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Sunday, April 6, 2014  
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What percent of your contact lens wearers also have seasonal allergies (i.e., hay fever)?





 > 20%

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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
If you think about life, it seems that as though we are constantly looking for ways to simply things and improve efficiencies. Think about trends in consumer goods—3 in 1 shampoo/condition/body wash, tie-less shoes for men and kids, cameras in smartphones, prepackaged lunches for kids. The list goes on and on. Certainly that is one of the main focuses of the introduction of new technologies. While improving efficiency is important to our patients, we also do not want to compromise safety and comfort of our patients. Think about this balance as you consider practice strategies and education of patients.

CooperVision Collaborates with the AOSA to Connect Students with Clinical Opportunities through Adopt-a-Patient Program
CooperVision, Inc. is collaborating with the American Optometric Student Association (AOSA) to raise awareness of the company’s Adopt-a-Patient program. The initiative is focused on optometry students across the United States, giving them an opportunity to develop clinical experience while helping people who need vision correction and care in communities near participating universities.

The Adopt-a-Patient program, which started in 2007, allows primarily third- and fourth-year optometry students to gain clinical experience by examining and fitting eligible patients in CooperVision's contact lenses, and providing them with follow up care. Patients receive a complimentary year’s supply of their prescribed lenses from CooperVision. Vision Service Plan (VSP) subsidizes the cost of the exam.

AOSA will create a featured page regarding the Adopt-a-Patient program on its website, will publish an article featuring the program in its national magazine, Foresight, give the program presence on its Facebook page, and offer program administrative support.

According to students, the program is much more than free contact lenses; it’s about improving lives. They have found participants who are struggling in school, or feel restricted in their ability to play sports because of the limitations of glasses, or even have been teased for wearing glasses. The students’ ability to enhance lives by providing contact lenses not only reinforces clinical principles, but also helps them see the life-changing power of the profession.

Optometry school students and faculty who want to take part can email Mark Andre, FAAO, director of academic affairs for CooperVision (mandre@coopervision.com) for more information.

Paraoptometric Training Resource Available for AOA Members and Associate Members
The American Optometric Association’s (AOA) Paraoptometric Resource Center has made available the Paraoptometric Skill Builder Training Program, a package consisting of three audio CDs that help train optometric staff to run the office and work with patients as efficiently as possible.

The Paraoptometric Skill Builder Training Program covers a variety of topics for various job responsibilities in 20-minute units. The “start and stop” feature allows staff to pick up where they left off in their last session. Questions are sprinkled throughout the units, and a final review quiz at the end is used to measure retention of all the information covered on the CD. All three levels of the Paraoptometric Skill Builder Training Program are supported by Johnson & Johnson Vision Care, Inc., through an education grant.

As an AOA associate member benefit—AOA member ODs may enroll their optometric staff as AOA associate members at no charge—the beginner level CD is offered online for free, and discounted member pricing is also offered on the intermediate and advanced level CDs. Bundling options are also available for additional member savings.

According to the U.S. Bureau of Labor Statistics, by the year 2020, the number of ophthalmic assistant jobs will increase by 31 percent, and optician and optical dispensing jobs will grow by 24 percent. Lori Kindschy, CPOT, Paraoptometric Resource Center Executive Committee chair, in announcing the program noted that, with paraoptometric job opportunities growing, the Paraoptometric Skill Builder Training Program is a beneficial tool to have in the office. When training a new employee, usually either the optometrist or the office manager must take time away from their key responsibilities, and unless the practice has a step-by-step staff training manual, there is room for inconsistency in sharing information from one staff person to another.

If you are an AOA member or associate member and would like to order the Paraoptometric Skill Builder Training Program, click here to go to the AOA Marketplace. For questions regarding the program, please contact the Paraoptometric Resource Center at PRC@aoa.org or call 800-365-2219, ext. 4108.

CooperVision Presents 2nd Annual Science and Technology Awards Program
For the second consecutive year, CooperVision is offering the CooperVision Science and Technology (S&T) Awards Program. The goal of this awards program is to bring recipients and CooperVision scientists together to explore new areas of technology advancement in contact lens applications.

The CooperVision S&T Awards Program is comprised of two awards: The CooperVision Seedling Award and the CooperVision Translational Research Award. Research proposals should demonstrate significant potential for research discoveries and technological advancements that CooperVision can rapidly commercialize to improve the performance, enhance the functionality, and/or broaden the use of contact lenses.

The CooperVision Seedling Award is intended to incentivize collaborations with CooperVision in a new research area for a one-year period. The award enables investigators to generate preliminary data that could be used toward a future CooperVision Translational Research Award. The maximum total cash amount for a CooperVision seedling is $100,000, including indirect costs.

A CooperVision Translational Research Award is a multi-year award for a substantive translational research project. Research under this award is milestone-driven in order to remain focused on a well-defined goal. A CooperVision Translational Research Award provides funding for up to two years, totaling up to $400,000, including indirect costs. A maximum of $250,000 can be requested for any one year. A CooperVision Translational Research Award may be considered for renewal at the end of the initial research period.

For information on the application process and materials, please visit http://coopervision.com/our-company/science-and-technology-awards.

