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Sunday, April 26, 2015  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

As we are learning more and more, the limbal epithelial stem cells are vital to the normal function of the cornea. Compromise of these cells can be devastating and thus it is vital to understand risks for compromise, and treatments for compromised stem cells are being investigated. This week’s abstract highlights one such treatment approach using a contact lens as a cellular delivery vehicle during treatment—an interesting approach indeed.

NaturalVue 1 Day Multifocal Introduced

Visioneering Technologies, Inc. (VTI) announced the launch of NaturalVue Multifocal 1 Day daily disposable contact lens. Inspired by advanced camera optics, this design channels light for clear distance vision through the lens center, while significantly increasing depth of focus. Per VTI, the Neurofocus Optics technology allows the visual cortex to “autocorrect” what wearers see, optimizing visual clarity and enabling spectacle-level stereo acuity for greater depth perception, and provides excellent near, intermediate and distance vision.

NaturalVue multifocal lenses are designed to be easy to fit, similar to a single-vision spherical lens. With one base curve (8.5mm), one diameter (14.5mm) and one universal ADD — which generates up to 3.00D equivalent near power, encompassing ADD power requirements from +0.75D to +3.00D — NaturalVue multifocal lenses have an 89% fitting success rate, reduced office visits, and require less time to fit, according to the company.

The NaturalVue Multifocal 1 Day lens is manufactured in etafilcon A with a Class 2 UV blocker. It is available in 90-packs, 30-packs, and 10-lens trial packs. Diagnostic sets will also be available.

NaturalVue Multifocal 1 Day daily disposable contact lenses have been launched in a select group of practices with distribution expanding throughout 2015 and a national launch beginning in the first quarter of 2016. For more information, visit

CooperVision’s Science and Technology Awards Program

For the third consecutive year, CooperVision is offering the CooperVision Science and Technology (S&T) Awards Program. The goal of this awards program is to bring recipients and CooperVision scientists together to explore new areas of technology advancement in contact lens applications and enable the translation of concepts into real world solutions. The focus on this year’s program is two-fold: 1) approaches to improve contact lens discomfort, including intervention and management strategies, and 2) technologies to enhance the functionality of contact lenses beyond conventional vision correction.

The CooperVision S&T Awards Program is comprised of two awards: The CooperVision Seedling Award and the CooperVision Translational Research Award.

The CooperVision Seedling Award is intended to incentivize collaborations with CooperVision in a new research area for a one-year period. The award enables investigators to generate preliminary data that could be used toward a future CooperVision Translational Research Award. The maximum total cash amount for a CooperVision seedling is $100,000, including indirect costs.

A CooperVision Translational Research Award is a multi-year award for a substantive translational research project. Research under this award is milestone-driven in order to remain focused on a well-defined goal. This award provides funding for up to two years, totaling up to $400,000, including indirect costs. A maximum of $250,000 can be requested for any one year. This award may be considered for renewal at the end of the initial research period.

For information of the application process and materials, please visit

Contamac Appoints Chairman and New Managing Director

Contamac Ltd. announced the appointment of John McGregor to Chairman and that Robert McGregor will succeed his father as Managing Director.

John McGregor founded the company in 1987 and led it through the development of many ground breaking products, facility expansions and awards, including the Queens Award for Enterprise; International Trade in 2012. While continuing to play an active role in the company, he will dedicate more time to the Worshipful Company of Spectacle Makers, an organization dedicated to helping the visually impaired, and other pursuits.

Robert McGregor joined the company in 1994 and has either worked in or been responsible for every department within the company. This hands-on knowledge underpins his new role of Managing Director. For the past decade, Rob has led the Sales, Marketing, R&D and Business Development activities of the company. Over the past three years there has been a steady restructuring of the company in readiness for this change in leadership. The move to a larger purpose-built facility provides an exceptional platform for the next stage of Contamac’s expansion and its research strategy.

