Fiona Stapleton

Fiona Stapleton
UNSW Sydney | UNSW

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363
Publications
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Publications

Publications (363)
Poster
Purpose: Both non-autoimmune and autoimmunemediated dry eye disease (DED) significantly impact ocular surface epithelial immune cells (EICs) and corneal nerves, as observed by in vivo confocal microscopy (IVCM). The primary aim was to compare corneal EIC density and nerve characteristics between individuals with DED and healthy controls, and furthe...
Article
The increased usage of nonrefractive cosmetic contact lenses in Asia and a trend toward increased online purchasing of both refractive and cosmetic contact lenses poses unique challenges in the management of contact lens–related complications. However, regulations have lagged behind this increased uptake in the community. This paper reviews regulat...
Article
Full-text available
Objective: To identify and assess the quality of currently available validated patient reported outcome measures (PROMs) used to measure the quality of life (QoL) impacts of ocular surface diseases (OSDs). Methods: A literature search was performed in the PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases. Articles reporting on...
Article
Objectives To assess the reliability of the liquid jet esthesiometer (LJA) for measurement of corneal sensitivity. Methods Two separate studies were conducted to assess intrasession repeatability (study 1) and intersession reproducibility (study 2) of corneal sensitivity measured using the LJA. Thirty participants (13 female and 17 male participan...
Article
Full-text available
Dry eye disease is a multifactorial condition characterised by tear film instability, hyperosmolarity and ocular surface inflammation. Understanding the epidemiology of dry eye disease and recognising both modifiable and non-modifiable risk factors can assist eye care practitioners in assessing, treating, and managing patients with the condition. T...
Article
SIGNIFICANCE Prolonged computer use may result in repeated stimulation of the ocular surface due to ocular dryness, potentially leading to alterations in its sensitivity. PURPOSE This study aimed to evaluate the relationship between ocular symptoms and corneal sensitivity to cold and mechanical stimuli in computer users. METHODS Fifty-two young (...
Article
SIGNIFICANCE This is the first study to evaluate the retention time of lubricating eye drops containing various concentrations of sodium hyaluronate using fluorophotometry in a symptomatic dry eye population. Information regarding eye drop retention may be useful for eye care practitioners to assist in the selection of more effective treatments for...
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Purpose The purpose of this study was to investigate differences in the composition of meibum extracted from human meibomian glands displaying different morphological characteristics. Methods Adult participants with evidence of meibomian gland shortening were enrolled. Glands were observed using infrared meibography, and meibum was collected from...
Article
Significance Dry eye sufferers have a highly irregular corneal epithelial surface compared with those without dry eye. This study demonstrated that corneal epithelial thickness irregularity can be significantly reduced after as little as 48 hours following treatment with regular use of topical ocular lubricants. Purpose This study aimed to compare...
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Full-text available
Acanthamoeba keratitis (AK) is a severe, rare protozoal infection of the cornea. Acanthamoeba can survive in diverse habitats and at extreme temperatures. AK is mostly seen in contact lens wearers whose lenses have become contaminated or who have a history of water exposure, and in those without contact lens wear who have experienced recent eye tra...
Preprint
Full-text available
Acanthamoeba keratitis (AK) is a severe, rare protozoal infection of the cornea. Acanthamoeba can survive in diverse habitats and at extreme temperatures. AK is mostly seen in contact lens wearers, whose lenses have become contaminated, or a history of water exposure, and in those without contact lens wear, who have experienced recent eye trauma in...
Article
Full-text available
Purpose The purpose of this study was to assess the immediate ocular immune response to soft contact lens (CL) wear by examining presumed epithelial immune cell (EIC) density and morphology at the central, peripheral, limbal cornea, and conjunctiva. Methods Fifty-four participants naïve to CL wear (mean age = 24.8 ± 9.8 years, 44% female participa...
