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Sunday, May 12, 2013  
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Last question:
What is your first choice for fitting a presbyopic patient who has -1.00 D spectacle astigmatism in contact lenses?

 a. Soft spherical multifocal

 b. Soft toric multifocal
 c. GP multifocal
 d. Monovision
 e. Distance CLs with reading glasses

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

This week's abstract is quite intriguing. It is often anticipated that patients with dry eye disease should be at a higher risk for infectious keratitis. Yet, clinical and epidemiological data don't tell a clear story in this regard. This issue is one that is desperately in need of more research to elucidate the relationship between dry eye disease and infection, if any.

CooperVision Launches Science and Technology Awards Program

CooperVision announces a Science and Technology (S&T) Awards Program. The goal of this program is to bring recipients and CooperVision scientists together to explore new areas of technology advancement. The awards program will address ocular surface health and anterior segment symptomology through advancement of technologies including, but not limited to materials, devices and compounds.

Two awards comprise the CooperVision S&T Awards Program: 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. This award enables investigators to generate preliminary data that could be used toward a future CooperVision Translational Research Award. Early-career and established faculty in areas other than contact lens research are strongly encouraged to apply. A CooperVision Seedling Award provides funding for one year and is awarded on a one-time basis only. The maximum total cash amount for this award is $100,000, including indirect costs.

The CooperVision Translational Research Award is a multi-year award for a substantive translational research project. Early-career and established faculty in areas other than contact lens and research are strongly encouraged to apply. Collaboration between basic scientists, engineers and clinicians are strongly encouraged in order to achieve high-quality, innovative translational research. A CooperVision Translational Research 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. A CooperVision Translational Research Award may be considered for renewal.

For information of the application process and materials, please visit http://coopervision.com/our-company/science-and-technology-awards.

Academy 2013 Seattle: Registration Now Open

The American Academy of Optometry's 92nd annual meeting, Academy 2013 Seattle, will take place October 23-26, 2013, at the Washington State Convention Center in Seattle, Washington. Registration and housing are now open and early bird registration ends August 20, 2013.

The American Academy of Optometry's annual meeting offers a wide array of clinically relevant CE courses and cutting edge research in the clinical and vision sciences. Attendees can choose from over 250 hours of lectures and workshops, nine Section and Special Interest Group (SIG) symposia, hundreds of scientific papers and posters, and excellent social events.

This year's Plenary Session, "Today's Research, Tomorrow's Practice: Stem Cells and Ocular Regenerative Therapies," will cover the unique properties of adult and embryonic stem cells and their capabilities for regenerative treatment for anterior and posterior ocular diseases. The Monroe J. Hirsch Symposium, "Retinal Imaging," will highlight applications of using adaptive optics (AO) and optical coherence tomography (OCT), while the Ezell Fellows Present Symposium will focus on "Progress in Glaucoma Research."

The Academy 2013 Seattle Program Preview provides an overview of the exciting events and CE that will be offered. For more information, visit http://www.aaopt.org.

B+L Introduces Incise Microincision IOL in Europe

Bausch + Lomb (B+L), announced the launch of its new Incise microincision intraocular lens (IOL) in Europe. This enhanced acrylic IOL, in combination with the capabilities of the Stellaris Vision Enhancement System, allows surgeons to perform microincision cataract surgery less than 2mm, delivering less invasive surgery for a more rapid visual recovery.

According to the company, Incise has been designed to minimize posterior capsular opacification (PCO), a common long-term problem with IOLs that can cause patient vision to become clouded post-surgery.

The Incise lens received CE Mark approval in the European Union and is not approved for sale in the U.S.

Scleral Lens in LASIK Patient with Secondary Ectasia
By Augusto Rosse, IACLE, Santiago, Chili

In this picture you can see a normal geometry scleral design on a myopic patient with a old LASIK procedure who developed secondary ectasia. The photo shows touch in a very steep area around the surgery. This lens was not successful. The patient was later fit with a reverse geometry scleral lens; the fit was successful with no touch.

We thank Augusto Rosse for sending this image and welcome photo submissions from our readers. It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit http://www.cltoday.com/upload/upload.aspx 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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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

ARVO in Seattle

The annual ARVO meeting just concluded in Seattle this past week. This marked the first time in the organization's history that they held a meeting outside of sunny Florida. This year, the contact lens posters and papers were presented on Sunday and Thursday, keeping many of our faithful contact lens researchers in sunny (yes, sunny) Seattle all week.

One notable poster was a case-control study of risk factors for contact lens associated microbial keratitis (MK) in Singapore. The authors have published similar studies from the early 2000's when modern lens types (daily disposables and silicone hydrogel lenses) were new or had not deeply penetrated the market. This case control study was in part repeated with wearers from 2009-2010 in an era when these lens types were more prevalent.

Their findings revealed similar trends to years passed: washing and drying hands before lens insertion was associated with an 8X lower risk, and one particular care solution no longer available in the U.S. was associated with almost a 28X greater risk of MK. This is one of the few studies that confidently reported a greater risk (3X) of MK in those that showered with lenses. Lastly, they found a lower risk (7X) in wearers of Chinese ethnicity – which suggests that some innate defense mechanisms may play a role in this population.

Risk Factors for Contact Lens Related Microbial Keratitis in Singapore. C. Lim, N. Carnt, M. Farook, J. Lam, JS Mehta, DT Tan, F Stapleton. ARVO E-abstract 509. 2013.

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Ronald K. Watanabe, OD, FAAO

Extreme Ortho-K

Orthokeratology (OK) is an excellent treatment for low to moderate myopia and is becoming a more popular option for myopia control in children. Higher myopes have traditionally been steered away from OK because they are more difficult to fully correct. But high myopes are often interested in OK. The correction of higher myopia is less predictable, and patients are less likely to attain acceptable uncorrected visual acuity even with maximum treatment. But several OK options are available for these patients.

A few designs that can correct up to -10.00 D of myopia are iSee (GP Specialists), GOV (Global-OK Vision), and VIPOK XC. To be able to correct higher amounts of myopia, lens designs may incorporate flatter base curves, steeper mid-peripheral curves that create more compression peripherally, and smaller optic zones, among other proprietary design features. The result is more central corneal flattening and paracentral steepening with smaller treatment zones. Though these designs are not for every patient, by setting appropriate expectation levels, they can work quite well. My last high myope with moderate astigmatism is seeing 20/20 throughout the day with her iSee lenses. I'm impressed.

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Dry eye disease and microbial keratitis: is there a connection?

Dry eye is a common ocular surface disease of multifactorial etiology characterized by elevated tear osmolality and inflammation leading to a disrupted ocular surface. The latter is a risk factor for ocular surface infection, yet overt infection is not commonly seen clinically in the typical dry eye patient. This suggests that important innate mechanisms operate to protect the dry eye from invading pathogens.

This article reviews the current literature on epidemiology of ocular surface infection in dry eye patients and laboratory-based studies on innate immune mechanisms operating at the ocular surface and their alterations in human dry eye and animal models. The review highlights current understanding of innate immunity in dry eye and identifies gaps in our knowledge to help direct future studies to further unravel the complexities of dry eye disease and its sequelae.

Narayanan S, Redfern RL, Miller WL, Nichols KK, McDermott AM. Dry eye disease and microbial keratitis: is there a connection? Ocul Surf. 2013 Apr;11(2):75-92.

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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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