August 11, 2002

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches 8,726 readers in 74 countries.

RP Gene Linked to Macular Degeneration in Men
Scientists at the University of Michigan Kellogg Eye Center are a step closer to understanding the genetics of macular degeneration. Radha Ayyagari, Ph.D., has found that a gene associated with retinitis pigmentosa (RP) also causes a form of macular degeneration. In the August issue of Genomics, Ayyagari reports that the gene RPGR has a direct link to a form of early-onset macular degeneration that primarily affects men. Ayyagari's study marks the first time any scientist has mapped a macular degeneration gene to the X chromosome.

InSite and B&L Partner on Bacterial Infection Treatment
InSite Vision, Inc., and Bausch & Lomb (B&L) have signed a licensing agreement to develop InSite’s ISV-403 for the treatment of ocular bacterial infections. InSite is responsible for the clinical development of ISV-403 through to FDA approval, and B&L will handle subsequent commercial manufacturing and marketing. ISV-403 combines a fourth-generation fluoroquinolone with InSite’s patented DuraSite drug delivery system. Preclinical studies indicate that ISV-403 is effective against bacteria that are resistant to currently marketed fluoroquinolone products, and the dosing frequency of ISV-403 may be lower than other products.

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Do Your Patients Want to Change Their Eye Color?
They may be thinking about it, says Vistakon, makers of Acuvue Colours contact lenses. The company polled 1,000 Americans and found that 30% of adults age 18 to 24 are considering changing their eye color.

Staph Shows No Preference
Bacteria associated with daily wear soft contact lenses, solutions and cases appear to be associated with extended-wear (EW) also, say Atlanta researchers in the July issue of the Contact Lens Association of Ophthalmologists Journal. The researchers examined lenses after 30 days of extended wear and found coagulase-negative staphylococci in 74% of the lenses. The incidence of Serratia marcescens was 10%, and the incidence of Pseudomonas aeruginosa was 6%.

Keep Watch on Certain Patients with Therapeutic CLs
Consider aggressive follow-up of patients with Sjögren’s syndrome who wear therapeutic contact lenses after penetrating keratoplasty (PK). Some patients may develop infectious fungal keratitis, reports a study in the July issue of the Contact Lens Association of Ophthalmologists Journal. The authors followed a 40-year-old Sjögren’s patient. Two months after wearing the therapeutic lenses, a biomicroscopic examination revealed corneal infiltrates; a corneal tissue sample, saline and CL cultures tested positive for Candida albicans. Topical and systemic antifungal therapy cleared the infection in the right eye; however, the left eye required corneal graft surgery.

Editor's Commentary: Mail-Order Firm Has Own Lens. Will It Sell?
With its purchase of IGEL, 1-800 Contacts will have its own contact lens brand. The company will advertise the lens and believes your current or future patients will go to your offices and ask for it. The company says its market research shows that practitioners will prescribe the lenses patients ask for most of the time. More than 90% of doctors will do this, says 1-800, indicating poor doctor loyalty by patients. Interestingly, the mail-order firm claims eye doctors have a conflict of interest when selling contact lenses that they also prescribe. Now 1-800 has a conflict of interest. Does the company fill your patients’ Rx’s or does it switch them to its own brand? I guess that’s OK. They’re not doctors who have to worry about the patient’s eye health. Or do they?

Fitting Tip: Contact Lenses Are Like Dishes
When I know my patient will be using a “no rub” multipurpose solution, I point out that the directions call for extensive rinsing of the contact lenses. I like to use the analogy of washing dishes. Most people are disgusted by the thought of cleaning dishes by soaking only, and they can easily see how the same principle could apply to contact lenses. I tell my patients that thorough rinsing is the least they should do to avoid eye problems, but rubbing and rinsing before storage in fresh solution is even better.
--Elizabeth B. Diener, O.D., Pottstown, Pa.

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