Late last week, a United States District Court ruled that the Acuvue Oasys spherical contact lens infringed upon the "Nicholson" patents owned by CIBA Vision, Inc (Novartis), which protect their silicone hydrogel contact lenses. This case is one of several patent infringement cases the two companies have filed against each other in the United States. At this time, Acuvue Oasys products remain available in the United States. It is expected that Vistakon will appeal the decision. 

The Gas Permeable Lens Institute (GPLI), in conjunction with the Contact lens Manufacturers Association (CLMA), is sponsoring two clinical symposia entitled GP Lens Specialty Practice Today and Tomorrow. The inaugural symposium will be held Sunday, September 13, 2009 at the New England College of Optometry in Boston, Massachusetts, and the second will be held Sunday, December 6th at the Southern California College of Optometry in Fullerton, California.
     The programs will provide eight hours of continuing education (COPE approval pending) including five hours of clinical symposia followed by a three hour interactive component featuring evaluations of select patients wearing specialty GP lenses with a projection video slit lamp. Cases will be discussed by the symposia faculty and the audience will be encouraged to ask questions about the design and fit of each patient's lenses.
     "These symposia present an exceptional opportunity for eyecare practitioners to participate in a program focused on GP specialty lens fitting," said Ed Bennett, OD, MSEd, FAAO, Executive Director of the GP Lens Institute. "In addition to clinical presentations from an expert faculty, the interactive Grand Rounds session provides a unique, stimulating forum for case study discussion."
     The Boston symposium faculty includes Dr. Christine Sindt, who will present GP Management of the Irregular Cornea Patient, and Drs. Ron Watanabe, Steve Byrnes, Marjorie Rah, Jason Chin and Ed Bennett. The California faculty includes Drs. Tim Edrington and Harue Marsden.
     For further details and registration information, visit http://www.gpli.info/events/calendar.htm. 

Your practice thrives when your patients are healthy and happy—and ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR® Plus can help you fulfill this goal, by providing exceptional comfort, vision, and health. It's a fact: more than 9 out of 10 patients stay in ACUVUE® OASYS™ Brand.¹ So when you fit your patients with ACUVUE® OASYS™, you're laying a solid foundation of patient commitment and satisfaction leading to practice growth.

$100 rebate for new wearers!
Good when patients get an eye exam and purchase 8 boxes of ACUVUE® OASYS™ (spherical product only). Visit www.jnjvisioncare.com/rebates.htm for more details.

1. Data on file.
     ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from VISTAKON®, Division of Johnson & Johnson Vision Care, Inc., by calling 1-800-843-2020 or by visiting jnjvisioncare.com.
     HYDRACLEAR® Plus is our brand name for the next generation of our proprietary technology that allows us to use a higher volume of a moisture rich wetting agent in a state of the art formulation. This creates a more wettable, ultra smooth contact lens, especially for challenging environments that make eyes feel dry.
     ACUVUE®, ACUVUE® OASYS™, HYDRACLEAR®, and VISTAKON® are trademarks of Johnson & Johnson Vision Care, Inc.
© Johnson & Johnson Vision Care, Inc. 2009.
--ADVERTISING

An emerging issue for eyecare practitioners to watch for in coming months will be possible attempts to introduce generic versions of key ophthalmic drugs as Alcon's eye allergy treatment Patanol and Allergan's dry eye drug Restasis. Both of these widely used drugs have annual sales in the $500 million range.
     One Restasis patent for "method of use" has just expired but a critical "formulation" patent is effective until 2014. In the case of Patanol, one patent expires in December of next year but another remains in effect until 2015. Patanol patents have already been challenged by Apotex and Barr Labs, which produce generic versions of market-leading drugs. Alcon has vigorously defended the patents.

Prevent Blindness America (PBA) has been awarded a multi-year grant from the Maternal and Child Health Bureau (MCHB), a bureau of the Health Resources and Services Administration, U.S. Department of Health and Human Services. PBA will use the funds to establish the National Universal Vision Screening for Young Children Coordinating Center that will promote and ensure a continuum of eye care for young children within the healthcare system.
     The Center will focus on providing national leadership in the development of the statewide vision screenings and eye health programs for all children prior to entering school, developing and implementing a plan to assist states in coordinating existing vision screening activities, and collaboration with the states of Georgia, Illinois, Massachusetts, North Carolina and Ohio to develop and implement a statewide strategy for universal vision screening, data collection and creation of a standardized performance measure for vision screening.
     The organization will also establish a National Expert Panel on Young Children's Vision Screening as part of this groundbreaking grant award. The Panel will include representatives from the fields of ophthalmology, optometry, pediatrics and public health. This panel will also serve as an expert advisory panel to the National Coordinating Center.

