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Sunday, July 7, 2013  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

July is the month in our editorial calendar that we devote to dry eye disease. In fact, the 2013 marks the 5th anniversary of the Contact Lens Spectrum "dry eye issue." As we know, dry eye disease has become one of the most prevalent ophthalmic conditions eyecare practitioners face. While we've seen some new technologies come to the market to help diagnose the condition during these past five years, we've seen little movement in the form of pharmaceuticals that can help us treat the disease. Let's hope another five years do not pass us, and our patients, by in this regard.

Google Glass Used During Eye Exam at Ferris' Michigan College of Optometry

Google Glass was used during an eye examination in Ferris State University's Michigan College of Optometry to determine how the wearable computer can improve vision care.

Elyse Kleifgen, a second-year intern in the university's professional program, is among 8,000 people chosen by the technology giant to be a Google Glass Explorer. On Tuesday, July 2, she and MCO professor Bruce Morgan conducted what may be the first eye exam using the much-anticipated device.

Craig Norman, director of the Vision Research Institute within MCO, believes that Google Glass may have far reaching potential in optometry from the perspective of hands-off video and photographic documentation, ocular image and data comparisons, plus remote live interactions with professors and instructors. The team at the Vision Research Institute is looking forward to discovering more ways the device can be used in the eye examination process.

Kleifgen was inspired to apply after the Vision Research Institute offered students financial support for the $1,500 device to explore implications for the eye care field. Kleifgen picked up her Glass last week at Google's Venice Beach, California office and got right to work familiarizing herself with the device. Tuesday's eye examination was the first step in ongoing research efforts that will include input from MCO faculty, staff and students.

Google created the Explorer program earlier this year to find "bold, creative individuals" to test Glass before its wide release in late 2013 or early 2014. Applicants were required to submit their ideas through social media sites Twitter or Google Plus; Kleifgen used Twitter to state how the technology could help optometry evolve.

Images are available in a gallery on the university's Facebook page: https://www.facebook.com/FerrisState.

UHCO and GPLI Team to Present Specialty Contact Lens Education

The University of Houston College of Optometry (UHCO) and GP Lens Institute (GPLI) have collaborated to present Building Your Specialty Lens Practice on Sunday, July 21, 2013 at the InterContinental Hotel in Dallas, Texas.

This multi-track program will highlight the newest specialty lenses on the market and include a sclera GP lens workshop. The speaker line-up includes: Edward Bennett, OD, MSEd, FAAO; Greg DeNaeyer, OD, FAAO; Matt Kauffman, OD; Norman Leach, OD, MS, FAAO; Clarke Newman, OD, FAAO; and Chirag Patel, OD.

Topics will include:

  • GP Lens Update
  • GP Multifocal Fitting & Problem Solving
  • Contact Lens Management of the Irregular Cornea
  • Specialty Contact Lens Coding & Billing
  • Bitoric GP Design and Fitting
  • Orthokeratology Update
  • Scleral GP Lens Workshop
  • GP & Custom Soft Lens Case Grand Rounds
  • 2013 Professional Responsibility Course
If you would like to attend, more information can be found at http://ce.opt.uh.edu/live-events/GPLens.

GSLS Papers and Posters Submissions Due by August 31

Plan now to attend the Global Specialty Lens Symposium to be held January 23 – 26, 2014 at the Rio All Suites Hotel and Casino in Las Vegas, Nevada. This meeting will include insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.

The Program Committee of the GSLS invites the submission of Papers and Posters. Papers and abstracts related to presbyopia, keratoconus, corneal topography, post penetrating keratoplasty or related irregular corneal surface, myopia control, orthokeratology and lens care topics are welcome.

To submit a photo for the photo contest, submit up to two (2) photographic images in the following anterior segment categories: Contact Lens and Cornea/Conjunctiva/Lids. Contestants also will be able to submit images obtained utilizing such equipment as OCT, topographers, etc.

Visit www.GSLSymposium.com for more information. Web submissions only. Deadline for submissions is August 31, 2013.

UltraVision CLPL and TMVC Launch New Contact Lenses in Taiwan

UltraVision CLPL, Cambridge, UK, and Taiwan Macro Vision Corporation (TMVC), Taipei, Taiwan, announced the launch of iDealsoft contact lenses in Taiwan.

iDealsoft is a full range of aspheric, toric, multifocal and multifocal toric contact lenses covering all possible prescriptions so no wearer is limited. The lenses are currently in mid-water Hydrogel material and plans are in place for a full launch in a silicone hydrogel material too by mid-2014.

TMVC will also launch iDealsoft into mainland China and the South East Asian markets once full product licences are in place for each relevant country.

iDealsoft lenses are manufactured in Taipei by TMVC's sister company Hiline Optical Co. Ltd. under license from UltraVision CLPL.

Calcific Band Keratitis
By Edward Boshnick, OD, Miami, Florida

This is a photo of a scleral lens on a cornea with Calcific Band Keratitis. The scleral lens enables the patient to see 20/70. Without the lens, the patient's visual acuity is finger counting at 12 inches. The patient has a history of chronic uveitis and juvenile rheumatoid arthritis.

