Words cannot express how deep a loss the contact lens community has felt with this week's passing of Professor Brien Holden (view CLT Special Edition). Although I try hard to avoid making my editorials personal, I was with him just last week, which makes his passing even more surreal for me. He was at a minimum an uncle to many of us, a father to some of us, and a friend to all of us. A servant to all mankind, with the deepest generosity and kindness I have ever known. Rest in peace, Brien—you are missed by all of us.

Alcon has appointed Sergio Duplan as Region President, Alcon North America. He succeeds Robert Warner, who assumes a new Alcon executive committee role as Global Franchise Head, Alcon Vision Care.

Warner is a well-known leader in the eyecare community with over two decades of experience at Alcon. He has held key global and regional roles throughout his career, including successfully leading Alcon U.S. since 2012. Prior to that, he served as Region President, Alcon Latin America and the Caribbean. In his new role as Global Franchise Head, Warner will lead Alcon’s global Vision Care business, with responsibility for strategy, marketing, portfolio development, commercial execution, and chairing the global franchise team.

Duplan most recently served as Region President, Alcon Latin America and Canada. He joined Novartis more than 11 years ago and has held several leadership roles within Novartis Pharmaceuticals before joining Alcon in 2012. Duplan earned a Bachelor’s degree from Universidad Iberoamericana in Mexico and a Master’s of Business Administration from the Wharton School of the University of Pennsylvania in Philadelphia. Like Warner, he is widely respected as a strong people- and customer-focused, strategic leader who builds strong teams in service of the company’s mission.

Bausch + Lomb announced the appointment of Brian Rosenblatt, OD, as director, Professional Strategy for the U.S. Vision Care Business. Dr. Rosenblatt will join Dr. Jill Saxon and Todd Love, directors of Professional Strategy, on B+L’s Professional Strategy team.

In his new role, Rosenblatt will be responsible for enhancing B+L’s professional outreach program through its team of U.S. contact lens experts, maximizing communication and support through professional educational events, and continuing to forge relationships with key optometric industry members.

Immediately prior to joining B+L, Rosenblatt was the president and co-owner of Rosenblatt Family Eye Care Associates, in Raritan, NJ, where he worked in private practice for 23 years. A member of the New Jersey Society of Optometric Physicians and the American Optometric Association, Rosenblatt has served as the principal investigator in numerous ophthalmic studies and as a proctor for the National Board of Optometry. He is a published author in optometric peer reviewed journals, has been a national continuing education presenter on topics ranging from inflammation and trauma to glaucoma, and serves as medical director for Sidewalk University’s Gift of Sight project.

North America’s largest, independent optometric service alliance, Vision Source, a portfolio company of Brazos Private Equity Partners of Dallas, announced that it has entered into a definitive agreement to be acquired by Essilor. Both companies share in their longstanding commitment to continuously elevate independent optometry through innovation, partnership and choice. Vision Source will continue to be led and managed as an independent company by the current leadership team, which includes the company’s Founder and Executive Chairman, Glenn Ellisor, OD. The acquisition remains subject to standard regulatory approvals.

According to the company, Vision Source, with Essilor’s support, will further invest in eyecare professionals, providing them with a stronger position in the industry by offering them choice in a vast array of business tools, services and products they need to further enhance the patient experience.

Registration is open at www.GSLSymposium.com for the 10th Global Specialty Lens Symposium to be held January 21 – 24, 2016 at Caesars Palace Las Vegas, Nevada. Plan now to attend this meeting for insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.

In addition, the Program Committee of the GSLS invites the submission of Papers, Posters and images for the Photo Contest. Web submissions only. Deadline for submissions is August 31, 2015. Visit www.GSLSymposium.com for more information.

--ADVERTISING

The U.S. Department of Health & Human Services/Centers for Disease Control and Prevention’s Healthy Contact Lenses Program announced exciting new additions to their website in preparation for the second annual Contact Lens Health Week, August 24-28, 2015.

Contact Lens Health Week 2015 has been moved to August to coincide with “back to school” health promotion efforts. The theme for this year’s observance is Healthy Habits Mean Healthy Eyes, and it targets teenage contact lens wearers, their parents, and eyecare providers.

