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Sunday, July 15, 2012  
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Last question:
If you are practicing "myopia control" in kids with contact lenses, which approach are you using most frequently?

 1. Multifocal

 2. Orthokeratology

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

Product development, commercialization and marketing are fascinating processes to be involved with, and I think that we as practitioners don't often appreciate the trials and tribulations of this process. When a product does come to market, what often resonates with practitioners, and patients, are its need in the market, followed by its specific attributes and selling points. Practitioners should be provided with evidence-based reasons to believe in prescribing a product, which should be translated into easy to understand reasons for patients to believe their practitioner. Keep this in mind as you see new technologies come to the contact lens market place.

Power Practice Launches The Power Hour

The Power Practice will launch The Power Hour, optometry's first free weekly online radio talk show on Wednesday, July 18, 2012, at 9 p.m. Eastern. The Power Hour can be heard via Skype or phone.

Hosted by Dr. Gary Gerber, founder of The Power Practice, The Power Hour is a live discussion vehicle for current practice-building events in optometry, political viewpoints, and clinical topics. The program will also welcome guests, both in and out of the optometric profession.

Planned topics for upcoming programs include:

  • Are eyeglasses still profitable?
  • Why is there so much emphasis on medical billing?
  • Are there too many ODs or not enough patients?
  • Tell us about the worst staff member you ever hired.
  • The best thing you ever did to grow your practice was...
  • Why even bother with contact lenses? It just feeds the 1-800 monster!
  • Can optometry exist without vision plans?
For more information about tuning into The Power Hour, visit www.PowerHour.info. For more information on The Power Practice, please visit http://www.powerpractice.com.

Contamac Celebrates 25 Years

Contamac Ltd. celebrated its 25th Anniversary with a party at the Tower of London in The Pavilion facility located in the North Moat section of the historic structure. Over 350 people from six continents, 27 countries and nearly 100 businesses and organizations speaking 19 different languages attended the event honoring Contamac's global successes over the past 25 years within the contact lens and IOL materials manufacturing industry. The Company welcomed a wide variety of customers, industry friends and associates, current and previous staff members, and its network of global distributors from India, China, Mexico, Brazil, Russia and the American partner company Contamac U.S. to this occasion. Attendees enjoyed a late afternoon champagne reception, followed by a private tour of the Crown Jewels, dinner and dancing.

Global Specialty Lens Symposium ... August 31 Deadline for Paper and Poster Submission

The Global Specialty Lens Symposium will be held January 24-27, 2013 at the Rio All Suites Hotel and Casino in Las Vegas, Nevada, USA. 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 Educational Program Committee of the GSLS invites the submission of abstracts. 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.

Those interested in submitting can visit www.GSLSymposium.com for more information. Web submissions only. Deadline for submissions is August 31, 2012.
New BCLA Member Resource Addresses Compliance

The British Contact Lens Association (BCLA) has produced a new patient handout for members to aid contact lens compliance.

Entitled, 'Your Checklist for Healthy Contact Lens Wear', the single-sided, full color handout is based on current evidence and features a checklist of 12 key steps for healthy contact lens wear. It is designed to act as a patient education tool that optometrists and contact lens opticians can use when discussing contact lens compliance with their patients at each aftercare visit. It is ideal for use alongside the BCLA patient leaflet, 'Looking after contact lenses' for new wearers, which has more information.

Online (affiliate) members can download it as a PDF from the Members' area of the BCLA website, www.bcla.org.uk, under 'Factsheets'.

Staff Education to Be Featured Among Resources at ODX National Conference

OD Excellence (ODX), a professional optical consulting group, is gearing up for their second annual National Conference. In addition to the comprehensive agenda that gives optometrists and opticians a valuable opportunity to further their vision education, one of the most exciting developments is OD Excellence's obtainment of ABO and CPC approval for Staff Education. With this advancement, ODX National Conference attendees will be given full insight and strategic aid in improving their businesses — from the exam room to the dispensary.

Experts on all elements of care, including practice management, technological integration, marketing strategy, and ocular education will be presenting, coaching and fielding questions. Complete information on the 2012 ODX National Conference, to be held in San Diego, CA from July 26-28, as well as memberships, meetings, webcasts and other industry services provided year-round, can be found on the company's website: https://www.odexcellence.com.

