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Sunday, January 6, 2013 
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Last question:
What's tops your holiday contact lens wish list for 2013?

 1. Less internet glasses and contact lens prescription sales

 2. More compliant contact lens wearers
 3. More multifocal lens fits

 4. Less adverse events in contact lens wearers

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

The story found in the following link was recently printed by U.S. News & World Report (http://health.usnews.com/health-news/news/articles/2012/12/26/young-girls-plea-for-contact-lenses-pays-off). I think it nicely portrays the issues and benefits of fitting children in contact lenses from the child's and parent's perspective. For practitioners who actively fit children in contact lenses, the story might not be that unfamiliar. Although it is easy to fall back on using an age criterion for fitting children in contact lenses, the contact lens community at large has moved away from this concept and moved toward evaluating the maturity of each patient, amongst other things.

X-Cel Adds Atlantis Scleral Lens to Toolbox of Designs

X-Cel Contacts announced the addition of the Atlantis Scleral lens to their offering of irregular cornea designs. This lens will be manufactured at X-Cel's manufacturing facility in Duluth, Georgia.

According to the company, Atlantis is a scleral lens design that performs well on any patient with irregular cornea, including keratoconus, pellucid marginal degeneration, corneal transplants, post refractive surgery, post corneal rings, and ocular surface disease. Scleral lenses have also been utilized on regular corneas, dry eye patients, and athletes.

The Atlantis proprietary lens design was developed to provide a problem solving solution along with a simplified fitting system with the 1-2-3 fit strategy. The unique peripheral curve calculation will allow central clearance while providing good distribution of pressure in the landing area, adequate edge lift and overall superior comfort, per the company announcement. The Atlantis fitting set includes an extensive fitting guide, patient insertion and removal take home card, small and large DMV suction cups, lap towels and unpreserved single use saline packs.

For additional information, contact an X-Cel Consultant at 1-800-241-9312 or xcelinfo@walman.com.

Academy 2013 Seattle Call for Courses Is Open

The Lectures and Workshops Committee of the American Academy of Optometry invites the submission of course proposals for Academy 2013 Seattle, to be held Wednesday, October 23 through Saturday, October 26, 2013. The Academy's annual meeting traditionally offers over 300 hours of CE credit for optometrists, vision scientists and other professionals.

The course submission window will be open through February 1, 2013. Each applicant can submit up to three course proposals for consideration by the Lectures and Workshops Committee. In addition to three course proposals, applicants can submit cases for consideration for Grand Rounds sessions. Course selection will be made by the Lectures and Workshops Committee based on topical interest, outline content, and course originality within mainline optometric education and practice.

Notification of course selections will be provided to all applicants by March 31, 2013. Accepted presenters will receive a teaching stipend and reduced registration fees for Academy 2013 Seattle.

For more information and full submission guidelines, visit http://www.aaopt.org/meetings/academy2013/LWSubmission. For questions related to the submission process, please contact Melissa Leuschel at 321-710-3953 or by email at MelissaL@aaoptom.org.

There's Still Time! Register for GSLS 2013 Today.

The Global Specialty Lens Symposium is approaching fast. Plan to be there January 24-27, 2013, at the Rio All Suites Hotel and Casino, Las Vegas, Nevada. With an expert international faculty and a CE-accredited agenda, the 2013 GSLS will include a fundamentals pre-conference, insightful presentations by experts in the field, hands-on demonstrations of cutting-edge products, as well as scientific papers and posters and networking opportunities with your colleagues from over 30 different countries.

For more detailed information and registration visit www.GSLSymposium.com.

Ring In a Brighter New Year with the 2013 Eye Health Checklist from AllAboutVision.com

A new year is a time for reprioritizing. To encourage patients to make their eyes a priority in 2013, AllAboutVision.com has issued its 2013 Checklist for Better Vision and Eye Health.

The Checklist includes 22 simple steps people can take to better their long-term eye health, improve their visual acuity and comfort, and upgrade their appearance. Topics range from healthy eating and proper contact lens care to new eye-related apps for smartphones.

The 2013 Checklist for Better Vision and Eye Health, as well as a link to abridged one-page PDF available for ECPs to download and provide to patients, can be found at www.allaboutvision.com/resources/checklist.htm.

Scleral Lens-Induced Corneal Graft Edema
By Boris Severinsky, MOptom, Jerusalem, Israel

This is a photo of scleral lens-induced corneal graft edema in an eye with 12.00 diopter residual post-keratoplasty astigmatism.

We welcome photo submissions from our other readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit http://www.cltoday.com/upload/upload.aspx to upload your image. Please include an explanation of the photo and your full name, degree or title and city/state/country.

