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Can contact lenses do more than just correct sight? Perhaps extend our healthspan?

Image credit: https://www.pexels.com/photo/white-magnifying-glass-on-blue-table-5843417/

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J. Nikola
J. Nikola Dec 20, 2020
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What would you like your contact lenses to do, besides correcting your sight?
Is there something interesting you found?
Can they help us live easier, longer, healthier?
What are their possible weak points?

Contact lenses are small prosthetic devices, regulated by the FDA and used by more than 150 million people worldwide. Contacts can be made from various materials, such as Plexiglas or silicone. They are mostly used to correct vision, but people actually use them in various ways :

Standard functions of lenses:
  • correcting vision by:
  • correcting refractive error
  • correcting the presbyopia (inability to focus close objects)
  • correcting the color deficiencies
  • cosmetics (changing the eye color)
  • protection and recovery (therapeutic lenses, lens bandages)

Special functions of contact lenses (updated from contributions):
  • Delivering healthspan or lifespan drugs to the eyes
  • Non-invasive measurement of glucose levels
  • Glaucoma progression-monitoring contact lens
  • Telescopic/zooming contact lens to treat visual impairments
  • Smart contact lenses with a camera to help blind people

Describe the idea creatively, explain how it can help us, and propose some adjustments/improvements if you have something in mind :)

[1]https://onlinelibrary.wiley.com/doi/abs/10.1002/adhm.201900368

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Creative contributions

Non-invasive measurement of glucose levels

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J. Nikola
J. Nikola Dec 23, 2020
In 2018, a group of scientists presented a phenylboronic acid (PBA)-based HEMA contact lens.

The product idea

It would consist of a PBA-based HEMA contact lens coupled with a device/smartphone application. When the sugar blood levels rise, the sugar tear fluid levels rise with a certain time delay, causing a change in lens thickness. A red light-emitting diode detector module would be used to measure the thickness of a lens (Figure 1).

Figure 1. An innovative non-invasive glucose level monitoring. Taken from Lin et al. (2018) .

The underlying mechanism

PBA is a Lewis acid that can reversibly bind to glucose and other cis-1,2 or cis-1,3 diols. HEMA, or poly(2-hydroxyethyl methacrylate hydrogel consists of neutral boronic acid (hydrophobic) and anionic boronate (hydrophilic). As glucose concentrations increase, more anionic groups form, making the system accumulate water, thus increasing in volume. As glucose concentrations decrease, the volume of the lens decreases, too, causing different light refraction/reflection.

Pluses
  • Non-enzyme system
  • Portable
  • Cost-effectiveness
  • Non-invasive
  • Easy to use
  • Fast
  • Does not impact the vision
Minuses
  • 15 to 30 min time delay of the tear fluid level after glucose is transported from the blood level

Although this method could help continuously monitor tear fluid sugar levels and thus, sugar levels in general, it is recommended to check the sugar level with other blood-based techniques from time to time.

[1]Lin YR, Hung CC, Chiu HY, et al. Noninvasive Glucose Monitoring with a Contact Lens and Smartphone. Sensors (Basel). 2018;18(10):3208. Published 2018 Sep 22. doi:10.3390/s18103208

[2]Lane JD, Krumholz DM, Sack RA, Morris C. Tear glucose dynamics in diabetes mellitus. Curr Eye Res. 2006 Nov;31(11):895-901. doi: 10.1080/02713680600976552. PMID: 17114114.

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J. Nikola
J. Nikolaa year ago
What I thought of while writing the contribution was that it would be handy if the lens somehow affected the vision while sugar levels are altered. That way, there would be no need for continuous monitoring, but instead, a person would be warned in time.
It could be dangerous if the vision would get a bit blurry. The other option is a slight color change (for all of you who played COD, the reddish screen when you´re hurt 😄), which would be a sign of a change in sugar levels.

