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Sunday, May 19, 2013  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

Keratoconus is a disease that affects many of our patients, particularly in specialty contact lens practices. We know that the disease has a tremendous impact on quality of life and our hope is to develop better understandings of the etiology of this condition. That said, we do have a variety of new lens designs that have been quite clinically efficacious in managing this condition. I highly encourage you to try something new for these patients, particularly when old technologies and designs are failing you.

Alcon to Officially Launch DAILIES TOTAL1 in U.S. at AOA

Alcon is planning the launch of their new contact lens, DAILIES TOTAL1, at the American Optometric Association's 116th Annual Congress, June 26-30 in San Diego. Recently launched in the UK and other parts of Europe, DAILIES TOTAL1 contact lenses are the first and only water gradient contact lenses featuring an increase from 33 percent to over 80 percent water content from core to surface, with a surface water content that's nearly the same as the cornea, according to the company. The company also reports that the lens has the highest oxygen transmissibility of any daily disposable contact lens.1

Watch for further details in a future issue of Contact Lenses Today.

1. Based on ratio of lens oxygen transmissibilities; Alcon data on file, 2010

New Lens Storage System Available from Lens Den

Lens Den LLC, a supplier of modular, space-saving diagnostic (trial) contact lens storage systems for eyecare practitioner offices, has developed a new storage layout for daily disposable lenses for astigmatism. Lens Den units can reduce the space used for storage of trial lenses by up to 50% in some cases.

For more information, please visit www.thelensden.com or contact Lens Den at 877-370-LENS (5367).

EyeXam MVPs To Be Sponsored by Industry Partners

EyeXam, a leading consumer eyecare mobile application, announced new industry partners to help "mobil-eyez" selected eyecare practices by supporting the development of their Mobile Virtual Profile (MVP), thus highlighting these practices to current and future patients via the mobile space, social media and other channels. Sponsors to date include Eyefinity, Vision Source, Menicon America, SynergEyes, FOCUS Laboratories, Inc. and QSpex. Discussions with other potential sponsors are in progress.

MVPs allow practices to enter the mobile space, have a presence on different social media channels and stay connected with patients anytime, anywhere. Practices can customize their MVP to include any information they wish to share or simply display their Facebook page so patients can "like" their posts, view their photos and "check-in" while at their office.

EyeXam is now available on Apple iOS (iPhone, iPad and iPod touch) and Android devices. According to the company, the EyeXam app is #1 in the app store when searching for keywords such as "eye exam" and was listed in the top 50 medical applications in 2012. Using the app, users can take self-guided, patent-pending vision screening tests, find an eyecare practitioner, exchange bi-directional messages with the practice, schedule appointments, view and "reserve" available office promotions, read the eye doctor's Yelp reviews and connect with the office on Facebook.

To learn more about the EyeXam platform and to request a demo, visit www.eyexam.com/demo.

Davis Joins Alden Optical

Alden Optical has brought on industry veteran John Davis, FCLSA as a Senior Product Specialist. Mr. Davis will strengthen Alden Optical's consultation team and contribute to the development of key new specialty lens designs.

Davis, a trained optician, has over 30 years of experience in specialty lens fitting including most recently seven years leading the consultation team at SynergEyes, Inc. Prior to SynergEyes, he was General Manager of Herslof Contact Lens Service, a GP lens lab in Milwaukee, WI, where he also directed the contact lens program at the Medical College of Wisconsin. Davis has achieved both FCLSA and NCLE Advanced Accreditation status.

Scleral Lens Fitted on GVHD Patient
By Boris Severinsky, MOptom, Jerusalem, Israel

This image shows a scleral contact lens fitted for relief of ocular Graft vs. Host Disease (GVHD). Note greasy lens deposits (front surface) and conjunctival folds.

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 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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Katherine M. Mastrota, MS, OD, FAAO

Changes in the Tear Film and Ocular Surface After Cataract Surgery

From Japan, comes a very interesting 2012 study on post-operative cataract patients.

