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Sunday, July 29, 2012  
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Last question:
Which number do you believe best estimates the number of contact lens wearers there are in the world?

 1. 75 million

 2. 100 million

 3. 125 million

 4. 150 million

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

Around this time each year, the Contact Lens Spectrum editorial staff and advisors undergo planning for next year's editorial calendar. We typically request feedback from each of you for ideas of topics that you would like to see covered. As always, we'd appreciate hearing your suggestions and thoughts in this regard. Please drop us a note about any topics related to cornea, contact lenses, and the ocular surface disease which you would like us to cover in 2013 at cltoday@wolterskluwer.com. Thank you very much for your suggestions.

CLAO to Join ASCRS in New Administrative Agreement

The Contact Lens Association of Ophthalmologists, a non-profit organization with about 300 members dedicated to providing ophthalmologists, optometrists, and other eye care professionals with leading edge information in contact lens and related vision science, will be managed under the administrative umbrella of the American Society of Cataract and Refractive Surgery effective August 15, 2012. ASCRS is a 9,000-member international society dedicated to improving the education and skill sets of anterior segment surgeons.

The move comes as the CLAO Board of Directors initiates an effort to grow membership, increase its educational offering, and launch a new vision for the organization's future. Other societies and organizations under the ASCRS umbrella include the ASCRS Foundation, the American Society of Ophthalmic Administrators and The Cornea Society. Joyce D'Andrea, who has served as ASCRS Clinical Coordinator since 2005, will assume responsibilities as the CLAO staff liaison.

Under the arrangement, the CLAO Education and Research Foundation, which supports education and the advancement of research and technologies related to contact lenses, anterior segment vision care services, and public eye health care, will also be managed by ASCRS. CLAO's annual symposium and congress and its publications will remain independent and the organization will continue to function under its current bylaws and leadership board, with the sole addition of an ASCRS representative.

Diep Named CEO for Menicon Holdings B. V.

Menicon Co., Ltd. announced the appointment of Anatole Diep as the new Chief Executive Officer of Menicon Holdings B. V. (MHBV), the European headquarters and subsidiary based in Emmen, the Netherlands.

In his new role, Diep will lead Menicon's business activities across Europe, including launches of a series of new products. The first product will be a hyper-Dk monthly disposable lens, which will reinforce the distribution of Solocare Aqua, a multipurpose solution that went on sale in the member states of the European Economic Area in April. Noting the growing popularity of daily disposable lenses in Western Europe, Diep said he looked forward to overseeing the roll-out of Menicon's new daily-disposable lens pack there in 2013.

Diep, a French national, previously served as president of the Menicon Pharma contact lens care solution factory in France, as well as chief manufacturing officer for Menicon Holdings. As CEO, Diep will report directly to Toshio Matsushima, president of MHBV and executive officer of the parent company Menicon Co., Ltd.

August 31 Deadline for Paper and Poster Submission for GSLS

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

Take the World Sight Day Company Challenge 2012

Optometry Giving Sight is once again inviting the North American optical industry to join its annual World Sight Day Company Challenge by raising funds throughout October for people who are blind or vision impaired simply because they can't access an eye exam and glasses.

One of the first companies to announce their support for the 2012 Challenge is TLC Vision. The fifty TLC Laser Eye Centers will all celebrate sight, raise funds, and participate in employee giving programs leading up to World Sight Day on October 11th. TLC Vision has also become a Silver National Sponsor of Optometry Giving Sight. The company will be making a donation of $5 for every completed consultation between June and October and will invite their patients to make donations as well.

Other companies who have already advised their participation in this year's Challenge include CooperVision, Marchon, Hoya, Alcon, Essilor, ABB Concise, Transitions Optical, Focus Laboratories, AllAboutVison.com, SynergEyes, Johnson and Johnson Vision Care (Canada), Westgroupe (Canada), Carl Zeiss Vision (Canada) and the Contact Lens Manufacturers Association.

More information about making a donation or joining the Company Challenge is available at www.givingsight.org or by calling 1 888 OGS GIVE.

Eyemaginations Launches New Software Update

Eyemaginations, Inc. announced its latest software update for LUMA, the comprehensive patient education and marketing software platform for healthcare professionals. LUMA v1.9.5 features a wide variety of new eyecare topics including Tear Osmolarity Testing, Exfoliation Glaucoma, and Mixing Premium IOLs. With LUMA, doctors can help patients understand their conditions and treatments. Concurrently, the practice can market premium products and services.

The update also includes a new series of silent waiting room segments designed to provide specific messaging and call-to-action language for patient marketing. These segments, called vignettes, include such topics as Contact Lens Options, AMD Pigment Density and Vitamin Therapy, and Polarized Lenses. New vendor media have also been added from Allergen, Essilor, Physio, Alcon, and Zeiss.

For additional information, call 877.321.5481 or visit www.eyemaginations.com.

Impact of Silicone Hydrogel Contact Lenses

The comments below were sent in response to last week's Editorial requesting thoughts on whether silicone hydrogel materials have changed the contact lens market and, if so, how.

I feel silicone hydrogel lenses have made us, practitioners, feel safer. We understand the benefits of increased oxygen for corneal well-being. But, as I still see about the same number of contact lens-related red eyes, I don't feel the newer lenses have reduced the incidence of red eyes significantly. I don't know that patients appreciate a real difference.