Stevens-Johnson Syndrome
By Gregory W. DeNaeyer, OD, FAAO

This shows the right eye of a 54-year-old man with Stevens-Johnson syndrome. His symptoms started at age 10. His best-corrected visual acuity is count fingers for the right eye and 20/40 for the left eye. He currently uses combination tobramycin and dexamethasone (Tobradex, Alcon Laboratories Inc.) twice per week in both eyes, ciprofloxacin (Ciloxan, Alcon Laboratories Inc.) twice per week in both eyes, loteprednol (Lotemax, Bausch + Lomb) every day in both eyes, and Refresh Tears (Allergan Inc.) in both eyes as needed. The patient has had surgeries to correct symblepharon and trichiasis. He has successfully worn scleral contact lenses for 5 years.

For more on this patient and Stevens-Johnson syndrome, see http://www.clspectrum.com/articleviewer.aspx?articleID=106444.

We 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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Katherine M. Mastrota, MS, OD, FAAO

Headaches and Dry Eye

Patients have often told me that discomfort in their eyes causes them to have headaches. From personal experience, I believe that there is a correlation between ocular discomfort and headaches. A 2010 office-based case series in dry eye by Jacqueline Muller, MD1 hypothesized that eyestrain and the struggle to see clearly in individuals with dry eye could trigger headaches in susceptible individuals. There is also more recent evidence that corroborates the proposed association between headaches and dry eye/ocular surface disease. Koktekir et al,2 in a observational comparative study, documented that an increased frequency of dry eye disease (as characterized by tear break-up time, Schirmer scores, lissamine green staining and OSD index scores) was found to occur in patients with migraine (headache pain scores determined by the American Headache Society's Migraine Disability Test), suggesting that migraine headaches are related to dry eye disease. Furthermore they propose that some migraine attacks may be aggravated in the presence of dry eye syndrome.

I am pleased to have this study to substantiate patient complaints and to validate their ocular concerns; hopefully we all can consider this important relationship in our clinical care of patients with ocular surface disease.

1. Accessed July 4, 2012. http://www.dryeyespecialist.com/images/HeadachesandDryEye.pdf
2 Koktekir BE, Celik G, Karalezli A, Kal A. Dry Eyes and Migraines: Is There Really a Correlation? Cornea. 2012 Jun 15. [Epub ahead of print]

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Susan J. Gromacki, OD, MS, FAAO

Hydrogen Peroxide Contact Lens Solution and Travel

The preparation for my July 1 column, "Contact Lens Solutions and Travel,"1 uncovered almost as many questions as answers. For example, a Google web search turned up various travel blogs, many with conflicting information. Since some patients reported having their hydrogen peroxide (H2O2) contact lens solution confiscated at security while others did not, I was curious about the Transportation Security Administration's (TSA) policy.

I phoned the TSA toll-free number to ask for some clarification. The official directed me to a prompt on the TSA website where I could type in "hydrogen peroxide."2 TSA classifies it as a "hazardous material that is permitted aboard an aircraft." Reportedly, H2O2 can be used to help create bombs (although in much higher concentrations than the 3% found in CL solutions) and as such can alarm the TSA's liquid testing equipment. As a result, H2O2 CL solution is not considered an "over-the-counter medication," as with multipurpose lens care solutions.

So the policy on hydrogen peroxide based care solutions is this: if the bottle is 3.4 ounces or less, it can be placed in the 1 quart plastic bag and carried on; anything larger must go through checked baggage.

There is one practice, although commonly recommended on these travel blogs, with no controversy at all from the practitioner's perspective. Transferring contact lens solution from its original, sterile bottle into a smaller, travel-sized one contaminates its contents,3 which can lead to serious eye infection — a much graver consequence than having to purchase another bottle of solution post-security or at your destination.

1. http://www.cltoday.com/issues/CLToday_070112.htm
2. http://apps.tsa.dhs.gov/mytsa/cib_results.aspx?search=hydrogen+peroxide
3. http://www.clspectrum.com/articleviewer.aspx?articleid=100766

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Restrictions of the Sale of Pharmaceuticals and Medical Devices Such As Contact Lenses Over the Internet and the Free Movement of Goods

In the light of new case law development, this article examines whether national restrictions on the online sale of pharmaceuticals and medical devices such as contact lenses are consistent either with EU secondary law, either with Article 34 TFEU that prohibits measures having equivalent effect to quantitative restrictions on imports. In particular, this article focuses on an analysis of two judgments on this important issue delivered by the Court of Justice of the European Union in 2003 and 2010, namely the Deutscher Apothekerverband decision and the Ker-Optika decision.

de Sadeleer N. Restrictions of the sale of pharmaceuticals and medical devices such as contact lenses over the internet and the free movement of goods. Eur J Health Law. 2012 Mar;19(1):3-28.

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Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
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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