.

Srinivasan S, Keech A, Keir N, Jones L. Self vs. examiner-guided administration of ocular surface disease index (OSDI). Canadian Optometry Schools Research Conference, Waterloo, Canada, 2013.

Srinivasan S, Menzies K, Jones L. Meibography and lipid layer evaluation in Sjogren’s syndrome. Canadian Optometry Schools Research Conference, Waterloo, Canada, 2013.

Srinivasan S, Menzies K, Jones L. Infra-red imaging of meibomian glands & evaluation of the lipid layer in Sjogren’s syndrome patients. Tear Film & Ocular Surface International Conference, Sicily, Italy, 2013.

Ngo W, Srinivasan S, Schulze M, Jones L. Inter- and intra-observer agreement and repeatability of imaging the meibomian glands with the Oculus Keratograph 4 and Keratograph 5M. Tear Film & Ocular Surface International Conference, Sicily, Italy, 2013.

Srinivasan S, Keech A, Keir N, Jones L. Self vs. examiner-guided administration of ocular surface disease index (OSDI). Optom Vis Sci 2013;90: E-Abstract 130001.

Ngo W, Srinivasan S, Schulze M, Jones L. Inter- and intra-observer agreement and repeatability of imaging the meibomian glands with the oculus Keratograph 4 and Keratograph 5M. Invest Ophthalmol Vis Sci 2013;54: E-Abstract 3569. [ PDF ]

2012

Srinivasan S, Menzies K, Sorbara L, Jones L. Infra-red Imaging Of Meibomian Gland Structure Using A Novel Keratograph. Invest Ophthalmol Vis Sci 2012;53:ARVO E-Abstract 591.

Hutchings N, Jayakumar V, Srinivasan S, Trusit D, Keir N, Jones L. Comparison of anterior surface aberrations between subjects with clinically stable and unstable tear films. Optom Vis Sci 2012;89:E-abstract 125122.

Srinivasan S, Luensmann D, Otchere H, Yu M, Yang J, Jones L. The impact of cosmetics on the surface appearance and wettability of silicone hydrogel contact lenses. Optom Vis Sci 2012;89:E-abstract 120317.

Luensmann D, Srinivasan S, Ochtere H, Yu M, Yang G, Jones L. The impact of cosmetics on the physical dimension and optical performance of silicone hydrogel contact lenses. Contact Lens & Anterior Eye 2012;35,S1:e6.

Srinivasan S, Menzies K, Sorbara L, Jones L. Non-contact meibography using a novel keratograph. Contact Lens & Anterior Eye 2012;35,S1:e31-e32.

Srinivasan S, Menzies K, Sorbara L, Jones LW. Appearance of meibomian gland structures imaged using a Keratograph. Global Specialty Lens Symposium, 2012.

2011

Srinivasan S, Menzies K, Sorbara L, Jones L. Imaging meibomian gland structures using the oculus keratograph. Optom Vis Sci 2011;87:E-abstract 110775.

2010

Srinivasan S, Martell E, Heynen M, Jones L. Clinical signs, tear lipocalin and lysozyme concentrations in postmenopausal women symptomatic of dry eye . 7th Canadian University Conference in Optometry (Montreal, Canada), 2010.

Srinivasan S, Martell E, Heynen M, Luensmann D, Cira D, Gorbet M, Jones L. Ocular surface sampling techniques. 7th Canadian University Conference in Optometry (Montreal, Canada), 2010.

Srinivasan S, Martell E, Heynen M, Luensmann D, Cira D, Gorbet M, Jones L. Ocular surface sampling techniques. 20:20 National Science and Engineering Council Network meeting (Horseshoe Valley, Ontario, Canada), 2010.

2009

Keir N, Srinivasan S, Jones L, Woods C, Fonn D. The performance of a silicone hydrogel daily disposable contact lens in a group of asymptomatic silicone hydrogel lens wearers. Asia Pacific Contact Lens Meeting (Hong Kong), 2009.

Spurr-Michaud SJ, Senchyna M, Srinivasan S, Ritter III R, Heikkila E, Heynen M, Jones L, Gipson I. Assay of membrane-associated mucins in conjunctiva and tears of postmenopausal women with and without dry eye. Invest Ophthalmol Vis Sci 2009;50: E-Abstract 539.

2008

Srinivasan S, Joyce E, Boone A, Simpson T, Jones L, Senchyna M. Clinical characteristics and tear lysozyme concentration in dry eyed postmenopausal women. Optom Vis Sci 2008;85: E-Abstract 070069.

Dalton K, Senchyna M, Srinivasan S, Jones L. Tear film osmolality in a symtomatic dry eyes population. Optom Vis Sci 2008;85: E-abstract 85314.

