The role of eyelid bacteria in contact lens discomfort: BCLA Dallos Award 2017

Jaya Sowjanya Siddireddy, Ajay Kumar Vijay, Jacqueline Tan, Mark Willcox

Research output: Contribution to conference (non-published works)Abstractpeer-review


Purpose: To evaluate the effect of micro blepharon exfoliation (MBE) on eyelid bacteria, signs and symptoms of contact lens discomfort (CLD).
Methods: Thirty contact lens wearers were enrolled in a randomized, cross over, interventional study. At baseline, ocular clinical scores were recorded, eyelids swabbed and participants completed the CLDEQ-8 comfort questionnaire. Participants were then randomly assigned to receive either MBE in combination with a hypoallergenic foam cleanser, or treatment with the cleanser alone. Eyelid swabs and CLDEQ-8 responses were collected again immediately after treatments. Study procedures were repeated 7 days after treatment. Following a washout period of 28 days, baseline study procedures were repeated and subjects crossed-over to the other treatment with another follow-up visit 7 days later.
Results: No crossover-effect was observed. At baseline, symptomatics were found to have higher numbers of bacteria (mean CFU/ml of 400) compared to asymptomatics (197; p < 0.05). A significant reduction in microbial numbers was found immediately after each treatment [mean CFU/ml of 207 and 97 with MBE or 207 and 155 with cleanser (p < 0.05) in symptomatics and asymptomatics respectively]. An insignificant increase in the total number of bacteria was observed at the follow-up visits. Symptomatic lens wearers had greater lid wiper epitheliopathy (p < 0.05), tear evaporation rate with or without contact lenses (p < 0.05), foam at meibomian orifices (p < 0.01), orifice capping (p < 0.01), meibum volume (p < 0.01), quality (p < 0.01) or expressibility (p < 0.01). The CLDEQ-8 scores were positively correlated with total number of microbes at baseline (r = 0.946; p = 0.036) and 7–10 days (r = 0.714; p = 0.059) after MBE. MBE improved symptoms of CLD, measured 7–10 days after treatment, in 34% of symptomatic CL wearers.
Conclusions: Reduction in eyelid microbial load improved signs and symptoms of discomfort suggesting a vital role of eyelid bacteria in CLD.
Original languageEnglish
Number of pages1
Publication statusPublished - 1 Jun 2018
Externally publishedYes


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