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Sunday, August 12, 2012  
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Last question:
Thinking back through the years, what percent of hydrogel lens wearers that you've tried to refit into silicone hydrogels ended up being unsuccessful in silicone hydrogel materials?

 1. 0-3%
  42%


 2. 4-7%
   30%

 3. 8-11%
   19%

 4. > 12%
   9%

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

Each year we try to accumulate a "top 10" list of the most important issues in the contact lens field, which is something we are working on now. There are many things that could be considered to be added to the list this year, and we always like to get reader feedback. Please send any thoughts you have directly to me at jnichols@optometry.uh.edu.


Allergan Partners with AAO to Provide Travel Fellowships for Residents

As part of its continued commitment to support the optometric community, Allergan has provided funding to the AAO to send a select group of graduating optometry students to the 2012 American Academy of Optometry (AAO) annual meeting.

The travel fellowships will give up to 40 residents the opportunity to attend the meeting in Phoenix this October.

To apply, students must complete and submit the required application online along with current Curriculum Vitae. The Academy's Residents Day Committee will evaluate all completed Disease Resident Travel Fellowship applications. The deadline for applications is August 20, 2012, and the application can be accessed at http://www.aaopt.org/content/docs/Disease Resident Travel Fellowship.doc.

Brien Holden Vision Institute Takes Controlling Share in Quantum Catch

The Brien Holden Vision Institute has taken a controlling share holding in U.S. based Quantum Catch, a diagnostic technology development company that has focused on making real time, high resolution systems, including retinal cameras, for detection and diagnosis of eye diseases and other conditions related to general health.

Quantum Catch LLC, is a social enterprise, founded in 2009, focusing on the design, manufacture, and sale of affordable, high-quality medical devices to make detection and screening of diseases, as well as measurement of the progression of chronic diseases, easy and convenient. The Quantum Catch team has extensive experience in design and development of products for the ophthalmic market, in software development, biomedical engineering, and in commercialization and distribution of medical technologies.

Peter Galen, CEO of Quantum Catch has more than 30 years experience in research, development and commercialization. He is dedicated to the design and development of affordable medical products for emerging countries. Their first two products are an affordable retinal imaging system and anterior segment imaging and diagnostic device for ocular and neurological disorders affecting pupillary responses and eye movements.

Through cutting edge research over the last 25 years, the Brien Holden Vision Institute, a non-profit organization, has contributed to the commercialization of products that have enhanced the vision of billions worldwide. The Institute will combine its clinical, epidemiology, eye care technology and delivery knowledge of the Institute and its partners with that of Quantum Catch to take the next step in developing instruments that can capture, analyze and diagnose conditions such as glaucoma, retinal disease, early signs of vascular and other chronic diseases and refractive error.

GSLS Paper and Poster Submissions Deadline: August 31


Plan now to attend the Global Specialty Lens Symposium to be held January24 - 27, 2013 at the Rio All Suites 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.

Those interested in submitting can visit our redesigned website at www.GSLSymposium.com for more information. Web submissions only. Deadline for submissions is August 31, 2012.
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Optometry Giving Sight U.S. Announces 2012 Project Funding

Optometry Giving Sight's U.S. National Committee has identified close to $250,000 in projects that will be supported by funds raised throughout 2012. They include two projects to benefit underserved communities within the USA; and four new projects in El Salvador and Haiti. These are in addition to ongoing support for VOSH International projects in Latin America and projects in Africa and Asia.

The two domestic projects include a partnership with the Special Olympics Lions Clubs International Opening Eyes program to provide a comprehensive vision screening service to athletes with intellectual disabilities in the USA; along with disability vision care training for the volunteer ECPs working in the program.

Funds have also been allocated for the Illumination Foundation's Mobile Eye Care Clinic project in Orange County to purchase equipment to support large- and small-scale eye care clinics providing treatment and follow up care for uninsured, homeless, and impoverished individuals.

The regional projects include a Child Eye Screening Project in El Salvador, which will screen and provide glasses to 64,000 children from extremely poor communities and a separate project will seek to build the capacity and infrastructure of an Optical Shop model being developed by VisionSpring to deliver services to remote communities in El Salvador. In Haiti projects include equipment for an Optical Lab, Vision for the Poor; and a Vision Entrepreneurs pilot project through VOSH Pennsylvania to deliver prescription eye wear and sunglasses to poor people in remote parts of Haiti.

The above disbursements were in addition to allocations made at the global level to support projects in Africa and Asia. More information is available at www.givingsight.org.


Improper Use of Daily Wear Lenses on an Extended Wear Basis
By William Townsend, OD, FAAO

These photos show the anterior segment of a 19-year-old male who presented with discomfort and reduced vision. He admitted very poor compliance with his two-week daily wear lenses, wearing them on an extended basis and not removing them for months at a time.

The superior limbus shows edematous changes with and loss of normal peripheral corneal architecture. Palisades of Vogt are no longer visible, and neovascularization extends into the peripheral cornea.

