CONTACT LENSES TODAY
April 22, 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.
CDC Requests Acanthamoeba Cases
The Centers for Disease Control (CDC) has asked the American Optometric Association’s Contact Lens and Cornea Section (AOA CLCS) to join in a comprehensive study of the incidence
of Acanthamoeba and its possible relationship to contact lens wear. The group is asking that O.D.s report any instances of ulcerative keratitis, especially if you suspect or confirm Acanthamoeba,
to the CDC. Because Acanthamoeba keratitis (AK) can have devastating complications, any patients presenting with a red eye and history of contact lens wear should raise suspicion.
The AOA CLCS has
published an educational paper that details the clinical presentation and management of Acanthamoeba keratitis, as well as office procedures, patient counseling and the national reporting procedure. The
paper is available AOA Web site.
The CDC has established a process for O.D.s to report cases of ulcerative keratitis. If you suspect ulcerative keratitis in any case since Jan. 2205, report it to the CDC
through the AOA CLCS Web page at http://www/aoa.org/acanthamoeba.xml. Please include your name and contact information. The state health department, working in
conjunction with the CDC, may contact you if further information is required.
Vision Lost to Cost U.S. $51.4 Billion
Prevent Blindness America (PBA) released a new report that estimates the cost associated with adult vision problems in the U.S. to be $51.5 billion, exceeding the total combined
profits of the top two 2006 Fortune-500 companies, Exxon Mobile and Wal-Mart stores. The report follows PBA’s Vision Problems in the U.S. study released in 2002 and analyzes the financial impact vision loss has
on the individual, caregivers, the government and insurance premiums.
Two groups of health economists collaborated to produce the report; David Rein, Ph.D., or RTI International and the CDC researched the
costs of the U.S. economy and determined the impact to be $35.4 billion. Kevin Frick, Ph.D., of Johns Hopkins Bloomberg School of Public Health estimated the financial impact to the individual, caregivers and others
at $16 billion. “It is a troubling reality that an increasing number of Americans are going to be faced with escalating costs due to vision loss unless we focus on prevention,” says Dr. Frick.
Vision Care for Kids Act of 2007 Introduced
Sens. Christopher Bond (R-Mo.) and Christopher Dodd (D-Ct.) introduced S. 1117, the Vision Care for Kids Act of 2007, which seeks to provide children with follow-up care after a
comprehensive eye exam or vision screening identifies a potential vision problem. S. 1117 serves as a complement to H.R. 507, identical legislation introduced earlier this year in the House of Representatives. It
is supported by the alliance of the Vision Council of America (VCA), the American Academy of Ophthalmology (AAO), the American Association for Pediatric Ophthalmology and Strabismus, the American Optometric
Association (AOA), Better Vision Institute and Prevent Blindness America. For more information, visit http://www.2020advocacy.com.
The Next Generation of Silicone Hydrogels
The latest advance in the ULTRA COMFORT SERIES™ offers comfort, vision and health to contact lens wearers. ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR™ Plus
are made from a new lens material, senofilcon A, a proprietary formulation including a remarkable moisture-rich wetting agent with no surface coating. ACUVUE® OASYS™ Brand Contact Lenses have excellent
oxygen transmissibility, high volume of wetting agent and a smooth surface. This breakthrough material creates a lens so moist and smooth that an eyelid glides effortlessly over it. Prescribing a lens that offers
patients comfort in dry environments that can make eyes feel tired and dry will keep them from dropping out of lens wear and increase patient satisfaction.
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Silicone Hydrogel Vs. Hydrogel CLs
A study published in this month’s Optometry and Vision Science shows daily-wear silicone hydrogel contact lenses (CLs) may improve patient comfort over hydrogel lenses. Nearly
500 contact lens wearers between the ages of 18 and 40 participated in the Vistakon-sponsored study at 48 clinical sites throughout the country. Researchers used participants’ subjective responses to evaluate the
frequency of soft CL use and associated comfort in 12 challenging environments. More than 80% of participants reported wearing their lenses “always,” or “frequently,” when reading, sitting in an air-conditioned or
heated car, using a computer and while driving at night. Fewer than 40% reported wearing their lenses “always,” or “frequently,” while on an airplane, at high altitudes or while napping or sleeping. They reported
dusty, polluted or smoky environments as the least comfortable situations for CL wear.
