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Sunday, July 21, 2013  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
It seems like many more practitioners are talking about the importance of the fit of a standard soft contact lens in terms of the ultimate the success of a contact lens wearing patient. Perhaps this goes without saying, but most mass produced soft lenses are designed so as to fit the vast majority of the population. While manufacturers have data that suggest this is indeed true, a growing segment of practitioners seem to think there is more to this story. If you have a thought on this, please share it with us at cltoday@pentavisionmedia.com.

CooperVision Appoints Aragon as Senior Vice President, Global Professional and Clinical Affairs
CooperVision, Inc. announced the appointment of Dr. Juan Carlos Aragon to the newly established role of senior vice president, Global Professional and Clinical Affairs, effective immediately.

Dr. Aragon is now responsible for creating, implementing, and managing the company's professional and clinical affairs strategy worldwide, reflecting CooperVision's continued growth in developed and emerging markets.

As a qualified optometrist, Dr. Aragon has nearly three decades of experience in professional services, sales, marketing, general management and business development within the global ophthalmic industry. Since 2000, he has worked in various international roles within CooperVision, and most recently led the company's Latin America commercial operations and Americas region business development initiatives. He previously held leadership roles with Ocular Sciences, CIBA Vision, and Bausch + Lomb.

Dr. Aragon also chairs the Global Development Board for Optometry Giving Sight, the nonprofit organization CooperVision supports as a Global Platinum Sponsor.
Alden Optical Launches NovaKone Practice Locator
Alden Optical has unveiled a new mapping tool to aid keratoconic patients interested in locating practices fitting NovaKone - the company's custom soft lens for keratoconus. The mapping tool is featured prominently on the company's redesigned patient page at http://www.aldenoptical.com/patient.

Over 500 NovaKone fitting practices are listed on an intuitive "Google Maps" like map interface. Patients merely zoom into their geographic region to see practices actively fitting the NovaKone lens. The company expects that this tool will be used by keratoconic patients, who are extremely passionate about their eye health, to actively seek out new solutions to improve their vision and/or quality of life. For more information, visit the NovaKone page on Alden's website at www.aldenoptical.com/novakone.
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.
Kirchner Named SynergEyes President
SynergEyes, Inc. has promoted James Kirchner, OD, to the position of president of SynergEyes. Dr. Kirchner previously served as the senior vice president of clinical and professional relations at SynergEyes. He provided professional leadership of product development and product management. He also represented SynergEyes within the ECP community.

Prior to joining SynergEyes, Dr. Kirchner was Chief Professional Officer for Eyefinity/OfficeMate, a VSP Global company. With more than 35 years in private practice optometry, Dr. Kirchner also has been president and CEO of more than a dozen start-up companies, both within and outside the ophthalmic industry.
Ocusoft Introduces Retaine Supplements
Ocusoft, Inc. announced the availability of two new dietary supplements specially formulated to support ocular health, Retaine OM3 and Retaine FLAX. Retaine supplements contain a unique blend of Omega-3 and Omega-6 Essential Fatty Acids, which have been reported to reduce inflammation associated with dry eye. Retaine OM3 contains high potency EPA and DHA, 800 mg and 400 mg per serving respectively, while Retaine FLAX contains flax seed oil making it ideal for individuals who cannot tolerate fish oil-based supplements.

Both supplements are conveniently packaged in blister cards to improve compliance and reduce the potential for missed doses. Retaine OM3 contains 60 softgel capsules, two taken daily and Retaine FLAX contains 120 softgel capsules, four to be taken daily or as directed by a health care professional.

Retaine OM3 and Retaine FLAX join a growing line of Retaine brand eye care products, including artificial tears, exclusively available through eyecare professionals. Introductory discount pricing is available to practitioners dispensing from their office, however, patients may also order online directly at www.ocusoft.com/retaine.

For more information, call (800) 233-5469 or visit www.ocusoft.com.
B+L Acquires Option to License New Compound to Treat DES
Bausch + Lomb (B+L) and Mimetogen Pharmaceuticals Inc. announced that B+L has acquired an option to license an investigational compound currently in Phase 2 development for the treatment of dry eye syndrome (DES). The compound, called MIM-D3 and developed by Mimetogen, has the potential to be the first in a new class of agents called TrkA agonists.

Currently available dry eye therapies work to increase tear production, but do not address tear quality. MIM-D3 stimulates the production of mucin, which plays a critical role in the protection and overall health of the ocular surface. Mucins are essential for lubrication; the removal of allergens, pathogens, and debris; and corneal epithelial healing to reduce ocular surface damage. Also, according to the companies, MIM-D3 may have additional benefits than currently available dry eye therapies including the potential to improve neural function, which may improve corneal sensitivity and integrity.1

Phase 2 study results for MIM-D3 demonstrated that the use of MIM-D3, dosed twice a day, results in consistent improvements across multiple dry eye signs and symptoms with no safety or tolerability issues. A Phase 3 study is scheduled to begin before the end of 2013.

Under the terms of the agreement, Bausch + Lomb will pay Mimetogen an upfront payment as an option fee to secure the right to acquire an exclusive global license on set terms triggered by the availability of top line results from a Phase 3 study. Should Bausch + Lomb choose to pursue development based on the Phase 3 results, the company will assume all development responsibilities and costs, and also will pay development milestones, sales milestones and royalty fees to Mimetogen.

1. Joo MJ et al. The Effect of Nerve Growth Factor on Corneal Sensitivity after Laser in Situ Keratomileusis. Arch Ophthalmology. 2004 Sep; 122(9): 1338-41

Corneal Tattoo Deposits in Prosthetic Soft Contact Lens
By Biman Das, BOptom, Rajeswari Mahadevan, PhD, Chennai, India

The images show an eye with prosthetic soft contact lens fit after a failed graft followed by corneal tattooing failure. The prosthetic lens was suggested to improve cosmetic appearance. After a month of daily wear, the patient reported with multiple round, black deposits from the corneal tattoo in the prosthetic soft contact lens.

