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Sunday, June 28, 2015  
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When fitting patients with Keratoconus, which is your first contact lens of choice?

 Corneal GP



 Custom soft

38 total responses.

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

Most practitioners have some sort of business plan relative to running their practices, but I imagine these vary drastically in detail. What sort of plans does your office have to increase the contact lens portion of the business? As we know, contact lens wearers are more “valuable” to the practice than a non-contact lens wearer, so growth in this practice segment makes sense. I’d urge you to work with you staff, in addition to your company representatives to help you seek out novel ways to expand your business and strategic plans.

Introducing 1-Day Acuvue Moist Multifocal
Contact Lenses

At Optometry’s Meeting in Seattle, WA, Johnson & Johnson Vision Care, Inc. launched 1-Day Acuvue Moist Brand Multifocal Contact Lenses, now available nationwide. According to the company, the lens is the only multifocal contact lens that has been created with uniquely optimized optic designs to address the natural variations in pupil size according to age – and refractive power.

The company announcement states that this lens features a unique aspheric center-near design for the presbyopic eye, with innovative Eye-Inspired Design with the following features:

  • Pupil Optimization: 1-Day Acuvue Moist Multifocal is the only multifocal contact lens that closely matches the optical design to the pupil size for a better visual experience. Sixty-one distance powers (in quarter diopter steps from +6.00D to -9.00D) and three ADD powers equals 183 unique designs for built-in precision. This precision delivers more consistent performance in a multifocal lens that can help minimize chair time and maximize success.
  • Hybrid back-curve design: The hybrid back curve design helps deliver a superior vision experience in two ways: first, the spherical periphery helps ensure centration of the optics over the pupil, and second, the aspheric center closely mimics the natural shape of the cornea to maintain the integrity of the complex front-surface optics.

The lens is built on the 1-Day Acuvue Moist platform and utilizes Lacreon Technology, a unique process that permanently embeds the wetting agent PVP in the lens material. The lens also provides Class 2 UV blocking which blocks approximately 82% of UVA rays and 97% of UVB rays.

For more information, visit

CooperVision Advantage Unveiled at Optometry’s Meeting

Expanding its heritage of partnering with eyecare practitioners, CooperVision, Inc. is unveiling CooperVision Advantage – an inclusive set of business tools designed to support practice growth.

CooperVision estimates that the typical contact lens patient can provide more than $30,000 in lifetime value to a practice. However, an estimated 21 percent of contact lens wearers drop out each year. CooperVision Advantage aims to add new patients, minimize the non-clinical reasons for patient loss, and ensure that practitioners have access to the most comprehensive portfolio of contact lenses to provide options for every eye.

At launch, CooperVision Advantage brings together a number of tools under a single, unified brand. It incorporates EyeCare Prime (which includes WebSystem3), Premier, and LensFerry services. CooperVision Advantage also includes the company’s promotional and loyalty programs, training and education initiatives, and other value-added services. Other services are expected to be added over time.

For additional information, visit

Alcon Launches Clear Care Plus in the U.S.

Alcon announced the U.S. launch of Clear Care Plus Cleaning & Disinfecting Solution, which is preservative-free and the only hydrogen peroxide-based solution available in the United States with HydraGlyde Moisture Matrix technology.

According to the company, Clear Care Plus combines deep cleaning and outstanding disinfection with the added benefit of Alcon’s proprietary wetting technology that surrounds soft contact lenses with lasting moisture, complementing moisture from the wearer’s own tears.

Clear Care Plus Cleaning & Disinfecting Solution, which contains 3% hydrogen peroxide and is indicated for use with soft (hydrophilic) and rigid gas permeable (GP) contact lenses, is now available in the United States for over-the-counter purchase.

SynergEyes New Oblate Design Hybrid Lens to Launch Nationwide

SynergEyes, Inc. announces the nationwide availability of UltraHealth FC, a new hybrid lens in an oblate design. Combining exceptional gas permeable optics with SoftCushion comfort technology, this hybrid lens is indicated for post-refractive surgery patients.

The UltraHealth FC lens has a reverse geometry vaulted lens design and includes a 130 Dk GP center and an 84 Dk silicone hydrogel skirt that offers oxygen permeability, enhanced tear exchange and lens movement. Design and material advances in hybrid contact lens technology are now available for patients with flatter corneas who are looking for an improved visual outcome.

More information on UltraHealth FC and patient case studies from independent eye care professionals are available at

Online Multifocal Simulator Tool Available

SpecialEyes, LLC recently introduced a Web-based Multifocal Simulator tool to help eyecare practitioners achieve optimal outcomes when designing and prescribing the SpecialEyes 54 Multifocal custom soft contact lens. Based on the user’s specified parameters, the proprietary software program automatically calculates the appropriate multifocal zones and simulates the potential visual performance of the custom multifocal or toric multifocal contact lenses.

