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Sunday, April 24, 2011  
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Materials & Designs
Ronald K. Watanabe, OD, FAAO

Recently I've discussed material related issues and their potential effects on comfort. Lens design may also be important in determining the comfort of lenses. Let's first consider the edge, as a good edge design for both soft and GP lenses is critical for initial and long-term comfort. For GP lenses, the optimal edge design is a gradual taper to a slightly rounded tip. Blunt, sharp, or poorly shaped edges tend to be less comfortable. Edge lift (EL) also affects comfort. Greater EL results in more lid interaction, while reduced EL can cause the lens to impinge on the cornea and limbus. Shoot for enough peripheral clearance to allow tear exchange but not so much that it will interact excessively with the lids.

For soft lenses, edges are not as easily evaluated. Edge shape often depends on how the edge shaped during the manufacturing process. Though very flat edges or very tight edges can be readily diagnosed through either fluting or conjunctival staining, respectively, most edge designs are not as easily assessed clinically. A recent article described the use of OCT to visualize edge fitting characteristics of soft lenses.1 Perhaps technology can help create better designs for improved comfort and overall lens performance.

1. Shen M, Cui L, Riley C, et al. Characterization of soft contact lens edge fitting using ultra-high resolution and ultra-long scan depth optical coherence tomography. Invest Ophthalmol Vis Sci 2011; Mar 2. (Epub ahead of print)

Research Review
Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

Dr. Kathy Dumbleton and colleagues at the Centre for Contact Lens Research in Canada recently reported a significant association between non-compliance with contact lens replacement and contact lens related complications.1 They assessed surveys from 501 silicone hydrogel lens wearers from seven eyecare practitioner's offices regarding lens wear and any lens related problems in the preceding 12 months. About half of their respondents wore 2-week replacement and about half wore 1-month replacement silicone hydrogel contact lenses.

Sixty-seven percent wore their lenses for longer than the manufacturers' recommended replacement frequency and sixty percent wore their lenses for longer than their eyecare practitioner's recommended replacement frequency. The rate of potential complications was significantly higher for wearers who were non-compliant (complication rate of twenty-six percent) with their eyecare provider's recommended replacement frequency compared to compliant wearers (complication rate of eighteen percent), p=0.028.

Interestingly, an effect of rubbing lenses was also noted to be protective; complication rates were higher for those multipurpose solution users who reported never/almost never rubbing and rinsing their lenses when compared with those who did this every night (twenty-nine percent versus seventeen percent, p=0.007).

This complements a study by Yeung and coworkers that similarly reported a trend toward a higher rate of contact lens complications in patients that were non-compliant with replacement frequency.2

Unfortunately, many soft lens wearers stretch the recommended replacement schedules as recommended by their eyecare provider. Now, at least two studies show that there is a trend towards a higher rate of contact lens related complications in those patients that are non-compliant with the recommended replacement frequency. In these two separate studies, encompassing about 1500 soft lens wearers, there was either a trend or a statistically significant increase in rates of signs and symptoms consistent with potential contact lens complications in those patients that self-reported a replacement frequency longer than that which was recommended.

1. Dumbleton KA, Woods CA, Jones LW, Fonn D. The relationship between compliance with lens replacement and contact lens-related problems in silicone hydrogel wearers. Cont Lens Anterior Eye. 2011 Apr 12. [Epub ahead of print]
2. Yeung KK, Forister JF, Forister EF. Chung MY, Han S, Weissman BA. Compliance with Soft Lens Replacement Schedules and Associated Contact Lens-Related Ocular Complications: The UCLA Contact Lens Study. Optometry. 2010 Nov; 81(11): 598-607.


CooperVision Unveils Redesigned Website

CooperVision launched a new, redesigned U.S. website to provide enhanced usability and a variety of new resources for both eye care practitioners (ECPs) and contact lens wearers.

Based on research with ECPs, the new www.CooperVision.com creates a more personalized experience for ECPs after they log in. The site showcases tools for marketing and managing their practice, including:

  • Personalized information featuring top CooperVision products, trial lenses available, and the status of their product banks
  • Easy access to product information, fitting tips and tools and marketing support
  • Practice locations are automatically entered into a new ECP locator tool for patients

The company also states that wearers will benefit from the enhanced site, which now offers a Lens Finder that provides a lens recommendation based on the wearer's lifestyle that they can bring to their ECP to discuss the right contact lens for them. In addition, a number of rebates, free trial offers and an enhanced ECP locator to help wearers find an eye care practitioner in their area is available.


Teens Have a Chance to Win with the "Acuvue 1•Day Contest"

Vistakon announced the "Acuvue 1•Day Contest," which will bring three lucky fans of singing star Charice a trip to Los Angeles to be featured in the music video for her new single, "One Day."

Now through May 23, 2011, fans can enter the contest at www.facebook.com/ACUVUE for their chance to win one of:

  • Three Grand Prizes: A trip for two to Los Angeles and $500 spending money
  • Fifty First Prizes: Lucky fans will have their contest submission photos included in Charice's music video
  • Thirty-five Daily Prizes: Packages include a six month supply of 1•Day Acuvue Moist Brand Contact Lenses (awarded in the form of a $230 Visa Gift Card, which can be used toward the lenses) and a $50 iTunes Gift Card

Fans also will be able to view other entries, vote for their favorites to win and download a free copy of Charice's "One Day" single. Official Rules can be found at www.facebook.com/ACUVUE.