Studying 48 eyes that underwent phacoemulsification, the authors evaluated slit lamp, Schirmer scores, corneal sensitivity, tear film breakup time and conjunctival impression cytology (to quantify goblet cell density) of each eye. This data was collected one day before surgery and one day, one month and three months after surgery. Corneal sensitivity decreased at one-day post-op, however returned by one month post-op. The postoperative Schirmer scores were no different from pre-op levels. Tear film breakup decreased at one day post-op, but returned close to pre-op level by one month. Interestingly, mean goblet cell density decreased at one day, one month and three months post-operatively. In addition, the decrease in goblet cell density and cataract operative time were highly correlated. The authors conclude that since goblet cell density loss correlated with operative time and that it had not recovered at three months post-op, that microscopic ocular surface damage occurs during cataract surgery. Accordingly, these changes seem to be one of the pathogenic factors that cause ocular discomfort and dry eye syndrome after cataract surgery.1

1. Oh T, Jung Y, Chang D, Kim J, Kim H. Jpn J Ophthalmol. 2012 Mar;56(2):113-8.
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Susan J. Gromacki, OD, MS, FAAO

Eye Foods

The word "doctor" originates from the Latin word for "teacher". One of my favorite aspects of practice is educating my patients on their eyes and medical health. I have found that informed patients comply more readily with my contact lens care instructions and medical treatment plans. Now I have a good made-for-patients reference to assist me in this endeavor.

Two weeks ago, I visited Canada at the invitation of the Ontario Association of Optometrists. There I was introduced to a wonderful little book, EyeFoods: a Food Plan for Healthy Eyes. Written by two eyecare practitioners, Drs. Laurie Capogna and Barbara Pelletier, it explains many of the common eye conditions and their treatments in a vernacular appropriate for health-conscious patients. Its medical information is both accurate and up-to-date. It goes on to describe the science behind why certain foods and their nutrients are beneficial to the eyes and body.

Patients have found it difficult to resist reading the copy in my examination room. With all of its vibrant, colorful photos, it would also make a welcome addition to my waiting room--and perhaps to my living room as well.

Dr. Gromacki has no proprietary interest in the book, EyeFoods: a Food Plan for Healthy Eyes.

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In Vitro Power Profiles of Daily Disposable Contact Lenses

These researchers' goal was to evaluate and compare the distribution of refractive power within the optic zone of different soft contact lenses and to investigate the effect of lens decentration on the power profiles.

The Nimo TR1504 instrument was used to measure the optical power across different aperture diameters (from 1.5mm to 5.5mm in steps of 0.5mm) of four daily disposable contact lenses: Dailies Total1, Proclear 1-Day, SofLens daily disposable and 1-Day Acuvue Moist. Measurements were performed using a wet cell. Power data were evaluated when contact lenses were in its centered position and after inducing different amounts of lens decentration (from 0.2mm to 1.0mm in steps of 0.2mm).

All contact lenses showed an increase – more negative – in lens power with distance from the lens center. The amount of change varied depending on the lens. It was about 10% of lens power for Dailies Total1 (-0.29diopters (D)), SofLens daily disposable (-0.36D), and Proclear 1-Day (-0.32D) whereas 1-Day Acuvue Moist showed a percentage variation of 3.3% (-0.10D). After inducing a lens decentration up to 1mm, the power curves were shifted in the negative direction. However, the change obtained in lens power compared with well-centered position was always lower than a quarter of diopter both for all the lenses and aperture diameters.

The authors concluded that their results showed a variation of the refractive power from the lens center, becoming more negative toward the periphery, with a negligible effect of the decentration for all disposable contact lenses studied.

Belda-Salmeron L, Madrid-Costa D, Ferrer-Blasco T, Garcia-Lazaro S, Montes-Mico R. In vitro power profiles of daily disposable contact lenses. Cont Lens Anterior Eye. 2013 Apr 29. [Epub ahead of print]

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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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