Australian ophthalmologist Tom Spring is widely credited as being the first to observe an allergic-like reaction of the upper tarsal conjunctiva, which was later to become known as ‘giant papillary conjunctivitis’. In his 1974 letter to the editor of the…
Increased conjunctival redness in response to contact lens wear is so easily recognised that it serves as a fundamental indicator to clinicians of the physiological status of the contact lens–wearing eye. It is not surprising that the first two clinical…
Lid-parallel conjunctival folds (LIPCOFs) are sub-clinical folds in the lateral, lower quadrant of the bulbar conjunctiva, parallel to the lower lid margin, which are easily observable with the slit lamp biomicroscope ( Fig. 12.1 ). This phenomenon, first described by…
In the open eye, contact lenses are primarily in physical apposition with the cornea. Well-fitted rigid lenses generally reside almost exclusively on the cornea and only occasionally impinge on the limbus. The situation is different with soft lenses. If the…
Various forms of organic and inorganic matter can accumulate in the post-lens tear film. These include intrinsic matter, such as desquamated epithelial cells, inflammatory cells and microorganisms, and extrinsic matter, such as dust particles that may have entered the eye…
Dry eye in contact lens wearers has been identified as a growing public health problem. Between 2015 and 2017, the Tear Film and Ocular Surface Society (TFOS) convened an international collaboration of over 150 experts in the field of dry…
Disorders of the eyelashes (cilia) and of the associated structures at the base of the eyelashes such as the eyelash follicles, glands of Zeis and skin of the lid margin, have implications with respect to contact lens wear. Practitioners need…
The meibomian glands in the upper and lower eyelids play a critical role in forming and maintaining a viable tear film. Specifically, these glands produce a clear, oily secretion that serves two main functions: (1) forming a hydrophobic lining along…
Contact lens practitioners routinely examine the tarsal conjunctiva and lid margins of their patients, but little attention is generally given to the overall integrity of the eyelids. Eyelid dysfunction, whether caused by contact lens wear or other factors, can pose…
The concept of the ‘lid wiper’ and a proposed condition brought about by disturbance to this structure, referred to as ‘lid wiper epitheliopathy’ (LWE), were first described by Korb et al. in 2002. The terms ‘lid wiper’ and ‘LWE’ are…