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Ronald K. Watanabe, OD, FAAO

What's in store for the New Year?
Happy New Year! 2012 was a banner year for contact lens designs and materials. We welcomed many great new products to help us with our patients. At least three new daily disposables were introduced including one sphere, one toric, and one multifocal. The sphere is made with a brand new material that does not contain silicone. Several new scleral lens designs were introduced, some targeting the "normal" cornea patient. And a couple of new soft lens designs for irregular corneas were brought to market, providing more good options for those who can't tolerate corneal GP lenses.

What do I see for 2013? I don't really know what new designs and materials will be introduced, but I anticipate more options in all types of contact lenses. Presbyopia is still a huge potential market, and new options are always welcome. I think we will see more daily disposable options, particularly multifocals, in addition to new scleral lens options, with more multifocal designs in this category as well. Finally, I think the custom soft lens market will continue to increase as better lens designs keep coming out.

I wish you all a healthy and prosperous (contact lens-wise) 2013!

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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

Effect of Daily Lens Replacement During Overnight Wear on Ocular Adverse Events
Ozkan and colleagues used a unique study design to try to disentangle the factors leading to adverse events during overnight wear with silicone hydrogel lenses. They enrolled a total of 215 subjects in India to wear lotrafilcon A silicone hydrogel lenses on a 30-night continuous wear schedule but had the subjects replace the lenses daily either each night before sleeping (n = 178 eyes) or each morning after waking (n = 252 eyes). They tracked the subjects for 1 month and compared them for adverse event rates to a historical control group of 191 eyes using the same site, subject demographics, and visit schedule but monthly lens replacement.

Interestingly, there was a significant reduction in mechanical adverse events (0.8 vs. 5.2%, p = 0.01) and overall mechanical adverse events (inflammatory and mechanical events) (4.0 vs. 8.9%, p = 0.04) when lenses were replaced each morning compared with being replaced monthly. Replacing lenses at night had no beneficial effects, the overall adverse events rate was 7.9% which was not significantly different from the historical control group.

A subset of subjects were asked to handle a lens after handwashing and the lenses were cultured; Staphylococcus aureus was cultured from the lenses of 35% of subjects, and 65% of subjects had more than 1000 colony-forming units per lens of gram-positive bacterial contamination. They concluded that morning lens replacement (compared to nightly) during overnight wear reduced mechanical and overall ocular adverse events likely because of contamination of the contact lens caused by lens handling just before overnight eye closure. Contact lens wearers on an extended wear schedule should be advised to minimize lens handling before sleep to reduce the risk of complications.

1. Ozkan J, Willcox MD, de la Jara PL, Mandathara PS, Rathi VM, Thomas V, Holden BA. The effect of daily lens replacement during overnight wear on ocular adverse events. Optom Vis Sci. 2012 Dec;89(12):1674-81. http://journals.lww.com/optvissci/toc/2012/12000

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UVB-Induced Epidermal Pigmentation in Mice Eyes with No CL Wear and Non-UVB Blocking and UVB Blocking CL Wear

Irradiation by ultraviolet (UV) B is known to increase the number of Dopa-positive melanocytes in the skin. This study examines the effectiveness of a contact lens for the defense of UVB eye irradiation-induced pigmentation.

A 2.5kJ/m(2) dose of UVB radiation was delivered by a sunlamp to the eye of C57BL/6j male mice, and changes in the expression of Dopa-positive melanocytes in the epidermis and the plasma level of alpha-melanocyte-stimulating hormone (alpha-MSH) was analyzed.

The degree of change in the Dopa-positive melanocytes expression was reduced by UVB blocking contact lens using mice given UVB irradiation to the eye. The plasma level of alpha-MSH increased in the C57BL/6j mice after irradiation to the eye, but there was no increase in the UVB blocking contact lens mice given UVB irradiation to the eye. Both the increase of the expression of Dopa-positive melanocytes and the plasma level of alpha-MSH were strongly suppressed by an alignment fitting UVB blocking contact lens and only a slightly suspended UVB blocking contact lens. In addition, these changes were successfully inhibited by a UVB blocking contact lens but not by a non-UVB blocking contact lens with a similar absorbance.

The researchers concluded that these observations suggest that the UVB blocking contact lens inhibits the pigmentation of the epidermis in mice by suppressing of the alpha-MSH.

Hiramoto K, Kobayashi H, Yamate Y, Ishii M, Sato T, Inoue M. UVB-induced epidermal pigmentation in mice eyes with no contact lens wear and non-UVB blocking and UVB blocking contact lens wear. Cont Lens Anterior Eye. 2013 Feb;36(1):28-31.

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Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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