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Sunday, April 19, 2015  
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Results from Last Question
What do you perceive to be your number one barrier to increasing your multifocal fittings in your practice?



 Visual performance

 Lack of patient interest

 Contact lens discomfort

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
As noted in the Quick Poll results this week, it seems that practitioners still question visual performance associated with current multifocal contact lenses. I strongly believe we have come a long way in contact lens technologies for presbyopia correction, and often think practitioners are too quick to make adjustments or set unreasonable expectations. If you have given up, I urge you to try new technologies in multifocal contact lenses once again.

Accu Lens Announces Scleral Lens Academy

Accu Lens has announced its sponsorship of the Scleral Lens Academy to be hosted by the UCHealth Eye Clinic at the Rocky Mountain Lions Eye Institute in Denver, Colorado. This regional training center will educate eye doctors, technicians, and residents on how to utilize scleral lenses in the management of ocular surface diseases and as an alternative to soft toric lenses. This workshop is designed to provide eyecare practitioners an effective, convenient, and efficient venue for learning how to implement scleral lenses in their practice.

Accu Lens will be presenting these Saturday workshops frequently throughout the year.

The Academy will be taught by leading optometrists. The first session will be instructed by Melissa Barnett, OD, FAAO, FSLS on June 6, 2015. The course will consist of a morning lecture, followed by an afternoon hands-on wet-lab in the clinic’s exam lanes. Space will be limited and reserved on a first come first serve basis. Accu Lens is taking registrations now for the June 6, 2015 course. For more information and to reserve space, contact Accu Lens at 800-525-2470 ext. 101.

AOA Offers Resources in Advance of ICD-10 Rollout

The compliance deadline for the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) is October 1, 2015. Once in effect, this will serve as the new system for reporting medical conditions on insurance claims and in patient records.

With less than six months left for optometrists to prepare to adopt new coding guidelines, the American Optometric Association (AOA) is providing guidance and support to the profession.

Resources available from the AOA include:

  • The AOA's Third Party Center Coding Experts, who are available to answer questions about ICD-10 and other coding topics at
  • A 10-part ICD-10 webinar series developed by AOA's Coding Experts. The webinar series is available exclusively to members at
  • Kara Webb, the AOA's associate director for coding and regulatory policy, is also available to answer questions about ICD-10 and related topics at
  •, a no-cost, members-only, online resource that offers CPT/ICD-9/ICD-10 information.
  • The 2015 Coding Bundle, which includes the 2015 AOA ICD-10 Codes for Optometry Book, 2015 AMA Professional Edition CPT Book and AOA Express Mapping Card. A digital download version of the Codes for Optometry Book is also available at

Introducing OCuSOFT Lid Scrub Plus Platinum

OCuSOFT Inc. introduces their next generation in eyelid cleansers, OCuSOFT Lid Scrub Plus Platinum. OCuSOFT Lid Scrub Plus Platinum is an extra strength leave-on eyelid cleanser containing surfactants plus a moisturizer and preservative blend that effectively eradicates seven different strains of bacteria commonly found on the eyelids including MRSA and Staph epi, according to the company. It contains PSG-2, a proprietary formulation that includes 0.2% phytosphingosine, a water-binding agent that mimics the natural lipid layer of the outer epidermis for increased moisturizing throughout the day. The company release states that phytosphingosine has been reported to offer both anti-bacterial and anti-inflammatory properties as well as aid in wound-healing.

OCuSOFT Lid Scrub Plus Platinum joins a growing line of eyelid hygiene management products to address all types of eyelid conditions including new OTC OCuSOFT HypoChlor Solution (0.02% Hypochlorous acid) and OCuSOFT HypoChlor Gel (0.02% Hypochlorous acid) used as an adjunct to OCuSOFT Lid Scrub products in the most severe blepharitis cases.

For more information, visit

Amniotic Membrane Use with Severe SPK
Stephanie Woo, OD, FAAO, Lake Havasu, AZ

A 60 year-old, white female presented to the clinic with severe SPK and eye pain (top photo). An amniotic membrane was placed and her cornea significantly improved after 24 hours (bottom photo).

