Purpose: To investigate the inflammatory response of the ocular surface with different soft contact lens (CL) replacement frequencies and materials. Methods: Twenty soft CL wearers were required to wear 3 lens types: reusable Acuvue 2 (A2), reusable Acuvue Oasys (AO), and daily disposable Acuvue Oasys (AODD), for 1 week in random sequence in 1 eye with the nonlens-wearing eye acting as a control. Three methods were used to assess the subclinical response: tear cytokine evaluation, in vivo confocal microscopy (IVCM), and impression cytology. Results: Of 13 cytokines investigated, differences were observed only for IL-12p70, which was present in greater concentrations for A2 (interocular difference 8.8 pg/mL, 95% confidence interval 5.5–12.1) and AO (8.9 [5.7–12.1]) compared with AODD (3.7 [0.6–6.8]). For IVCM, corneal presumed dendritic cell density was lower for AODD (interocular difference 1.9 [−0.1 to 3.9] cells/mm2) than for both A2 (9.3 [7.2–11.4]) and AO (10.6 [8.6–12.6]). This trend was the same for the other 5 IVCM measures evaluated. The proportion of CD45+ cells in the bulbar conjunctiva was lower for AODD (0.6 [−0.3 to 1.5]%) compared with A2 (4.6 [3.7–5.6]) and AO (4.8 [3.9–5.8]). Similar findings were observed for cells in the upper lid margin. Conclusions: This work has demonstrated for the first time that daily disposable CL wear produces a minimal subclinical inflammatory response compared with no lens wear over 1 week. By contrast, this inflammatory response is upregulated with reusable lenses but appears to be similar between hydrogel and silicone hydrogel materials over this short time frame.

Traumatic brain injury (TBI) causes structural and functional damage to the central nervous system including the visual pathway. Defects in the afferent visual pathways affect visual function and in severe cases causes complete visual loss. Visual dysfunction is detectable by structural and functional ophthalmic examinations that are routine in the eye clinic, including examination of the pupillary light reflex and optical coherence tomography (OCT). Assessment of pupillary light reflex is a non-invasive assessment combining afferent and efferent visual function. While a flashlight assessment is relatively insensitive, automated pupillometry marked 95% specificity and 78.1% sensitivity in detecting TBIrelated visual and cerebral dysfunction with an area under the curve (AUC) of 0.69-0.78. OCT may also serve as a non-invasive biomarker of TBI severity, demonstrating changes in the retinal ganglion cell layer and nerve fiber layer throughout the range of TBI severity even in the absence of visual symptoms. This review discusses the impact of TBI on visual structure and function.