CONTACT LENSES TODAY

April 15, 2007

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.


Optometry A Top Career Choice in 2007
Optometrist is one of 25 careers chosen as the best for 2007, according to a recent article in U.S. News & World Report. The March 19 article identified 25 professions that it says will grow in demand “as baby boomers age, the Internet becomes ubiquitous and Americans seek richer, simpler lives.” The article goes on to say that “with so may aging boomers in need of vision care, the job prospects are strong [for O.D.s]. Another benefit listed: job satisfaction, as it says O.D.s “regularly watch patients walk out the door in better shape than when they came in.”
    Each of the 25 positions was also graded on several job elements; Optometry received a grade of B for Job market outlook, attainability and prestige and an A for Quality of life. To read the entire article, please visit http://www.usnews.com/usnews/biztech/best_careers_2007.

Wharton and TVCI Announce Executive Program for O.D.s
Executive Chief Optometrists, a new program from the Wharton School of the University of Pennsylvania and the Vision Care Institute, was designed to help eye care professionals develop advanced skills in areas such as marketing, organizational and financial management. The program will be held from June 21 to 24, 2007, at Wharton’s Steinberg Conference Center in Philadelphia. Tuition is $3,500 and includes lodging and meals. Registration information is available at http://executiveeducation.wharton.upenn.edu.

Contact Lens Council to Expand Resources
The non-profit Contact Lens Council (CLC) has announced a series of new initiatives to help better educate consumers about contact lenses and provide eye care professionals practical tools and information. Upcoming offerings include a redesigned Website and a unique office-training tool that can be used to teach office staff how to most effectively answer patient questions and offer counseling about contact lens options. For more information, visit http://www.contactlenscouncil.org.

Show Your Patients the Difference Some of your astigmatic patients may still not realize that they’re able to wear contact lenses. Your astigmatic patients already wearing contact lenses might say that their vision is good enough, but may be hoping for something better. Finding the right lens for these patients can provide a substantial boost to your contact lens practice. ACUVUE® ADVANCE™ Brand Contact Lenses for ASTIGMATISM gives patients a breakthrough design with real-world results. Its Accelerated Stabilization Design (ASD) offers patients superior rotational stability, and immediate, all-day comfort. Try ACUVUE® ADVANCE™ Brand for ASTIGMATISM on your patients and ask them to see the difference during daily activities and throughout the day. And now, ACUVUE ADVANCE for ASTIGMATISM meets more patients' needs with the introduction of -2.25 cylinder.
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April is Women’s Eye Health and Safety Month
As part of Women’s Eye Health and Safety Awareness month, the not-for-profit National Women’s Health Resource Center (NWHRC) has released two reports. The first, Women & Healthy Vision, offers information about eye health as we age and can be downloaded at http://www.healthywomen.org/documents/nationalwomenshealthreport.april2006.pdf. Second, Fast Facts for Your Health: The Sun and Your Eyes – What you Need to Know, explains how the sun can damage vision and the products consumers can use to protect their eyes. Download a copy at http://www.healthwomen.org/documents/nwhrc_fastfacts_sunandyoureyes.pdf. Call 1-877-986-9472 for complimentary bulk copies.

Federal Court Upholds Judgment for Allergan in Acular Suit
The United States Court of Appeals for the Federal Circuit has affirmed an earlier ruling in favor of Allergan and Roche Palo Alto, formerly known as Syntex, in a patent infringement lawsuit against Apotex Inc, Apotex Corp. and Novex Pharma. In 2006, the Defendants appealed a ruling by the U.S. District Court for the Northern District of California that stipulates that the effective date of any approval of the Defendants’ Abbreviated New Drug Application may not occur before U.S. Patent No. 5,110,493 expires in 2009. It also enjoins them from making any preparations that make, use, sell or offer for sale ketorolac tromethamine ophthalmic solution 0.5% (Acular, Allergan) in the U.S. The Federal Circuit affirmed the District Court’s decision.

Clarification
In last week’s issue of CLToday, we reported on the discontinuation of Vistakon’s Acuvue Toric contact lenses. The company has since provided the following clarification: the discontinuation is taking place in the U.S. only.

Abstract: Probability of Corneal Infiltrates with Silicone Hydrogels
A study published in this month’s Archives of Ophthalmology reports corneal staining and limbal redness may predict corneal infiltrative events in silicone hydrogel patients on a continuous-wear (CW) schedule. The researchers attempted to determine the cumulative probability and risk factors for developing corneal infiltrates during three years of CW lotrafilcon A lenses. A total of 317 patients participated in the study. The Kaplan-Meier unadjusted cumulative incidence of corneal infiltrate after CW was 5.7% after the first year, 8.5% after two years and 10.3% at the end of the study. Corneal staining and limbal redness in the affected eye on a previous visit were significantly associated with the development of a corneal infiltrative event.
    The researchers conclude that corneal staining and limbal redness may predict the subsequent development of an infiltrative event among CW contact lens wearers. They calculate the probability of remaining free of any corneal infiltrates at the end of three years of CW was 89.7%.
Szczotka-Flynn L, Debanne SM, Cheruvu VK, Long B, et al. Predictive factors for corneal infiltrates with continuous wear of silicone hydrogel contact lenses. Arch Ophthalmol. 2007 Apr;125(4):488-92.


Editor's Commentary: Evidence-Based Rules
Our abstract this week is a study I am very familiar with. I am one of the et als. I think it offers a key finding. Some have suggested legislation that would prevent those of us who prescribe contact lenses from selling them in the future. If I were a member of the legislature presented with this rationale for prescribing and selling I'd ask for some valid, scientific evidence that supports that it's important for doctors to monitor the patient to whom they have sold lenses.
    This study says that in continuous-wear, detection of corneal staining may imply a future infiltrative event.
Therefore, I believe it is one such instance of that evidence: If we continue to follow patients after we dispense the lenses, we can make sure they are safe and if need be, modify the prescription, i.e. prescribe other lenses or modify the treatment plan with the current lenses. If the patient buys them elsewhere, they may not return for check-ups as readily or regularly


CLToday Tip: Maximizing Mulitifocals
At a recent soft lens multifocal teaching session where real patients were fitted, we discussed the value of maximizing the minus for good distance vision, perhaps in only one eye, as opposed to pushing the plus in both eyes. Some practitioners prefer one approach to the other. Either may work depending upon the patient. My approach is to push the plus to obtain acceptable reading vision and then provide just enough more minus (less plus) to obtain acceptable distance vision or the best balance between distance and near. Plus, I am more than ever, a true believer that the greater the variety of lenses you are willing to use, the more success you will have with presbyopic contact lens wearers.
The Editor.


This month at http://www.siliconehydrogels.org, review the etiology and presentation of CLPC in silicone hydrogel wearers and the success of high-Dk in bandage lens application.

Report adverse contact lens reactions here: http://www.accessdata.fda.gov/scripts/medwatch/ 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: http://www.arbo.org/arbo.asp?dt=R&doc=Complications. Complete and send the form online or print it out and fax it to (866) 886-6164.

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Visit Contact Lens Spectrum ( http://www.clspectrum.com ) for interactive clinical posters and issue archives. Visit Contact Lenses Today for our Best Fitting Tips.
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