Article
Clinical relevance: Realistic benchmarks can serve as comparators for optometrists wishing to engage in clinical practice audits of their glaucoma care. Background: The iCareTrack study established the appropriateness of glaucoma care delivery through clinical record audits of Australian optometry practices. Benchmarks required for monitoring an...
Article
Clinical relevance: Valid and updated clinical indicators can serve as important tools in assessing and improving eyecare delivery. Background: Indicators for diabetic eyecare in Australia were previously developed from guidelines published before 2013 and then used to assess the appropriateness of care delivery through a nationwide patient reco...
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The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic conjunctivitis (AC), and non-allergic controls to examine if the allergy type causes differences in immune cell activation. The prospective study included 60 participants: 20 with VKC, 20 w...
Article
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The Tear Film & Ocular Surface Society (TFOS) Workshop entitled 'A Lifestyle Epidemic: Ocular Surface Disease' was a global initiative undertaken to establish the direct and indirect impacts of everyday lifestyle choices and challenges on ocular surface health. This article presents an Executive Summary of the evidence-based conclusions and recomme...
Article
Meibomian gland dysfunction is one of the most common ocular diseases, with therapeutic treatment being primarily palliative due to our incomplete understanding of meibomian gland (MG) pathophysiology. To progress in vitro studies of human MG, this study describes a comprehensive protocol, with detailed troubleshooting, for the successful isolation...
Article
Purpose: Meibomian gland dysfunction (MGD) is a chronic progressive disease with downstream effects on ocular signs and symptoms. AZR-MD-001 is a selenium sulfide ophthalmic ointment that was investigated as a potential treatment option for patients with MGD. Methods: A Phase 2, multi-center, double-masked, parallel group study was conducted acr...
Article
Purpose: Sex hormones impact inflammatory and immune-mediated diseases. During IVF (in vitro fertilisation) treatment, circulating estrogen levels increase dramatically (10-50x) alongside changes in other hormones. This study examined changes in dry eye with IVF and its relationship with sex hormones. Methods: A two visit study was conducted on...
Article
Full-text available
Contact lenses provide excellent vision correction for many people worldwide. However, they can become colonised by microorganisms and this can result in infections and inflammatory responses at the surface of the eye during wear. If not quickly and appropriately treated, the infections can lead to loss of vision and even loss of the eye. The micro...
Article
Clinical relevance: Traditionally, refraction is performed, and spectacles are manufactured in in 0.25D-steps. Trial and spectacle lenses manufactured in smaller increments may allow for a more accurate refraction and prescribed spectacles. Background: To determine whether refraction in 0.05D-steps improves the proportion of eyes achieving achie...
Article
Societal factors associated with ocular surface diseases were mapped using a framework to characterize the relationship between the individual, their health and environment. The impact of the COVID-19 pandemic and mitigating factors on ocular surface diseases were considered in a systematic review. Age and sex effects were generally well-characteri...
Article
Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultrav...
Preprint
Full-text available
Purpose: In this paper, we aimed to clinically interpret Temporal-Superior-Nasal-Inferior-Temporal (TSNIT) retinal optical coherence tomography (OCT) images in a convolutional neural network (CNN) model to differentiate between normal and glaucomatous optic neuropathy. Methods: Three modified pre-trained deep learning (DL) models: SqueezeNet, ResNe...
Article
Optometrists play an integral role in primary eyecare services, including prevention, diagnosis, and management of acute and chronic eye conditions. Therefore, it remains essential that the care they provide be timely and appropriate to ensure the best patient outcomes and optimal utilisation of resources. However, optometrists continuously face ma...
Article
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Plastics are synthetic materials made from organic polymers that are ubiquitous in daily living and are especially important in the healthcare setting. However, recent advances have revealed the pervasive nature of microplastics, which are formed by degradation of existing plastic products. Although the impact on human health has yet to be fully ch...
