Jansen Meredith E, Begley Carolyn G, Himebaugh Nikole H, Port Nicholas L
Indiana University School of Optometry, Bloomington, Indiana 47405, USA.
Optom Vis Sci. 2010 May;87(5):350-7. doi: 10.1097/OPX.0b013e3181d951df.
To study the effect of extrinsic controls on blinking by examining blink parameters and tear stability among adapted soft contact lens (CL) wearers performing tasks that require varying amounts of visual concentration.
The Demographic Questionnaire, Contact Lens Dry Eye Questionnaire, and Current Symptoms Questionnaire were completed by 15 adapted soft CL wearers (nine females). Three 55 s simultaneous measurements of tear film stability via retroillumination and blinking were obtained with a slit-lamp biomicroscope and 200 Hz video camera while subjects listened to music and played a video game with and without their habitual CLs. Interblink interval (IBI) and blink amplitude (BA) were calculated. The area of break-up (AB) was calculated for the retroillumination image before each blink. The Current Symptoms Questionnaire was completed four times throughout testing.
With the game compared to music, IBI was significantly longer and BA significantly decreased without CLs (p < or = 0.001). With CLs, the IBI did not significantly change between tasks but the BA significantly decreased (p = 0.100). The AB significantly increased with CL and the game (paired t-test, p < or = 0.001). The BA was significantly correlated with self-reported severity of dry eye for all testing scenarios (Spearman r > or = 0.5579, p < 0.0001) and several symptom measures (Spearman r > or = 0.6262, p < 0.0001). The AB was significantly correlated with symptom measures including bothersome discomfort for the game with and without CLs (Spearman r > or = 0.5064, p < 0.0001).
During tasks requiring concentration, the IBI increased (blink rate decreased) and many blinks were incomplete without CLs. With CLs, tear film instability increased. Blinking frequency also increased, but it remained high when subjects played the game, and symptoms of ocular irritation increased. This suggests that wearing soft CLs, even when fully adapted, provides enough extrinsic ocular surface stimulation to override internal controls and affect blink parameters.
通过检查佩戴软性隐形眼镜（CL）的适应者在执行需要不同程度视觉注意力的任务时的眨眼参数和泪膜稳定性，研究外部控制对眨眼的影响。
15名佩戴软性CL的适应者（9名女性）完成了人口统计学问卷、隐形眼镜干眼问卷和当前症状问卷。在受试者佩戴和不佩戴其常用CL听音乐和玩电子游戏时，使用裂隙灯生物显微镜和200Hz摄像机对泪膜稳定性进行三次55秒的同步测量，测量通过反光照明和眨眼进行。计算眨眼间隔（IBI）和眨眼幅度（BA）。计算每次眨眼前反光照明图像的破裂面积（AB）。在整个测试过程中，当前症状问卷共完成了四次。
与听音乐相比，玩游戏时，不佩戴CL时IBI显著延长，BA显著降低（p≤0.001）。佩戴CL时，任务之间IBI无显著变化，但BA显著降低（p = 0.100）。佩戴CL并玩游戏时，AB显著增加（配对t检验，p≤0.001）。在所有测试场景中，BA与自我报告的干眼严重程度显著相关（Spearman r≥0.5579，p < 0.0001），与多项症状指标也显著相关（Spearman r≥0.6262，p < 0.0001）。AB与症状指标显著相关，包括佩戴和不佩戴CL玩游戏时的烦人的不适感（Spearman r≥0.5064，p < 0.0001）。
在需要集中注意力的任务中，不佩戴CL时IBI增加（眨眼频率降低），许多眨眼不完整。佩戴CL时，泪膜不稳定性增加。眨眼频率也增加，但受试者玩游戏时仍保持较高水平，眼部刺激症状增加。这表明佩戴软性CL，即使是在完全适应后，也会提供足够的眼表外部刺激来超越内部控制并影响眨眼参数。
