In looking at business structures in general, models of organizational structures include both “vertical and horizontal”. The idea in a vertical structure is that there is a hierarchical system of employee reporting in a classic “top down” fashion. Opposite to this, the horizontal structure is one that has more functional or programmatic layers that each report to a central administrative figure—based around domains or areas of the business. Both systems have advantages and disadvantages, and in both systems, you need buy in from your constituents. We are curious how you view the organizational structures of your practices, or how much thought you give to models such as these. Please email us at cltoday@pentavisionmedia.com.to share your thoughts on practice organization structures.

NovaBay Pharmaceuticals, Inc. announced receipt of 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market its novel intelli-Case with hydrogen peroxide solutions.

According to the company, about 2 million people in the U.S. use hydrogen peroxide disinfection solution, but hydrogen peroxide can be tricky to use. Too low a concentration and it doesn’t fully disinfect lenses; too high, and it can irritate the eye. Getting the concentration right is challenging because hydrogen peroxide degrades over time. Many eyecare practitioners favor the disinfection and lens material compatibility peroxide systems provide, yet side effects associated with misuse and non-compliance minimize peroxide system use.

The intelli-Case monitors the neutralization of hydrogen peroxide during the disinfection cycle with sophisticated microprocessor electronics embedded in the cap of what otherwise looks like a standard peroxide lens case. The high-tech cap has three LED lights labeled UNSAFE, BUSY and READY. Lenses are placed into the case with hydrogen peroxide solution. The green light (READY) blinks when lenses are safe to insert into the eyes and continues to blink green until contact lenses are removed from the case.

Click here to watch a video explaining the technology behind intelli-Case.

The International Association of Contact Lens Educators presented the first-ever IACLE Award for Lifetime Achievement in Contact Lens Education to Professor Desmond Fonn. The award ceremony took place at a dinner at the Manchester Museum, Manchester, UK, on May 27 to mark the Third IACLE World Congress.

Professor Fonn’s contribution to global contact lens education includes being a founding member of IACLE and its vice president for 15 years. He also served as Editor in Chief of the first edition of the IACLE Contact Lens Course (ICLC), used by educators around the world. And in 1994 and 2002, he organized the previous two IACLE World Congresses.

A Distinguished Emeritus Professor at the University of Waterloo, Canada, Professor Fonn joined the university in 1986 and was founding Director of its Centre for Contact Lens Research (CCLR). He retired from the university’s School of Optometry in 2010.

The Third IACLE World Congress was made possible by the generous support of sponsors Alcon, CooperVision and Johnson & Johnson Vision Care.

Alden Optical announced that effective June 8, 2015, ABB Optical Group will begin distributing Zenlens, the company’s acclaimed scleral lens design. With the addition of Zenlens, ABB Optical Group is now ready to support all Alden manufactured products. Practitioners now have the choice to work directly with Alden Optical on Zenlens fits, or through ABB Optical Group. Practitioners interested in Zenlens should contact either Alden Optical or their ABB Optical Group consultant or sales representative

For additional information on Zenlens or other Alden designs, visit www.aldenoptical.com. For additional information on ABB Optical Group’s products and services, visit: www.abboptical.com.

The European Academy of Orthokeratology (EurOK), a non-profit, independent organization that represents the European section of the International Academy of Orthokeratology (IAO), will hold its third annual meeting July 10-12, 2015 in Budapest, Hungary.

The meeting features three days of continuing education with experts from all over the world. The agenda includes workshops in basic Ortho-k as well as problem solving and advanced Ortho-K lens design, a scleral lens workshop, and updates in latest clinical topics and scientific research in myopia management and Ortho-K.

For more information visit http://www.eurok.eu/content/budapestok.

An experienced daily disposable contact lens user with low myopia came in for an urgent eye exam due to headaches, blurred vision and micropsia in his left eye, developed in the last two days. Upon presentation he was wearing three daily lenses in that eye and a single lens in the right. Patient admitted to being stressed recently and not being compliant with contact lens wearing regimen. After all lenses were removed, he was able to achieve 20/20 vision with his spectacles.This case emphasizes that even for established contact lens wearers compliance may still be an issue and additional education may never be redundant.

We thank Boris Severinsky for the 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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Planting Seeds

I planted my garden in preparation for the summer. It was a lovely time but arduous and somewhat labor intensive. I had to prepare the soil and after the seeds were in the ground, I needed to make sure that everything was getting water. And most importantly, I had to follow through ensuring that the darn rabbits in my yard didn't steal my harvest.

