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Sunday, April 20, 2014  
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How do you think the majority of contact lenses are distributed to patients in the United States market?

 Direct from the manufacturer


 Mass merchandiser

 Internet supplier

44 total responses.

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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
I believe that the surface of a contact lens is critical in the success of the contact lens wearer. There are many reasons why I believe this—from wettability, to lubricity, to deposit resistance, to reduced mechanical response of the ocular tissues. Many of the manufacturers have certainly spent significant efforts on their improving their contact lens surfaces, and we have come a long way. However, we still have room to grow in making improvements to contact lens surfaces. I think we should look for more and improved technologies in the future to help reduce the common issue of contact lens discomfort.

New Custom Multifocal Contact Lens in Toric and Sphere from SpecialEyes
SpecialEyes introduces the SpecialEyes 54 custom multifocal contact lens with personalized center-zone and power progression, enabling presbyopic and astigmatic patients to achieve enhanced near, intermediate, and distance vision.

According to the Company announcement, mass-market contact lenses are designed using a one-size-fits-most approach, with limited add-power, sphere-power, cylinder-power, and axis values, and a single diameter and center-zone size. Most do not offer variable base curves, or have very limited options. The SpecialEyes 54 Multifocal contact lens is fully customizable – from the add power and center-zone size and type to the aspheric power progression zone. And like all of their custom contact lenses, the 54 Multifocal allows practitioners to specify any base curve, any power, and any axis.

The lens offers several additional benefits to eyecare practitioners and patients: Not only does the SpecialEyes 54 Multifocal provide significant advantages in terms of customization, but the lenses are also competitively priced. Furthermore, the Company offers a full warranty on both trial and supply lenses, and fast turnaround – orders are delivered within two to four business days.

For complete details on SpecialEyes’ custom multifocal contact lenses – including a multifocal fitting guide – as well as information on the company’s bifocal, spherical, and toric custom contact lenses, visit or call 866-404-1060.

CooperVision Unveils Eye Care Prime Premier for the U.S. Market
CooperVision, Inc., through its subsidiary WebSystem3 LLC, debuted Eye Care Prime Premier, which brings individualized, digital marketing consulting and execution services to eyecare practices across the United States.

Designed to assist eyecare professionals with acquiring, retaining and engaging patients in an increasingly competitive marketplace, Eye Care Prime Premier provides each practice with a personal marketing consultant. Based on specific business objectives, each consultant develops a customized integrated marketing approach, executes the plan across all digital platforms (e.g., social media, web, and customer relationship marketing), and provides regular reporting, analysis and program refinements.

The service is the only one of its kind founded, managed and staffed by marketing professionals from the eyecare industry. Because of their proximity to Silicon Valley, Eye Care Prime Premier consultants are immersed in the fast-changing universe of online reviews, online visibility, reputation management, search mechanisms, e-mail communication and other digital ecosystem factors that are now part of smart practice management.

Eye Care Prime Premier is being launched first in the United States, with other markets expected to follow. For more information, visit or call 1-888-218-4777.

Menicon America Introduces New Deluxe GP Lens Care Kit
Menicon America Inc. announced the availability of a convenient kit for getting patients started on the Menicon GP solutions system. The Menicon Deluxe Kit consists of a two fluid ounce (60 mL) bottle of Menicon Unique pH, a lens case and a single treatment package of Progent bi-weekly cleaner. These items come packaged in a TSA compliant clear plastic travel case.

The Menicon Deluxe Kit is available to eyecare professionals exclusively through the Menicon WebStore. For more information on Menicon’s GP lens care and WebStore visit: or log in at

Getting Closer to Understanding the Presbyopia Puzzle
A new breakthrough in optical imaging could be a major step forward in solving the problem of presbyopia. None of the current options to manage presbyopia are able to restore the youthful ability to focus at all distances and, up until now, one of the barriers to solving this puzzle is the inability to view the internal structures of the eye that are involved in this process.

By modifying Optical Coherence Tomography (OCT), researchers at the Ophthalmic Biophysics Center at Bascom Palmer Eye Institute in the U.S. are now able to provide images of the full internal structure of the eye. The advance not only promises to accelerate the development of an effective treatment for presbyopia, it may also be useful for surgeons in cataract removal, in the assessment of glaucoma treatments and in understanding the progression of myopia in children.

The research, which is supported through a National Institutes of Health (NIH) grant in the U.S., was recognized earlier this year at BiOS (The Biomedical Optics conference of SPIE), the world’s largest biomedical optics conference, when Dr. Marco Ruggeri, Research Assistant Professor at Bascom Palmer Eye Institute, won the Pascal Rol Award, which recognizes significant contributions to the field of ophthalmic technologies.

According to Dr. Ruggeri, the technology they have developed extends the capabilities of standard OCT implementations by providing a more comprehensive view of the eye that includes the cornea, retina, anterior chamber, the crystalline lens and the ciliary body and muscle.

Dr. Ruggeri also stated that studying the dynamic changes of the crystalline lens shape and the ciliary muscle geometry during accommodation, and with age, will advance the knowledge of the mechanism of presbyopia and will also serve as a clinical tool to evaluate the efficacy of procedures aimed to restore accommodation.

