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A CLEAR Spotlight on Evidence-Based Contact Lens Practice

An exciting new CPD series for optometrists, featuring the British Contact Lens Association Contact Lens Evidence-based Academic Reports (BCLA CLEAR), has been developed exclusively for mivision by optometrists Dr Debarun Dutta and Neil Retallic.

Professors James Wolffsohn and Philip Morgan introduce the CLEAR papers at the 2021 BCLA virtual conference.

Over the last 135 years there have been tremendous advancements in contact lenses, with more than 19,000 peer reviewed publications.. Today there are an estimated 140 million successful contact lens wearers worldwide… Despite this, a global consensus reviewing how the contact lenses literature can help shape practice, take an evidence-based approach, and identify future research needs has not materialised – until now.

Inspired by the positive response to global consensus reports produced by the Tear Film and Ocular Surface Society and Myopia Institute White Papers, Professor James Wolffsohn, and Professor Philip Morgan (Figure 1) were instrumental in the conception of BCLA CLEAR.


It took several years of work, by 102 authors from 16 countries, to produce the BCLA CLEAR reports, which were published in April 2021, in Contact Lens & Anterior Eye, the peer-review journal of the British Contact Lens Association. Each topic was led by internationally renowned experts (Table 1) and when combined, present over 300 pages of evidence-based science on contact lenses.

The reports address inconsistencies in terminologies and favoured descriptors used by the Federative Committee on Anatomical Terminology (FCAT). Examples include Bowman’s and Descemet’s membranes, referred to in the reports as the anterior and posterior limiting lamina respectively; the use of ‘rigid corneal lens’ (RCL) to differentiate from scleral lenses and ‘planned’ or ‘sporadic’ ‘overnight wear’ deemed appropriate representations for clinical use.

Interestingly, not all typical practice approaches have been supported by evidence-based findings, such as the need for new soft contact lens wearers to gradually build up wear time. The findings were brought to life at the BCLA virtual clinical conference in 2021, which provided a fantastic platform for presentations and discussions around each paper, followed by the launch of the BCLA CLEAR podcast series.


Supported by educational grants from Alcon and CooperVision, the project has generated a staggering response, with over 80,000 downloads and more than 200 citations…

You can access the papers for free at www. contactlensjournal.com/issue/S1367-0484(21) X0003-3. The popular BCLA CLEAR summary document – a bite-size evidenced based practical guide for clinicians, bringing together the key findings – is available in several languages at www.bcla.org.uk/Public/About/What_we_do/ BCLA-CLEAR/Public/Member_Resources/ CLEAR.aspx?hkey=1fa86ca8-1fc8-447d-a095- 6eb5fea298ae.


Table 1. BCLA CLEAR Topics.

BCLA CLEAR now regularly features in education across the globe and is becoming an important go-to suite of resources for the profession.

Starting in this issue of mivision, you’ll find a bimonthly series of CPD articles that provide an easily accessible overview of each of the 10 BCLA CLEAR reports. The articles in mivision will have an accompanying multiple-choice module (visit mieducation.com), enabling you to reinforce your understanding of evidence-based contact lens practice and clinical pearls acquired from the articles, and of course gain valuable CPD hours.

Turn to page 61 for the first CPD article in the series.

Dr Debarun Dutta is a lecturer in Optometry School, Aston University, UK and a BCLA Council member. Dr Dutta earlier worked at the Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney.

Neil Retallic is the president of the BCLA, Global Professional Services Manager at Menicon and an Examiner and Assessor for the College of Optometrists. He has previously held professional services, clinical and educational roles across academia, optician businesses and industry.


