August 15, 2004
Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches more than 10,000 readers in 74 countries.
Diabetic Resource Available for ODs, Other Healthcare Professionals|
The National Diabetes Education Program (NDEP) has issued Working Together to Manage Diabetes: A Guide for Pharmacists, Podiatrists, Optometrists and Dental Professionals (PPOD). The new publication emphasizes the key role that these healthcare professionals play in delivering health messages to people who have diabetes. The NDEP encourages all health care professionals to understand their unique contribution to diabetes team care so their advice to patients is consistent. To view the primer or to order a free copy, visit "What's New" at the NDEP Web site at http://www.ndep.nih.gov/resources/health.htm or call (800) 438-5383.
FDA Issues Approvable Letter for ZyLET
Bausch & Lomb has received an approvable letter from the FDA for ZyLET (it filed an NDA for this product last year). ZyLET is a loteprednol etabonate and tobramycin ophthalmic suspension aimed at treating patients who have steroid-responsive inflammatory ocular conditions and who have or are at risk of developing superficial bacterial ocular infections. In 2001, B&L acquired the rights to the loteprednol etabonate ophthalmic business of Pharmos Corporation and will pay Pharmos a milestone payment upon approval to market the product. B&L indicates that it continues to target approval of ZyLET in the second half of 2004.
Abstract: CL Dehydration in Different Environmental Conditions
Researchers in the United Kingdom conducted a study to ascertain the impact of environmental conditions on hydrogel contact lens dehydration. Six (young adult) subjects wore an Acuvue lens in one eye and a Proclear lens in the other eye for 200-minute sessions in arid, temperate and arctic conditions, maintained in a purpose-built environmental chamber in an aerospace medical facility. They measured lens water content before and after each session using a soft contact lens refractometer to determine dehydration and they assessed the comfort of the lenses at the conclusion of each session. The researchers found that lens dehydration was similar for the three environmental conditions but that subjects experienced less dehydration with the Proclear lens compared to the Acuvue lens. They detected no differences with respect to lens comfort between the three environmental conditions or the two lens types.
Morgan PB, Efron N, Morgan SL, Little SA. Hydrogel Contact Lens Dehydration in Controlled Environmental Conditions. Eye & Contact Lens 2004 Apr;30(2):99-102.
Editor's Commentary: Translating, Alternating Vision Bifocals: Best Vision for Presbyopes
Our tip of the week by Ed Bennett is a good one. More importantly, you can have more happy presbyopic patients if you just fit these lenses. Get a trial set from your lab. Follow the fitting guide. Fit presbyopic GP patients who don't have enough add with aspheric multifocals or who have failed with soft multifocals. Don't use them if the lower lid is too high. But use them. They aren't that hard to fit and the vision is great and the successful patients are yours forever. Charge for your valuable service and you and your patients will be happy.
Fitting Tip: Translating GP Bifocal Troubleshooting Made Easy
Troubleshooting translating GP bifocals isn't as difficult or complex as often perceived. In addition to making small changes in power to fine tune the prescription, the three most common changes to improve the fitting relationship and quality of vision are the following:
1. Excessive lens rotation with the blink: Flatten the base curve radius 0.50D to allow the lens to drop more freely to the lower lid and resist the effect of the upper lid.
2. Lens picked up too superiorly on the blink by the upper lid: Increase the prism by 0.50s to allow the lens to drop and stay at or near the lower lid.
3. Lens doesn't translate or only translates intermittently: Try a flatter base curve radius (again by 0.05D) to increase the edge lift and to optimize the impact of the lower lid on the lens edge with downward gaze.
--Edward S. Bennett, OD, MSEd
St. Louis, Mo.
Report adverse contact lens reactions here: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
Access a reporting form for complications you've seen that were a result of contact lenses dispensed without a valid prescription at the Association of Regulatory Boards of Optometry's (ARBO's) Web site: http://www.arbo.org/arbo.asp?dt=R&doc=Complications. Complete and send the form online or print it out and fax it to (866) 886-6164.
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