Bascom Palmer Eye Institute is a participant in the Accommodating Gel project, a collaborative effort by researchers in Australia, Finland, India and U.S., being undertaken through the Vision Cooperative Research Centre (Vision CRC), to develop a synthetic gel to replace the old, hardened lens of the presbyopic eye and restore accommodation. The Accommodating Gel technology is now being developed by Adventus Technology Inc., a participant in Vision CRC.

Chemical Burn
Boris Severinsky, MOptom, Jerusalem, Israel

This is an image of heavy corneal vascularization and haze after chemical (alkali) burn. Several months after the injury, the patient was able to achieve 20/40 with scleral lens correction; the vision drops to 20/200 level as the neovascularization progresses.

We thank Boris Severinsky 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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Katherine M. Mastrota, MS, OD, FAAO

Patient Questionnaires for Assessing QOL in DED

Patient questionnaires are useful tools for establishing and monitoring our patients with dry eye. Because of the negative effects of DED on patients' quality of life (QOL), disease-specific questionnaires that assess QOL in patients with dry eyes are essential in the management of this chronic ocular condition. Grubbs et al in a February 2014 review provides clinicians and researchers with a summary of the current questionnaires available for assessing QOL in patients with dry eyes. The authors describe that there are only two validated, reliable dry eye questionnaires with QOL measures currently available for clinic use: the Ocular Surface Disease Index (OSDI) and the Impact of Dry Eye on Everyday Life questionnaire (IDEEL). Multiple other dry eye questionnaires assess some degree of QOL, but they have either not been tested for validity and reliability or are limited in QOL measures they assess. Because of its extensive development process and multiple QOL measures, the IDEEL offers a more thorough assessment of the effect of DED on QOL for clinical trials, whereas the OSDI may be the more convenient option for clinical use as a result of its shorter completion time. Other questionnaires used to assess QOL in DED are fairly limited in this assessment. Finally, because of the negative effects of DED on QOL, this review emphasizes the importance of including QOL measures in future questionnaires for the monitoring and management of DED.

Grubbs JR Jr, Tolleson-Rinehart S, Huynh K, Davis RM. A review of quality of life measures in dry eye questionnaires. Cornea. 2014 Feb;33(2):215-8

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Susan J. Gromacki, OD, MS, FAAO

Case History at the Follow-up Visits
Between 15-30% of contact lens wearers permanently drop out of contact lenses each year.1,2 This not only affects our practices’ bottom line, but also our patients’ quality of life. They, of course, did not intend to drop out of contact lenses when they started wearing them. Some of them are willing to do whatever it takes to remain in their lenses, and they expect our help.

Although some of these patients probably should never have been fitted in the first place, the majority of these dropouts can be prevented. Prior to fitting, most of us do an excellent job of selecting candidates, material, prescription, care system, and wearing schedule.3 But it cannot end here. It is at the follow-up visits where we detect other nuances that lead to dropout. A vital component of these visits is the case history. A properly-asked history provides us the information to anticipate future problems before they happen.

Back in optometry school we learned that there are four topical areas, at a minimum, that need to be addressed with existing contact lens wearers.

1. Vision
2. Comfort
3. Care
4. Wearing time4

This takes no more than a minute of our (or our technicians’) time, but pays such great dividends for both our patients and our practices. How many of us are asking all of these questions at each and every visit…and how many of our patients are dropping out? I will explain the importance of addressing wearing time in my next column.

1. Nichols JJ. 2010 Annual Report on Dry Eye Diseases. CL Spectrum. 2010 Jul;15(8):22.
2. Geffen D. Dropouts- not in my practice.
3. Terry RL, Schnider CM, Holden BA, Cornish R, Grant T, Sweeney D, La Hood D, Back A. CCLRU standards for success of daily and extended wear contact lenses. Optom Vis Sci. 1993 Mar;70(3):234-43.
4. Badowski L. Optometry 653, The Ohio State University, Feb. 28, 1992.

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Modern Scleral Contact Lenses: A Review.

Scleral contact lenses (ScCL) have gained renewed interest during the last decade. Originally, they were primarily used for severely compromised eyes. Corneal ectasia and exposure conditions were the primary indications. However, the indication range of ScCL in contact lens practices seems to be expanding, and it now increasingly includes less severe and even non-compromised eyes, too. All lenses that partly or entirely rest on the sclera are included under the name ScCL in this paper; although the Scleral Lens Education Society recommends further classification. When a lens partly rests on the cornea (centrally or peripherally) and partly on the sclera, it is called a corneo-scleral lens. A lens that rests entirely on the sclera is classified as a scleral lens (up to 25mm in diameter maximum). When there is full bearing on the sclera, further distinctions of the scleral lens group include mini-scleral and large-scleral lenses.

This manuscript presents a review of the current applications of different ScCL (all types), their fitting methods, and their clinical outcomes including potential adverse events. Adverse events with these lenses are rare, but the clinician needs to be aware of them to avoid further damage in eyes that often are already compromised. The use of scleral lenses for non-pathological eyes is discussed in this paper.

van der Worp E, Bornman D, Ferreira DL, Faria-Ribeiro M, Garcia-Porta N, González-Meijome JM. Modern scleral contact lenses: A review. Cont Lens Anterior Eye. 2014 Mar 12. [Epub ahead of print]

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