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Research Review
Loretta B. Szczotka-Flynn, OD, PhD, FAAO
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Two important papers deserve mention in this first edition of Contact Lenses Today Research Review. They happen to be from 2003 and 2005; you may wonder why I am highlighting seven year old data now. Simply because the same problems we faced earlier in this decade have surfaced again. Thomas Steinemann and colleagues published two papers in Eye & Contact Lens entitled: Ocular Complications Associated with the Use of Cosmetic Contact Lenses (2003) and Over-the-Counter Decorative Contact Lenses: Cosmetic or Medical Devices? A Case Series (2005). These papers describe twelve patients seen urgently for acute eye pain and redness after wearing plano decorative contact lenses obtained without a prescription. Four patients developed blinding infections requiring hospital admission. These papers, in part, prompted the U.S. FDA to classify all contact lenses, whether they correct refractive error or not, as medical devices.
The recent interest in "circle tinted" contact lenses to obtain an anime-style look popularized by Lady Gaga raises similar concerns. Significant numbers of teenagers and young women are obtaining these non-FDA approved lenses over the internet without a prescription. It is our job to raise awareness of proper lens care, fitting and follow-up to prevent the types of complications described in Steinemann's articles. Lastly, if you examine any patients that experience adverse events second to such lenses, report it through the ARBO or FDA websites (see FDA link at end of this newsletter) so that regulatory bodies can continue to track this issue.
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CLToday Quick Poll
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Materials & Designs
Ronald K. Watanabe, OD, FAAO
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With so many good contact lens options today, it is often difficult to select the best one for our patients. A normal healthy patient may be successful with a number of different contact lens types. Silicone hydrogels may be the fastest growing contact lens material category. In the U.S., over two-thirds of the bi-weekly/monthly disposable lens market is silicone hydrogels, a trend that is still increasing. Daily disposable usage is high in Japan and parts of Europe, with about half of Japan's market being daily disposable. With the recent introduction of silicone hydrogel daily disposables, we may see this number grow even more.
Gas permeable (GP) lenses are still significant in the market, though their use has decreased slightly over the past several years. GP usage varies quite widely around the world, with the Netherlands at about 30% of fits and the U.S. at about 10%. A look at the contact lens market by material category gives us clues as to what is working for patients worldwide and may help drive our decisions for fitting our patients.
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Alden Optical Launches Phoenix Program
Alden Optical Inc, manufacturer of made-to-order soft and GP contact lenses, announced its new Phoenix Program. The Phoenix Program was developed to provide eyecare professionals with a simple solution when faced with discontinued soft sphere brands.
Alden Optical President Tom Shone commented, "Alden Optical is in a unique position to help solve the problems presented by the discontinuation of popular soft sphere brands. With the Phoenix Program we have harnessed our custom manufacturing expertise, extraordinarily broad parameter ranges, and comprehensive material availability to offer lenses that are very close substitutes for many discontinued brands." Shone continued, "The Phoenix Program is quite easy, simply call Alden Optical or an Authorized Distributor with your patient's Rx and current brand with specifications, and we will custom manufacture a very close replacement to the original lens and ship it within two business days."
Alden Optical offers lenses in polymacon, methafilcon, Benz 3X and Benz 5X in any base curve/diameter combination and with spherical powers of +/- 30.00D. Standard pricing and a 90-day full warranty are offered on all program lenses.
Visit www.aldenoptical.com for more information and a list of Authorized Distributors.
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B+L Announces Back-to-School Consumer Promotion
Bausch + Lomb (B+L) is teaming up with actress Marcia Gay Harden for a back-to-school PR campaign to encourage parents and kids to make vision care a priority. The actress' tween daughter, Eulala, wears SofLens daily disposable lenses.
Studies indicate that kids with glasses sometimes choose not to wear them, which negatively affects their performance in academics, sports and other areas. According to a recent study conducted by Fairfield Research among members of the Good Housekeeping Reader Advisory Panel:
- 42% of parents with a child who wears glasses say that their child dislikes wearing them.
- 41% say their child does not always wear glasses when he/she should.
- 50% say their child would rather be wearing contact lenses.
Along with this PR campaign, B+L is conducting the SofLens daily disposable "Seeing Eye to Eye" contest which asks parents with kids (ages 10-19) to submit a story of 200 words or less by August 27, 2010. Submissions may cover any topic from sports and academics to travel and hobbies. The grand prize winners will receive a $5,000 scholarship and the opportunity to attend the American Music Awards in November. More information on the contest can be found at www.facebook.com/soflens.
