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Who should fund clinical or basic studies on contact lens research?

 The government

 The industry

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
Compliance with contact lens wear is and will continue to be one of the largest challenges we face in working daily with contact lens wearers. Although people are often quick to point the finger at children and teens relative to non-compliance, I have and continue to find that it is the 20+ year old group that we face mostly with these challenges. Continued education is key, but we should also look to other disciplines to glean information on new and novel strategies to aid in this on-going discussion.

Alcon Partners with ECPs to Educate Patients with New Compliance Program
Alcon’s new Patient Compliance Kit will help eye care professionals educate their patients on how to take care of their contact lenses while also providing consumers with a clear doctor recommendation.

A recent survey showed that while an overwhelming majority (95%) of optometrists reported distributing sample starter lens care kits, only 31% of patients said they received an actual recommendation for a specific product.1 In other words, distributing free sample starter kits does not always translate into a recommendation. While samples are important to new contact lens wearers for in-office instruction and to begin at-home contact lens care, a more careful approach to distributing samples allows the practitioner to strengthen the doctor-patient relationship through education and a strong recommendation.

The new Patient Compliance Kits include compliance tips, patient education on the features and benefits of Alcon’s advanced lens care technology, a new lens contact lens case and coupon for Opti-Free PureMoist Multi-Purpose Disinfecting Solution. Alcon will continue to provide Starter Lens Care Kits for all new contact lens wearers and for those patients who should evaluate an Alcon lens care product.

1. A survey of 353 contact lens wearers, Trig Omnibus, July 2012; Alcon data on file.

Anterior Segment Image Catalog Now Available
Optometrists have another quick-reference clinical tool at their fingertips with a new ophthalmic image catalog now available from the American Optometric Association’s Contact Lens and Cornea Section (CLCS).

Accessible via an online database, the Anterior Segment Image Catalog provides all AOA members with a variety of clinically reviewed photographs of anterior segment conditions that will help both in patient education and optometric research. The current library may be viewed at

The online database features numerous images of anterior segment conditions, including corneal ulcers, gaping radial keratotomy (RK) incisions and keratoconus—among others—and could expand to include additional ocular images in the coming months. To ensure overall clinical accuracy, each image has been reviewed by an expert panel to ensure quality of photography and appropriate diagnosis before being placed in the catalog for members' reference.

Member ODs also can help support the selection of images in the catalog by submitting their own ocular pictures with a brief description of the image. Visit the CLCS webpage and click on the Anterior Segment Image Catalog banner portal to access the gallery. Select "upload images" to submit photographs for panel review.

The CLCS includes practitioners and optometry students with a passionate interest in the field of contact lens, cornea, anterior segment disease, refractive surgery and related technologies. Visit to learn more about what membership in the CLCS means for you.

2014 National Optometry Hall of Fame Inductees Announced
The American Optometric Association (AOA) and Optometry Cares–The AOA Foundation congratulate the AOA member doctors who have been selected into the prestigious National Optometry Hall of Fame. Since 1998, the National Optometry Hall of Fame has recognized and honored optometrists who have made significant and long-lasting contributions to the optometric profession.

The 2014 inductees are:

  • Arol R. Augsburger, OD of Chicago, Illinois. Dr. Augsburger is president and professor of optometry at the Illinois College of Optometry. Dr. Augsburger was named Optometrist of the Year by the AOA in 1986 and received a Distinguished Service Award in 2008. He was also named Keyperson of the Year in 2005 by the Illinois Optometric Association and Optometrist of the Year in Ohio (1985), Alabama (2000), and Illinois (2007).
  • Ron Fair, OD of Brighton, Colorado. Dr. Fair served as president of the American Optometric Association (1976), the Colorado Optometric Association (1968), and the National Academies of Practice (1996-1999). He received a Distinguished Service Award in 2000 and was named the Colorado Optometric Association’s Optometrist of the Year in 1970. He has proudly served patients in the community of Brighton for more than 50 years.
  • Karla Zadnik, OD, PhD of Worthington, Ohio. Dr. Zadnik is associate dean of The Ohio State University College of Optometry and Glenn A. Fry Professor in Optometry and Physiological Optics. She is immediate past president of the American Academy of Optometry. She served the AOA’s Contact Lens and Cornea Section and received its Dr. Donald R. Korb Award for Excellence in 2009. She also received the Young Optometrist of the Year Award in 1989 from the California Optometric Association and Distinguished Scholar Award (2010) from The Ohio State University.

