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Sunday, January 20, 2013 
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Last question:
Do you think daily disposable lens wearers are more likely to purchase their contact lenses on the internet than patients wearing other replacement schedules?

 1. Yes

 2. No

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

Internet filling of contact lens prescriptions, and now spectacles as we've seen in the last couple years, continues to grow year after year. The data from this past week's Quick Poll is quite interesting in that almost 50% of respondents believe that patients who are prescribed daily disposables are more likely to fill their prescription over the internet. I think growth in internet sales of contact lenses (and spectacles) should serve as a reminder of just how important your professional service fees really are.

Springer Adis US LLC Vision Care Assets Acquired by Management Group

Springer Adis US LLC announced the asset purchase of its Vision Care Group of media and events, including Contact Lens Spectrum magazine and its e-mail newsletter Contact Lenses Today, by a new company formed by the Vision Care Group's publishing management team. The new company, PentaVision LLC, is based in Ambler, Pennsylvania. Terms of the deal were not disclosed.

PentaVision will continue to produce all Vision Care Group conferences and electronic products, as well as the six magazines in its portfolio: Contact Lens Spectrum, Eyecare Business, Ophthalmology Management, Optometric Management, Ophthalmic Professional and Retinal Physician. The PentaVision management includes Mark Durrick, Douglas Parry, Robert Verna and Roger Zimmer, all currently operating units within the Vision Care Group at Springer. In addition, Thomas J. Wilson, a former owner of the Vision Care Group with BCI until 1999, will act as president of PentaVision and Managing Member of the LLC.

Springer acquired the Vision Care Group in December, 2011 as part of a larger divisional acquisition from Wolters Kluwer.

SynergEyes Names Kirchner Senior Vice President, Clinical and Professional Services

SynergEyes, Inc. announced that James Kirchner, OD has been promoted to the position of Senior Vice President of Clinical and Professional Services.

In this role, Dr. Kirchner will provide professional leadership of product development and product management. Additionally, he will leverage established industry relationships and industry knowledge to position the company's products in the marketplace, while also representing SynergEyes to the eyecare professional community. As the ECP member on the senior management team, he will advise on matters related to the eye care profession and contact lenses.

Prior to joining SynergEyes, Dr. Kirchner was Chief Professional Officer for Eyefinity/OfficeMate, a VSP Global company. He has also been President and CEO of over a dozen start-up companies. Dr. Kirchner has taken an active role in state, regional and national optometric association volunteerism throughout his career.

Onsite Registration Available or Register Now
for GSLS 2013!

The Global Specialty Lens Symposium is almost here. 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.

Healthy Vision... Podcast Highlights the Impact of Nutrition on Vision and Eye Health

On the new edition of Healthy Vision with Dr. Val Jones, optometrist, author and President of the Ocular Nutrition Society, Jeffrey Anshel, OD, and leading nutrition researcher Elizabeth Johnson, PhD, join Dr. Val to talk about nutrition and its impact on vision and eye health.

On this podcast, the two experts review what nutrients are important for your eyes, why they are important, and how much of them we should be taking in as part of our overall diet. Additionally, Drs. Anshel and Johnson offer advice about vitamins and nutritional supplements - who may need them, when to take them, and how to choose the right ones for you.

Free podcasts of Healthy Vision with Dr. Val Jones can be found on BlogTalk Radio (www.blogtalkradio.com/healthyvision) and on AllAboutVision.com (http://www.allaboutvision.com/healthy-vision/ )

Paraoptometric of the Year and Community Service Awards Nominations Sought

The American Optometric Association's (AOA) Paraoptometric Section is seeking nominations for the Paraoptometric of the Year Award.

The award is given annually to the optometric assistant or technician who has made outstanding and worthwhile contributions to the profession of optometry, paraoptometry, and the general public. The nominee's accomplishments are reviewed in the following categories: service to optometry and paraoptometric associations, participation in public service activities and personal endorsement by the nominating individual.

The award will be presented on June 28, 2013 during Optometry's Meeting in San Diego, California. The winner will be featured in a video and will receive a plaque, round-trip airfare to the meeting, three nights' lodging at the headquarters hotel, and $500 to help defray the travel expenses. Nominations must be received by AOA on or prior to February 1, 2013. For a nomination form or more information, please contact the AOA Paraoptometric Section at 800-365-2219, ext. 4108 or e-mail MRHarper@aoa.org.

The Paraoptometric Section is also seeking nominations for the 2013 Community Service Award. The award is given to the paraoptometric who demonstrates a commitment to helping improve his or her community and a dedication to the profession of paraoptometry. Criteria for judging include the individual's involvement in community service within the optometric practice and the community, as well as, the individual's personal and professional goals of community service.

The recipient will be presented a plaque of recognition, a $100 personal award, and a $100 award to the charity of the recipient's choice during the Paraoptometric Section Awards Reception at Optometry's Meeting.

To download a nomination form, go to www.aoa.org/x4979.xml. Completed nomination forms should be submitted by March 31, 2013.

