This is the fourth episode in the BCLA CLEAR series. By reviewing the physiological and anatomical changes which may occur while wearing contact lenses this paper provides eye care practitioners with a better understanding of the key clinical learnings for modern contact lens practice. This report consolidates clinical research information about the various physiological and anatomical changes which may result from using contact lenses. It takes an anatomy-centric approach covering changes to the lids and adnexa, the conjunctival regions and the various layers of the cornea and presents changes which are sub-clinical rather than those which are symptomatic or generally considered as 'adverse events'.

Professor Phil Morgan discusses some of the key findings of this paper with Dr Melissa Barnett. Professor Morgan is Professor of Optometry, Head of Optometry, Deputy Head of the Division of Pharmacy and Optometry, and Director of Eurolens Research at The University of Manchester.  His main research interests relate to the clinical performance of contact lenses and he teaches on the same subject area at undergraduate and postgraduate level.  He has managed an international survey of contact lens prescribing trends since 1996. He is also President of the International Society for Contact Lens Research and President of the International Association of Contact Lens Educators. He is an honorary member of the UK Association of Contact Lens Manufacturers, a Fellow of the British Contact Lens Association and the American Academy of Optometry.

Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.