The Educational Program Committee of the Global Specialty Lens Symposium invites the submission of abstracts for the Free Paper Section to be held January 28-31, 2010 in Las Vegas, Nevada, USA. Papers related to presbyopia, keratoconus, corneal topography, post penetrating keratoplasty or related irregular corneal surface, myopia control, ortho-k and lens care topics are welcome.
     Those interested in submitting free papers or posters to the Global Specialty Lens Symposium can visit www.GSLSymposium.com for more information. Web submissions only. Deadline for submissions is Monday, August 31, 2009.
--ADVERTISING

Aton Pharma, Inc. announced it has launched new education, distribution, sampling and reimbursement programs for Timoptic in Ocudose, the only preservative-free medication for glaucoma available in the United States. Aton acquired the U.S. marketing rights in February to the Timoptic product line from Merck & Co., Inc. Timoptic (timolol maleate) is a non-selective beta-adrenergic receptor blocking agent indicated for the treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.
     Aton will support the product with ophthalmic journal advertising, a coupon program, direct mail promotion and a patient information website (www.ocudose.com). Aton's sales force, which has been detailing Lacrisert since November 2008, will re-introduce Timoptic in Ocudose to eyecare professionals.
     "As we have done with Lacrisert and other Aton products, we will concentrate on enhancing distribution, sampling and reimbursement assistance while increasing patient and provider awareness," stated Michael G. Wells, Chief Executive Officer of Aton Pharma. "With Timoptic in Ocudose, we are able serve yet another niche market that is greatly underserved - glaucoma patients who will benefit from preservative-free medications."

Nerve growth factor (NGF) has been shown to be upregulated in conditions, which damage corneal nerves and to relieve dry eye. How NGF changes in nerve injury induced by established contact lens wear is not clear. The purpose of this study was to measure the subepithelial nerve plexus and tear NGF and transforming growth factor (TGF)-beta1 levels in patients with established contact lens associated with dry eye.
     Non-contact lens wearers and subjects who had worn soft contact lenses for more than 1 year were recruited and were divided into three groups: (1) normal controls; (2) contact lens wearers without dry eye; (3) contact lens wearers with dry eye. Corneal sensitivity was measured with a Cochet-Bonnet aesthesiometer. Nerve density and branching in the subepithelial plexus were measured using in vivo confocal microscopy. Tear NGF and TGF-beta1 levels were measured with an enzyme immuno assay.
     There was a statistically significant decrease of corneal sensitivity in contact lens wearers compared with normal controls. The nerve density in the subepithelial plexus of contact lens wearers with dry eye was 538.8 +/- 39.3 mum/image (3.959 +/- 0.28 pm/mum) and 537.1 +/- 30.9 mum/image (3.947 +/- 0.27 pm/mum) in those without dry eye. Both of these values were significantly (P=0.032) lower than in the normal controls (4.412 +/- 0.21 pm/mum). The concentration of tear NGF was increased in contact lens wearers with dry eye and was statistically significantly greater compared with contact lens wearers without dry eye. Transforming growth factor-beta1 levels were found to increase one fold in contact lens associated dry eye, and were significantly correlated to NGF.
     The researchers concluded that corneal subepithelial nerve density was decreased in long-term contact lens wear but this change was not significantly correlated with tear film NGF concentration. Tear film NGF levels were elevated in contact lens related dry eye, likely in response to anti-inflammatory factors such as TGF-beta1.
Liu Q, McDermott AM, Miller WL. Elevated Nerve Growth Factor in Dry Eye Associated With Established Contact Lens Wear. Eye Contact Lens 2009.

I continue to hear lots of buzz about multipurpose and hydrogen peroxide-based care solutions. Interestingly, just this week a relative emailed me that her eyecare practitioner discussed switching her from a commonly used multipurpose solution to hydrogen peroxide-based system (she was experiencing mild end-of-day dryness, but it was not significant enough to reduce her wearing time). I am curious to hear your thoughts on this. Would you switch this patient's MPS system to peroxide? Please send me your thoughts to tips@CLtoday.com.
Jason J. Nichols, OD, MPH, PhD, FAAO 

This month at www.siliconehydrogels.org: adverse events with daily wear of silicone hydrogels, SEALs with extended wear, controlling case contamination, contact lens complications, and part two of our AAO 2008 synopsis.