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WORKING GROUP ON CONTACT LENS USE UNDER ADVERSE CONDITIONS
KENNETH POLSE (Chair),
School of Optometry, University of California, Berkeley (optometry)
JOHN W. CHANDLER,
Clinical Science Center, University of Wisconsin (ophthalmology)
JAMES P. HUGHES
(IOM), Oakland, California (occupational medicine)
JAMES JENKINS,
Department of Theoretical and Applied Mechanics, Cornell University (engineering)
DONALD R. KORB,
Boston, Massachusetts (optometry)
GEORGE MERTZ,
Marietta, Georgia (optometry)
MIGUEL F. REFOJO,
The Eye Research Institute, Boston, Massachusetts (engineering)
COMMITTEE ON VISION
SUZANNE MCKEE (Chair),
Smith-Kettlewell Eye Research Foundation, San Francisco
LYNN COOPER,
Department of Psychology, Columbia University
RUSSELL LEE DEVALOIS,
Department of Psychology and Physiological Optics, University of California, Berkeley
MERTON CLYDE FLOM,
College of Optometry, University of Houston
DAVID L. GUYTON,
Wilmer Ophthalmological Institute, Johns Hopkins University
DONALD HOOD,
Department of Psychology, Columbia University
JAMES LACKNER,
Ashton Graybiel Spatial Orientation Laboratory, Brandeis University
GORDON E. LEGGE,
Department of Psychology, University of Minnesota
PETER LENNIE,
Center for Visual Sciences, University of Rochester
LOUIS SILVERSTEIN,
VCD Sciences, Scottsdale, Ariz.
KENT A. STEVENS,
Department of Computer and Information Science, University of Oregon
ANDREW B. WATSON,
NASA Ames Research Center, Moffett Field, Calif.
PAMELA EBERT FLATTAU, Staff Officer
JOANNE ALBANES, Research Assistant
CAROL METCALF, Administrative Secretary
ROSE WHITE, Secretary
CONTRIBUTORS
MATHEA R. ALLANSMITH,
Department of Immunology, Eye Research Institute, Boston, Mass., and Department of Ophthalmology, Harvard Medical School
LEO G. CARNEY,
College of Optometry, Ohio State University
RICHARD J. DENNIS,
U.S. Air Force, School of Aerospace Medicine, Brooks Air Force Base, Tex.
ROBERT P. GREEN, JR.,
U.S. Air Force, School of Aerospace Medicine, Brooks Air Force Base, Tex.
JAMES T. JENKINS,
Department of Theoretical and Applied Mechanics, Cornell University
JOSHUA E. JOSEPHSON,
Toronto, Ontario
STEPHEN D. KLYCE,
Louisiana State University Eye Center
MORRIS R. LATTIMORE, JR.,
U.S. Army Aeromedical Research Laboratory, Fort Rucker, Ala.
GERALD E. LOWTHER,
School of Optometry, Medical Center, University of Alabama, Birmingham
ROBERT B. MANDELL,
School of Optometry, University of California, Berkeley
ANDREW A. MARKOVITS,
Department of Ophthalmology, Naval Aerospace Medical Institute, Pensacola, Fla.
GEORGE W. MERTZ,
Department of Clinical Research, Vistakon Inc. (a division of Johnson & Johnson Vision Product, Inc.), Jacksonville, Fla.
MELVIN R. O'NEAL,
Armstrong Aeromedical Research Laboratory, Wright-Patterson Air Force Base, Ohio
MIGUEL F. REFOJO,
Eye Research Institute, Boston, Mass., and Department of Ophthalmology, Harvard Medical School
OLIVER D. SCHEIN,
Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Md.
JOHN P. SCHOESSLER,
College of Optometry, Ohio State University
JAMES F. SOCKS,
Alcon Laboratories, Inc., Fort Worth, Tex.
Foreword
The Committee on Vision is a standing committee of the National Research Council's Commission on Behavioral and Social Sciences and Education. The committee provides analysis and advice on scientific issues and applied problems involving vision. It also attempts to stimulate the further development of visual science and to provide a forum in which basic and applied scientists, engineers, and clinicians can interact. Working groups of the committee study questions that may involve engineering and equipment, physiological and physical optics, neurophysiology, psychophysics, perception, environmental effects on vision, and treatment of visual disorders.
In order for the committee to perform its role effectively, it draws on experts from a wide range of scientific, engineering, and clinical disciplines. The members of this working group were chosen for their expertise in research related to ocular response to contemporary contact lenses and for their familiarity with the application of those research findings to the use of contact lenses in extreme environments.
This report summarizes present understanding of the scientific, clinical, and technological issues surrounding the use of contact lenses. Symposium participants discussed the special occupational conditions experienced by military personnel in the aerospace environment that give rise to the question of whether contact lenses should or should not be used. The proceedings of the symposium will serve as the basis for further deliberations by the working group.
The results of this symposium will be of particular interest to those involved in the design of contact lenses and those responsible for occupational safety and health matters in the private sector.
Suzanne McKee, Chair
Committee on Vision
Preface
In response to a request from the Triservice Aeromedical Research Panel (TARP), the Committee on Vision established the Working Group on Contact Lens Use Under Adverse Conditions. The working group was asked to: (1) summarize current scientific, clinical, and technological issues in the use of contact lenses, (2) review the operational requirements of military personnel relative to the use of contact lenses, and (3) identify the critical factors to be taken into account by TARP in adopting a formal position on the use of contact lenses by U.S. military personnel.
To accomplish these goals, the working group convened a symposium to review what is known about the design and use of contemporary contact lenses. Special emphasis was given to the use of lenses in extreme environmental conditions. Twenty-five specialists from the fields of optometry, ophthalmology, visual psychophysics, and engineering met for two days in November 1988 at Brooks Air Force Base, San Antonio, Texas, in conjunction with the fall meeting of the Triservice Aeromedical Research Panel. Participants essentially provided a tutorial on recent developments in the design and use of contact lenses.
The two-day symposium was organized around scientific and clinical considerations in the use of contact lenses. Following a series of briefings by military personnel, members of the first session were asked to address environmental effects on contact lens wear, including the effects of low oxygen and low humidity. The second panel considered environmental conditions and tear chemistry, corneal topography, and biochemical aspects of contact lens wear. The third panel explored preventive measures relative to lens design, including blink rate and mechanical aspects of contact lens performance. The fourth panel addressed issues related to ocular risks, such as infection, inflammation, and endothelial effects. The fifth panel
reviewed limitations of contemporary materials with respect to selection criteria and task performance, including follow-up care. The program offered ample opportunity for formal and informal group discussion. The edited proceedings of the discussion together with the formal papers of the participants are the contents of this report.
In addition to the specialists who participated in the symposium, a number of people contributed in important ways to this project. Robert Miller of the Brooks Air Force Base staff facilitated arrangements for the symposium. Roger Wiley and his staff at the U.S. Army Aeromedical Research Laboratory assisted the working group in arranging for presentations by U.S. military personnel both at the symposium and at meetings of the working group. Pamela Ebert Flattau, the committee's study director, provided valuable assistance in organizing the symposium and preparing the proceedings report. As always, Carol Metcalf, the committee's administrative secretary, provided efficient and skillful support.
Kenneth Polse, Chair
Working Group on Contact Lens Use Under Adverse Conditions
