Towards better specialty contact lenses

Monday, November 6, 2023

When Dr. Sharon Qiu was growing up as a very nearsighted child, she hated wearing her thick glasses. She begged her parents for contact lenses, but they didn’t agree until she was in high school.

“When I first put on contact lenses and I could see without glasses, my whole demeanour changed,” says Qiu, now a PhD student at the School of Optometry and Vision Science. “I became more outgoing and more positive. I started smiling more and feeling more confident about myself. Contact lenses really did change my life in a profound way.”

That love for contact lenses stayed with her through her undergraduate degree in neuroscience and a combined OD and MSc degree at the New England College of Optometry. She moved to Waterloo in August 2022 to take up a position as the School’s cornea and contact lens resident, then stayed to do a PhD.

Qiu was one of just two students from across North America who won the prestigious OD/PhD scholarship from the American Academy of Optometry (AAO) Foundation this year. The scholarship was presented at the AAO’s Academy 2023 conference in New Orleans in October.

Dr. Sharon Qiu holding her award at the AAO meetings

Qiu had a busy conference – she also presented a paper on one of her residency patient cases and became a Fellow of the American Academy of Optometry (FAAO), a prestigious designation involving multiple submissions demonstrating the highest standards of professional competence and an oral exam at the conference.

Being just in the first term of her doctoral studies, Qiu is working with Drs. Lyndon Jones, Alex Hui and Daddi Fadel to refine her thesis. She plans to focus on scleral lenses, which are large, rigid contacts that dome over the cornea and sit on the white of the eye – the sclera.

Scleral lenses can be specially shaped to correct for irregularities in the cornea caused by conditions such as keratoconus or corneal scarring. They can also be used for severe cases of dry eye disease because they trap a layer of saline solution between the eye and the lens. The complexity in design makes it challenging for optometrists to fit scleral lenses and for patients to learn insertion and removal techniques.

How to better fit scleral lenses for patients is likely to be Qiu’s broad area of research. With Fadel, an expert in scleral lens design, she’s trying to identify what’s missing from current approaches to fitting and why current designs may not quite meet patient needs. For example, when the curve of the lens doesn’t perfectly align with an irregularly curved cornea, the patient will see less clearly and the health of the eye may be damaged.

Qiu is particularly interested in the limbus, which is the transitional area between the iris and the sclera. It contains a lot of stem cells, which help the cornea regenerate quickly if there’s any surface damage.

“If a scleral lens is rubbing on this part of the eye, it might destroy stem cells,” says Qiu. “Currently some of our designs don’t surround this limbus area perfectly, so we’re trying to look at ways to fit this area of the eye better with scleral lenses so the patient’s corneal health stays good over the long term.”

Another area of interest for Qiu is myopia control – the focus of her master’s research. She wishes she could have benefited from myopia control herself as a child, but even if she’d known about it, the only treatment available then was hard ortho-k lenses, which she suspects her parents wouldn’t have gone for.

“The next generation won’t have to be high myopes, at least not the percentage we’re currently seeing,” says Qiu. “We still think the majority of the population will become myopic, but the hope is we’ll be able to reduce the proportion who are highly myopic, which comes with greater risks for the health of the eye.”

Over the long term, Qiu hopes to continue in academia because she wants to combine research with clinical practice, teaching and perhaps commercialising research – she considers Dr. Christine Sindt, who developed EyePrintPRO, a role model.

If she doesn’t end up in academia, working in industry or in clinical practice also appeal to Qiu.

“I think this degree will give me flexibility, so I have different career paths to choose from,” says Qiu. “No matter what I end up doing, my long-term goal is to provide better care for patients as a clinician, researcher and educator.”