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Sunday, March 22, 2015  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
One of the things that I find most critical in patient management is communication—in fact, it probably goes without saying that open communication is key to success in most facets of life. There is no doubt that your staff play a key role in communication with your patients—whether it relates to contact lens follow-up visits or when a patient should consider removing their contact lenses to avoid a problem, communication is key to success. Make sure you and your staff are diligent stewards of communication to ensure your patients’ success.

Actavis Completes Allergan Acquisition

Actavis plc has completed the acquisition of Allergan, Inc. in a cash and equity transaction valued at approximately $70.5 billion. According to Actavis, the combination creates one of the world's top 10 pharmaceutical companies by sales revenue, with combined annual pro forma revenues of more than $23 billion anticipated in 2015.

Actavis continues to expect the transaction to generate double-digit accretion to non-GAAP earnings within the first 12 months, including approximately $1.8 billion in operating and financial synergies to be realized within one year following the close. These synergies exclude any additional revenue or manufacturing synergies, and are in addition to the $475 million of annual savings previously announced by Allergan in connection with Project Endurance. Actavis further expects to generate strong operating cash flow in excess of $8 billion in 2016, which would enable the Company to rapidly delever the balance sheet.

Actavis plc, headquartered in Dublin, Ireland, is a global pharmaceutical company with commercial operations in approximately 100 countries. The company is focused on developing, manufacturing and commercializing innovative branded pharmaceuticals, high-quality generic and over-the-counter medicines, and biologic products for patients around the world.

Actavis intends to adopt a new global name – Allergan – pending shareholder approval in 2015. For more information, visit Actavis' website at

A Few Minutes of Your Time Please
There has been a growing academic interest in myopia management over the past few years, but there is little information on what is actually happening in clinical practice. As part of an global initiative supported by the British Contact Lens Association, Contact Lens Spectrum, Optometry Australia, and the International Association of Contact Lens Educators amongst many others, a survey on myopia management has been developed. We would value just five minutes or less of your time to complete the survey at to share your current thoughts and practice. The information gathered will allow us to report back what is happening across the globe as well as what your peers are thinking/doing. Thank you in advance for your time.
New Duette Practitioner Videos from SynergEyes

SynergEyes, Inc. has released new practitioner interview videos on their experience with Duette contact lenses for astigmatic patients and Duette Progressive for presbyopic patients. The videos capture eight optometrists answering a variety of questions on topics such as: advice for new Duette fitters, presenting Duette to patients, the difference between Duette and a soft toric, Duette insertion and removal tips, the role of staff in Duette success, Duette for athletes, and more. The ODs share insights with other practitioners to help them achieve success with Duette, and also explain how Duette has had a positive impact on both patient satisfaction and their businesses.

The Duette videos, each no more than a few minutes in length, are available through the “Colleague Comments” link on the homepage of They can also be accessed directly at:

Hague Joins Alden Consultation Team

Alden Optical announced that Mika Hague, FCLSA, NCLE-ADV has joined the company as a Product Specialist. Ms. Hague’s primary responsibility is to consult with eyecare practitioners on complex specialty fitting towards successful outcomes with Alden designs. She brings substantial fitting experience to Alden with 20 years of hands-on specialty fitting in renowned clinics including Dean McGee Eye Institute in Oklahoma City.

Alden Optical manufactures premium specialty and made-to-order soft and gas permeable contact lenses. The company’s design portfolio includes HP Toric, Astera Multifocal Toric, NovaKone and Zenlens scleral. Additionally, Alden distributes BioColors, a custom tinted lens that is co-produced by Alden Optical and The Orion Vision Group. Ms. Hague can be reached at 800-253-3669.

LensFerry Begins Rollouts in New York and California

Following successful initial market testing, WebSystem3 announced at Vision Expo East that its LensFerry service is now available to select optometry practices in New York and California. WebSystem3 plans to introduce the service to additional practices and geographic markets using a phased approach over the coming months.

LensFerry is the first and only mobile commerce solution specifically developed for eyecare practitioners that allows patients to order contact lenses via a mobile device, tablet or computer for direct shipment to their homes. As part of WebSystem3’s EyeCare Prime suite of services, LensFerry includes contact lenses from all manufacturers at eyecare professionals’ specified prices, and the prescribing practice receives the sales revenue as if the lenses had been ordered in-office. All LensFerry communications are customized for each individual practice, incorporating the practice’s name and/or logo.

For more information, visit

CDC Spring Break Contact Lens Health Tips a Success

Centers for Disease Control and Prevention (CDC) and partners implemented a social media campaign to raise awareness about poor contact lens hygiene habits that can arise during vacation and times of travel. The campaign targeted college-age contact lens wearers and took place the week of March 2-6, just prior to many universities’ Spring Break. Key messages included:

  • Take contact lenses out before bed, even when staying up late or traveling.
  • Bring enough contact lens supplies and a spare pair of glasses when traveling.
  • Take out contact lenses before swimming or showering.
  • All contact lenses require a prescription from an eyecare provider.