There is already a material that could help in implementing this idea (https://abcnews.go.com/Technology/FutureTech/story?id=97664&page=1).
They propose photonic crystals that change color according to the glucose levels. By the scientists´ words, "High concentrations of glucose produce a purple color while low glucose would refract the light to produce a reddish color. Normal glucose levels would produce a green color."
Lenses could be made of those photonic crystals, boronic acids, and other chemicals, that react to different glucose concentrations by refracting/bending the light. Their idea would be to look in the mirror and see what color are your lenses and compare them to the color brochure.
But it would be best if the vision would become a bit reddish or purplish, right?
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Povilas S
Povilas Sa year ago
Juran In some cases, where a person would do a rather risky, high visual concentration requiring job (e.g. driving) that color change might be not so good. It might happen at a dangerous moment when small disturbances would mean a lot. A person could simply get slightly scared or confused, because of a sudden vision change or if it happened at a low-light situation like at dusk or in a tunnel this would only add up to poorer visibility and this might contribute to making an accident.
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J. Nikola
J. Nikolaa year ago
Povilas S I agree. I also think that slight color change of the picture we see would be hard to notice in low-light conditions. That is why maybe the second idea, with eye-color change could be more interesting. When you look at the mirror, you see that your eyes are slightly different color than usual.
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Glaucoma progression-monitoring contact lens

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J. Nikola
J. Nikola Dec 23, 2020
When you have serious heart problems, a doctor gives you a holter for 24h monitoring. But what about other health issues?

A Swiss company called Sensimed AG developed a soft contact lens that monitors the intraocular pressure continuously throughout the day. The contact lens is called SENSIMED Triggerfish and is approved by the FDA in 2016 and by the PMDA in 2018, as a device that provides valuable information about the changes of the eye, in order to help guide glaucoma treatment.

Why glaucoma? Because it is known that intraocular pressure fluctuate throughout the day in patients with glaucoma and is considered a major modifiable risk factor for glaucoma.

It consists of:
  • sensor - a soft contact lens (Figure 1.)
  • antenna - placed around the eye, receives the wireless signal from the lens
  • portable recorder - stores the information
Figure 1. Triggerfish contact lens sensor (taken from Dunbar et al, 2017 )

It cannot prevent glaucoma, but instead, it helps doctors determine if the treatment is right for the patient. As with other cancers, glaucoma has several levels of treatment, each being more aggressive than the previous. These lenses can help to evaluate if the treatment is working properly, or the next level of therapy is needed.

With new technology, the size of the system could be significantly reduced to a single soft contact lens, providing an incredible tool for glaucoma development and progression.

[1]Dunbar GE, Shen BY, Aref AA. The Sensimed Triggerfish contact lens sensor: efficacy, safety, and patient perspectives. Clin Ophthalmol. 2017;11:875-882. Published 2017 May 8. doi:10.2147/OPTH.S109708

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Delivering healthspan or lifespan drugs to the eyes

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Jamila
Jamila Dec 30, 2020
You can use eye drops for the eyes, but the problem is they are washed out quite quickly, so it isn't an effective drug delivery method. Scientists have coated contact lenses with drugs. The benefit of this method is that it can continuously deliver drugs into the eyes. Researchers can make these specialist lenses by combining drug particles with the lens monomers before creating the lenses.

I wondered what if we used this contact lens delivery method with lifespan extension drugs such as rapamycin, metformin, NAD, senolytics, etc. I'm not sure whether researchers have used these drugs paired with contact lenses before. Still, it would be interesting to see whether they perform better compared to the traditional drug delivery methods (via the mouth) if it hasn't already been tested.

[1]Kim, Joohee, Eunkyung Cha, and Jang‐Ung Park. "Recent advances in smart contact lenses." Advanced Materials Technologies 5.1 (2020): 1900728.

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J. Nikola
J. Nikolaa year ago
Hi Jamila! I think that your idea is really good!

Drug-delivering contact lenses can indeed help avoid many usual problems that occur during the ocular drug administration. What concerns me is still the bioavailability of the drug in the parts of the organism distant from the eye, due to many physiological and physical barriers.