Srinivasan S, Simpson T, Senchyna M, Jones L. Assessment of ocular surface dryness in postmenopausal females using dry eye questionnaires. Optom Vis Sci 2008;85: E-abstract 80023.

Srinivasan S, Simpson T, Senchyn M, Jones L. Use of dry eye questionnaires to assess ocular surface dryness in postmenopausal females with and without dry eye. Invest Ophthalmol Vis Sci 2008;49: E-abstract 5850.

2007

Srinivasan S, Joyce E, Jones L, Simpson T, Gamache D, Senchyna M. Clinical characteristics and tear lipocalin concentration in dry eyed postmenopausal women. Optom Vis Sci 2007;84: E-abstract 075330.

Srinivasan S, Joyce E, Jones L, Senchyna M. Comparison of tear lipocalin ratios in asymptomatic and symptomatic dry eyed postmenopausal women. Invest Ophthalmol Vis Sci 2007;48: E-abstract 6024.

Jones L, Subbaraman LN, Varikooty J, Srinivasan S, Glasier M. Activity of lysozyme deposited on oneday etafilcon contact lenses is correlated with subjective comfort. 14th Scientific Meeting of the International Society for Contact Lens Research (Whistler, Canada), 2007.

Srinivasan S, Joyce E, Jones L, Simpson T, Senchyna M. Comparison of tear lipocalin ratios in dry eyed and non dry eyed postmenopausal women. 6th Canadian Optometry Conference on Vision Science (Waterloo, Ontario), 2007.

Jones L, Srinivasan S, Joyce E, Senchyna M. Increased tear osmolality and altered tear ferning patterns in postmenopausal women with mild and moderate symptoms of dry eye. Contact Lens & Anterior Eye 2007;30,5:293.

Spurr-Michaud S, Senchyna M, Srinivasan S, Ritter R, Argueso P, Joyce E, Heynen M, Jones L, Gamache D, Gipson I. Assay of MUC16 in conjunctiva and tears of postmenopausal women with and without dry eye. 5th International Conference on the Tear Film and Ocular Surface (Sicily, Italy), 2007.

Jones L, Subbaraman L, Srinivasan S, Varikooty J, Glasier M. Subjective comfort is correlated with the activity of lysozyme recovered from one-day etafilcon lenses. British Contact Lens Association Annual Meeting, Manchester, England, 2007.

Srinivasan S, Joyce E, Heynen M, Jones L, Simpson T, Gamache D, Senchyna M. Expression of soluble and membrane bound MUC16 in dry eyed postmenopausal women. 5th International Conference on the Tear Film and Ocular Surface (Sicily, Italy), 2007.

Varikooty J, Srinivasan S, Chan A, Subbaraman L, Woods C, Simpson T, Jones L, Fonn D. Clinical manifestations of upper lid staining in adapted silicone hydrogel lens wearers. British Contact Lens Association Annual meeting (Manchester, UK), 2007.

Srinivasan S, Jones L, Joyce E, Simpson T, Senchyna M. Clinical signs and symptoms in post-menopausal females with dry eye. 6th Canadian Optometry Conference on Vision Science, Waterloo, Ontario, 2007.

Srinivasan S, Jones L, Joyce E, Simpson T, Senchyna M. Comparsion of tear lipocalin ratios in dry eyed and non-dry eyed post-menopausal woman. 6th Canadian Optometry Conference on Vision Science, Waterloo, Ontario, 2007.

2006

Subbaraman L, Jones L, Srinivasan S, Varikooty J, Glasier MA. Activity of lysozyme deposited on one-day etafilcon contact lenses is correlated with subjective comfort. Optom Vis Sci 2006;83:E-Abstract 060091.

Srinivasan S, Joyce E, Jones L, Senchyna M. Tear osmolality and ferning patterns in postmenopausal women with and without symptoms of dry eye. Optom Vis Sci 2006;83: E-Abstract 060011.

Varikooty J, Srinivasan S, Subbaraman L, Feng Y, Jones L, Simpson T, Fonn D. The influence of pre-soaking single-use etafilcon contact lenses on ocular comfort in symptomatic and asymptomatic contact lens wearers. Optom Vis Sci 2006;83:E-Abstract 065245.

Srinivasan S, Varikooty J, Subbaraman L, Chan A, Woods C, Simpson T, Jones L, Fonn D. Atypical manifestation of upper lid margin staining in silicone hydrogel lens wearers with symptoms of dry eye. Optom Vis Sci 2006;83:E-Abstract 065255.

Srinivasan S, Jones L, Joyce E, Simpson T, Senchyna M. Characterization of clinical signs and symptoms in asymptomatic and symptomatic dry eyed postmenopausal women. Optom Vis Sci 2006;83: E-Abstract 065201.

