Subjective and objective measures of corneal staining related to multipurpose care systems

Clinical staining of the ocular surface: Mechanisms and interpretations

“…Truong et al (2005) demonstrated increases in corneal permeability to two different MPSs in non-CL-wearing subjects, after short-term exposure. Bright et al (2012) observed that the character of the pattern, the intensity of the fluorescence (Jones et al, 2002;Andrasko and Ryen, 2008;Ward, 2008), the general lack of an associated limbal or bulbar hyperemia or corneal infiltrates (Pritchard et al, 2003;Garafolo et al, 2005) or other short-or long-term complications (Barr, 2006;Ward, 2008;Willcox et al, 2008), contrasted with events accompanying pathological staining in ocular surface diseases such as dry eye or BZK toxicity. Bright has proposed, instead, that the transient hyperfluorescence is a para-phenomenon related to interactions between the preservative, the epithelium and fluorescein (Bright et al, 2012).…”

Anterior eye health recording

“…For example the level of severity at which Australian optometrist would instigate treatment for corneal staining varied considerably between 'any sign of corneal staining' to 'grade 4 staining'. 1 Subjective grading has been extensively used to quantify and monitor ocular features such as bulbar hyperemia, palpebral roughness and corneal staining with sodium fluorescein (Efron, 1998 [6][7][8][9] although the range of possible features to grade is vast and there is no widely accepted guidance on which features should always be graded and which should be added when marked pathology is noted. Despite best efforts however, the sensitivity and reliability of the resulting assessments has been shown to be limited, 10,11 with natural bias such as to whole numbers.…”

Evaluation of Corneal Staining and Patient Preference With Use of Three Multi-Purpose Solutions and Two Brands of Soft Contact Lenses

“…Begley et al 11 showed significant corneal effects for lenses applied to rabbit eyes after they were soaked in various first-generation MPS or a neutralized hydrogen peroxide solution, with ReNu (Bausch & Lomb, Rochester, NY) showing the greatest effect. Recently, Pritchard et al 12 reported less staining with an MPS containing polyquaternium-1 than with either of two polyhexanide-preserved solutions, and that difference was statistically significant for the solution with the higher concentration of polyhexanide. Other studies have supported the concept of epithelial response related to polyhexanide concentration.…”

“…9,13 Cytotoxicities of contact lens solutions have been found to correlate better with irritant symptoms than with corneal staining. 14 It is widely recognized that symptoms can occur without confirmed slitlamp signs 12 and that significant corneal staining can occur without patient awareness. 15 However, corneal staining measurements remain the most promising method of evaluating contact lens solution tolerance.…”