I couldn't find papers exploring the ocular administration of drugs for non-ocular disorders, but I found a paper where an aqueous clear nanomicellar rapamycin topical drops were developed and characterized. The paper shows that rapamycin follows the conjunctival-scleral pathway to reach the back of the eye (retina-choroid) with no rapamycin detected in vitreous humor [1]. What further needs to be explored is the efficiency of the administration through the contact lens:

- what percentage of a drug (e.g. rapamycin) is being transferred to the blood and the final organ/tissue?
- how high needs to be the rapamycin concentration in the lens to reach effective blood concentration?
- does it negatively affect eye function?

References:
[1] Kishore Cholkar, Sriram Gunda, Ravinder Earla, Ashim Mitra, Posterior ocular drug delivery; An aqueous clear rapamycin topical drop for retinal delivery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1072.
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Manel Lladó Santaeularia
Manel Lladó Santaeulariaa year ago
Juran This is really interesting. However I would expect very little amount of the drug reaching the rest of the organism through the blood. This is because the eye is a very isolated structure, with little connection to the bloodstream. The retinal pigmented epithelium is the only connection between the two but allows very little contact, which is one of the main reasons the eye is an immunoprivileged region. This means that the immune system has very low activity in the eye because it literally cannot reach it (which has several advantages and disadvantages). This would probably greatly limit the amount of drug that could reach the bloodstream, especially considering that contact lenses would probably be able to deliver relatively low doses of a particular drug which may not have any significant effect on the body.
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J. Nikola
J. Nikolaa year ago
Manel Lladó Santaeularia I agree with you. The idea could maybe work in cases of drugs that are meant to be available in the bloodstream in extremely low concentrations and, at the same time, do not have negative effects on the eye (due to the necessarily high concentrations in the contact lens). But for not, hardly manageable.
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Contact lenses and the risk of eye infections and diseases

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Jamila
Jamila Dec 30, 2020
People that wear contact lenses have an increased risk of getting eye infections and even ocular diseases like microbial keratitis. Furthermore, individuals with microbial keratitis may experience eyesight loss in the most severe cases.

These eye problems can arise when the contact lenses become contaminated with pathogens. The contact lenses become contaminated when people wear them for longer than they should or because of improper lens care. So, there is a great need to develop lenses and lens accessories with antimicrobial properties to reduce the risk of ocular infections and diseases.

[1]Cheng, Kam H., et al. "Incidence of contact-lens-associated microbial keratitis and its related morbidity." The Lancet 354.9174 (1999): 181-185.

[2]Szczotka-Flynn, Loretta B., Eric Pearlman, and Mahmoud Ghannoum. "Microbial contamination of contact lenses, lens care solutions, and their accessories: a literature review." Eye & contact lens 36.2 (2010): 116.

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J. Nikola
J. Nikolaa year ago
Hi Jamila! Thank you for your contribution.
I agree that people who wear lenses have an increased risk of getting eye infections. I know that from personal experience of wearing contacts for almost 20 years and having multiple eye infections. New materials or coatings would definitely help people to have fewer eye problems.
But, in my opinion, the best prevention is good eye care and general hygiene. According to your lifestyle, you can choose to wear soft contact lenses that "last" from 1 day to 3 months (rigid lenses up to a few years!), with those of 1 day being the best in terms of infections and diseases. I rarely got an infection if I used the contacts the way how the manufacturer prescribed.
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Povilas S
Povilas Sa year ago
Juran Isn't it also something about the total time that you use them (like in terms of years), the longer you use them the riskier it gets for some reason? I don't know if this has something to do with eye infections, but my friend used predominantly lenses for many years and at one point her doctor told her that she has to stop, because she came to a point when it's no longer safe to keep using them. Maybe it has something to do with individual physiology, some people might damage the eye tissue this way, because of continuous contact and friction, I think that's what I heard also. Not sure how much of this it's true. But some people are more sensitive to them than others. When I tried them it was pretty uncomfortable for me.
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Jamila
Jamila a year ago
The good news is that researchers are already developing contact lenses with antimicrobial properties! In Khan and Lee's review article, they suggest various ways to give contact lenses antimicrobial properties, including antibiotics, antifungal medicines, metal coatings, quorum sensing quenchers, and much more. [1]

Reference
1. Khan, Shakeel Ahmad, and Chun-Sing Lee. "Recent progress and strategies to develop antimicrobial contact lenses and lens cases for different types of microbial keratitis." Acta Biomaterialia (2020).