We thank Dr. Boshnick 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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Susan J. Gromacki, OD, MS, FAAO

The EPA, Acanthamoeba and Our Patients

Most of us are aware of the extra attention given in the last few years to contact lens safety and care by the United States Food and Drug Administration (FDA) and Centers for Disease Control (CDC). In addition, the U.S. Environmental Protection Agency (EPA) has also sought to educate patients in this regard.

Because Acanthamoeba is so ubiquitous and present in water of all origins, the EPA website includes a section entitled, "Do You Wear Contact Lenses?" Contained within that section is the following list:

How can I prevent an Acanthamoeba eye infection?

  • Practice good personal hygiene when handling your contact lenses.
  • Remind young contact lens wearers about proper lens handling.
  • Clean, rinse, and disinfect lenses with commercially made sterile solutions before placing them in the eyes.
  • Clean lens cases with commercially made sterile solutions.
  • Don't use tap water, homemade solutions, and other non-sterile solutions to disinfect and store contacts.
  • Don't wet lenses with saliva.
  • Follow manufacturer instructions in rinsing and storing contact lenses.
  • Don't swim while wearing your contacts.
  • Don't trade, share, or borrow another person's lenses.
  • Replace lenses and lens cases as often as possible.
  • Only wear contact lenses prescribed by an eye care professional.
Many of our patients—even long-term contact lens wearers—are unaware of some of the items on the list and should be educated about them, either orally or via a practice informational handout.

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Katherine M. Mastrota, MS, OD, FAAO

Conclusive Best Treatment for Dry Eye Is Elusive

We all appreciate that the management of ocular surface disease, even its diagnosis, can be a mystery—challenging at best. Alves et al1 bring this fact to light in a June 2013 report in The Ocular Surface. In a meta-analysis attempt (contrasting and combining results from different studies, in the hope of identifying patterns among study results) of dry eye clinical trials, the authors conclude that heterogeneity in study design and in outcomes definition prevented meta-analysis from yielding meaningful results. Of interest, 78% of the 116 completed studies included in the monograph were sponsored by the pharmaceutical industry. Clinical trial reports obtained from eight databases were reviewed as well as public free-access electronic databases for clinical trial registration. The most frequent categories of drugs for dry eye disease in these studies were artificial tears, followed by anti-inflammatory drugs and secretagogues. The authors conclude that the identification of effective dry eye treatment strategies is hindered by the lack of an accepted set of definitive criteria for evaluating disease severity.

1. Alves M, Fonseca EC, Alves MF, Malki LT, Arruda GV, Reinach PS, Rocha EM. Dry Eye Disease Treatment: A Systemic Review of Published Trials and a Critical Appraisal of Therapeutic Strategies. Article in press. Accessed June 24, 2013. http://www.theocularsurfacejournal.com/article/S1542-0124(13)00051-7/fulltext

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Clinical Effectiveness of Topical Cyclosporine A 0.05% After Laser Epithelial Keratomileusis

Researchers wanted to evaluate the effect of topical cyclosporine A 0.05% after laser epithelial keratomileusis (LASEK).

This retrospective nonrandomized comparative analysis was performed in 40 patients (80 eyes) with myopia who underwent flap-off LASEK. Twenty patients (group A) were treated with topical cyclosporine A 0.05% in combination with conventional treatment, and 20 patients (group B) received conventional treatment only. In each group, 10 patients had preoperative dry eye. Uncorrected visual acuity, refractive error, corneal haze grade, symptom score, and ocular surface parameters were measured in both groups before LASEK and at 1, 2, 4, and 8 weeks postoperatively.

There were no significant differences between the groups in postoperative uncorrected visual acuity, spherical equivalent, corneal haze grade, Schirmer test values, and keratoepitheliopathy scores. Group A had lower symptom scores (0.80 +/- 0.52 vs.1.35 +/- 0.49; P < 0.01) and higher tear film break-up time (BUT) (8.05 +/- 1.39 vs. 6.55 +/- 1.39 seconds; P < 0.01) compared with group B at 4 weeks after LASEK. In addition, in preoperative dry eye patients, symptom scores and tear film BUT returned to preoperative level at 4 weeks postoperatively in group A, whereas they returned to preoperative level at 8 weeks in group B.

The researchers concluded that treatment with topical cyclosporine A 0.05% can improve ocular discomfort and increase tear film BUT during the early postoperative period, especially in patients with preoperative dry eye.

Lee HS, Jang JY, Lee SH, Im SK, Yoon KC. Clinical Effectiveness of Topical Cyclosporine A 0.05% After Laser Epithelial Keratomileusis. Cornea. 2013 Jul;32(7):e150-5.

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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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For more information on Contact Lenses Today including archives of previous issues, please visit our website at www.cltoday.com. For the latest articles on contact lenses, important clinical information and helpful tools related to the contact lens practice visit the Contact Lens Spectrum website at www.clspectrum.com.

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