CDC disseminated campaign messages and materials through web and social media channels, including:Contact Lens feature on CDC main website with tips added for Spring Break; Social Media Library updated with Spring Break Contact Lens Health Tips; contact lens wear and care recommendations added to Women’s Health, Men’s Health, and Spring Break CDC websites; plus Facebook posts and Tweets.

Twenty-two partner organizations from academic, public health, nonprofit, and industry sectors disseminated contact lens health messages via website postings, social media, and email announcements. Fifty percent of organizations were new partners that had not previously collaborated with CDC’s Healthy Contact Lenses Program.

Scleral Lens Patient with Severe Dry Eye
Stephanie Woo, OD, FAAO, Lake Havasu, AZ

A patient with severe dry eye was fit with a scleral lens. The mucous under the lens is different than typical scleral lens fogging, hers is related to severe dry eye.

We thank Dr. Woo for this image and 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 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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Susan J. Gromacki, OD, MS, FAAO

Scleral Lenses and Hydrogen Peroxide

Since a scleral gas permeable lens has less tear exchange than a corneal one, it must be filled with a nonpreserved solution prior to application. Along the same lines, some scleral patients prone to hypersensitivities find greater success with the modality if all preservatives are prevented from entering the eye. This can be accomplished by using a nonpreserved saline or artificial tear to completely rinse off the disinfection solution, or by using a nonpreserved disinfection system, such as hydrogen peroxide.

Currently, there are hydrogen peroxide systems approved for use with GP lenses. It must be noted that their “no rub” approval is for soft contact lenses only. With GP lenses, a digital rubbing step needs to be performed first—which is what I recommend for scleral lenses anyway, no matter which disinfectant is utilized.

2. Gromacki SJ. A How-To Guide: Scleral GP Lens Care. Review of Cornea and Contact Lenses, 2013; January-February;150(1):22-24.
3. Gromacki SJ. Handling and Care of Scleral GP Contact Lenses, Part 2. Contact Lens Spectrum 2012;27(1):19.
4. Gromacki SJ, Ward MA. Understanding Contemporary Contact Lens Care Products. Contact Lens Spectrum, Volume: 28 , Issue: June 2013, page(s): 20 – 25.

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David Kading, OD, FAAO

Happy Swimming!

On a recent trip to Mexico I thought about the age old contact lens question: what's a contact lens wearer to do when they want to swim in the ocean, lake, or pool? They could buy expensive lenses for their swimming goggles which they might not use all that often or disregard their eyecare provider’s advice to not wear contact lenses while swimming. We know from several studies that contact lenses become laden with microbes after swimming in them. So what is one to do? One thought is to do ortho-k, if the individual is a good candidate, as it eliminates the need for lenses all together. But, what if ortho-k isn't an option? Although not ideal, one might also consider single use lenses, either all the time or while on vacation, and have the patient replace them as soon as he or she finishes swimming. First and foremost it is our responsibility to educate on the risks and talk to our patients about why they should not wear contact lenses while swimming, and then to provide them the best options that will match their needs.

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Oral Omega-3 Fatty Acid Treatment for Dry Eye in Contact Lens Wearers

The aim of this study was to evaluate the effect of dietary omega-3 fatty acid (O3FA) supplementation on dry eye symptoms, tear film tests, and conjunctival impression cytology in patients with contact lens wear-associated dry eye.

In this randomized, double-blind, multicentric trial, contact lens wearers (n = 496) were randomized to receive either O3FAs or placebo capsules (corn oil) twice daily for 6 months. Subjects underwent examinations at baseline, 3 months, and 6 months. At each visit, a questionnaire of dry eye symptoms and lens wear comfort was administered. Subjects further underwent measurement of tear film break-up time (TBUT) and a Schirmer test. Conjunctival impression cytology was performed by the transfer method. Improvement in symptoms and lens wear comfort were primary outcome measures. Changes from baseline in TBUT, Schirmer, and Nelson grade at 6 months were secondary outcome measures.

The mean improvement in symptom score in the O3FA group was 4.7 ± 2 (2.0) as compared with 0.5 ± 2 (0.9) in the placebo group (P < 0.0001). Lens wear comfort levels improved significantly (P < 0.0001) from baseline. There was a significant increase in TBUT [3.3 ± 2 (1.5)] and Nelson grade [0.7 ± 2 (0.6)] in the O3FA group (P < 0.0001) as compared with 0.3 ± 2 (0.6) and 0.1 ± 2 (0.4) in the placebo group (P = 0.164 and 0.094, respectively). However, the magnitude of increase in Schirmer score [2.0 ± 2 (1.5)] was relatively small (P = 0.08).

The researchers concluded that the results of this study point toward benefits of orally administered O3FAs in alleviating dry eye symptoms, improving lens wear comfort, and cytological changes in contact lens wearers.

Bhargava R, Kumar P. Oral Omega-3 Fatty Acid Treatment for Dry Eye in Contact Lens Wearers. Cornea. 2015 Feb 18. [Epub ahead of print]

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