Craig Match, OD
Halifax, PA

I think the long-term benefits of increased oxygen and the subsequent reduction/elimination of corneal edema in contact lens wearers will make the change to SiHy lenses very worthwhile. Whether or not we will be able to measure the differences is another matter. For example, if someone's corneal endothelial cell count at age 75 is X% better due to their switching to higher Dk lenses when they were younger, will anyone notice? But even if the benefits (whatever they are) are not readily apparent in an individual, I still think there will be significant benefit when we consider the large number of eyes involved.

John M. Laurent, OD, PhD
Associate Professor
UAB School of Optometry

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Susan J. Gromacki, OD, MS, FAAO

Contact Lens Care and Air Travel

This is the third installment in my series on contact lens care systems and air travel. In my last column, I described a practice common among bloggers on travel websites, and likely our patients, too: the transfer of contact lens solution from its original 12 ounce bottle into a plain 3.4 ounce or less plastic container—all in an attempt to avoid the dreaded check-in bag. The fact that this behavior exists emphasizes how important it is for us as practitioners to specifically warn against it.

In addition, the United States Transportation Security Administration (TSA) will not pass through 3 ounces of solution in a 12 oz. bottle. The container must be appropriate for the volume.

Patients have many options as most major contact lens care solutions are now available for purchase in travel-sized bottles. If in a pinch, a patient could request a sample care kit from your office. He could declare his multipurpose solution (not hydrogen peroxide) as an "over-the-counter medication," bypassing the 1 quart bag altogether; or check it through. Lastly, he could wear daily disposables and leave his solutions at home.

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Katherine M. Mastrota, MS, OD, FAAO

Ocular Surface Disease, IL-17 and Demodex

Demodex is an ectoparasite found on the human body surface. Overpopulation of the mite in the eyelash follicle and/or the meibomian glands has been associated with chronic blepharitis.1 A number of mechanisms have been proposed to explain how the organism can precipitate lid disease/clinical signs and symptoms.

A small 2011 study by Kim et al compared cytokine levels in tear samples from a Demodex blepharitis group and controls. This sampling demonstrated that the concentration of IL-17 in tears was significantly higher in the Demodex blepharitis group than in the Demodex-free blepharitis group.2 Interleukin-17 (IL-17) is a pro-inflammatory cytokine secreted by activated T-cells. The authors suggest that infestation of Demodex mites induces change of tear cytokine levels, IL-17 especially, which cause inflammation of the lid margin and ocular surface.

A follow-up study found that the tear levels of IL-1β and IL-17 are significantly decreased after eradication of Demodex,3 supporting the prior correlation.

IL 17's association with demodicidosis is yet one more clue in our understanding of lid and ocular surface disease.

1. Zhao YE, Wu LP, Hu L, Xu JR. Association of blepharitis with Demodex: a metaB analysis. Ophthalmic Epidemiol. 2012 Apr;19(2):95B102. Epub 2012 Feb 24.
2. Kim JT, Lee SH, Chun YS, Kim JC. Tear cytokines and chemokines in patients with Demodex blepharitis. Cytokine. 2011 Jan;53(1):94-9. Epub 2010 Nov 2.
3. Kim JH, Chun YS, Kim JC. Clinical and immunological responses in ocular demodecosis. J Korean Med Sci. 2011 Sep;26(9):1231-7. Epub 2011 Sep 1.

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Fluid Filled Scleral Contact Lens in Pediatric Patients: Challenges and Outcome

The researchers wanted to study the indications and the challenges while fitting scleral contact lens (ScCL) filled with fluid prior to lens insertion in pediatric patients.

They retrospectively reviewed charts of patients of 16 years or less who received ScCL (PROSE - Prosthetic Replacement of the Ocular Surface Ecosystem, Boston Foundation for Sight, Needham Heights, MA, USA) that were filled with fluid (Normal saline) before lens insertion during July 2006 to April 2010. The main goal of ScCL fitting was to improve vision in patients having keratoconus (KC) and improve the ocular microenvironment in ocular surface disease (OSD). Visual acuity before and after lens wear was noted.

Fluid-filled ScCL were dispensed to 15 patients (20 eyes). The indications for ScCL fitting were KC (n=3 eyes), Stevens Johnson syndrome (SJS, n=13 eyes), radiation keratopathy (n=1 eye), combined KC and SJS (n=1 eye) and KC and vernal keratoconjunctivitis (VKC, n=2 eyes). Mean age of the patients was 12.85 years. The average daily lens wear was 9 hours. The vision improved by 2 lines or more in 85% and dropped by 2 lines or more in 45% eyes after 4 hours of lens wear due to tear debris collection. None of the patients had any complications. Patients were self-sufficient inserting and removing ScCL. Two patients had broken lenses during the follow-up.

The authors concluded that ScCL are useful for pediatric patients who have OSD, irregular astigmatism or the two coexisting, KC combined with VKC or SJS, helping to maintain the health of the ocular surface and improving vision in these patients.

Rathi VM, Mandathara PS, Vaddavalli PK, Srikanth D, Sangwan VS. Fluid filled scleral contact lens in pediatric patients: Challenges and outcome. Cont Lens Anterior Eye. 2012 Aug;35(4):189-92. Epub 2012 Mar 28.

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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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