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Sunday, August 10, 2014  
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Regarding the use of tap water for rinsing gas permeable contact lenses, which statement do you agree with most?

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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
From year to year, we often try to accumulate a top 10 list—a list of the top 10 items we feel are significant and deserving of attention in the contact lens field. And, each year, we solicit for your input for items on this list. Please send us contact lens items or issues that you think should go on the 2014 top 10 contact lens list. Send any thought you have to

Cooper Companies Says Acquisition of Sauflon Complete

The Cooper Companies, Inc., has completed its acquisition of the British contact lens and lens solution manufacturer Sauflon Pharmaceuticals Limited. The transaction was valued at approximately $1.2 billion.

Company officials said the acquisition strengthens its range of daily disposable contact lens options. CooperVision is now working to combine both companies’ people, processes and pipelines. Customers should continue working with their current CooperVision and Sauflon representatives, support resources and ordering mechanisms until advised otherwise.

In conjunction with the transaction, Cooper also announced it has closed a $700 million three-year Senior Unsecured Term Loan which matures Aug. 4, 2017. The company intends to use it to fund the acquisition of Sauflon, to provide working capital, and for general corporate purposes.

American Academy of Optometry Names Award Recipients

The American Academy of Optometry has named its 2014 award recipients who will be recognized at its annual meeting in November. The award recipients are Brien A. Holden, PhD, DSc, FAAO, Charles F. Prentice Medal and Lecture Award; Lyndon Jones, FCOptom, PhD, FAAO, Glenn A. Fry Award and Lecture (American Optometric Foundation Award); Laura E. Downie, BOptom, PhD, FAAO, Irvin M. and Beatrice Borish Award; Tone Garaas-Maurdalen, AAO-Essilor Award for Outstanding International Contributions to Optometry; Serge Resnikoff, MD, PhD, Carel C. Koch Memorial Award; Ron Melton, OD, FAAO and Randall K. Thomas, OD, MPH, FAAO, Vincent Ellerbrock Clinician Educator Award; Satya B. Verma, OD, FAAO, Life Fellow Award; Neville A. McBrien, MCOptom, PhD; Andrew I. Jobling; and Alex Gentle, PhD, FAAO, Garland W. Clay Award; and Edward J. Revelli, OD, FAAO, Michael G. Harris Award for Excellence in Optometric Education (American Optometric Foundation Award).

Recipients of the Section on Cornea, Contact Lenses & Refractive Technologies awards are Michel Guillon, PhD, FCOptom, FAAO, Max Schapero Memorial Lecture Award; Jean-Louis Blanchard, OD, Founders’ Award; David Rosenbloom, OD, FAAO (posthumously), Exemplary Service Award. In the Public Health & Environmental Vision Section Alden N. Haffner, OD, FAAO will receive the Henry B. Peters Memorial Award in Public Health and Environmental Vision.

Award winners will be recognized at the Academy 2014 Denver Awards Ceremony on Nov.14. The annual meeting will take place Nov. 12-15 at the Colorado Convention Center in Denver. For more information, visit

Alcon, Practitioners, Help Golfers Improve Their Games with Eye Care
Alcon partnered with The A Team–High Performance Vision Associates, a group of sports-minded eyecare practitioners, to evaluate the visual-motor skills of professional golfers at the Meijer LPGA Classic in Grand Rapids, Mich.

More than 80 professional golfers participated in the evaluations prior to tournament play, which began on Aug. 7. Evaluations included a variety of visual acuity tests, from eye-hand coordination, to tracking ability, to response time, to learning which eye is their dominant eye.

The A Team–High Performance Vision Associates offers specialized services for athletes, law enforcement professionals, aviation personnel and people with hobbies and careers that require visual skills that go above and beyond the norm. The team is composed of more than 30 practitioners who have completed the 16-hour consulting program in high performance vision created by Donald S. Teig, OD, FAAO, and founder of The A Team–High Performance Vision Associates.
GSLS Papers and Posters Submissions Due August 31
Plan now to attend the Global Specialty Lens Symposium to be held January 22 – 25, 2015 at Bally's 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 for more information. Web submissions only. Deadline for submissions is August 31, 2014.

Scleral Lens Over A Transplanted Cornea
Edward Boshnick, OD, Miami, FL

This 50-year-old patient underwent corneal transplant surgery in addition to cataract surgery due to ocular trauma. He is wearing an 18.2mm reverse geometry scleral lens. With this lens he can achieve 20/40 VA. Without this scleral lens his best corrected vision is less than 20/400.

We thank Dr. Boshnick for this image and we welcome photo submissions from our other readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit 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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S. Barry Eiden, OD, FAAO

Meibography – Detecting MG Drop Out and its Relationship to Dry Eye

New diagnostic technologies are being introduced at amazing rates and the clinician needs to determine which of these technologies are valid and clinically valuable in the diagnosis and management of disease. A lot of attention has been given recently to imaging of the meibomian glands (meibography) and clinically applicable systems are now available. The question is if this technology is clinically relevant in its ability to diagnose dry eye disease and can it be used to target effective therapy?

