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Sunday, July 17, 2011  
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Last week's question:
How is the contact lens portion of your practice doing compared to last year?

 1. Doing about the same

 2. Not doing quite as well

 2. Doing better

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

Each year, our editorial team for Contact Lens Spectrum undergoes editorial planning for content for the forthcoming year. Indeed, it is again that time of year for us and I'd like to get your input and feedback in that regard. Are we generally covering the right topics? Do we cover any one topic too much or too little? I'd very much appreciate hearing your thoughts. Please continue to send your thoughts, feedback and tips to tips@CLtoday.com.

TearScience Gains U.S. FDA Clearance for the LipiFlow Thermal Pulsation System

TearScience, Inc., a privately-held medical device company, announced that it has received U.S. Food and Drug Administration (FDA) clearance for its LipiFlow Thermal Pulsation System for the treatment of meibomian gland dysfunction (MGD). LipiFlow will be available immediately, but on a limited basis in the U.S. through the end of 2011. LipiFlow removes meibomian gland obstructions by applying directed energy to a patient's eyelid during a 12-minute in-office treatment.

TearScience will sell its LipiFlow and LipiView Ocular Surface Interferometer devices as a system for eye care practices. The LipiView enables eyecare practitioners to visualize the eye's tear film. For additional information, visit www.tearscience.com.

GPLI Announces 2011 Clinical Symposium

The GP Lens Institute (GPLI) announces GP Lens Practice...Today and Tomorrow, an in-depth clinical symposium featuring the latest advancements in the GP lens industry. Ten of the foremost experts and practitioners in the GP field will share important clinical pearls as well as practical applications for your practice to increase your comfort level in fitting spherical and specialty design lenses. Participants may earn up to seven hours of educational credit (COPE approval pending).

The symposium will be held at Hamburger University, adjacent to the Hyatt Lodge in Oakbrook, Illinois, a suburb of Chicago, on October 23, 2011. The event will feature a unique program structure allowing attendees the flexibility to customize their learning experience based on their practice needs. The day will begin with a general session on the topic of "Advancements in GP Lens Applications and Materials." Then each hour, attendees can select any course presented in Track One or Track Two. The symposium will conclude with a special two-hour case grand rounds program, with the management of representative cases pertaining to spherical and specialty GP lens applications.

For more information or to register, visit www.GPLI.info.

Global Specialty Lens Symposium Call for Papers, Posters and Photos

The Program Committee of the GSLS, to be held January 26 - 29, 2012 at the Paris Hotel and Casino in Las Vegas, 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.

New this year is the photo contest. Contestants may submit up to two (2) photographic images in the following anterior segment categories: Contact Lens, Lids, and Cornea/Conjunctiva. Contestants may also submit images obtained utilizing equipment such as OCT, topographers, etc.

Visit www.GSLSymposium.com for more information. Web submissions only. Deadline for submissions is August 31, 2011.

AOF and Vistakon Announce Award Recipients

The American Optometric Foundation (AOF) announced the 2011 Vistakon Award of Excellence in Contact Lens Patient Care recipients. This award recognizes outstanding fourth-year student clinicians who have demonstrated excellent overall knowledge of the contact lens field plus skillful, considerate and professional care of contact lens patients during their optometric education. Each winner will receive a $1,000 award and a personalized plaque commemorating their accomplishment.

Recipients are: Stefanie Ratermann, OD, Illinois College of Optometry; Colby Fletcher, OD, Indiana University at Bloomington School of Optometry; Charlie C. Dao, OD, Inter-American University of Puerto Rico School of Optometry; Lauren Evonne Quaine, OD, Michigan College of Optometry at Ferris State University; Yin-Yin Aung, OD, New England College of Optometry; Natalie Cathy Pham, OD, Northeastern State University Oklahoma College of Optometry; Brian Paul, OD, Nova Southeastern University College of Optometry; Brittany Nelson, OD, Pacific University College of Optometry; Lindsey Beth Barouh, OD, Pennsylvania College of Optometry at Salus University; Veronica Woi, OD, Southern California College of Optometry; Katherine Paulsen, OD, Southern College of Optometry; Dana Beth Pollack, OD, State University of New York College of Optometry; Joseph S. Conrad, OD, The Ohio State University College of Optometry; Sheila Karst Morris, OD, University of Alabama at Birmingham School of Optometry; Pam Satjawatcharaphong, OD, University of California - Berkeley School of Optometry; Katie Wicks, OD, University of Houston College of Optometry; Derek Wiles, OD, University of Missouri - St. Louis College of Optometry; Richard Wardé, OD, University of Montreal School of Optometry and Tanya Marie Polonenko, OD, University of Waterloo School of Optometry.

Khoshnevis Recognized as Philanthropist of the Year by Optometry Giving Sight

Amir Khoshnevis, OD is Optometry Giving Sight's Philanthropist of the Year. Khoshnevis is a Vision Source Administrator in North Carolina and his practice, Carolina Family Eye Care, has two locations in Charlotte, NC. He was chosen for this award because of his continued support of Optometry Giving Sight and his desire to provide eye care and glasses to those in need.