The inductees will be honored at Optometry’s Meeting, which will be held June 25-29 in Philadelphia, PA. For more information about the National Optometry Hall of Fame, visit

CooperVision Partners with Bogazici University for Leadership Program
Focused on developing its next generation of global leaders, CooperVision, Inc. has partnered with Bogazici University’s College of Business in Istanbul, Turkey. As a component of the company’s Inspirational Leadership Program, a select group of senior leaders spent five days on campus earlier this month, immersing themselves in issues relating to entrepreneurship, governance, national culture and institutions, financial management and growing a high caliber, emerging market workforce.

Bogazici University is ranked among the world’s top 200 institutions of higher education. Its dynamic faculty is internationally respected and globally connected, and highly able to share experiences and insights regarding the dynamic and sometimes volatile nature of multinational business challenges and opportunities.

In designing and delivering its multi-faceted leadership program, CooperVision is working with Dr. Jerry Estenson, professor of Organizational Behavior at Sacramento State University, Dr. Larry Bienati, vice president, Organization Development at CooperVision’s parent company, The Cooper Companies, and a host of world-leading subject matter experts. In addition, the Turkish program component has been supported Dr. Aysegul Toker, dean of Bogazici University’s Faculty of Economics, and by Professor Hakan Ozcelik, a Bogazici alumnus who specializes in organizational behavior, communications, management and emotional intelligence at Sacramento State.

Emerging Epithelial Ingrowth
Kyle Dohm, OD, FAAO, Oak Harbor, Washington

This images shows epithelial ingrowth status post LASIK, first developed/seen at 1.5 months
after surgery.

We thank Dr. Dohm 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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S. Barry Eiden, OD, FAAO

Corneal Biomechanics – A New Way to Look at Structure, Function and Potential Treatment Outcomes

New technologies have been developed that enable researchers and clinicians to quantitatively evaluate the biomechanical properties of the cornea. A recent publication provided a literature review of the potential role of the biomechanical properties of the cornea in different fields of visual science and the results obtained from the different instruments available.1 The authors describe corneal biomechanics as a branch of science that studies deformation and equilibrium of corneal tissue under the application of any force. The structure and hence the properties of a soft tissue, such as the cornea, are dependent on the biochemical and physical nature of the components present and their relative amounts. They describe the relative contribution of the epithelium, collagen of both Bowman’s layer and the stroma, as well as other stromal constituents, to the overall corneal biomechanical properties. In the recent years, two devices have been marketed to measure biomechanics: the Ocular Response Analyser (ORA, Reichert, Depew, NJ) since 2005 and the Corneal Visualization Scheimpflug Technology (Corvis ST, Oculus, Wetzlar, Germany) since 2011. The authors go on to review outcomes of numerous studies that have looked at the influence of a variety of corneal and ocular diseases as well as a number of therapeutic procedures on corneal biomechanical measures such as: glaucoma/intraocular pressure, corneal edema and the influence of contact lens wear, keratoconus, Fuch’s dystrophy, refractive surgical procedures, corneal cross linking, intra-corneal ring segments, and corneal reshaping/orthokeratology.

The authors’ review of the published literature sheds light on the potential utility of the biomechanical corneal properties. They conclude that new parameters derived from these measurements will serve as highly useful clinical tools for the future improvement of safety and efficacy of different eye health care strategies.