We thank Dr. Woo for these images 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
Comparison of Surface Roughness and Bacterial Adhesion Between Cosmetic and Conventional Soft Contact Lenses

A recent study from South Korea assessed the physical characteristics of cosmetic and conventional contact lenses (CL) in an attempt to understand susceptibility to bacterial adhesion to the contact lens surface.1 Research has shown that contact lens-related microbial keratitis is 16.5 times higher in cosmetic contact lens wearers2 with patient noncompliance being one of the primary etiologies for these infections. 2,3

Utilizing atomic force and scanning electron microscopy on cosmetic and non-cosmetic soft contact lenses made from the same material and the same manufacturer (six lens types total), cosmetic contact lenses exhibited greater surface roughness than non-cosmetic lenses. In addition, significantly more S. aureus and P. aeruginosa adhered to cosmetic vs. non-cosmetic CL.

Lastly, the authors evaluated removal of the bacteria with rub vs. no-rub regimens, utilizing a multipurpose disinfecting solution (MPDS). No P. aeruginosa remained after a 6-hour soak in MPDS, whether a rubbing step was performed or not. For S. aureus, a rubbing step also eliminated all colonies of microorganisms. However, without hand rubbing, many S. aureus colonies remained on the surface of the lens, and more than 100 colony forming units were observed.

The take-home message for practitioners is to be particularly vigilant regarding lens care education with patients who wear cosmetic contact lenses, and in particular, to recommend a daily digital rubbing step.

1. Ji YW, Cho YJ, Lee CH, et al. Comparison of Surface Roughness and Bacterial Adhesion Between Cosmetic and Conventional Soft Contact Lenses. Eye CL 2015;41(1):25-33.
2. Sauer A, Bourcier T. French Study Group for Contact Lenses Related Microbial Keratitis. Microbial keratitis as a foreseeable complication of cosmetic contact lenses: A prospective study. Acta Ophthalmol. 2011;89:e439-442.
3. Kim JH, Song JS, Hyon JY, et al. A survey of contact lens-related complications in Korea: The Korean Contact Lens Study . J Korean Ophthalmol Soc. 2014;55:20-31.

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David Kading, OD, FAAO

Plasma: Get It Because It Sounds Cool

Last time you were on the phone with your GP lab, did they offer you plasma treatment? Our lab just makes the assumption that we want it. Why wouldn’t I choose a plasma treatment for ALL my patients? After all, it just sounds cool. PLASMA. A cool word, but an even cooler process.

In general, this process is designed to make the lens surface more wettable by making the lens ultra clean. The treatment uses an electrical energy in a sealed chamber to alter the surface of the lens. An important point to make is that a plasma treatment is not an additional coating on the surface of the lens; rather it is a treatment to the existing surface of the lens. All in all, the treatment is approved by the FDA for nearly every material, making it a possible treatment for almost all lenses that you might order from your GP lab.

So to get your patients off to a good start, consider the best surface from the get go: PLASMA.

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Corneal Biomechanical Properties in Rheumatoid Arthritis.
The purpose of this study was to investigate the variations in biomechanical properties of the cornea in rheumatoid arthritis (RA) patients.

A total of 53 RA patients, and 25 healthy individuals (control group) were enrolled. Rheumatoid arthritis patients were classified as in active phase (group 1; n=24) or in remission phase (group 2; n=29). Corneal biomechanical parameters including corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Reichert Ocular Response Analyzer. Topographical measurements, including central corneal thickness (CCT), anterior chamber depth, iridocorneal angle, and corneal volume were measured using a Sirius corneal topographer.

The mean CH was 9.43±1.17 mm Hg in group 1, 9.42±1.84 mm Hg in group 2, and 10.47±1.68 mm Hg in the control group (P=0.03). The mean IOPcc was 17.85±3.2 mm Hg in group 1, 17.95±3.49 mm Hg in group 2, and 15.36±3.11 mm Hg in the control group (P=0.008). The CH showed a significant positive correlation with CRF (P=0.000, r=0.809) and CCT (P=0.000, r=0.461), and a significant negative correlation with IOPcc (P=0.000, r=-0.469).

The reseachers concluded that the decrease in the mean CH measurements indicates that ultrastructural changes in the cornea may occur in the active phase, and these changes persist in the remission period. In addition, IOPcc is significantly affected by the corneal biomechanical properties. In RA patients, it is important to control the corneal parameters and IOP measurements against the irreversible changes on the optic nerve.

Can ME, Erten S, Can GD, Cakmak HB, Sarac O, Cagil N. Corneal Biomechanical Properties in Rheumatoid Arthritis. Eye Contact Lens. 2015 Apr 1. [Epub ahead of print]

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