Injury of a Mini-scleral Contact Lens Wearer
By Brad A. Altman, OD, Mt. Juliet, TN

This photo shows a sports-related injury of a mini-scleral contact lens wearer. This 13 year-old girl was poked in the eye with a finger and fingernail during a basketball event. The force of the trauma broke the lens. One half immediately came out of the eye. The other half rested nicely in place, superiorly. The player noted that the finger poked the center of the eye and slid towards the outside corner.

As seen in the photo, the cornea was completely unaffected. The trauma occurred where the nail came in contact with the eye, but the cornea was protected.

We thank Dr. Altman for his image and 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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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

The Development of Silicone Hydrogel Contact Lenses: A Review Worth Reading
Many of you reading these columns have only practiced in the silicone hydrogel lens era. I recall the launches of the first generation silicone lenses,
lotrafilcon-A and balafilcon-A, which some argue to be the greatest game changers in our field in the last quarter century. Although silicone hydrogel lenses are not without their curiosities and incompatibilities, I can't imagine practicing without them. Professor Brian Tighe, who has just published a review (ahead of print), is uniquely qualified to summarize their development. In this review, he discusses the distinctive surface and mechanical properties of silicone hydrogels, in which advantages of enhanced oxygen permeability, reduced protein deposition, and modest frictional interaction are balanced by sometimes increased lipid and elastic response. He also discusses water content and the progressive rise from lotrafilcon-A (24%) to efrofilcon-A (74%), moduli which have decreased from 1.4 to 0.3 MPa, and ingenious approaches to achieve greater lubricity and lower contact angle hysteresis.

This excellent review balances Professor Tighe's unbiased perspective with readable science. No one is better suited to review this topic and now commonplace polymer technology.

1. Tighe BJ. A decade of silicone hydrogel development: surface properties, mechanical properties, and ocular compatibility. Eye Contact Lens. 2013 Jan;39(1):3-11.

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Ronald K. Watanabe, OD, FAAO

HVID Can Make a Difference
When fitting contact lenses, we always (I hope) take keratometry readings or perform corneal topography to help us determine the best lens parameters for the patient. Often overlooked but of equal importance is corneal diameter or horizontal visible iris diameter (HVID). Most "normal" corneal diameters are within the range of 11 to 12 mm, but occasionally we will get a patient with an unusually small or large HVID. This can have a huge impact on the way a lens fits, and we have to make the appropriate adjustments in lens design to attain a good fitting relationship.

Conceptually, we should think about how HVID (and corneal curvature) impact the eye's sagittal depth. A large cornea will have a greater sag than a small cornea, so a lens fitted to a large cornea should have a greater sag. When we are using a lens that is available in only one diameter but several base curve choices, the larger cornea should be fitted with a steeper base curve while the smaller cornea should be fitted flatter. Of course, if you have the ability to adjust lens diameter too, the base curve / diameter relationship can be optimized for each cornea. Keep this relationship in mind when you encounter an unusual corneal size.

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Cost of IOL vs. CL Treatment after Unilateral Congenital Cataract Surgery: Retrospective Analysis

These authors wanted to describe the differences in treatment costs for infants randomized to contact lens correction versus primary intraocular lens (IOL) implantation after unilateral cataract surgery in the Infant Aphakia Treatment Study (IATS). The study is a retrospective cost analysis of a prospective, randomized clinical trial based on Georgia Medicaid data and the actual costs of supplies used. The IATS is a randomized, multicenter (n=12) clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with unilateral congenital cataract. Infants underwent cataract surgery with or without placement of an IOL. The mean cost of cataract surgery and all additional surgeries, examinations, and supplies used up to 12 months of age were incldued.

The mean cost of treatment for a unilateral congenital cataract with primary IOL implantation was $14,752 versus $10,726 with contact lens correction. The initial cataract surgery accounted for approximately 50% of the treatment costs for both groups. Contact lens costs accounted for 15% ($1,600/patient) in the aphakic group, whereas glasses costs represented only 4% ($535/patient) in the IOL group. The increased costs in the IOL group were primarily due to the higher cost of cataract surgery in this group ($7,302 vs. $5,357) and the cost of additional operations.

The researchers concluded that for IATS patients up to 12 months of age, cataract surgery coupled with IOL implantation and spectacle correction was 37.5% (approximately $4,000) more expensive than cataract surgery coupled with contact lens correction.

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Carrigan AK, Dubois LG, Becker ER, Lambert SR. Cost of Intraocular Lens versus Contact Lens Treatment after Unilateral Congenital Cataract Surgery: Retrospective Analysis at Age 1 Year. Ophthalmology 2013;120:14-9.

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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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For more information on Contact Lenses Today including archives of previous issues, please visit our website at www.cltoday.com. For the latest articles on contact lenses, important clinical information and helpful tools related to the contact lens practice visit the Contact Lens Spectrum website at www.clspectrum.com.

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