Abstracts of the 2011 BCLA Annual Clinical Conference / Contact Lens & Anterior Eye 34, Supplement 1 (2011) S1–S43 junctival folds were observed nasal and temporal and summarized to LIPCOF Sum. Lipid-layer and non-invasive break-up time (NIBUT) was measured by tearscope, dry eye symptoms were evaluated by the Ocular Surface Disease Index (OSDI). Observer was masked against OSDI scores; meibographs analyzes was masked against prior observations. Correlations between MGL scores and ocular signs, tear film and symptoms were analyzed by Pearsons, differences between gender by U-test. The ability of MGL to predict dry eye symptoms was evaluated by area under the receiver operative characteristic curve (AUC). Results: MGL scores were significantly correlated to lipid-layer pattern (r=−0.68, p=0.001) NIBUT (−0.46, 0.032) LIPCOF Sum (0.42, 0.047) OSDI (0.89, 0.001) and age (0.61, 0.005). MGL was significantly larger in female (p=0.001). AUC of MGL was 95.8% (p=0.001; sensitivity = 88.9%; specificity = 87.5%; threshold = 32.3%). Conclusions: Meibomian gland loss is significantly correlated to tear film and dry eye symptoms. MGL seems to be a predictive to discriminate between symptomatics and asymptomatics. Myopia development – what can the chicken tell us? Jill Woods 1, *, Sarah Guthrie 1 , Nancy Keir 1 , Vivian Choh 2 , Desmond Fonn 1 , Lyndon Jones 1 , Beth Irving 2 1 Centre for Contact Lens Research, School of Optometry, University of Waterloo, Waterloo, ON, Canada; 2 School of Optometry, University of Waterloo, Waterloo, ON, Canada *E-mail address: jwoods@uwaterloo.ca Topic outline: Preventing or minimizing myopia has attracted significant research over the past 25-years. Myopia is a significant cause of blindness in the world, associated with many adverse side effects such as retinal degeneration and detachment, glaucoma and cataract. It has been suggested that the level of peripheral retinal defocus may play a role in myopia development. This theory has led to new lens designs aimed at controlling myopia progression, typically having increasing positive power in the periphery. Chickens have been shown to be a robust model and monitoring refractive error changes in response to varied lens powers is an established method of assessing the development of ametropia. It has been shown that a −10.00D lens placed in front of a newly hatched chicken’s eye results in development of approximately −10.00D of myopia within 10 days compared to the nonlens wearing eye, a process termed active emmetropisation. Recent work from our laboratory has shown that a −10.00D lens modified with a new myopiacontrol design does not cause any appreciable myopic shift. Furthermore, ultrasound and frozen section data showed that axial lengths were unchanged with the new lens design, in contrast to the axial elongation found with regular minus lenses. More work in this field is needed but we appear to be closer than ever to a lens design that controls the progression of myopia. A review of animal myopia research with various lens designs will be presented to provide an understanding of how animal research has furthered our path towards myopia control. Fitting children with OrthoK for myopia control – the pro’s and con’s Kate L Johnson Gerry & Johnson Optometrists, Brisbane, Australia E-mail address: kate@gjo.com.au Topic outline: There is much recent scientific interest in reducing the progression of myopia in children. Many methods have been researched and variable results achieved. The most consistent performer is currently Orthokeratology (OK), which has been shown to slow the progression of myopia by around half, and in some recent research even stop axial elongation over short periods of up to a year. But does the benefit of potential reduction to progression of myopia from OK lenses outweigh the associated risks from overnight lens wear? OK lens fitting is on the rise in China and Singapore as research outcomes continue to validate reduced progression of myopia with OK. It is reasonable to expect similarly increased interest in the Western World as people become more aware of the potential OK lens wear offers their myopic children. Consequently, it is inevitable that most practitioners, at some point in the near future, will be asked about fitting of OK lenses to reduce progression of myopia. This presentation will outline the clinical considerations of S13 implementing OK fitting for myopia control in children include the safety of extended wear, ethnic influence on fitting success and managing the paediatric contact lens wearer. The advantages and disadvantages inherent in this modality will be discussed from a clinical perspective. Case studies from a patient base of over 100 longterm paediatric OK wearers will be combined with the latest research to demonstrate how practitioners interested in paediatric OK fitting can incorporate this growing modality into their practice. What do patients want? Cheryl Donnelly*, Mohinder Merchea Bausch + Lomb, Kingston upon Thames, Surrey, UK *E-mail address: cheryl.donnelly@bausch.com Topic outline: Our patients come in all shapes and sizes and have very diverse lives and needs in general. Certainly, these unique differences come in to play when patients are choosing products for their eyes and seeking our services as eye care professionals. One thing is for sure, we must look at each patient encounter with a personal approach taking into account their specific needs, symptoms, desires and environment to determine which of our services products will best meet their needs and expectations. As eye care professionals we hope that we know what our patients want and need but do we always hit the mark? It is best to start by asking the patients themselves. To this end, a global survey was undertaken with 1000’s of vision- corrected patients input on 40 different features of eye care products and which they find of greatest importance and14 different ocular symptoms to which they were asked to report which of these symptoms they experience, how often, how bothersome the symptoms are, how they are currently being treated, and with what degree of success. The survey, known as NSIGHT, is providing the global eye care community with new, in some cases unexpected, insights into our patients’ needs and preferences and valuable clues on how to ensure patient satisfaction. CONFERENCE SESSION 19 – Scientific Paper Session on Ocular Surface From a neophyte to an experienced wearer: how adaptation to contact lens wear changes the composition of the tear film Maria Markoulli*, Eric Papas, Nerida Cole, Brien Holden Brien Holden Vision Institute, School of Optometry & Vision Science, University of New South Wales, Sydney, Australia *E-mail address: m.markoulli@brienholdenvision.org Purpose: Matrix Metalloproteinases (MMPs) are collagen degrading enzymes which maintain and remodel tissue architecture by degrading the major components of the epithelial basement membrane. In excess, MMPs have been associated with recurrent corneal erosions and ulceration. As these conditions also occur in contact lens (CL) wear, this study set out to determine how CL wear and adaptation affects the levels of MMP-9 in the tear film. Method: Flush tears were collected from 38 healthy neophytes at baseline, during the first day of CL wear and after one month in either extended (EW) or daily wear (DW). Each time, tears were collected at midday, before sleep and upon waking. Tears were analysed for concentrations of total protein, MMP-9 and its inhibitor, TIMP-1, and another potential inhibitor, NGAL. Results: At baseline, group mean MMP-9 levels were 11.7±2.4ng/ml (mean ± SE), 8.3±1.9ng/ml and 2,302.0±321.9ng/ml for midday, before sleep and upon waking, respectively, the latter being significantly greater than the others (p<0.001). Initial EW doubled the MMP-9 levels upon waking (4,814.5±782.1ng/ml) compared to the same time point at baseline (p=0.03) whilst DW remained unchanged (2373.0±493.0ng/ml, p=0.11). After one month of EW, the levels upon waking were no longer different to baseline (3,042.1±222.5 ng/ml p=1.00). DW levels remained unchanged (p=0.11). Conclusions: The doubling in MMP-9 after the first night of EW suggests that EW, but not DW, initially disturbs tear film homeostasis. However, after one month, the adaptive process returns the levels to baseline.