Messages and materials are also suitable for contact lens wearers of all other ages.

Visit their website for new Contact Lens Health Week 2015 materials:

• Start planning your Contact Lens Health Week 2015 celebration with our new toolkit.
• Order free posters and tear-off pads, thanks to generous financial support from the Contact Lens Institute.
• Download and share Contact Lens Health Week 2015 posters and web buttons.
• Tweet and post about Contact Lens Health Week 2015 using our new social media messages (#OnePairTakeCare).

For more information and resources for promoting healthy contact lens wear and care throughout the year, visit www.cdc.gov/contactlenses.

The American Optometric Association (AOA) announced the launch of a new AOA member benefit, the Paraoptometric Career Ladder, which is designed to revolutionize training and hiring for paraoptometrics and have a big impact on the success of optometrists’ practices. The Paraoptometric Career Ladder was developed by the AOA Paraoptometric Resource Center (PRC) and is available to AOA-member optometrists and their staff.

The Paraoptometric Career Ladder is a self-paced program and streamlines the training of new staff, or cross-training of seasoned staff, in six different job areas. The program, complete with an assessment tool, helps the optometrist or office manager determine the full range of staff’s abilities and identifies the areas of need for additional training. Once the job areas are identified, goals and timelines are set for learning, and paraoptometrics follow the step-by-step approach to learn equipment, terminology, processes and procedures. All learning objectives are linked to the education materials that cover each topic. The AOA recommends using the Paraoptometric Career Ladder when evaluating staff’s yearly performance, preparing paraoptometrics for the certification examination, or during team meetings.

The Paraoptometric Career Ladder is exclusive to AOA members and is a benefit included in AOA membership. For more about how to take advantage of the Paraoptometric Career Ladder, continuing education, and staff training, contact PRC@aoa.org.

The CLX System, a contact lens ordering, management and patient marketing system, is now fully integrated with OOGP, providing OOGP customers the opportunity to seamlessly order contact lenses, check order status and manage returns online, significantly reducing administration time for ECP staffs and improving the patient experience within the practice, according to a CLX announcement. CLX integration with several leading practice management systems can boost office productivity even further.

Besides streamlining the ordering process for OOGP customers, CLX provides easy to use, detailed reports designed to reveal key practice metrics and help guide management strategies for enhanced profitability within the practice. The integration also allows OOGP to extend to customers additional CLX resources, including such innovations as the CLX Catalog, the industry’s only on-line, daily updated contact lens catalog; Price Check, a monthly tracking of “on-line” competitive pricing; and My CL Reorder, automated patient e-mail and text communications designed to capture contact lens reorders between exams.

To learn more about the CLX System, please visit www.CLXsystem.com.

This patient developed acute corneal hydrops three days after epi-off corneal collagen cross-linking procedure for progressive keratoconus. The patient was treated conservatively with topical steroids, broad spectrum antibiotics and hyperosmotics. Three months later, residual scar formation led to significant flattening of the central cornea and the patient was able to achieve 20/40 corrected vision with a scleral lens. Note detached Descemet membrane.

We thank Boris Severinsky for this image and welcome photo submissions from our other 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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And to All a Good Night

I must say, although I experience occasional dry eye symptoms, for my age and my 30-year soft contact lens wear history, I am pleased that generally I have minimal ocular surface complaints and remain a full-time soft contact lens wearer. Perhaps it’s because I practice good lid hygiene… or maybe it’s good genes. But maybe it is because I always make sure that each night I get the hours of sleep that I need.

Sleep deprivation has been reported to contribute to several disease processes and to reduced longevity¹ and it also leads to hormonal and neurochemical changes.² Not surprisingly, a 2014 study demonstrated that it also induces tear hyperosmolarity, shortened TBUT, and reduced tear secretion.³ Sleep deprivation therefore, can exacerbate signs and symptoms in patients with ocular surface disease. Although this was a small study cohort of 20 healthy men, the results are compelling.

Please remember important lifestyle changes for your patients when managing ocular surface disease---prescribe a good night’s sleep!