SpecialEyes’ Multifocal Simulator only requires the practitioner to enter three basic parameters: multifocal type (near center or distance center), add power, and pupil size. The software’s advanced algorithm then uses these inputs to determine the center zone and peripheral zone measurements, which are displayed on screen along with a series of images representing the progression from distance to near vision across the specified add-power range. By taking pupil size into account, the Multifocal Simulator ensures the resulting custom contact lenses achieve a proper balance of distance, intermediate, and near visual acuity for each individual patient, according to the company.

Eyecare practitioners can access the Multifocal Simulator tool, view video tutorials, and sign up for a free five-day email course by visiting The video demos and email course explain how to use the simulator and interpret its images, while highlighting outcomes from several real-life case studies.

Biotrue ONEday for Presbyopia Offers Expanded High Add Powers

Bausch + Lomb announces the expansion of Biotrue ONEday for Presbyopia (nesofilcon A) contact lenses with the addition of High Add power range from +6.00D to -9.00D (0.25D steps). This addition will now provide eye care practitioners the full power offering of Biotrue ONEday for Presbyopia lenses for their multifocal patients.

Biotrue ONEday for Presbyopia contact lenses combine the bio-inspired material of Biotrue ONEday contact lenses with B+L’s 3-Zone Progressive optical design used in PureVision2 multifocal contact lenses for Presbyopia.

Eyecare practitioners can direct patients to a new consumer-facing website to learn more about Biotrue ONEday and Biotrue ONEday for Presbyopia contact lenses. The website encourages patients to visit their eyecare practitioner and describes how the lenses work and the unique High-Definition optics. The presbyopia section of the website further details the next generation 3-Zone Progressive design and the bio-inspired material of Biotrue ONEday for Presbyopia contact lenses. To view the new website, visit:

VTI Taps MidSouth as Exclusive Distributor for NaturalVue

Visioneering Technologies, Inc. (VTI) has named MidSouth Premier Ophthalmics, Inc. as its exclusive national distributor.

NaturalVue Multifocal 1 Day Contact Lenses, introduced in March, are in a limited launch in select regional markets, with a national rollout continuing into 2016. The innovative lenses work with the brain to give the patient spectacle-level stereoacuity and vision at near, intermediate, and at a distance, according to the company.

A member of the Diversified Ophthalmics, Inc. family of companies, MidSouth has locations in Memphis, TN, Nashville, TN, Atlanta, GA, New Orleans, LA, and Lafayette, LA. Key services available through MidSouth include expanded hours, knowledgeable and friendly customer service, access to a range of ordering services and software interface platforms, and free shipping of direct-to-patient for annual supply orders. Additional information is available at

Seshadri Promoted to Vice President, North America Marketing at CooperVision

CooperVision, Inc. announced that Simon Seshadri has been appointed Vice President, North America Marketing. In this role, Seshadri will be responsible for overseeing regional marketing strategies, including the development of product launches, ongoing programs, promotions, and demand creation initiatives.

Seshadri joined CooperVision in 2014 as Senior Director, Global Brand Marketing, for which he had global responsibility for the Biofinity and Avaira contact lens brands. Earlier this year, he took on additional responsibilities as the interim Vice President, North America Marketing.

Prior to joining CooperVision, Seshadri served in a variety of national, regional and global marketing leadership roles with GE Healthcare, Bausch + Lomb, Philips Oral Healthcare, and Boots Healthcare. His previous responsibilities have included the management of brand, professional, trade, and digital marketing teams in Japan, the United Kingdom, and the United States.

Multiple Corneal Surgeries and Advanced Glaucoma
Daniel G. Fuller, OD, FAAO, FSLS, Memphis, TN

A 75 year-old African-American woman with advanced glaucoma was referred by a corneal specialist to determine if any vision improvement could be obtained with a contact lens. The patient has had posterior chamber intraocular lens implant, penetrating keratoplasty and filtering procedure with a shunt. Lens shown is an oblate scleral lens, 16.0 mm OAD; 4.700 mm sag/9.00 BC; APS:standard; LCD:0;0.35 mm CT; -2.00 CLP. There was no improvement with +1.25DS sph-cyl over-refraction (20/100). Central vision loss was judged related to glaucomatous atrophy rather than irregular cornea.

We thank Dr. Fuller for this image and 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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Katherine M. Mastrota, MS, OD, FAAO

Water, Children and Dry Eye

Earlier this year The American Journal of Public Health reported that in U.S. children (4134 sampled subjects aged 6 to 19) the prevalence of inadequate hydration was 54.5% as measured by mean urine osmolality (urine osmolality >800mOsm/kg).1 Nearly a fourth of the children and teens in the study said they never drank plain water. Boys were more likely than girls to be under-hydrated. The study also noted that an 8-fluid-ounce daily increase in water intake was associated with a significantly lower risk of inadequate hydration.

It has also been demonstrated that patients classified as having dry eye have suboptimal whole-body hydration (as determined by plasma osmolarity, > 316mOsm.L) as compared with non-dry eye patients.2

Mild dehydration can cause headaches, impaired physical performance, irritability, and difficulty concentrating.

As we head into summer, remember to council all your patients, young and old, about the importance of proper hydration, especially with water, to promote well-being and perhaps, prevent, in part, dry eye.

