1. Jason Nichols, OD MPH PhD TFOS CLD Workshop Chair INTRODUCTION

2. COULD/SHOULD Be Much Bigger! – ~3 billion worldwide require vision correction. – At most  140 million CL Wearers.

3. INTRODUCTION

4. WHAT IS CONTACT LENS DISCOMFORT?

5. INTRODUCTION

6. Evaporation… Dehydration… Corneal Staining… High vs. Low Water… Ionicity… Environment… Hydrogel vs. SiHy… Wettability… Lubricity… Oxygen… Friction… Disposability… Lens Care… Inflammation… Change in sensation Ocular surface changes… Glandular changes…MGD or aqueous or mucin expression….

7. INTRODUCTION

8. STANDARDIZATION & GLOBAL CONCENSUS IS ON THE WAY…

9. INTRODUCTION March 2011 – Completion of MGD Workshop – Next workshops? Infection, allergy, outcomes, contact lenses. Feb 2012 – TFOS GB approves CLD Workshop. – Approves Organizer (David Sullivan) & Workshop Steering Committee Chair (Jason Nichols) & Vice-Chair (Mark Willcox). – Steering Committee (SC) formed. June 20, 2012 – SC decides upon Mission Statement and Subcommittee topics. – SC decides upon workshop membership (n = 79). – SC recommends IOVS (GB later approved).

10. INTRODUCTION

13. Presented progress to Industry Liaison Subcommittee (January 14, 2013, Houston TX). INTRODUCTION

14. Presented draft reports to entire CLD Workshop May 10-11, 2013 (post-ARVO, Seattle, WA). INTRODUCTION

15. June 2013 Final Draft Report Due June –Sep, 2013 Harmonization Aug –Sep, 2013 IOVS Submission Sept 18-23, 2013 TFOS Meeting Taormino, Italy *First Public Presentation Of CLD Workshop. **IOVS on-line release today!

16. As of now, all are available in unedited form on-line at IOVS: http://www.iovs.org/content/early /recent INTRODUCTION

18. A REQUEST: Cover Images!!! Please nominate images representative of CLD. INTRODUCTION

19. TFOS Subcommittees Subcommittee Chairs Harmonization Subcommittee IOVS INTRODUCTION

20. Alcon – Title Sponsor Santen Menicon Allergan Vistakon Laboratoires Théa Bausch & Lomb Optima Oculus CooperVision Contact Lens Spectrum