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Sunday, August 25, 2013  
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What percent of your daily disposable prescriptions are for part-time wear?




Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
Corneal infiltrative events (CIEs) can be serious outcomes in contact lens wearing patients. Unfortunately, we do not have a full understanding of the incidence of CIEs, nor predictive risk factors as prospective studies have not been done. I suppose a bigger question in this regard is why not? For us to move forward on the discussion related to these issues, it will be important to see the clinical research on the topic take the next step as well.

TFOS Launches Global Campaign:
Blink Around the World
Dry eye awareness got a boost with the launch of a year-long social global campaign dubbed Blink Around the World. Eye health professionals around the world are joining the Tear Film & Ocular Surface Society (TFOS), to generate dry eye awareness with a new song and corresponding online campaign.

Dry eye disease is a global problem. Approximately twenty to forty million people live with dry eye in the United States, with Europe close behind and Asia nearly double in prevalence. The normal person blinks about 16,800 times a day, between 10 and 30 times per minute and approximately 1200 blinks per hour. The simple act of blinking reduces dry eye symptoms by flushing fresh tears over the eye, re-moisturizing and keeping foreign matter and irritants out.

According to Amy Gallant Sullivan, Executive Director of TFOS, Blink Around the World is a fun and catchy way to remind people to blink their eyes. Sullivan is amassing a coalition of partners including scientists, clinicians, pharma and patients to help spread the importance of blinking and eye health. To help reinforce the message, TFOS has also launched a new song to promote global eye-health. TFOS collaborated with Italian pop singer Sabrina to create the new music single. "Blink Around the World," the song, can be purchased on Amazon.com or via iTunes. Proceeds from the sale of Blink Around the World will benefit the TFOS educational mission.

To find out more about the campaign, visit the campaign website: www.blinkaroundtheworld.com.
Annual HOACLS Meeting Announced
The 53rd Annual Heart of America Contact Lens Society Contact Lens and Primary Care Congress will be held February 14-16, 2014 at the Sheraton Kansas City Hotel at Crown Center in Kansas City, Missouri.

This convenient Midwest location allows attendees access to one of the best continuing education values available anywhere. The meeting will offer a total of 58 CE hours and a large exhibit hall which provides an opportunity to browse the latest ophthalmic products and technology. Relatively new to the Heart experience are the abstracts presented by students and residents in their second annual scientific poster session.

For meeting and registration information, visit www.hoacls.org. You may also email registration@thehoacls.org.
Celebrate Paraoptometric Recognition Week
The American Optometric Association (AOA) Paraoptometric Section has designated September 15-21, 2013 as Paraoptometric Recognition Week. Now in its eleventh year, the recognition week is designed to honor paraoptometrics for their dedication to the patients they serve and to the profession of optometry.

Doctors are encouraged to be creative in planning their festivities. The AOA Paraoptometric Section has suggestions for recognition ideas and a variety of ways to celebrate the week. To help in making plans for the observance, a free-of-charge Paraoptometric Recognition Week Promotional Kit is available. Choose from over 30 ideas to thank your staff for all they contribute to the success of the practice. Kits may be requested by sending an e-mail to pararecognition@aoa.org.
Early Bird Registration Savings End August 31 - Register Now for Optometric Management Symposium
Plan now to attend the Optometric Management Symposium on Contemporary Eye Care, December 6-8, 2013 at Disney's Contemporary Resort in Lake Buena Vista, Florida. This popular annual symposium provides the perfect balance of timely, disease management courses and practice-building courses with plentiful networking and leisure time to enjoy all that Disney resorts and theme parks have to offer.

The educational program is presented by the Pennsylvania College of Optometry, Salus University. Register by August 31 for Early Bird Savings. For agenda, more information and to register visit www.OMConference.com.
Ellisor Appointed Executive Chairman of Vision Source, Greenwood Named President and CEO
The Vision Source board of directors announced that Glenn D. Ellisor OD will transition from chairman and chief executive officer to executive chairman of the corporation effective immediately, and Jim Greenwood will assume the role of president and chief executive officer.