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Telescopic/zooming contact lens to treat visual impairments

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J. Nikola
J. Nikola Dec 23, 2020
In a 2013 research , Tremblay and his team described a switchable telescopic lens that can help you see 2.8x magnified picture (Figure 1). The lens had two options: normal vision through a central clear aperture and magnified vision through a set of positive and negative annular concentric reflectors. The switching was done using orthogonal polarization films over the apertures combined with a pair of off-the-shelf switching liquid crystal (LC) glasses made for 3D television. The invention was tested on an optomechanical model eye and was intended to help people with age-related macular degeneration, but has opened many other possibilities.
Figure 1. Images captured through the contact lens and optomechanical eye (taken from Tremblay et al, 2013 ).

In a 2019 paper , scientists from the University of California described a biomimetic soft lens controlled by blinking. Actually, blinking or any other eye movement generates an electrooculographic signal that is used to control the lens. Lens was programmed to change its focal length and the change was as big as 32%, just through deformation. The system connecting the eye movements and lens was synchronized fast and easy but was just in a prototype phase.

Both above-mentioned solutions could result in a terrific invention if combined. Soft telescopic lenses with combined magnification systems that could be controlled by blinking could bring new solutions to people suffering from visual impairments.

[1]Eric. J. Tremblay, Igor Stamenov, R. Dirk Beer, Ashkan Arianpour, and Joseph E. Ford, "Switchable telescopic contact lens," Opt. Express 21, 15980-15986 (2013)

[2]https://onlinelibrary.wiley.com/doi/full/10.1002/adfm.201903762

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Smart contact lenses with a camera to help blind people

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J. Nikola
J. Nikola Dec 23, 2020
X Development LLC., a semi-secret R&D organization founded by Google (before called Google X), put a camera into a contact lens . The camera was able to take raw photos and process them. The intention was to develop a prosthetic device that can process the image and send the information about the surroundings (e.g. danger, car approaching, a person coming) to a blind person through an audio warning, for example.

Unfortunately, I could not find more information on this device.

[1]https://www.extremetech.com/extreme/180571-google-invents-smart-contact-lens-with-built-in-camera-superhuman-terminator-like-vision-here-we-come

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Silicone hydrogel contact lenses as detectors of organic solvents

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J. Nikola
J. Nikola Feb 19, 2021
Recently, I saw a precaution on a label of a chemical that says that wearing contact lenses is not advisable while using the chemical. That made me think.

In the last few decades, many papers assessed the safety of using contact lenses in environments with organic solvents, acids, alkalis, etc and came to the following findings:
  • although soft contact lenses absorb up to 90 times more trichloroethylene and xylene than physiologic saline, the concentrations of the chemicals released into the tear saline were low compared to direct exposure. Chemicals were primarily released into the air .
  • lenses also protected the cornea from strong acids .
  • contact lenses could be used as a standard company's personal protective equipment (PPE) .
  • contact lenses could protect eyes from volatile agents .

Conclusions:
  • Lenses didn't worsen the effect of volatile solvents.
  • Protection of the eyes depends on the chemical, but in the case of acetic acid, n-butylamine, acetone, and few others, it seems to be better to wear them than not.
But these organic solvents are widely used in the production of pharmaceuticals, pesticides, and other industries and can, by accumulation, have a negative effect on a person's health. Ventilation systems are often the systems on which money is saved or the detectors are positioned too high, too far from the workers.

The idea

To prevent it, we could develop special lenses for workers in the above-mentioned environments that would detect organic solvents. As the solvents are absorbed by the lens, its color could change, warning the employee that the air concentration of the specific solvent is dangerously high. That way the workers could be alarmed precisely and in-time to leave the area and vent the working space.

It could potentially be made for all organic compounds that surround and harm us.

[1]https://ohsonline.com/Articles/2005/10/Contact-Lenses-in-a-Chemical-Environment.aspx?Page=1

[2]https://pubmed.ncbi.nlm.nih.gov/1559287/

[3]https://www.scientificamerican.com/article/do-contact-lenses-protect/

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