These changes are now thought to be caused by damage to or loss of limbal stem cells secondary to chronic hypoxia and inflammation.

For more on this patient and interesting references to articles on this topic see http://www.clspectrum.com/articleviewer.aspx?articleID=103343.

We welcome photo submissions from our 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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OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD, FAAO

Botulinum Toxin and Dry Eye, Part 1 of 4

Many of the patients treated for ocular surface disease/dry eye are in the age group that are also engaged in facial rejuvenation procedures, namely the injection of botulinum toxin (BOTOX) which functions to lessen the appearance of wrinkles, especially around the eye and between the eyebrows, by temporary chemical denervation of the muscles that cause the wrinkles to develop. Numerous case studies conclude that an adverse side effect from the use of botulinum toxin for cosmetic and medical concerns such as blepharospasm, is dry eye,1-4 thought to be the result of local diffusion to structures adjacent to the injection site.5 Besides decreased tear production, it has been proposed that botulinum neurotoxin chemodenervation of the obicularis oculi muscle leads to a poor blink mechanism, lagophthalmos and ectropion that may result in corneal dryness.6

Please follow along in upcoming newsletters to learn of how, conversely, botulinum can be used to treat dry eye, methods to monitor for dry eye in patients who undergo botulinum injections, and how this complication can be parlayed into a system used to study dry eye.


1. Coroneo MT, Rosenberg ML, Cheung LM. Ocular effects of cosmetic products and procedures. Ocul Surf. 2006 Apr;4(2):94-102.
2. Northington ME, Huang CC. Dry eyes and superficial punctate keratitis: a complication of treatment of glabelar dynamic rhytides with botulinum exotoxin A. Dermatol Surg. 2004 Dec;30(12pt2):1515-7
3. Arat YO, Yen MT. Effect of botulinum toxin type-A on tear production after treatment of lateral rhytids. Ophthal Plast Reconstruc Surg. 2007;23 (1) 22-24.
4. Mack WP. Complications in periocular rejuvenation. Facila Plast Surg Clin North Am. 2010;18(3);435-456.
5. Klein AW. Complications and adverse reactions with the use of botulinum toxin. Dis Month 2002;48:336-356.
6. Ozgur O, Murariu D, Parsa AA, Parsa FD. Dry eye syndrome due to botulinum toxin type-a injection: guideline for prevention. Hawaii J Med Public Health. 2012 May;71(5):120-3.

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CARE SOLUTION CORNER
Susan J. Gromacki, OD, MS, FAAO

Contact Lenses and Air Travel

As we are nearing the end of the summer vacation season (at least for me), this will be my final column on this topic. In my last column, I recommended fitting your patients who travel frequently with daily disposable contact lenses. Wearing daily disposables can certainly help our patients avoid the confusion surrounding the Transportation Security Administration's (TSA) policies. However, for long trips requiring high volumes of contact lenses, consider this: they, too, are subject to the 3-1-1 Rule since they are packaged in solution.

As I wrote in my previous columns, patients are often misinformed regarding contact lens solutions and the 3-1-1 Rule. It can be helpful to prepare a simple handout for your practice. This document should also contain general advice for contact lens wear and air travel. For example: the airplane cabin environment is especially dry. If wearing your contact lenses on the flight, use rewetting drops at frequent intervals; avoid alcohol and caffeine, which can dehydrate; drink plenty of other beverages; and position the air vents away from your eyes. If you think you may fall asleep on the plane, wear your glasses.

For further information and updates on security regulations for the U.S. and other countries that have adopted the TSA guidelines, check the TSA Web site http://www.tsa.gov/travelers.

Have a great rest of the summer, and I hope you are able to find time for a vacation of your own.

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Pigmentation of the Cornea Secondary to Tinted Soft Contact Lens Wear

In this retrospective case report from the U.K. the authors detail a case of pigmented corneal iron lines following use of tinted soft contact lenses (CL). Methods. A retrospective case report.

A 16-year-old girl was referred with suspected CL-related keratopathy OU, having recently switched to tinted soft monthly disposable CLs (8.4/14.0 -3.00 OD, -3.25 OS Aquamarine SofLens Natural Colours, Bausch and Lomb, New York, USA). Both corneas exhibited symmetric superficial corneal pigmented iron lines, which gradually disappeared following discontinuation of CL wear. Pigmented corneal rings have been reported in normal ageing corneas, in certain pathological conditions, and in association with altered corneal topography following LASIK and orthokeratology. The authors suspect a poorly fitting CL resulted in localized tear pooling between the CL and cornea, and subsequent iron pigment deposition, similar to that seen with orthokeratology. They concluded that cosmetic CLs bought via the Internet can be used in an unsupervised manner, with possible impacts on visual function and potential complications.

Spiteri N, Choudhary A, Kaye S. Pigmentation of the cornea secondary to tinted soft contact lens wear. Case Rep Ophthalmol Med. 2012;2012:852304.

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