From a clinical perspective let’s envision in-office biomechanical measurement systems used to detect inadequate oxygenation of the cornea with contact lens wear, or pretreatment measures taken to better determine candidacy for corneal reshaping treatments. Add these uses to early detection of keratoconus and implementation of cross linking treatments to avoid the development of vision loss from the disease among many other potential applications. Whether or not measurement of corneal biomechanics in the practical clinical sense ends up living up to its potential remains to be seen.

1. Garcia-Porta N,Fernandes P, Queiros A, Salgado-Borges J, Parafita-Mato M, González-Méijome JM. Corneal Biomechanical Properties in Different Ocular Conditions and New Measurement Techniques. ISRN Ophthalmol. 2014 Mar 4;2014:724546. eCollection 2014.

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David Kading, OD, FAAO

This is the sixth in a series of articles highlighting designs and innovative technology from our industry partners including some of the specialty contact lens laboratories.


If you want something special, consider looking to SpecialEyes. Started in 2004 in Sarasota, Florida, the lab was created to develop high-quality, precision-fit custom lenses that could be made quickly, accurately and reliably. We all know that with custom soft lenses, this has been a challenge over the years. Started by a chemist and an engineer, with the help of two of our fellow optometrists, the company has now grown to around 20 employees.

SpecialEyes utilizes Hioxifilcon A, B and D. Hioxifilcon B is the lowest water content at 49%, D has 54% and A has 59%. All of their sphere, toric, multifocal, and toric multifocals can be made in any of these materials allowing for options depending on the practitioners preferences. An example of the quality of Hioxifilcon A, it reportedly loses only 1% of its water content over a 12-hour period of lens wear.1

They have recently released their SpecialEyes 54 Multifocal which is a custom aspheric multifocal design available in sphere or toric. They have designed this new custom multifocal to carry the same parameter range as their custom toric and sphere contact lenses which mean you can specify any base curve, and diameter, and sphere/cylinder power, and any axis. The center-zone size and type (distance or near), the rate of power progression, and the distance at which full power is reached in the periphery are all customizable.

If you have not used them, they are definitely worth looking into for their SpecialEye’zed approach.

1. Contact Lens Spectrum, Volume: 27, Issue: July 2012, page(s): 21)

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Compliance Study of CL Wearers in Japan, Part 1: Internet Survey of Actual Circumstances of Lens Use

The researchers wanted to conduct a survey of contact lens (CL) wearers who use their CLs with satisfaction in Japan and to establish the actual circumstances of CL use.

An Internet survey was conducted in 1,000 CL wearers in Japan with questionnaires concerning CL purchase/change, compliance with the duration of wear, and occurrence of complications of CL use.

Replies from 636 women (63.6%) and 364 men (36.4%) were received. The largest source of CL purchase was CL specialty stores (eyeglass chains, 41.3%). The most frequent CL types were 2-week frequent replacement (2WFR) soft CLs (SCLs) (32.1%), daily disposable (DD) (31.0%), and other lenses. The main determining factors of purchase were "price" (38.0%), "recommendation of a doctor/staff" (37.6%), and "comfort" (34.1%). The number of wearers who changed their CLs was 372 (37.2%), and the main reasons for change were "inexpensive" (34.9%) and "recommendation of a doctor/staff" (31.2%). In DD and 2WFR/planed replacement SCLs, 270 (42.7%) of 632 wearers were compliant with the recommended duration of use, and the remainder were self-identified as noncompliant. The main reason given for noncompliant behavior was "no harm in extending the duration of use" (60.3%). The number of wearers with eye complications related to lens was 373 (37.3%).

The researchers concluded that the choice of CLs by wearers seems to be price driven rather than being safety focused. Despite being aware of noncompliant behaviors regarding CL use, there were many noncompliant wearers. Clearly, ophthalmologists, optometrists, CL manufacturers, and other CL-related practitioners should cooperate and better educate patients to promote the importance of compliance with safe lens use.

Ichijima H, Shimamoto S, Ariwaka Y, Muraki K, Cavanagh HD. Compliance Study of CL Wearers in Japan, Part 1: Internet Survey of Actual Circumstances of Lens Use. Eye Contact Lens. 2014 May;40(3):169-74.

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