CONTACT LENSES TODAY

February 9, 2003

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches 9,303 readers in 74 countries.

Report Illegal CL Complications Online
You can now report complications caused by contact lenses that patients bought without a valid prescription. The Association of Regulatory Boards of Optometry (ARBO) developed an online form, which is available at http://www.arbo.org/complications.htm. The form asks you for the patients presenting signs and symptoms, your course of treatment and the outcome. Complete and submit the form online or print it out and fax it to (866) 886-6164. In fulfilling its mission of protecting the health of the public, ARBO will gather the data that you and other prescribers report and will make it available to the attorneys general, other licensing agencies, state legislators and other interested persons.

Gelflex Introduces Quarterly Replacement Custom Toric
Gelflex Laboratories recently launched its custom-manufactured, quarterly replacement toric contact lens, Synergy. Synergy Toric is packaged in a 1+3 modality, where you order the initial lens, and upon your completion of the initial lens fitting, you then order a three pack that's manufactured to exact specifications.

Alcon's OPTI-FREE EXPRESS NO RUB MPDS Lasting Comfort Formula: Wetter, Fresher, Longer. Opti-Free Express is the first no-rub solution with long-lasting comfort for all soft contact lenses including silicone hydrogels. In a randomized, controlled clinical study, more patients using Opti-Free Express report that their lenses feel comfortable at the end of the day than patients using ReNu MultiPlus*. Opti-Free Express contains Tetronic* 1304, a special hydrating ingredient that allows lenses to retain more moisture for lasting comfort. For more information, contact Alcon at (800) 451-3937 or visit http://www.norub.com.
* ReNu MultiPlus and Tetronic are trademarks of other companies.
--ADVERTISING

OTC Diabetes Test Approved
The FDA recently cleared Metrika, Inc. to make its A1cNow diabetes monitor available to patients over the counter. The pager-size A1cNow Monitor provides quantitative glycated hemoglobin (HbA1c or A1C) results in just eight minutes from a small drop of blood. The monitor is currently available through mail order for a retail price of $22 to $25. It will soon become available in pharmacies nationwide. Direct your diabetic patients to call (877) 212-4968 or to visit http://www.A1CNow.com for more information.

Abstract: CL Wear Causes Cytological Changes
In evaluating the cytological changes in the conjunctiva following regular contact lens wear, researchers from the Department of Ophthalmology at the Christian Medical College and Hospital, Ludhiana in Punjab, India, sought to determine the correlation, if any, between severity of cytological alteration and symptoms related to contact lens wear. The researchers followed 100 eyes in 50 normal, asymptomatic subjects and studied the conjunctival impression cytology (CIC) before and after fitting each subject with either gas permeable or soft contact lenses at three and six months. They found that the severity of cytological changes increased with the duration of lens wear (P = 0.00001). Epithelial changes occurred within three to six months of contact lens fitting. Soft contact lens wearers, although asymptomatic, showed severe CIC changes.
Simon, P; Jaison, S.G.; Chopra, SK; and Jacob, S. Conjunctival Impression Cytology in Contact Lens Wearers. Indian J Ophthalmol 2002 Dec;50(4):301-6.

Editor's Commentary: Sharing Fee Information
We're working on an article for Contact Lens Spectrum on contact lens fees. Our fee surveys in the past have been a source of great interest to many readers. This year, we'll feature a summary of a few fee schedules from three diverse practices and we'll have a feature article on how to establish fees using a medical model. Of course I always think of what Neal Bailey used to say, "Yeah, but do practitioners really follow their fee schedules or do they make too many deals" (to give away their services)? In this day of reduced margins on lenses because of increased competition and directives from third parties, as most eyecare business consultants tell us, your contact lens prescribing, fitting and follow-up services have great value. You better charge for them.

Fitting Tip: Consider a Bifocal for Monovision Patients
In response to your comments in "Good Old Monovision" (CLToday January 19, 2003, Editor's Commentary), I agree that the best thing we can do is listen to our patients. They will often show us whether we need to make a change. However, for monovision patients (particularly those who insert and remove contact lenses at work), I describe the possible benefit of switching to a bifocal contact lens, even if it's just to use it in lieu of the near lens. To introduce the option, I ask the patient, "How would you like it if I gave you back some of your distance vision while maintaining your ability to read?" In doing so, patients are educated about the option and the added benefit may take them from being "thrilled" to being "ecstatic" with the care they receive.
-- Stephen Cohen, O.D.
Scottsdale, Ariz.

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