Demodex Mites
Nathan Schramm, OD, CNS, Weston, Florida

Patient complained of itchy eyes, especially at night time. Epilation of two eyelashes from each eye were examined under a microscope and the picture shows an active critter. Demodex mites are known to cause increases in ocular allergies when the lights are turned off because they come out of the lash follicles to lay their eggs. Patient is to begin treatment with tea tree oil shampoo on scalp, Oasis lid foam every night on eye lids and every morning to use Cliradex lid scrubs. Follow up in one month.

We thank Dr. Schramm 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 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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Susan J. Gromacki, OD, MS, FAAO

New Product: PeroxiClear

Bausch + Lomb introduced PeroxiClear 3% hydrogen peroxide cleaning and disinfecting solution in the United States this month.

Neutralization of the H2O2 is achieved with a catalytic disc and takes only four hours. The case is unique in that the lens baskets are colored white for the right eye and green/teal for the left eye. In addition, lenses are placed onto the part of the lens basket that swings open 90 degrees, rather than onto its central core.

PeroxiClear contains three separate wetting agents. The “Enhanced Moisture Formula” with “Triple Moist Technology” includes Poloxamer 181 to attract and retain moisture, Propylene glycol to bind water, and Carbamide to moisturize and prevent dehydration.

In addition, Poloxamer 181 serves as a surfactant to aid in cleaning. The system is FDA-approved for no rub with soft contact lenses (after a required rinse). It is also approved, with a digital rubbing step and rinse, for gas permeable contact lenses. It will be available in April at Target, Rite-Aid and K-Mart; in May at Walmart, Walgreens and CVS; and in June at most smaller retailers.

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Katherine M. Mastrota, MS, OD, FAAO

Kiss and Tell

Nocturnal lagophthalmos is inadequate closure of the eyelids during sleep. Lagophthalmos is associated with exposure keratopathy, poor sleep, and persistent exposure-related symptoms. There are a variety of causes of lagophthalmos, grouped as proptosis/eye exposure etiologies and palpebral insufficiency etiologies. Although obvious lagophthalmos is usually detected, it is sometimes difficult to recognize obscure lagophthalmos, due either to eyelash obstruction or overhang of the upper lid anterior and inferior to the most superior portion of the lower lid in a closed position.1

When nocturnal lagophthalmos is suspected, ask the patient if they have ever been told that they “sleep with their eyes open”. Often patients will validate your suspicion and reply in the affirmative, usually with a humorous anecdote. Recently I was sure that a symptomatic patient suffered from nocturnal lagophthalmos. I posed the aforementioned query and she replied that she has never been told that she sleeps with her eyes open. I continued on with the exam a bit disappointed that I did not glean evidence for my theory. Then my patient had a revelation: she recounted that her boyfriend asked her why she always kissed him with open eyes. I surmised that similarly she doesn’t completely close her eyes when sleeping. So there you have it: a new question for the patient with telltale inferior corneal staining.

1. Latkany RL, Lock B, Speaker M. Nocturnal lagophthalmos: an overview and classification. Ocul Surf. 2006 Jan;4(1):44-53.

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Short-Term Changes in Ocular Biometry and Refraction after Discontinuation of Long-Term Orthokeratology

The researchers’ objective was to assess refractive and biometric changes 1 week after discontinuation of lens wear in subjects who had been wearing orthokeratology (OK) contact lenses for 2 years.

Twenty-nine subjects aged 6 to 12 years and with myopia of -0.75 to -4.00 diopters (D) and astigmatism of <=1.00 D participated in the study. Measurements of axial length and anterior chamber depth (Zeiss IOLMaster), corneal power and shape, and cycloplegic refraction were taken 1 week after discontinuation and compared with those at baseline and after 24 months of lens wear.

A hyperopic shift was found at 24 months relative to baseline in spherical equivalent refractive error (+1.86±1.01 D), followed by a myopic shift at 1 week relative to 24 months (-1.93±0.92 D) (both P<0.001). Longer axial lengths were found at 24 months and 1 week in comparison to baseline (0.47±0.18 and 0.51±0.18 mm, respectively) (both P<0.001). The increase in axial length at 1 week relative to 24 months was statistically significant (0.04±0.06 mm; P=0.006). Anterior chamber depth did not change significantly over time (P=0.31). Significant differences were found between 24 months and 1 week relative to baseline and between 1-week and 24-month visits in mean corneal power (-1.68±0.80, -0.44±0.32, and 1.23±0.70 D, respectively) (all P<=0.001). Refractive change at 1 week in comparison to 24 months strongly correlated with changes in corneal power (r=-0.88; P<0.001) but not with axial length changes (r=-0.09; P=0.66). Corneal shape changed significantly between the baseline and 1-week visits (0.15±0.10 D; P<0.001). Corneal shape changed from a prolate to a more oblate corneal shape at the 24-month and 1-week visits in comparison to baseline (both P<=0.02) but did not change significantly between 24 months and 1 week (P=0.06).

The researchers concluded that the effects of long-term OK on ocular biometry and refraction are still present after 1-week discontinuation of lens wear. Refractive change after discontinuation of long-term OK is primarily attributed to the recovery of corneal shape and not to an increase in the axial length.

Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutiérrez-Ortega R. Short-term changes in ocular biometry and refraction after discontinuation of long-term orthokeratology. Eye Contact Lens. 2014 Mar;40(2):84-90.

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