We thank Biman Das and Rajeswari Mahadevan for sending these images 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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Katherine M. Mastrota, MS, OD, FAAO

Impairment of Lacrimal Secretion in Unaffected Fellow Eye of Patients with Recurrent Unilateral HK

A May 2013 study in Ophthalmology investigates the impact of recurrent unilateral herpetic keratitis (HK) on the tear secretion of the unaffected fellow eye. Thirty-five patients with a history of recurrent unilateral HK (clinically quiescent for at least 3 months) (HK group) and 35 patients who were age- and sex-matched with no history of corneal disease (control group) were included in the study. Tear osmolarity, tear break-up time (tear stability), Schirmer's I (tear reflex) and central corneal sensitivity were measured in the HK and control groups. Tear osmolarity and Schirmer's I were similar between the affected and unaffected eyes of the HK group. Corneal sensitivity and TBUT were statistically lower in the affected eyes compared with the unaffected eyes in the HK group. The central corneal sensitivity of unaffected eyes in the HK group was not significantly different from that in the control group. The TBUT and Schirmer's were decreased and tear osmolarity was increased in the unaffected eyes of the HK group compared with the control group. The authors conclude that tear function is impaired in the unaffected eyes of patients with unilateral recurrent HK, even when the disease is apparently quiescent and that HK induces a reduction in the afferent pathways of the tear secretion reflex from the affected eye, leading to tear dysfunction in the unaffected eye.1

M'garrech M, Rousseau A, Kaswin G, Sauer A, Barreau E, Bourcier T, Labetoulle M. Impairment of Lacrimal Secretion in the Unaffected Fellow Eye of Patients with Recurrent Unilateral Herpetic Keratitis. Ophthalmology. 2013 May 9. pii: S0161-6420(13)00215-7.
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Susan J. Gromacki, OD, MS, FAAO

Two New Daily Disposable Contact Lenses

"These are the most comfortable lenses I have ever worn." This is a statement I have heard often from patients lately, as two new daily disposable (DD) contact lenses have recently been launched in the United States. Certainly we welcome the new technology that leads to better comfort, but the ultimate benefit to both practitioner and patient is the change to a DD modality, the replacement frequency shown by science to have the highest rates of compliance and lowest rates of infection.1,2 The features of the two new lenses are as follows.

Biotrue ONEday (nesofilcon A, Bausch + Lomb) was the first of the two to debut in the U.S. With its Dk of 42 it is among the most oxygen permeable of the HEMA lenses. With a low modulus of elasticity (0.49) and a high water content (78%) it is a very comfortable lens. The lens also contains a UV blocker and a B+L's High Definition Optics.

Dailies Total1 (delfilcon A, Alcon) launched last month. It contains a silicone hydrogel core with a water content of 33% and a Dk of 140. On its surface, its water content exceeds 80%. This is achieved by a structure that binds water and cross-linked polymeric wetting agents that form a soft, hydrophilic surface gel, resulting in increased comfort.3

More information about the lenses can be accessed via their websites: http://www.bausch.com/en/ECP/Our-Products/Contact-Lenses/Myopia-Contact-Lenses/Biotrue-ONEday and http://www.dailies.com/.

1. Dumbleton K, et al. Compliance with contact lens replacement in Canada and the United States. Optom Vis Sci. 2010; 87(2):131-139.
2. Chalmers RL, Keay L, Long B et al. Optom Vis Sci. 2010; 87(10):725-735.
3.Stone R. Introducing water gradient technology. Cont Lens Spectrum. 2013 28(13):34-38.

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Compliance and Hygiene Behavior Among Soft CL Wearers in the Maldives

Significant levels of non-compliance and poor hygiene among contact lens wearers have been reported previously from different parts of the world. This survey aimed at identifying the scope of hygiene and non-compliant behavior of soft contact lens wearers in the Maldives.

Established soft lens wearers attending two eye clinics in Male' city, were interviewed in office or via telephone. A set of interviewer-administered questions was used to access the subjective response on compliance and hygiene behavior (hand and lens case hygiene, water exposure, adherence to lens replacement schedule, dozing and overnight wear, awareness of aftercare visits and reuse of disinfecting solution). Participants were also asked to rate themselves as a contact lens user based on their perceived compliance and hygiene practices.

Out of 107 participants, 79 (74.8 percent) were interviewed in the office and the rest via telephone. The majority of lens wearers were female, office workers and students, with a mean age of 20.64 +/- 4.4 years. Mean duration of lens wear was 28.04 +/- 8.36 months. Most of them were using spherical lenses (86.9 percent) on a daily wear basis (96.3 percent). Major reported forms of non-compliance were poor hand hygiene (60.7 percent), lack of aftercare awareness (39.3 percent), water exposure (35.5 percent) and over-use of lenses (24.3 percent). While females were more likely to overuse their lenses than males (p < 0.005), other socio-demographic factors were not associated with reported non-compliance. Although around 90 percent of the participants considered themselves average or good contact lens wearers, most exhibited some form of non-compliant and poor hygienic behavior.

The authors concluded that a significant number of Maldivian contact lens wearers exhibited poor levels of hygiene and compliance with contact lenses and lens care systems. An effective educational reinforcement strategy needs to be developed to modify lens wearers' non-compliance.

Gyawali R, Nestha Mohamed F, Bist J, Kandel H, Marasini S, Khadka J. Compliance and hygiene behaviour among soft contact lens wearers in the Maldives. Clin Exp Optom. 2013 May 27. doi: 10.1111/cxo.12069. [Epub ahead of print]

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