1. Cirelli C. Cellular consequences of sleep deprivation in the brain. Sleep Med Rev. 2006 Oct;10(5):307-21. Epub 2006 Aug 21.
2. Nascimento DC, Andersen ML, Hipólide DC, Nobrega JN, Tufik S. Pain hypersensitivity induced by paradoxical sleep deprivation is not due to altered binding to brain mu-opioid receptors. Behav Brain Res. 2007 Mar 28;178(2):216-20. Epub 2006 Dec 21.
3. Lee YB, Koh JW, Hyon JY, Wee WR, Kim JJ, Shin YJ. Sleep deprivation reduces tear secretion and impairs the tear film. Invest Ophthalmol Vis Sci. 2014 May 15;55(6):3525-31.

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Thinking Out of the Box for Dry Eye Therapy – Steroid “Nanowafer” Therapy

A recent publication described the use of a steroid loaded nanowafer applied to the ocular surface of animal models for the treatment of dry eye disease. To improve convenience and efficacy, a dexamethasone (Dex) loaded nanowafer (Dex-NW) was developed that can release the drug on the ocular surface for a longer duration of time than drops, during which it slowly dissolves. The Dex-NW was fabricated using carboxymethyl cellulose polymer and contains arrays of 500nm square drug reservoirs filled with Dex. The in vivo efficacy of the Dex-NW was evaluated using an experimental mouse dry eye model. These studies demonstrated that once a day Dex-NW treatment on alternate days during a five-day treatment period was able to restore a healthy ocular surface and corneal barrier function with comparable efficacy to twice a day topically applied dexamethasone eye drop treatment. The Dex-NW was also very effective in down regulating expression of inflammatory cytokines (TNF-α, and IFN-γ), chemokines (CXCL-10 and CCL-5), and MMP-3, that are stimulated by dry eye. The authors stated that despite less frequent dosing, the Dex-NW has comparable therapeutic efficacy to topically applied Dex eye drops in experimental mouse dry eye model, and these results provide a strong rationale for translation to human clinical trials for dry eye.

We are well aware that dry eye disease is pervasive in our clinical populations and has not been successfully managed despite a multitude of treatment modalities that have been developed over the past years. We continue to explore both the root causes of dry eye disease and the potential treatment options. Consideration of alternatives, some of which may seem “out of the box” will be required in order for us to more successfully tackle this common yet significant problem.

Coursey TG, Henriksson JT, Marcano DC, Shin CS, Isenhart LC, Ahmad F, De Paiva CS, Pflugfelder SC, Acharya G. Dexamethasone nanowafer as an effective therapy for dry eye disease. J Control Release. 2015 Jul 13;213:168-174. [Epub ahead of print]

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This study aimed to evaluate the increase in tear meniscus height (TMH) induced by 3% diquafosol ophthalmic solution in eyes with a contact lens (CL).

Ten healthy subjects wearing high-water-content CLs received topical instillation of two ophthalmic solutions - 3% diquafosol ophthalmic solution in one eye and artificial tears in the other eye. Lower TMH was measured at 5 minutes, 10 minutes, 15 minutes, 30 minutes, and 60 minutes after instillation by anterior segment optical coherence tomography.

TMH increased significantly (P<0.001) at 5 minutes and 15 minutes after instillation of saline compared with the baseline values. After instillation of 3% diquafosol ophthalmic solution, TMH significantly increased (P<0.05) at 5 minutes, 15 minutes, 30 minutes, and 60 minutes compared with the baseline values. Increases in TMH after diquafosol instillation were significantly greater (P<0.05) at 15 minutes, 30 minutes, and 60 minutes than increases in TMH after saline instillation.

The researchers concluded that topical instillation of 3% diquafosol ophthalmic solution increases TMH for up to 60 minutes in eyes with high-water-content CLs.

Nagahara Y, Koh S, Nishida K, Watanabe H. Prolonged increase in tear meniscus height by 3% diquafosol ophthalmic solution in eyes with contact lenses. ClinOphthalmol. 2015 Jun 9;9:1029-31. doi: 10.2147/OPTH.S86173. eCollection 2015.

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