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Background Increased density and altered morphology of dendritic cells (DC) in the cornea and conjunctiva occur during active allergic conjunctivitis. This study investigated whether inflammation (characterised by altered DC density and morphology) persists during the symptom-free phase of allergic conjunctivitis. Methods Twenty participants (age...
Article
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Background Corneal and conjunctival epithelial dendritic cells (DC) have an established role in vernal keratoconjunctivitis, however, their role in more prevalent forms of allergic eye disease remains unclear. This study evaluated corneal and conjunctival epithelial DC density, morphology, and distribution observed using in vivo confocal microscopy...
Article
Objective: The study aimed to profile and quantify tear metabolites associated with bacterial keratitis using both untargeted and targeted metabolomic platforms. Methods: Untargeted metabolomic analysis using liquid-chromatography-Q Exactive-HF mass-spectrometry explored tear metabolites significantly associated with bacterial keratitis (n = 6)...
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A clinical study of antimicrobial contact lenses containing the cationic peptide Mel4 was conducted. The few adverse events that occurred with this lens occurred on or after 13 nights of wear. The current study examined whether the Mel4 contact lenses lost activity during wear and the mechanism of this loss. Participants wore contact lenses for up...
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Purpose: Dendritic cells (DC) play a crucial role in ocular surface defence. DC can be visualised in vivo by confocal microscopy but have not yet been fully characterised in humans. This study investigated the diurnal variation, topographical distribution and repeatability of DC density and morphology measurements. Methods: In vivo confocal micr...
Preprint
Full-text available
Purpose: Dendritic cells (DC) play a crucial role in ocular surface defence. DC can be visualised in vivo by confocal microscopy but have not yet been fully characterised in humans. This study investigated the diurnal variation, topographical distribution, and repeatability of DC density and morphology measurement. Methods: In vivo confocal microsc...
Article
Full-text available
Staphylococcus aureus (S. aureus) is a frequent cause of eye infections with some isolates exhibiting increased antimicrobial resistance to commonly prescribed antibiotics. The increasing resistance of ocular S. aureus to ciprofloxacin is a serious concern as it is a commonly used as a first line antibiotic to treat S. aureus keratitis. This study...
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Infection of the ocular surface can have devastating consequences if not appropriately treated with antimicrobials at an early stage [...]
Poster
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Purpose: The study profiled and compared tear metabolomes associated with culture-positive and culture-negative keratitis. Methods: Six tear samples were collected using a Schirmer strip under topical anaesthesia from participants with bacterial keratitis, two of which were culture-negative and four culture-positive (Staphylococcus aureus, Staphyl...
Poster
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PURPOSE Chronic abnormal eye rubbing may induce corneal trauma with a long-established association with the development and progression of keratoconus (KC). This study aimed to compare the eye rubbing habits of normal and keratoconus subjects using a novel questionnaire. METHODS A questionnaire was designed based on eye rubbing characteristics repo...
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Purpose: LASIK causes corneal nerve damage and may affect the neuro-immune crosstalk. This study examined the effects of LASIK on corneal epithelial dendritic cells (CEDC) density and morphology and explored their relationships with corneal nerves and tear neuropeptides. A grading system was developed to assess CEDC morphology. Methods: Intra- a...
Article
Sex steroids play a role in regulation of tear film function and may exert their action locally at the ocular surface. However, measurement of sex steroids in tears is difficult due to small-volume tear samples and very low concentrations of the hormones. This short communication highlights what has been achieved to date in the analysis of tear sex...
Article
Purpose: The objective of this study was to undertake a systematic review of the literature reporting on clinical registries in dry eye disease (DED). Methods: Electronic searches were conducted using systematic review methodology to provide an overview of clinical registries in ophthalmology and to identify clinical registries reporting on dry...
Thesis
Bacterial keratitis is a serious corneal disease, which can cause irreversible vision loss in all age groups. Understanding metabolic pathways in bacterial keratitis may help understand the host-pathogen interaction, which is responsible for the disease severity and pathogenesis. The thesis aimed to identify, characterise, and quantify tear metabol...