Walsh Promoted to Director of Consultation for Alden

Alden Optical announced the promotion of Maggie Walsh to Director of Consultation.In this new role she will direct the growing Alden consultation team to ensure they are supporting the company’s customers with the best possible fitting guidance, training and technical expertise. Walsh brings almost 40 years of specialty lens fitting and consultation experience to this new position.

Alden Optical ( manufactures premium specialty and custom made-to-order soft and gas permeable contact lenses. The company’s portfolio of specialty lenses includes HP Toric, Astera Multifocal Toric, NovaKone and now Zenlens. Additionally, Alden offers a full line of corneal GPs and distributes BioColors, a custom tinted lens that is co-produced by Alden Optical and The Orion Vision Group.

1st World Congress of Optometry Announces Its Headline Sponsor

Organizers of the 1st World Congress of Optometry announced that Johnson & Johnson Vision Care Companies is to be the event’s headline sponsor. The Congress, organized by the World Council of Optometry and the Colombian Federation of Optometrists, takes place August 14-17, 2015 in Medellin, Colombia. It will be the first global event to encompass all aspects of optometry in order to share knowledge, explore clinical and technological innovation and establish an agreed holistic policy for the sector and for the future of accessible eye health care.

During the Congress, representatives of Johnson & Johnson Vision Care will deliver a keynote lecture and will also address the Presidents’ Forum on August 13.

The three-day Congress itinerary includes two parallel programs: a scientific program with lectures and workshops on 17 topics, which will support delegates’ continuing education through COPE and CET accreditation, and an educators’ program, which focuses on six key areas of optometric education. Lectures and seminars will be presented by leading experts from across the globe including Prof. Brien Holden, Prof. Thomas Freddo and Drs. Randall Thomas and Ron Melton. The Congress will also offer an exhibition of clinical videos and photographs, a public outreach program and a trade exhibition with more than 40 international and national exhibitors. Further information is available at

Contact Lens Corneal Protection
Boris Severinsky, FAAO, FBCLA, FSLS, Boston, MA

Ocular injury following penetrating keratoplasty is not a rare event. In this case, a patient wearing a scleral contact lens was accidentally hit by an exposed armature when doing electric work at home. The lens was damaged, but the transplant was preserved. This case represents the protective features of scleral contact lenses in eyes vulnerable to ocular trauma.

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

Be Like the Dentist

Yesterday I was counseling a patient about the epiretinal membrane he had in one eye---then the patient said something amazing. “What does this have to do with ocular surface disease?” You must be thinking “and what was so amazing?”

This is what he said: "You know, I just had my 6 month dental-check appointment---what you said doc was just what I heard a few hours ago from the dentist. My dentist told me that routine evaluation and maintenance of my teeth and gums will head off more serious problems and that constant oral health vigilance will keep them in top form."

Wow! It finally connected with this patient that eye care should be as routine and top-of-mind as dental care.

A few months ago, a group of our colleagues who focus on ocular surface disease and dry eye met at the Dry Eye Summit. One primary goal of the meeting was to reach a consensus of the most basic ocular surface health management strategies. The group concurred that all patients should use ocular lubricants, add nutritional support to their diets (essential fatty acids) and practice daily lid hygiene. Lid hygiene--- the “brush and floss” of ocular surface health. Expanding the analogy, tears can parallel saliva---without adequate, healthy saliva, as in patients with Sjögren's, teeth and gums become diseased and painful.

My patient got it — ocular surface wellness requires commitment to daily maintenance. Prescribe ocular wellness to your patients – discuss lubrication; recommend GLA omegas to boost system health and demonstrate lid hygiene with effective solutions formulated for the eye. Expand your clinical experience to include lid micro exfoliation (BlephEx) and familiarize yourself with newer hypochlorous acid solutions such as the Rx product Avenova or OTC HypoChlor.

Be like the dentist.

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S. Barry Eiden, OD, FAAO

Documentation Can Encourage Observation… International Recording Behaviors of Anterior Segment Eye Health for Best Practices

An on-line survey of eight hundred and nine eye care practitioners from across the world examined the reported use of a variety of documentation behaviors following examination of the anterior ocular segment. The intent of this survey analysis was to establish best practice guidelines.

