Zenlens is diagnostically fit via a robust 24 lens set. With two diameters and two profiles, the set can be considered four mini-sets. Fitters determine appropriate lens diameter from HVID, then design profile (i.e. prolate or oblate) from the corneal shape. Fitting adjustments are dramatically simplified as the Smart Curve ensures that only the parameter needing refinement changes, all others remain constant. For example, with Zenlens there is no need to rethink the entire fit when all that is needed is a slight sag or base curve change.

Alden Optical will host webinars on June 30 and July 17 to introduce practitioners to Zenlens, review the fitting principals and discuss beta testing cases. Additionally, attending eyecare practitioners can take advantage of a generous discount on the Zenlens diagnostic set. To register, please go to https://www1.gotomeeting.com/register/307970344 for June webinar or https://www1.gotomeeting.com/register/911099112 for July program.

Eyecare practitioners can learn more about Zenlens at the company’s website, www.aldenoptical.com, or by calling 800-253-3669.

Under the terms of agreement, Santen will make an undisclosed option payment to secure certain rights to P-321 and to support the upcoming Phase 1/2a clinical trial. Should Santen elect to exercise their option, Santen will have responsibility for all clinical, regulatory, and commercial activity for the ophthalmic use of P-321 in the agreed Asian territories. Parion retains all rights to develop and commercialize P-321 in the rest of the world, including North America and Europe.

The epithelial sodium channel (ENaC) plays a key role in the regulation of tear film volume and is, therefore, an attractive target for the treatment of dry eye. Studies with preclinical models of dry eye disease have demonstrated that by blocking ENaC, the tear film volume is restored, maintaining its protective and lubricating actions on the ocular surface. P-321 is the product of a comprehensive research effort to develop a potent ENaC inhibitor with unique pharmacokinetic and pharmacodynamic characteristics designed for topical ocular administration, metabolic stability and limited systemic exposure.

Paul Rose began development on the Rose K keratoconus lens in 1989. After going through testing 700 lenses and 12 different designs, he came up with a set of 26 lenses from which all patients could be fitted. A further two years was spent in a development stage to perfect the lens design. The Rose K lens was then launched in the New Zealand market. In 1995 the U.S. FDA gave approval for the Rose K lens to be marketed in the United States. The Rose K lens is now manufactured and distributed in many countries throughout the world.

This hybrid lens wearer is a plasterer. After two months of lens wear, the small dust particles to which the lens is sequentially exposed cause the skirt to become opaque. The patient is using hydrogen peroxide solution and
a once a week a protein tablet. Despite this regimen, the lens appears as shown in the picture.

We thank Remco Rouwenhorst 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.

Myopia Progression Management – Developing Awareness of Options Will Be a Key to Successful Implementation

A survey study was conducted by researchers in Hong Kong, China to solicit information regarding knowledge about myopia control strategies from parents of myopic children.¹ Telephone interviews were conducted with parents who responded to advertisements for two myopia control studies, one on corneal reshaping (ortho-k) and one on myopia control soft lenses. The questions explored attitudes regarding the use of corneal reshaping (ortho-k), daily wear soft lenses, and spectacles for myopia control, assuming all three optical strategies were equally effective for myopia control; and to collect their opinion on the age at which children can commence contact lens wear for vision correction (not for myopia control).

Of the 196 respondents corneal reshaping (ortho-k) was the most commonly known myopia control strategy (86%). Parents who initially responded to the advertisement for the ortho-k study selected ortho-k (49%) and spectacles (45%) (p < 0.001) as their preferred myopia control strategy, whereas parents who initially responded to the advertisement for the daily wear soft lens study had no preference (p = 0.57). The decision was affected by prior knowledge of myopia control strategies. Major considerations were convenience and safety among parents selecting contact lenses and spectacles, respectively, as their preferred options. Overall, because of the lack of confidence in safety of contact lens wear, most parents (75%) were of the opinion that contact lenses for vision correction were only for children older than 14 years (53%) and not indicated for children younger than 8 years.