Dr. Khoshnevis said he is passionate about Optometry Giving Sight because of the charity's mission and approach to solving preventable blindness worldwide. "Optometry Giving Sight has not only saved thousands from unfathomable loss of functional life due to uncorrected refractive error blindness, but has also created a new generation of eye care professionals in countries that, up until now, have had no ability to train optometrists or eye care personnel. Having local optometrists will mean that future generations will not suffer from refractive error blindness," he said.

To learn more about Optometry Giving Sight please visit www.givingsight.org or call 1-888-OGS-GIVE in the U.S. or 1-800-585-8265 ext. 4 in Canada.

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Your Photo Here

An image from your interesting case could appear in this column next week!

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.

Kelly K. Nichols, OD, MPH, PhD, FAAO

Therapies on the Horizon
A number of therapeutic approaches exist for the management of ocular surface disease in the broadest sense, yet as clinicians we struggle to identify which approach will be most effective for our patients. We all are aware of the only FDA approved therapy for dry eye though to have an inflammatory component, Restasis (cyclosporine A, Allergan). In addition, there are multiple investigational molecules that impact or interact with the inflammatory pathway that are mid-way through the FDA approval process. These products include non-steroidal anti-inflammatory drops, Remura (ISTA Pharmaceuticals) & ISV-101 (InSite Vision)—both bromfenac derivitaves, thought to inhibit cyclooxygenases 1 & 2. Calcineurin inhibitors, Cyclokat (Novagali), a cyclosporine derivative, and LX214 (LuxBio), a voclosporine are under investigation. Several small molecule inflammatory mediators are being assessed: AIN457 (Novartis, neutralizes IL-17A), and ESBA105 (Alcon, anti-TNF-a) among a few with publicly available information. This is in addition to treatments targeted to MGD or anterior blepharitis, either with or without an inflammatory component or the presence of bacteria, including topical azithromycin (Azasite, Merck) and antibiotic steroid combination products (Tobradex ST, Alcon; Zylet, B+L). Many doctors use alternative therapies in addition to the aforementioned off-label uses to help relieve patient symptoms.

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Susan J. Gromacki, OD, MS, FAAO

Put Yourself in your Patient's Shoes
Not long ago, I received my first shipment of Opti-Free Pure Moist (Alcon, more information to follow in my next column). Every time I receive a new product, I take the time to learn what makes it different from the existing products already on the market. Listening to a product presentation from a company sales representative is also helpful, but I consider it just as important to do it on my own. I like to read the package and put myself in the place of my patient, who will be doing the same.

In every walk of life, any time a provider of a service can identify with the person he is serving--whether it is a patient, client, customer, student, fan, or audience member-- it increases his chance for success. So, if you are a contact lens wearer, try the new care systems yourself. Read the package labeling, follow the directions, and clean and disinfect your lenses with the product as a patient would, taking note of such items as ease of use and comfort. It will pay great dividends for your practice.

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Pilot Study of Contact Lens Practitioner Risk-Taking Propensity

Researchers wanted to determine risk-taking propensity of optometrists and the association with the volume of contact lens practice and prescribing profile. Other factors associated with high practitioner risk taking and larger volume contact lens practices were also investigated.

Sixty-four practitioners were recruited through Australian professional associations. Practitioners completed a risk-taking propensity survey and rated the importance of risk factors for contact lens-related microbial keratitis on prescribing decisions and wearer advice (prescribing profile). Demographics and the number of contact lens wearers seen per week were documented. Risk-taking propensity was estimated after adjusting for item difficulty using Rasch analysis, then scaled 0 to 100. Prescribing profile, practice type, practitioner age, and gender were tested for association with risk-taking propensity. Risk-taking propensity, practitioner age, personal contact lens wear, and the socioeconomic status of the practice location were investigated for association with the volume of contact lens patients with regression.

Rasch analysis of the risk-taking questionnaire indicated good person separation and reliability (2.44, 0.86) but some item redundancy (1.69, 0.74). Risk taking (mean 35, range 0 to 71) was associated with increasing number of contact lens patients (p = 0.02). The perceived importance of risk factors (p = 0.9) and likelihood of discussing them with patients (p = 0.7) were not associated with risk-taking propensity. Risk taking (p = 0.02) and socioeconomic status of the practice location (p = 0.03) were predictors of higher volume contact lens practices.

The researchers concluded that practitioners who see a higher volume of contact lens patients tend to have higher risk-taking personalities. However, increased risk taking did not affect the perceived importance and type of advice given to contact lens wearers. Higher socioeconomic status of the practice location is also associated with larger volume of contact lens patients. This information gives insight into what drives higher volume contact lens practice within Australia and may have applications to the contact lens and wider optical industry.

Carnt N, Keay L, Willcox MD, Evans V, Stapleton F. Pilot Study of Contact Lens Practitioner Risk-Taking Propensity. Optom Vis Sci. 2011 May 12. [Epub ahead of print]

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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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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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