Results found that word description (p<0.001), sketches (p=0.002) and grading scales (p<0.001) were used more commonly for recording the anterior eye health of contact lens patients as compared to non-contact lens wearing patients. Of the respondents, 84.5% used some form of a grading scale, with the original Efron system (51.6%) and CCLRU/Brien-Holden-Vision-Institute system (48.5%) being the most popular. The median number of features graded was 11 (range 1-23). The most commonly graded feature was bulbar hyperemia (91%) and the least commonly reported feature was endothelial bleb formation (19%).

Based upon the outcomes of this endeavor the authors stated that eye care practitioners should record and grade bulbar and limbal hyperemia, limbal corneal neovascularization, conjunctival papillary redness and roughness (in white light to assess coloration with fluorescein instilled to aid visualization of papillae/follicles), blepharitis, meibomian gland dysfunction and sketch staining (both corneal and conjunctival) at every visit. Additional notations should be made based upon observation of anomalies of other tissues.

For many of us the recommendations made by the authors are relatively basic and apparent. However there is more to it than appears on the surface. The fact is that when detailed documentation is performed, our observational skills become fine-tuned. Notation of subtle variations in normal appearance will make abnormalities seem extremely obvious. Paying attention to the details of the ocular surface and anterior segment will allow us to detect, diagnose and appropriately treat. For our contact lens patients improved diagnosis and management of ocular surface abnormalities will result in a significant increase in contact lens wear success and hopefully a measurable reduction of contact lens dropout rates.

Wolffsohn JS1, Naroo SA, Christie C, Morris J, Conway R, Maldonado-Codina C; British Universities Committee of Contact Lens Educators (BUCCLE). Anterior eye health recording. Cont Lens Anterior Eye. 2015 Mar 23. (Epub ahead of print).

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Clinical Outcomes of Xeno-Free Expansion and Transplantation of Autologous Ocular Surface Epithelial Stem Cells via Contact Lens Delivery: A Prospective Case Series

Depletion of limbal stem cells leads to a debilitating condition known as limbal stem cell deficiency, characterized by impaired corneal wound healing and poor vision. The aim of this study was to determine whether delivering progenitor cells on a contact lens is a viable and effective alternative to current transplantation techniques, which are complicated by biological and xenogeneic materials.

Sixteen eyes of 16 patients who had total (n = 14) and partial (n = 2) limbal stem cell deficiency (chemical burns, five eyes; iatrogenic causes, four eyes; aniridia, three eyes; trachoma-induced, two eyes; contact lens over-wear, one eye; and cicatrizing conjunctivitis, one eye) and who had failed prior therapy were recruited prospectively into the study. Autologous limbal (n = 7) or conjunctival epithelial (n = 9) biopsies were harvested from patients and placed on the concave surface of silicone hydrogel contact lenses. Cells were expanded in culture with autologous serum and transplanted onto the ocular surface.

Restoration of a transparent avascular and clinically stable corneal epithelium was attained in 10 of 16 eyes (63%) at a median follow-up time of 2.5 years (range of 0.8 to 5.8 years). Although minor complications occurred in two eyes of two patients because of contact lens insertion or removal, these were not associated with long-term sequelae.

According to the researchers, this is the first and largest study to evaluate the mid-term outcomes of autologous limbal/conjunctival stem cell transplantation via a U.S. Food and Drug Administration-approved contact lens, demonstrating that delivery of ocular progenitor cells via this procedure offers a viable, effective, and xeno-free alternative to current transplantation methodologies.

Bobba S, Chow S, Watson S, Di Girolamo N. Clinical outcomes of xeno-free expansion and transplantation of autologous ocular surface epithelial stem cells via contact lens delivery: a prospective case series. Stem Cell Res Ther. 2015 Mar 12;6(1):23. doi: 10.1186/s13287-015-0009-1.

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