The authors concluded that the parents surveyed appeared to regard myopia control contact lenses as "treatment" and not as visual aids. They were more conservative in the use of contact lenses for vision correction in children. Parents' decision in selecting a myopia control strategy, assuming all three strategies to be equally effective, was affected by the individual's concerns of safety and additional benefits as well as influenced by positive evidence on myopia control effects.

In the United States awareness of proven methods for the control of myopia progression is just starting to develop. Moreover, awareness of the impact of myopia on both visual function and ocular health also has a long way to go. Not only can higher degrees of myopia significantly impact quality of life measures but it can also significantly increase the risk of vision loss due to diseases such as myopic macular degeneration, retinal detachment and glaucoma.² I expect to see significant advances in the awareness of both of these areas over the years to come as more and more eyecare practitioners come to realize the importance of myopia intervention strategies.

1. Cheung SW^, Lam C, Cho P. Parents' knowledge and perspective of optical methods for myopia control in children. Optom Vis Sci. 2014 Jun; 91(6):634-41.
2. Holden B, Sankaridurg P, Smith E, Aller T, Jong M, He. Myopia, an underrated global challenge to vision: where the current data takes us on myopia control. Eye (Lond). 2014 Feb; 28(2): 142-6.

Today, we have so many options with contact lenses, at times it can be overwhelming. When my grandfather practiced optometry, from 1950-2000, he had less challenges with contact lenses. His options for solving problems in the very early days were: “take it or leave it – here are your glasses.” I am grateful for all the possibilities, opportunities, and struggles to decide which of the many great lens materials and designs to use for our patients –a blessing that my grandfather didn't have early on.

When a new patient presents to the office with their lengthy contact lens history and vision or comfort issues, it is refreshing to have a revolving door of new materials and designs. I’d like to take the next couple columns to celebrate where we have come and to highlight some materials that have been on the market for years, but are not outdated. Looking at contact lens history, we’ve gone from the 1500’s when DaVinci conceptualized the idea of the contact lens to modern silicone hydrogels in daily disposable, toric and multifocal designs. What will tomorrow bring?

The purpose of this study was to compare the effectiveness of a single LipiFlow treatment with combined lid warming and massage in patients with meibomian gland dysfunction (MGD).

In this prospective, randomized, crossover, observer-masked clinical trial, subjects were randomized to receive either a single 12-minute LipiFlow Thermal Pulsation (LTP) system treatment or to perform combined twice-daily lid warming and massage for 3 months. All subjects were examined before, and 1 and 3 months after initiation of treatments. Investigated parameters included subjective symptoms, lipid layer thickness, meibomian gland assessment, tear break-up time, tear osmolarity, corneal and conjunctival staining, Schirmer test values, and tear meniscus height.

A total of 31 subjects completed the 3-month follow-up. At 1 and 3 months, patients in the LipiFlow treatment group had a significant reduction in Ocular Surface Disease Index (OSDI) scores compared with those in the lid-margin hygiene group. Both treatments produced a significant improvement in expressible meibomian glands compared to the baseline parameters, but no significant difference was noted between the two groups. The other investigated objective parameters did not show a significant difference.

The researchers concluded that the results of the study show that a single LipiFlow treatment is as least as effective as a 3-month, twice-daily lid margin hygiene regimen for MGD. However, the present study was observer-masked only, and therefore a placebo effect may have confounded any improvements in subjective symptoms and other parameters in both groups.

Finis D, Hayajneh J, König C, Borrelli M, Schrader S, Geerling G. Evaluation of an Automated Thermodynamic Treatment (LipiFlow) System for Meibomian Gland Dysfunction: A Prospective, Randomized, Observer-Masked Trial. Ocul Surf. 2014 Apr;12(2):146-54. Epub 2014 Jan 22.