  1. J.S. Wolffsohn, P.B. Morgan, M. Barnett, L.E. Downie, D.S. Jacobs, L. Jones, K. Richdale, F. Stapleton, S.J. Vincent, M. Willcox, Contact Lens Evidence-Based Academic Reports (CLEAR), Contact lens & anterior eye 44(2) (2021) 129-131.
  2. L.E. Downie, S. Bandlitz, J.P.G. Bergmanson, J.P. Craig, D. Dutta, C. Maldonado-Codina, W. Ngo, J.S. Siddireddy, J.S. Wolffsohn, CLEAR – Anatomy and physiology of the anterior eye, Contact lens & anterior eye 44(2) (2021) 132-156.
  3. M. Willcox, N. Keir, V. Maseedupally, S. Masoudi, A. McDermott, R. Mobeen, C. Purslow, J. Santodomingo-Rubido, S. Tavazzi, F. Zeri, L. Jones, CLEAR – Contact lens wettability, cleaning, disinfection and interactions with tears, Contact lens & anterior eye 44(2) (2021) 157-191.
  4. P.B. Morgan, P.J. Murphy, K.L. Gifford, P. Gifford, B. Golebiowski, L. Johnson, D. Makrynioti, A.M. Moezzi, K. Moody, M. Navascues-Cornago, H. Schweizer, K. Swiderska, G. Young, M. Willcox, CLEAR – Effect of contact lens materials and designs on the anatomy and physiology of the eye, Contact lens & anterior eye 44(2) (2021) 192-219.
  5. K. Richdale, I. Cox, P. Kollbaum, M.A. Bullimore, R.C. Bakaraju, P. Gifford, S. Plainis, C. McKenney, S. Newman, E.S. Tomiyama, P.B. Morgan, CLEAR – Contact lens optics, Contact lens & anterior eye 44(2) (2021) 220-239.
  6. S.J. Vincent, P. Cho, K.Y. Chan, D. Fadel, N. Ghorbani-Mojarrad, J.M. González-Méijome, L. Johnson, P. Kang, L. Michaud, P. Simard, L. Jones, CLEAR – Orthokeratology, Contact lens & anterior eye 44(2) (2021) 240-269.
  7. M. Barnett, C. Courey, D. Fadel, K. Lee, L. Michaud, G. Montani, E. van der Worp, S.J. Vincent, M. Walker, P. Bilkhu, P.B. Morgan, CLEAR – Scleral lenses, Contact lens & anterior eye 44(2) (2021) 270-288.
  8. D.S. Jacobs, K.G. Carrasquillo, P.D. Cottrell, F.J. Fernández-Velázquez, R. Gil-Cazorla, I. Jalbert, A.D. Pucker, K. Riccobono, D.M. Robertson, L. Szczotka-Flynn, L. Speedwell, F. Stapleton, CLEAR – Medical use of contact lenses, Contact lens & anterior eye 44(2) (2021) 289-329.
  9. F. Stapleton, M. Bakkar, N. Carnt, R. Chalmers, A.K. Vijay, S. Marasini, A. Ng, J. Tan, H. Wagner, C. Woods, J.S. Wolffsohn, CLEAR – Contact lens complications, Contact lens & anterior eye 44(2) (2021) 330-367.
  10. J.S. Wolffsohn, K. Dumbleton, B. Huntjens, H. Kandel, S. Koh, C.M.E. Kunnen, M. Nagra, H. Pult, A.L. Sulley, M. Vianya-Estopa, K. Walsh, S. Wong, F. Stapleton, CLEAR – Evidence-based contact lens practice, Contact lens & anterior eye 44(2) (2021) 368-397.
  11. L. Jones, A. Hui, C.M. Phan, M.L. Read, D. Azar, J. Buch, J.B. Ciolino, S.A. Naroo, B. Pall, K. Romond, P. Sankaridurg, C.M. Schnider, L. Terry, M. Willcox, CLEAR – Contact lens technologies of the future, Contact lens & anterior eye 44(2) (2021) 398-430.
  12. L. Jones, K. Walsh, M. Willcox, P. Morgan, J. Nichols, The COVID-19 pandemic: Important considerations for contact lens practitioners, Contact lens & anterior eye 43(3) (2020) 196-203.
  13. BCLA data on file 2022.