Poster
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Nucleosides are glycosamines consisting of nucleobases and five-carbon sugar, which are obligatory for all organisms to regulate biochemical and cellular reactions in biological cells ranging from metabolic activity to gene expression. This study quantified and compared tear nucleosides between 15 participants with microbial keratitis and their 15...
Article
Full-text available
Staphylococcus aureus is a major cause of ocular infectious (corneal infection or microbial keratitis (MK) and conjunctivitis) and non-infectious corneal infiltrative events (niCIE). Despite the significant morbidity associated with these conditions, there is very little data about specific virulence factors associated with the pathogenicity of ocu...
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Purpose: Staphylococcus aureus, cause a range of ocular diseases in humans, including noninfectious corneal infiltrative events (niCIE), infectious conjunctivitis and sight threatening microbial keratitis (MK). This study aimed to determine the possession of known virulence genes of S. aureus associated with MK and conjunctivitis, in strains isola...
Article
This is the first study to validate the combination of TE for evaluating MGD. This study didn’t show correlations between TE combination against MGD14 and against meibography. In addition, there was no correlation between meibography and MGD14. Overall, this study displayed poor relationship between symptoms and signs of dry eye; however, these res...
Article
Infectious keratitis is a rare but severe condition associated with a range of ocular and systemic predisposing conditions, including ocular trauma, prior surgery, surface disease, and contact lens (CL) wear. This review explores the epidemiology of infectious keratitis, specifically the differences in disease incidence and risk factors, causative...
Article
Clinical relevance Current levels of appropriateness for primary diabetic eyecare delivered by Australian optometrists are presented along with realistic targets (benchmarks) for quality improvement. The demonstrated methods can be used in practice evaluation and benchmarking of other clinical practice areas and settings. Background To examine the...
Article
Clinical relevance Establishing the level of appropriateness and barriers to glaucoma care delivery by Australian optometrists are important first steps in developing tailored interventions aimed at improving glaucoma care delivery. Background To determine the appropriateness of and barriers to glaucoma care by optometrists. Methods A mixed metho...
Article
Full-text available
(1) Purpose: This study aimed to investigate the effects of Mel4 antimicrobial contact lenses (MACL) on the ocular surface and comfort during extended wear. (2) Methods: A prospective, randomised, double-masked, contralateral clinical trial was conducted with 176 subjects to evaluate the biocompatibility of contralateral wear of MACL. The wearing m...
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PurposeTo determine the recovery of structural and functional corneal sensory nerves within the LASIK flap in order to provide insight to more proximal corneal reinnervation and symptoms post-LASIK.Methods Twenty participants underwent femtosecond LASIK with a superior flap hinge. Ocular Comfort Index in Chinese (OCI-C), Cochet-Bonnet esthesiometry...
Article
Aims Determine demographic and clinical characteristics associated with positive culture in suspected microbial keratitis. Methods Retrospective audit of patients that had corneal scrapings between October 1999-September 2004 at Princess Alexandra Hospital. Clinical information was gathered from medical records, smear and culture results from the...
Article
Purpose: To compare the effect of the use of different lubrication eye drops and nonpreserved saline for the application of miniscleral contact lenses (CLs) on subjective experience during 6 hr of lens wear. Methods: Experienced soft CL wearers aged 18 to 45 years (inclusive) were enrolled in this prospective, randomized, double-masked, three ar...
Article
Purpose A recent nationwide medical record audit of optometry practices has identified an evidence-to-practice gap in primary diabetic eyecare delivery. This study aimed to explore the determinants (barriers and enablers) to appropriate diabetic eyecare delivery in Australia. Methods A qualitative study involving focus-group discussions and interv...