As part of the contest, B+L is offering a special back-to-school promotion to address the barrier of price by reducing the SofLens daily disposable cost per day equivalent to that of wearing the leading two week lens. For more information, contact your B+L representative or visit: www.bausch.com/.
Call for Submissions for BCLA 2011
The British Contact Lens Association (BCLA) is inviting proposals for Clinical Workshops for presentation at its 2011 Clinical Conference, to be held May 26-29 at Manchester Central. Presenters will receive a voucher valued at £100 towards the cost of attending the conference for each workshop session presented.
Any topic related to contact lenses or the anterior eye will be considered. Workshops must have a hands-on practical approach and allow delegates the opportunity to learn new clinical skills. The time allocated for a workshop is 90 minutes.
In addition, the Association is inviting submissions of continuing education/professional development sessions for its new presentation category, Clinical Spotlight.
"The new Clinical Spotlight category has been developed with contact lens and eyecare practitioners in mind," explained BCLA President Elect and Conference Program Committee member, Dr. Catharine Chisholm. "We are inviting practitioners to submit proposals on topics that are relevant to clinical practice today, providing conference delegates with valuable take-home 'pearls' to apply in their day-to-day practice."
Groups or individuals are invited to submit proposals for a two-hour Clinical Spotlight session (90 minutes of continuing education presentations followed by a 30-minute Q&A period) on any topic relating to contact lenses and/or the anterior eye. Successful applicants will receive a conference voucher worth £100 for each speaker, which can be used towards their 2011 full delegate fee.
For further detailed information on conference submissions, including submission forms, visit www.bcla.org.uk/en/events/index.cfm.
This month at www.siliconehydrogels.org: fitting silicone hydrogels for patients with sub-optimal endothelial cell function, tear exchange rate with silicone hydrogel lenses, and our synopsis of silicone hydrogels at the 2009 AAO meeting.
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Editor's Commentary
Jason J. Nichols, OD, MPH, PhD, FAAO
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As you have probably noticed with this issue, Contact Lenses Today has undergone a significant revision in both design and content. As you can see, the format is intended to be more interactive, and we have also expanded to include an Editorial Board of prominent clinicians who will be responsible for developing regular content on contact lens materials and designs, care solutions and compliance, ocular surface disease, and research. We hope you enjoy this new format and as always, look forward to hearing from you in this regard.
It is difficult not to comment on this week's abstract and column by Dr. Loretta Szczotka, each of which highlight the importance of the need for eyecare practitioners to remain vigilant in educating our patients and the public about the proper use of contact lenses. These materials also emphasize the absurdity of viewing or regulating contact lenses as anything another other than medical devices. Stay tuned for upcoming content on these topics.
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Abstract
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Emergency Visits for Medical Device-Associated Adverse Events Among Children
The purposes of this study were to provide national estimates of emergency department (ED) visits for medical device-associated adverse events (MDAEs) in the pediatric population and to characterize these events further.
ED medical record reports from the National Electronic Injury Surveillance System All Injury Program database from January 1, 2004, through December 21, 2005, were reviewed. MDAEs among pediatric patients were identified, and data were abstracted. National estimates for pediatric MDAEs were determined according to medical specialty, device category and class, injury diagnosis, and patient characteristics and outcome.
The total estimated number of pediatric MDAEs during the 24-month period was 144799 (95% confidence interval: 113051-183903), involving devices from 13 medical specialties. Contact lenses accounted for most MDAEs (23%), followed by hypodermic needles (8%). The distribution of MDAEs according to medical specialty varied according to age subgroup. The most-prevalent types of injuries included contusions/abrasions, foreign-body intrusions, punctures, lacerations, and infections. The most-frequently affected body parts were the eyeball, pubic region, finger, face, and ear. The majority of pediatric MDAEs involved class II (moderate-risk) devices. The incidence of pediatric MDAEs decreased with increasing age from early to late childhood and then spiked after 10 years of age. More girls than boys were affected at older ages (16-21 years) and more boys than girls at younger ages (≤ 10 years). Hospitalizations were more likely to involve invasive or implanted devices.
Researchers stated that this study provides national estimates of pediatric MDAEs resulting in ED visits and highlights the need to develop interventions to prevent pediatric device-related injuries.
Wang C, Hefflin B, Cope JU, Gross TP, Ritchie MB, Qi Y, et al. Emergency Department Visits for Medical Device-Associated Adverse Events Among Children. Pediatrics. 2010 July 26, 2010:peds.2010-0528.
http://pediatrics.aappublications.org...
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