March 19, 2006

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches more than 12,000 readers in 74 countries.

N.C. Law Mandating Eye Exams for Children On Hold
A Superior Court judge in Raleigh, N.C., signed an order this week that prevent the state from enforcing a new law that requires children to have an eye exam within six months of starting kindergarten. It specifies that the law may not be enforced until July 1, 2007 and prohibits any further court proceedings until October.
Judge Leon Stanback consolidated two lawsuits: one was filed on behalf of the North Carolina School Boards Association and local school boards; the other was filed by a parent. Opponents claim the exams are too expensive and unnecessary because children are already required to have a vision screening before entering school. They want the law declared unconstitutional, arguing that it denies children a free public education and creates an unreasonable barrier to access to public schools.

Antibiotic Effective Against Trichiasis
Results of a recent study sponsored by the National Eye Institute show a single dose of oral azithromycin after surgery reduces the rate of recurrence of trichiasis by 33%. Every year, an estimated 11 million people worldwide develop trichiasis, often caused by trachoma. The World Health Organization (WHO) had previously endorsed a multi-faceted strategy to control trachoma that included a six-week regimen of tetracycline ointment. The new findings may improve treatment because most countries with widespread trichiasis now have access to a free azithromycin distribution program.

AOA Paraoptometric Section Seeks Nominations
The American Optometric Association (AOA) Paraoptometric section is accepting nominations for its annual Community Service Award until April 28th. The award honors one member who has generously donated his or her time and talent to the profession. The recipient will receive a plaque of recognition, a $100 cash award and a $100 for the charity of his or her choice. The award will be presented at the Paraoptometric Section Awards luncheon during the 109th annual AOA Congress in June.

A Combination of Wettability and Lubricity
The world can be a dry place — especially for contact lens wearers. Whether sitting at home, in an office or on a plane, some lens wearers must repeatedly use rewetting drops to keep their eyes moist, or limit lens wear because of the discomfort. ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR™ Plus decrease patients’ reliance on rewetting drops and lets them wear their lenses longer and more comfortably. ACUVUE® OASYS™ Brand Contact Lenses, with the breakthrough material senofilcon A, are the smoothest silicone hydrogel lenses, with a moisture-rich wetting agent and no surface coating. ACUVUE® OASYS™ Brand Contact Lenses, with the balance of wettability and lubricity, will keep patients wearing their lenses, and not grabbing for their eye drops.


Abstract: Therapeutic Use of Silicone Hydrogel CLs in Children
Researchers in the U.K. performed a prospective, non-randomized study to evaluate the safety and efficacy of silicone hydrogel extended-wear contact lenses when used therapeutically in children. They fit 29 pediatric patients with anterior segment disorders with silicone hydrogel contact lenses. Conditions treated included burn (seven eyes), corneal erosion (three eyes), neurotrophic keratitis (four eyes), descemetocele (one), corneal ulcer (one), keratouveitis (one), herpetic keratitis (one), corneal perforation (two eyes) and corneal injury (seven eyes). Total bandage wear was effective in 93% of eyes (27 of 29). One patient with herpetic keratitis experienced increased inflammation and ceased lens wear after 24 hours. The researchers conclude that silicone hydrogel contact lenses are safe and efficacious for therapeutic use in children on a continuous-wear basis.
Bendorien J, Vogt U. Therapeutic use of silicone hydrogel contact lenses in children. Eye Contact Lens. 2006 Mar;32(2):104-8.

Editor's Commentary: Silicone Hydrogel Lens Handling
Some of these thoughts and suggestions are theoretical, some are based on clinical experience or on recent clinical results. Make sure your hands and fingers are clean before you handle these lenses. The same goes for your patients. Before handling, consider rinsing fingers with modern solutions that have been tested with silicone hydrogels. Finally, consider applying a good dry eye product on the eye prior to applying these lenses or other modern hydrogels. You may ask why all of this is necessary. My response: to gain all of the benefits.

Fitting Tip: Pearls For GP Lenses
Be sure to have a wratten filter to use with your slit lamp and new materials. The slit lamp blue filter alone doesn't show as good a flourescein pattern.
Don't ignore edge lift. Although many labs have design defaults, look carefully at the edge of the lens relative to the cornea. It can mean the difference between a lens that is well positioned and comfortable and one that is not.
Don't be afraid to go with a larger diameter, even if it means the lens doesn't move or vent as well. With today's highly breathable materials, less movement can still properly oxygenate the healthy cornea. And, less movement could be more comfortable and optically acceptable.
Laney Brown, O.D.
Minneapolis, Minnesota

This month at, consider the impact that lens care products can have on comfort; compare the characteristics of lysozyme deposition on various contact lens materials; and compare the corneal staining characteristics of various lens-solution combinations.

Report adverse contact lens reactions here: or call (800) FDA-1088.

Access a reporting form for complications you've seen that were a result of contact lenses dispensed without a valid prescription at the Association of Regulatory Boards of Optometry's (ARBO's) Web site: Complete and send the form online or print it out and fax it to (866) 886-6164.

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