Srinivasan S, Jones L, Joyce E, Simpson T, Senchyna M. Clinical signs and symptoms in postmenopausal females with and without symptoms of dry eye. Invest Ophthalmol Vis Sci 2006;47: E-Abstract 249.

Subbaraman LN, Jones L, Srinivasan S, Varikooty J, Glasier MA. Clinical signs & symptoms and protein deposition in one day wear of etafilcon lenses in symptomatic and asymptomatic subjects. Invest Ophthalmol Vis Sci 2006;47: E-Abstract 2400.

Rogers R, Jones L, Srinivasan S, Varikooty J, Fonn D. The influence of care regimen composition and wear time on ex vivo wettability of etafilcon contact lenses. Contact Lens & Anterior Eye 2006;29,4:189.

Subbaraman L, Jones L, Srinivasan S, Varikooty J. Clinical signs & symptoms and protein deposition in one day wear of etafilcon lenses in symptomatic & asymptomatic subjects. British Contact Lens Association Annual Meeting, Birmingham, England, 2006.

Srinivasan S, Chan C, Jones L, Simpson T, Fonn D. Diurnal variation in interior tear meniscus height that occurs in dry-eyed and non-dry-eyed participants. British Contact Lens Association Annual Meeting, Birmingham, England, 2006.

Subbaraman LN, Jones L, Srinivasan S, Varikooty J, Glasier M. The role of protein deposition and surface wettability in symptoms of contact lens-induced dryness during one day wear of etafilcon lenses in symptomatic and asymptomatic subjects. Contact Lens & Anterior Eye 2006;29,4:194-195.

Subbaraman LN, Glasier MA, Srinivasan S, Varikooty J, Jones L. Correlation between clinical signs & symptoms and protein deposition in one day wear of etafilcon lenses in symptomatic and asymptomatic subjects. University of Waterloo Graduate Student Research Conference, 2006.

Varikooty J, Srinivasan S, Subbaraman L, Chan A, Woods C, Jones L, Simpson T, Fonn D. Clinical manifestations of upper lid staining in adapted silicone hydrogel lens wearers. Optom Vis Sci 2006;83:E-abstract 065256.

Subbaraman L, Jones L, Srinivasan S, Varikooty J, Glasier MA. The relationship between protein deposition and clinical signs and symptoms in one day wear of etafilcon lenses in symptomatic and asymptomatic subjects. Canadian Student Health Research Forum (Winnipeg, Canada), 2006.

2005

Srinivasan S, Chan C, Jones L, Simpson T, Fonn D. Diurnal variation in inferior tear meniscus height that occurs in dry eyed and non-dry eyed participants. Optom Vis Sci 2005;82: E-abstract 050064.

Srinivasan S, Heikkila E, Kyveris A, Senchyna M, Jones L. Method optimization for the isolation of total protein from human conjunctival epithelial cells collected via impression cytology. Invest Ophthalmol Vis Sci 2005;46: E-abstract 2667.

Jones L, Srinivasan S, Varikooty J, Simpson T. Novel methodologies to investigate patients with symptoms of dry eye. British Contact Lens Association Annual Meeting, Brighton, England, 2005.

Srinivasan S, Jones L, Senchyna M. Comparison of bulbar conjunctival hyperemia in postmenopausal dry eyed and non-dry eyed subjects. Graduate Student Research Conference (University of Waterloo, Ontario), 2005.

Subbaraman LN, Jones L, Srinivasan S, Varikooty J, Glasier M. The relationship between protein deposition and clinical signs & symptoms in one day wear of etafilcon lenses in symptomatic and asymptomatic subjects. Canadian Student Health Research Forum, 2005.

2004

Srinivasan S, Senchyna M, Heikkila L, Jones L. Method optimization for the isolation of total RNA from human conjunctival epithelial cells collected via impression cytology. Invest Ophthalmol Vis Sci 2004;45: E-Abstract 1500.

Srinivasan S, Jones L, Senchyna M. Comparison of bulbar conjunctival hyperemia in postmenopausal dry eyed and non dry eyed subjects. Optom Vis Sci 2004;81,12s:213.

Srinivasan S, Jones L, Senchyna M. Comparison of non-invasive tear break up time and bulbar conjunctival hyperemia in postmenopausal dry-eyed and non dry-eyed subjects. Tear Film and Ocular Surface Society (Puerto Rico), 2004.

Professional Publications

2015

Srinivasan S. Maintaining Ocular Surface Wellness. Contact Lens Spectrum 2015;30,July:34-36, 38, 40, 42.

Srinivasan S. Research update column. Ocular Surface News 2015;January,Issue 44:.

Srinivasan S. Research update column. Ocular Surface News 2015;February,Issue 46:.

Srinivasan S. Research update column. Ocular Surface News 2015;March,Issue 48:.

Srinivasan S. Research update column. Ocular Surface News 2015;April,Issue 50:.

