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; for the FAST Research Group IMPORTANCE Methotrexate and mycophenolate mofetil are commonly used immunomodulatory therapies for achieving corticosteroid-sparing control of noninfectious uveitis, but there is uncertainty about which drug is more effective. OBJECTIVE To compare the effect of methotrexate and mycophenolate for achieving corticosteroid-sparing control of noninfectious intermediate uveitis, posterior uveitis, and panuveitis. DESIGN, SETTING, AND PARTICIPANTS The First-line Antimetabolites as Steroid-sparing Treatment (FAST) uveitis trial screened 265 adults with noninfectious uveitis requiring corticosteroid-sparing immunosuppressive therapy from 9 referral eye centers in India, the

Purpose To understand soft contact lens (SCL) and gas permeable lens (GP) wearers’ behaviors and knowledge regarding exposure of lenses to water. Methods The Contact Lens Risk Survey (CLRS) and health behavior questions were completed online by a convenience sample of 1,056 SCL and 85 GP wearers age 20–76 years. Participants were asked about exposing their lenses to water and their understanding of risks associated with these behaviors. Chi-square analyses examined relationships between patient behaviors and perceptions. Results GP wearers were more likely than SCL wearers to ever rinse or store lenses in water (rinsing: 91% GP, 31% SCL, p<0.001; storing: 33% GP, 15% SCL p<0.001). Among SCL wearers, males were more likely to store (24% vs 13%, p=0.003) or rinse (41% vs 29%, p=0.012) their lenses in water. Showering while wearing lenses was more common in SCL wearers (86%) than GP wearers (67%) (p<0.0001). Swimming while wearing lenses was reported by 62% of SCL wearers and 48% of GP wearers (p=0.027). Wearers who rinsed (SCL; p<0.0001, GP; p=0.11) or stored lenses in water (SCL; p<0.0001, GP p=0.007) reported this behavior had little or no effect on their infection risk, compared with those that did not. Both SCL (p<0.0001) and GP wearers (p<0.0001) perceived that distilled water was safer than tap water for storing or rinsing lenses. Conclusion Despite previously published evidence of Acanthamoeba keratitis’ association with water exposure, most SCL, and nearly all GP wearers regularly expose their lenses to water, with many unaware of the risk.

Purpose To evaluate the changes in quality of life in noninfectious uveitis patients treated with two of the most commonly prescribed antimetabolite treatments. Design Secondary analysis of a multicenter, block-randomized, clinical trial (ClinicalTrials.gov NCT01232920). Methods Eighty patients at Aravind Eye Hospitals in Madurai and Coimbatore, India, with noninfectious intermediate, posterior, or panuveitis were randomized to receive oral methotrexate, 25 mg weekly, or oral mycophenolate mofetil, 1 g twice daily, and were followed up monthly for 6 months. Best-corrected visual acuity, IND-VFQ, and SF-36 were obtained at enrollment and at 6 months (or prior in the event of early treatment failure). Results IND-VFQ scores, on average, increased by 9.2 points from trial enrollment to 6 months (95% CI: 4.9, 13.5, P =0.0001). While the SF-36 physical component summary score did not significantly differ over the course of the trial, the mental component summary score decreased by 2.3 points (95% CI: −4.4, −0.1, P=0.04) and the vitality subscale decreased by 3.5 points (95% CI: −5.6, −1.4, P=0.001). Quality of life scores did not differ between treatment arms. Linear regression modeling showed a 3.2 point improvement in IND-VFQ score for every 5 letter improvement in visual acuity (95% CI: 1.9, 4.3; P<0.001). Conclusions Although uveitis treatment was associated with increased vision and vision-related quality of life, patient-reported physical health did not change after 6 months of treatment, and, mental health decreased. Despite improved visual outcomes, uveitis patients receiving systemic immunosuppressive therapy may experience a deterioration in mental health-related quality of life.