Article
The widely used immortalised human meibomian gland epithelia cell (iHMGEC) line has made possible extensive studies of the biology and pathophysiology of meibomian glands (MG). Tissue culture protocols for iHMGEC have been revised and modified to optimise the growth conditions for cell differentiation and lipid accumulation. iHMGEC proliferate in s...
Article
Full-text available
Staphylococcus aureus is a frequent cause of ocular surface infections worldwide. Of these surface infections, those involving the cornea (microbial keratitis) are most sight-threatening. S. aureus can also cause conjunctivitis and contact lens-related non-infectious corneal infiltrative events (niCIE). The aim of this study was to determine the ra...
Article
Significance: Water exposure during contact lens wear can transfer pathogenic microorganisms to the eye, causing ocular complications. This study determined that water exposure is prevalent among lens wearers and is independently associated with higher case contamination. Contact lens compliance education to minimize water exposure should be reenf...
Article
Objectives To assess the quality of diabetic eye disease clinical practice guidelines Study design and setting A systematic search of diabetic eye disease guidelines was conducted on six online databases and guideline repositories. Four reviewers independently rated quality using the Appraisal of Guidelines, Research and Evaluation (AGREE II) inst...
Article
Two spectrophotometric microplate assays with dual staining for either fluorescent Nile red (NR) plus 4,6-diamidino-2-phenylindole (DAPI) or non-fluorescent Oil red O (ORO) plus Crystal violet (CV) were applied and optimised to evaluate the lipid producing capacity of immortalised human meibomian gland epithelial cells (iHMGEC). Cells were treated...
Article
Infectious keratitis is a rare but potentially severe sight-threatening disease, associated with considerable societal burden, cost and morbidity. This review summarises the most recent evidence for the incidence, risk factors and impact of disease, all of which vary widely according to region, access to health care, socioeconomic and environmental...
Article
Full-text available
Purpose: To determine whether Mel4-coated antimicrobial contact lenses (MACLs) can reduce the incidence of corneal infiltrative events (CIEs) during extended wear. Methods: A prospective, randomized, double-masked, single-center, contralateral, extended contact lens wear clinical trial was conducted with 176 subjects. Each participant was random...
Article
Full-text available
Three hundred and twenty-eight myopic children, randomized to use either 0.01% (N = 166) or 0.02% (N = 162) atropine were enrolled in this study. Gender, age, body mass index(BMI), parental myopia status, atropine concentration used, pupil diameter, amplitude of accommodation, spherical equivalent refractive error (SER), anterior chamber depth (ACD...
Article
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Significance: The results of this study demonstrate that Smart Touch Technology packaging, which is designed to reduce and simplify contact lens handling before insertion, is effective in reducing the frequency of bacterial contamination of the back surface of contact lenses after short-term wear. Purpose: The purpose of this study was to invest...
Poster
Full-text available
Metabolites are small biological molecules (Biomolecules) produced by the cell to cell interaction. Tear fluid is one of the common biofluid used in the study of metabolite expression. Bacterial keratitis is the ulcer of the cornea which is associated with a painful event. In the pilot study, we examined the expression of tear metabolites associate...
Article
Full-text available
The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for suc...
Article
Evidence-based contact lens->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patie...
Article
Optometry Australia’s infection control guidelines 2020 deliver a revision of the paper: Infection control guidelines for optometrists 2016. A review of recent literature was undertaken, with information collected from peer-reviewed journal articles, guidelines from professional societies, government health departments and instructions from equipme...
Article
Contact lens-related complications are common, affecting around one third of wearers, although most are mild and easily managed. Contact lenses have well-defined anatomical and physiological effects on the ocular surface and can result in other consequences due to the presence of a biologically active material. A contact lens interacts with the tea...
Article
Purpose The purpose of this study was to investigate the effect of Mel4 antimicrobial peptide-coated contact lenses (MACL) on the microbiota of the conjunctiva and lenses during three months of extended wear. Methods One hundred and seventy-six participants were recruited into a randomised, contralateral, double masked, biweekly extended wear MACL...