Srinivasan S. Research update column. Ocular Surface News 2015;May,Issue 52:.

Srinivasan S. Research update column. Ocular Surface News 2015;June,Issue 54:.

Srinivasan S. Research update column. Ocular Surface News 2015;July,Issue 56:.

Srinivasan S. Research update column. Ocular Surface News 2015;August,Issue 58:.

Srinivasan S. Research update column. Ocular Surface News 2015;September,Issue 60:.

Srinivasan S. Research update column. Ocular Surface News 2015;October,Issue 62:.

Srinivasan S. Research update column. Ocular Surface News 2015;November,Issue 64:.

Srinivasan S. Research update column. Ocular Surface News 2015;December,Issue 66:.

Srinivasan S. Subbaraman L. Current Innovations in Contact Lens Materials. Review of Optometry 2015;February 15.

2014

Srinivasan S. Overview: 2013 report from the Tear Film & Ocular Surface Society’s Workshop on Contact Lens Discomfort. ContactLensUpdate.com 2014.

Srinivasan S. Research update column. Ocular Surface News 2014;September 18,Issue 35:.

Srinivasan S. Research update column. Ocular Surface News 2014;August 21,Issue 33:.

Srinivasan S. Research update column. Ocular Surface News 2014;July 24,Issue 31:.

Srinivasan S. Research update column. Ocular Surface News 2014;June 26,Issue 29:.

Srinivasan S. Research update column. Ocular Surface News 2014;May 29,Issue 27:.

Srinivasan S. Research update column. Ocular Surface News 2014;May 01,Issue 25:.

Srinivasan S. Research update column. Ocular Surface News 2014;April 03,Issue 23:.

Srinivasan S. Research update column. Ocular Surface News 2014;March 06,Issue 21:.

Srinivasan S. Research update column. Ocular Surface News 2014;February 06,Issue 19:.

Srinivasan S. Research update column. Ocular Surface News 2014;January 09,Issue 17:.

Srinivasan S. Research update column. Ocular Surface News 2014;October 16,Issue 37:.

Srinivasan S. Research update column. Ocular Surface News 2014;November 13,Issue 39:.

Srinivasan S. Research update column. Ocular Surface News 2014;December 11,Issue 41:.

2013

Srinivasan S. Research update column. Ocular Surface News 2013;November 21,Issue 15:.

Srinivasan S. Research update column. Ocular Surface News 2013;October 25,Issue 13:.

Srinivasan S. Research update column. Ocular Surface News 2013;September 26,Issue 11:.

Srinivasan S. Research update column. Ocular Surface News 2013;August 29,Issue 09:.

Srinivasan S. Research update column. Ocular Surface News 2013;August 02,Issue 07:.

Srinivasan S. Interview on “Breaking New Ground in Meibography”. Review of Ophthalmology 2013;20,7:14-17.

Srinivasan S. Research update column. Ocular Surface News 2013;July 05,Issue 05:.

Srinivasan S. A review of “Lid Wiper Epitheliopathy in Contact lens wearers". ContactLensUpdate.com 2013.

Srinivasan S. Research update column. Ocular Surface News 2013;June 07,Issue 03:.

Srinivasan S. Research update column. Ocular Surface News 2013;May 01,Issue 01:.

Srinivasan S. Corneal staining and infiltrative keratitis – Is there evidence of link? . Contact Lens Spectrum 2013;28,5:34-37.

Subbaraman L, Srinivasan S. A Lens Fit for Dry Eye. Review of Cornea and Contact Lenses 2013 17-21.

Srinivasan S. Contact Lens Wear and Meibomian Gland Dysfunction. ContactLensUpdate.com 2013.

2012

Srinivasan S. Contact lens wear and meibomian gland dysfunction. ContactLensUpdate.com 2012.

2011

Srinivasan S, Menzies K, Sorbara L, Jones L. Meibography of the upper lid. Optician 2011;242,6318:12-15.

Srinivasan S, Sorbara L, Jones L, Sickenberger W. Imaging the structure of the meibomian glands . Contact Lens Spectrum 2011;26,7:52-53.

2010

Srinivasan S, Jones L. Tear osmolarity measurements using novel osmometers. Optician 2010;240,6270:50-52.

2002

Krishnakumar R, Sukumar S, Subbaraman LN, Srinivasan S. Variability in the measurement of Interpupillary Distance. The Indian Optician 200268-70.

Books

2013

Srinivasan S, Jones L. Contemporary dry eye tests. In: Dry Eye Syndrome: Basic and Clinical Perspectives.. Future Medicine Ltd. 2013.

2010

Jones L, Srinivasan S. Clinical Instruments. In: Contact Lens Practice 2nd Edition. Butterworth-Heinemann. 2010.