Researchers recently examined the morphological changes in the meibomian glands (MG) of eyes of patients with dry eye disease using a non-contact infrared meibography system and to assess their relationship with meibomian gland dropout, clinical signs, and tear-film function.1 Subjects included 264 randomly selected patients (528 eyes) suffering from dry eye disease. Tear-film break-up time (BUT) was measured and tear-film production was evaluated by the Schirmer test I (SIT). Subjective symptoms were also scored. The upper and lower eyelids were everted, and the meibomian glands were imaged using a non-contact meibography system. Partial or complete loss of the meibomian glands (meibomian dropout) was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area was >2/3 of the total meibomian gland area). Results showed that SIT and BUT were significantly negatively correlated with the meibomian gland photographic score, whereas corneal fluorescein staining was positively correlated. Conclusions: The results suggest a large proportion of meibomian dropout cases among patients with dry eye disease, indicating that treatment targeted at the meibomian glands will become an important direction for treating dry eye disease.

Dry eye disease is a common clinical condition that significantly exacerbates contact lens discomfort symptoms. The ability to identify the specific primary cause of dry eye for individual cases can allow the clinician to target their therapy accordingly. Meibography allows the clinician to non-invasively detect drop out of MGs. MG drop out is a significant indicator of meibomian gland disease (MGD) and associated dry eye. Its detection can allow for appropriate targeted therapy. The question remains unanswered as to if, with therapy, can MG drop out be reversed.

1. Feng Y, Gao Z, Feng K, Qu H, Hong J. Meibomian Gland Dropout in Patients with Dry Eye Disease in China. Curr Eye Res. 2014 Jul 22:1-8.

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Katherine M. Mastrota, MS, OD, FAAO
New Option for Managing Lid Disease

NovaBay Pharmaceuticals recently announced the FDA’s clearance of i-Lid Cleanser, a prescription only, eyelid and lash cleaner that contains pure hypochlorous acid (HOCl) and targets skin and lash surface microbial populations. Certainly great opportunity exists in the management of lid disease and I look forward to gaining experience with this product. Here are some insights into its use.

Biologically, hypochlorous acid is a naturally occurring small molecule generated by activated neutrophils (white blood cells) that contributes to the destruction of pathogens in the early stages of acute inflammation.

The antimicrobial nature of HOCl has been well documented, including drug-resistant organism.1 In vitro analysis of cell toxicity testing shows no negative effects on keratinocytes or fibro- blasts.2 It has proven useful in the treatment of chronic wounds for removing micro-organisms and biofilms.3 A number of mechanisms of action for disinfection properties of HOCl have been proposed and include inhibition of glucose oxidation, depletion of adenine nucleotides (depresses metabolic function), inhibition of DNA replication and alteration in protein unfolding and aggregation of bacteria subject to it.

1. McKenna,SM, Davies, KJA. The inhibition of bacterial growth by hypochlorous acid; possible role in the bacterial activity of phagocytes. Biochem.J. 254, 685-692. 1998
2. Sampson CM, Boston D, Sampson MN. Hypochlorous acid: a safe and efficacious new wound therapy. Poster presentation at the World Union of Wound Healing Societies. Toronto, Ontario. June 4–8, 2008.
3.; accessed July 30, 2014

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Application of Adipose-Derived Stem Cells on Scleral Contact Lens Carrier in an Animal Model of Severe Acute Alkaline Burn.
The purpose of this study was to evaluate the therapeutic effect of human adipose-derived stem cells (hASCs) overlaid on a scleral contact lens (SCL) carrier in a rabbit model of ocular alkaline burn.

After inducing alkaline burn in 11 New Zealand white rabbits, hASCs cultured on SCLs were placed on the right eye of five rabbits, SCLs without cells were used in five, and no treatment was applied in one eye. Each eye was examined and photographed for corneal vascularization, opacities, and epithelial defect in week 1, 2, and 4 after surgery. After 1 month, rabbits were killed and the corneas were removed and cut in half for electron and light microscopy examination.

Human adipose-derived stem cells were attached to SCL surface and confluent easily. Human adipose-derived stem cells on SCL eyes showed smaller epithelial defect, less corneal opacity, corneal neovascularization relative to SCL eyes. Both groups showed no symblepharon. However, the cornea in the untreated eye was melted in 2 weeks and developed severe symblepharon.

The researchers concluded that human adipose-derived stem cells on SCL can reduce inflammation and corneal haziness in severe ocular alkaline burn injury in rabbits.

Espandar L, Caldwell D, Watson R, Blanco-Mezquita T, Zhang S, Bunnell B. Application of Adipose-Derived Stem Cells on Scleral Contact Lens Carrier in an Animal Model of Severe Acute Alkaline Burn. Eye Contact Lens. 2014 Jun 4. [Epub ahead of print]

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