Lovely of me to talk about horticulture, but is a change in our practice different? To date, our daily disposable practice has reached 90% of all lenses. However, it didn't grow to this number overnight. In fact it has taken nearly 3 years to get here. Just like I decided to grow my garden, we made a conscious decision in the office to grow our daily disposable usage. First we convinced ourselves that one-day throwaway lenses were the best for our patients’ health. Next we figured out how we were going to convert our problematic patients into single use lenses. The challenges really began when we decided it was time to convert our happy and compliant 2-week and one-month wearers. To do this, we educated them on long-term health benefits of a more frequent replacement lens, ease of use, and being free of any care solution. Next we needed to share with them the financials (the excuse I hear the most from clinicians). Single use lenses carry a much larger sticker price than other lenses. Would you buy a more expensive car if you never had to pay for case? Many people are finding the option more appealing. We present the fact that solution sales will save the patient between $200-400 a year depending on how they care for their lenses. This savings gets us into the neighborhood of cost being nearly equal. But most importantly, you have to plant the seed and start the garden process somewhere. Without that conscious decision to become an advanced daily disposable office, the seed will never grow.

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Words of Wisdom from an Elder Statesman–Part 2

Less than two weeks after I wrote a Contact Lenses Today column about him, my 95 year-old contact lens patient, Mr. L., gave me a call at the office. In the almost three years that I have cared for his eyes, he has never given me a call at the office.

Of course, I did not tell him that I wrote a column about him. Like many in his generation, he probably would have been more embarrassed than impressed. He would have cared little about having his “name in lights” (or initials in print, in this case).

He called while I was in with a patient, but he did not want to talk with our receptionist or technician; he wanted to speak with me. Was this a CL Today version of the Sports Illustrated jinx? Was he calling about his first contact lens complication in decades? Given the immune system of a typical 95 year-old, I was understandably concerned.

He wears gas permeable (GP) lenses, and cleans and disinfects them perfectly every night. Once per week, he utilizes an enzymatic cleaner. (Yes, an enzymatic cleaner with GPs. Many of my patients utilize one.) Why did he call? Well, the brand of enzymatic cleaner that he uses is being discontinued. He was very concerned about this, and wanted to ask me which brand I recommend for him in its place. This has, of course, been documented frequently in the literature, but somehow the tale of this 95 year-old patient who has never experienced a contact lens complication serves as proof that those patients who are most diligent with their lens care do experience fewer contact lens complications. As Mr. L. would say, this story “takes the cake.”

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The purpose of this study was to demonstrate the use of the slitlamp photography and videography with extremely high magnifications for visualizing structures of the anterior segment of the eye.

A Canon 60D digital camera with Movie Crop Function was adapted into a Nikon FS-2 slitlamp to capture still images and video clips of the structures of the anterior segment of the eye. Images obtained using the slitlamp were tested for spatial resolution. The cornea of human eyes was imaged with the slitlamp, and the structures were compared with the pictures captured using the ultra-high-resolution optical coherence tomography (UHR-OCT). The central thickness of the corneal epithelium and total cornea was obtained using the slitlamp, and the results were compared with the thickness obtained using UHR-OCT.

High-quality ocular images and higher spatial resolutions were obtained using the slitlamp with extremely high magnifications and Movie Crop Function, rather than the traditional slitlamp. The structures and characteristics of the cornea, such as the normal epithelium, abnormal epithelium of corneal intraepithelial neoplasia, laser in situ keratomileusis interface, and contact lenses, were clearly visualized using this device. These features were confirmed by comparing the obtained images with those acquired using UHR-OCT. Moreover, the tear film debris on the ocular surface and the corneal nerve in the anterior corneal stroma were also visualized. The thicknesses of the corneal epithelium and total cornea were similar to that measured using UHR-OCT (P<0.05).

The researchers concluded that they demonstrated that the slitlamp photography and videography with extremely high magnifications allow better visualization of the anterior segment structures of the eye, especially of the epithelium, when compared with the traditional slitlamp.

Yuan J, Jiang H, Mao X, Ke B, Yan W, Liu C, Cintrón-Colón HR, Perez VL, Wang J. Slitlamp Photography and Videography With High Magnifications. Eye Contact Lens. 2015 May 23. [Epub ahead of print]

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