1. Kenney EL, Long MW, Cradock AL, GortmakerSL Prevalence of Inadequate Hydration Among US Children and Disparities by Gender and Race/Ethnicity: National Health and Nutrition Examination Survey, 2009–2012. Am J Public Health. 2015 Jun 11:e1-e6. [Epub ahead of print]
2. Walsh NP, Fortes MB, Raymond-Barker P, Bishop C, Owen J, Tye E, Esmaeelpour M, Purslow C, Elghenzai S. Is whole-body hydration an important consideration in dry eye? Invest Ophthalmol Vis Sci. 2012 Sep 25;53(10):6622-7.

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S. Barry Eiden, OD, FAAO

Anterior Segment OCT Discloses SiHy Fitting Characteristics Otherwise Not Observable

Researchers utilized anterior segment Fourier domain optical coherence technology to evaluate the fitting characteristics of a number of SiHy contact lenses.1 A sample of four SiHy contact lens designs were used in the study that reflected different types of edge shapes (knife-edge, round edge, semi-round edge and chiseled edge). A variety of lens powers for each design were also evaluated in order to determine if power influenced the physical lens fitting characteristics. ASOCT images were taken at the corneal center and at the limbus within 15-30 minutes after insertion for 20 healthy subjects. The images were evaluated with respect to two parameters: conjunctival indentation exerted by the lens edge; and the tear film gaps between the posterior surface of the lens and the ocular surface. The amount of conjunctival indentation was measured with the distortion angle of the conjunctiva at the lens edge. The outcomes of the study found that the degree of conjunctival indentation was highest with the chisel-edged design followed by the semi-round design (P<0.0001). Knife- and round-edged lenses exerted similar levels of conjunctival indentation that was significantly lower compared to chisel-edged lens (P<0.001). For each one of the tested lens edge designs, no significant difference was observed in the conjunctival indentation with respect to lens power. The chisel-edged lens produced the highest amount of conjunctival indentation for each one of the six lens powers (P<0.0001). Post-lens tear film gaps at the limbus were observed at most in the round-edge design (P=0.001). The researchers concluded that the fitting properties of contact lenses may be influenced by their edge design but not by their lens power.

Traditional evaluation of soft contact lens physical fitting characteristics has been limited to slit lamp examination of lenses on eyes. Determination of lens centration and movement are classically performed and documented, however numerous other fitting characteristics including lens to cornea alignment and lens edge to conjunctival surface interactions are impossible to determine accurately with slit lamp examination. The use of ASOCT can now provide the contact lens practitioner with an exquisitely accurate means to evaluate some of these other fitting characteristics. The implications of anomalies in these fitting characteristics are yet to be clearly defined, however suggestions that there may be a relationship between them and contact lens wearing comfort, tear exchange and other physiological complications, such as contact lens induced conjunctival staining (CLICS) and conjunctival epithelial flaps (CEFs), have been mentioned.2,3 New technologies such as ASOCT and others being developed will allow the contact lens practitioner to much better understand the implications of contact lens wear on the ocular surface and likely allow us to provide our patients with a healthier and more comfortable contact lens wearing experience.

1. Turhan SA, Toker E. Optical coherence tomography to evaluate the interaction of different edge designs of four different silicone hydrogel lenses with the ocular surface. Clin Ophthalmol. 2015 May 25;9:935-42.
2. Santodomingo-Rubido J, Wolffsohn J, Gilmartin B. Conjunctival epithelial flaps with 18 months of silicone hydrogel contact lens wear. Eye Contact Lens. 2008 Jan;34(1):35-8.
3. Lin MC, Yeh TN. Mechanical complications induced by silicone hydrogel contact lenses. Eye Contact Lens. 2013 Jan;39(1):115-24.

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Treatment Options for Advanced Keratoconus: A Review

Traditionally, the mainstay of treatment for advanced keratoconus (KC) has been either penetrating or deep anterior lamellar keratoplasty (PK or DALK, respectively). The success of both operations, however, has been somewhat tempered by potential difficulties and complications, both intraoperatively and postoperatively. These include suture and wound-healing problems, progression of disease in the recipient rim, allograft reaction, and persistent irregular astigmatism. Taken together, these have been the inspiration for an ongoing search for less troublesome therapeutic alternatives. These include ultraviolet crosslinking and intracorneal ring segments, both of which were originally constrained in their indication exclusively to eyes with mild to moderate disease. More recently, Bowman layer transplantation has been introduced for reversing corneal ectasia in eyes with advanced KC, re-enabling comfortable contact lens wear and permitting PK and DALK to be postponed or avoided entirely. These authors offer a summary of the current and emerging treatment options for advanced KC, aiming to provide the corneal specialist useful information in selecting the optimal therapy for individual patients.

Parker JS, van Dijk K, Melles GR. Treatment options for advanced keratoconus: A review. Surv Ophthalmol. 2015 Mar 5. pii: S0039-6257(15)00038-7. doi: 10.1016/j.survophthal.2015.02.004. [Epub ahead of print]

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