Natural course of Lid Wiper Epitheliopathy (LWE) in symptomatic contact lens wearers

Purpose- To establish the time course of lid wiper epitheliopathy (LWE) in established CL wearers after a single day (6–10 h) of daily disposable contact lens (CL) wear, the following day post-CL removal and 1-week after CL discontinuation. Methods- Twenty-one symptomatic (CLDEQ-8 score ≥ 12) habitual wearers of MyDay® silicone hydrogel daily disposable were included. LWE staining was assessed prior to CL wear (Visit 1, V1) using semi-automated analysis after instillation of two drops of 1 % lissamine green (10 μL) that were applied to the superior bulbar conjunctiva. LWE measurements were repeated after 6–10 h of continuous CL wear (Visit 2, V2), post-CL removal the following day (Visit 3, V3) and after 1-week CL discontinuation (Visit 4, V4). At each visit, ocular symptoms were evaluated using the SPEED-8 questionnaire and set of 0–100 visual analogue scales (VAS). Results- LWE showed no significant changes after 6–10 h of continuous CL wear (p = 0.536), post-CL removal the following day (p = 0.677) or following 1-week of CL discontinuation (p = 0.478). Analysis revealed a significant improvement in symptomatology between V1 and V2 (SPEED-8, p < 0.01) and also improvements in the 0–100 VAS scores between V2 and V4 for average daily dryness (p < 0.01), end-of-day dryness (p < 0.01) and frequency of end-of-day dryness (p < 0.05). Conclusion- The present data suggest that the etiology of LWE is multifactorial and the sole intervention of temporarily discontinuing CL wear does not lead to resolution of these clinical signs.