Subjects were then randomized to be refit with one of three silicone hydrogels for daily-wear; senofilcon A (Acuvue
Oasys, Vistakon), galyfilcon A (Acuvue Advance, Vistakon) or lotrafilcon A (O2Optix, CIBA). After two weeks of wear, researchers compared the subjective responses of participants who reported “always,”
or “frequently,” wearing CLs in the environments in question. Patients reported that many environments, particularly those in which they reported the most discomfort with hydrogel CLs, no longer appeared
to pose such a challenge.
AOA Supports National Health Service Corps Act of 2007
The American Optometric Association (AOA) has declared its support for H.R. 1884, the National Health Service Corps Improvement Act of 2007, aimed at expanding access to vision
care in medically underserved communities across America. The bills seeks to build on a successful federal inventive program to develop new links between highly qualified doctors of optometry and communities
with limited access to eye and vision care services. The program provides financial support specifically aimed at easing the debt burden associated with a professional education and allows carefully selected
clinicians to undertake a multi-year commitment to safeguarding public health. Since the NHSC was restructured in 2002 to exclude optometrists. Today, only about 17% of community health care centers have an
optometrist on staff, which severely restricts access to primary eye care services. H.R. 1884 also has the support of the Tennessee Optometric Association (TOA), the Pennsylvania Optometric Association (POA), the
American Optometric Student Association (AOSA) and the Association of Schools and Colleges of Optometry (ASCO).
Gary Gerber Appointed Benedict Professor
Dr. Sam Quintero, Chair, Department of Clinical Sciences at the College of Optometry, University of Houston recently announced the selection of Dr. Gary Gerber to the Benedict Professor
in Practice Management for 2007-08 clinical year. The professorship was established in 1984 to provide a focus on administrative and management tools in the optometric curriculum and thus to promote the independent
practice of the profession. Past Benedict professors include Drs. Irving Bennett, Irvin Borish and Robert Koetting. Dr. Gerber is the founder and president of the Power Practice, a company that aims to make doctors
more profitable.
Abstract:
Acanthamoeba and Orthokeratology
Researchers at the Pusan National University College of Medicine’s Department of Ophthalmology in Korea recently reported on four cases of Acanthamoeba keratitis related to
overnight orthokeratology. Four patients presented with corneal ulcers and a history of overnight wear with orthokeratology contact lenses. Corneal scraping isolated the Acanthamoeba organism. Clinicians
initiated treatment with polyhexamethylene biguanide (PHMB) and chlorhexidine, which resolved the inflammation.
Investigators conclude that Acanthamoeba keratitis is a potential complication of
overnight orthokeratology and should be considered, especially in patients with more than one-year of contact lens wear. They also note the need to manage these patients and to eliminating tap water rinsing from
the lens care regimen.
Lee JE, Hahn TW, Oum BS, Choi HY, Yu HS, Lee JS. Acanthamoeba keratitis related to orthokeratology. Int Ophthalmol. 2007 Mar 22;[Epub ahead of print].
Editor's Commentary:
The Good News: Bifocals, The Bad News: Acanthamoeba
Dr. Don Ezekiel's comment below is a good one. There is no question that an alternating vision, translating lens provides the best vision for presbyopic contact lens wearers. Touché. It
may take some time and your fees need to reflect the value of this service, but you will have a patient for life once you succeed.
Acanthamoeba raises it's ugly, little head again in our news this
week. Hygiene, hygiene, hygiene is so important and lens care compliance — without getting tap water or stagnant water directly in the eye — is our never-ending goal. We invite your comments on lens care compliance
and preventing injection.