April Optometric Management Focuses on Contact Lenses

This month Optometric Management presents its annual Contact Lens Update. Several feature articles are devoted to the contact lens market and contact lenses in today's practice. In the lead article, Tara Rosenzweig provides updates on market trends, including what age group leads in office visits (you may be surprised), as well as other interesting market analysis.

Other contact lens related feature articles include: A Wall Street Perspective by Jeffrey D. Johnson, OD; You Truly Change Lives by Robert Murphy; Care Impacts Successful Wear by Gina Wesley, OD, MS, FAAO; and A New Dimension in Contact Lens Marketing by Richard A. Driscoll, OD.

To read these and other informative articles, look for your issue in the mail or review the issue on line at: http://www.optometric.com/thismonth.aspx.

PBA Launches Most Beautiful Eyes Contest

Star Pupils, the national children's eye health program from Prevent Blindness America (PBA) is rewarding children's most sparkling eyes with a $25,000 scholarship during its Most Beautiful Eyes Contest. Starting in August, parents of children up to 17 can enter their child by submitting a photo to the Star Pupils Facebook page.

The winners will be determined through two rounds of voting. During the first round, the public will be encouraged to select their favorite contestant by voting through the Facebook page. The contestants with the most votes will advance to the second round. Prevent Blindness America staff and celebrity judges, including former CNN news anchor Larry King, Baltimore Orioles player Derrek Lee and former astronaut Walter Cunningham will then select the three finalists and the contest winner.

In addition to the scholarship, the winner will become the face of the Star Pupils program for 2012. Runners up will receive money and prizes valued up to $2,500.

The contest is being sponsored by Marchon Eyewear and Advantica. For more information, please visit www.starpupils.org or www.facebook.com/starpupils.

This month at www.siliconehydrogels.org: Ethnic differences in ocular physiology, tear mixing and contact lens-related adverse events, risk factors for inflammatory and mechanical events, and our synopsis of the 2010 meeting of the American Academy of Optometry.
Editor's Commentary
Jason J. Nichols, OD, MPH, PhD, FAAO

This week, we are doing things a bit different in terms of the abstract in our newsletter. As you will note, we've chosen to highlight the recently published International Workshop Report on Meibomian Gland Dysfunction, which was organized by the Tear Film and Ocular Surface Society. Each of the individual reports is highlighted below, with a hyperlink to the original report, which was recently published in an unprecedented special issue of Investigative Ophthalmology and Visual Science. Without question, this was a monumental effort and all who were involved should be congratulated. As you will note, contact lenses issues were discussed in several of the various reports.

Please see our Quick Poll question this week as is relates to your thoughts on meibomian gland dysfunction and your contact lens wearers.

CLToday Quick Poll

If you are having problems voting, your email settings may be blocking you. Click here to vote through your browser.

Nichols KK. The international workshop on meibomian gland dysfunction: introduction. Invest Ophthalmol Vis Sci. 2011;52(4):1917-21. http://www.iovs.org/content/52/4/1917

Nichols KK, Foulks GN, Bron AJ, Glasgow BJ, Dogru M, Tsubota K, et al. The international workshop on meibomian gland dysfunction: executive summary. Invest Ophthalmol Vis Sci. 2011;52(4):1922-9. http://www.iovs.org/content/52/4/1922

Nelson JD, Shimazaki J, Benitez-Del-Castillo JM, Craig JP, McCulley JP, Den S, et al. The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee. Invest Ophthalmol Vis Sci. 2011;52(4):1930-7. http://www.iovs.org/content/52/4/1930

Knop E, Knop N, Millar T, Obata H, Sullivan DA. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci. 2011;52(4):1938-78. http://www.iovs.org/content/52/4/1938

Green-Church KB, Butovich I, Willcox M, Borchman D, Paulsen F, Barabino S, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease. Invest Ophthalmol Vis Sci. 2011;52(4):1979-93. http://www.iovs.org/content/52/4/1979

Schaumberg DA, Nichols JJ, Papas EB, Tong L, Uchino M, Nichols KK. The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on the Epidemiology of, and Associated Risk Factors for, MGD. Invest Ophthalmol Vis Sci. 2011;52(4):1994-2005. http://www.iovs.org/content/52/4/1994

Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI, et al. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci. 2011;52(4):2006-49. http://www.iovs.org/content/52/4/2006

Geerling G, Tauber J, Baudouin C, Goto E, Matsumoto Y, O'Brien T, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2011;52(4):2050-64. http://www.iovs.org/content/52/4/2050

Asbell PA, Stapleton FJ, Wickstrom K, Akpek EK, Aragona P, Dana R, et al. The international workshop on meibomian gland dysfunction: report of the clinical trials subcommittee. Invest Ophthalmol Vis Sci. 2011;52(4):2065-85. http://www.iovs.org/content/52/4/2065

Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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For more information on Contact Lenses Today including archives of previous issues or to subscribe to this newsletter, please visit our website at www.cltoday.com. For the latest articles on contact lenses, important clinical information and helpful tools related to the contact lens practice visit the Contact Lens Spectrum website at www.clspectrum.com.

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