In this newly created role, Ellisor will continue to lead the company's board of directors as the executive chairman and will remain actively involved in the company's strategy development, including being the full-time clinical lead of the company and setting the strategic direction of the optometric alliance organization. Jim Greenwood will lead the senior team and will be responsible for the execution of major strategic plans and investments and initiatives required for achievement of key organization priorities, while working closely with Ellisor.

Dr. Ellisor is the founder of the organization and has served as its top executive in various roles including president, chief executive officer and chairman of the board. Since June 1991, Dr. Ellisor has owned and co-owned several Vision Source practices and currently owns a multi-doctor practice in Kingwood, Texas. He's served on numerous industry boards and advisory panels, as well as those of charitable organizations.

Greenwood brings to the chief executive role more than 20 years of healthcare experience and a proven track record of accomplishment at Concentra. During his 20 years at Concentra, a $1 billion physician practice management company, Jim worked in close partnership with the clinical leaders of a dynamic industry-leading organization that consistently delivered excellent clinical outcomes and an outstanding patient experience during a time of rapid transformational change. Additionally, Greenwood serves on the board of directors for several, premium healthcare organizations and a healthcare administration program's advisory council.
ABB Optical Group Sponsors Primary Eye Care Network's "Compliance Boot Camp"
ABB Optical Group is sponsoring Primary Eyecare Network's (PEN) upcoming event "Compliance Boot Camp" which will be facilitated by Dr. John A. McGreal and the President of CS EYE Billing Partner. The seminar will be held in Las Vegas, Nevada at the Wynn Hotel on Thursday, October 3rd, between 1:00-5:00pm. This is an excellent opportunity for practices to establish a compliance program during their attendance at Vision Expo West.

This seminar will show attendees how to comply and protect their practices by having a Healthcare Assessment. With pending CE credit, the seminar also includes a self-audit assessment and $1,000 worth of compliance materials. Practices do not need to be PEN members to attend.

According to Lynda Baker, executive Vice President of ABB Optical Group, this event will cover a range of topics from ICD-10 and Compliance Review to preparing for audits; and the event can help practices get a better understanding of areas like ICD-10 Basics, CPT Profiling, Fee Schedule Analysis Chart Review, Self-Audit Assessment, and Compliance Minimums.

Interested practices can register by going to www.primaryeye.net or by calling PEN directly at 800-444-9230. The registration fee is $250 per practice which allows for two attendees. Each additional attendee from the same practice is only $100 more.

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Tinted Lens on Traumatized Eye
By Edward Boshnick, OD, Miami, Florida

This patient appears to have two pupils. In reality one of the "pupils" was caused by trauma. Patient is wearing a dark brown opaque lens. The lens has a clear 4mm pupil. This lens allows the patient to read an additional three lines when compared to a clear lens with the same Rx.

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 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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Ronald K. Watanabe, OD, FAAO

Prosthetic Lenses: Standard Colors

Prosthetic contact lenses are fantastic options to improve the appearance of disfigured eyes. In the past, Ciba Vision and CooperVision had offered prosthetics in standard color options, and it was relatively straightforward to find the best color match for the fellow eye. Today, a few laboratories in the U.S. offer standard color options for their prosthetics. One example is Orion Vision Group, which has a standard palette of colors as well as the options of a dark limbal ring and pupillary starburst to make the lens appear more natural. Their fitting set allows you to stack two or three lenses to simulate new colors with over- and under-prints and with the optional tint features.

Another example is Advanced Vision Technologies, which distributes the Cantor + Nissel (United Kingdom) line of prosthetics. Nissel Naturals has a standard set of brown and blue tints that are produced on an opaque background. Cantor Prosthetics uses computer generated color reproducibility technology with either a black background or a clear background. Also, Alden Optical has a line of walnut brown tints that work well for brown-eyed patients. These options can help many patients with ocular disfigurements improve their cosmetic appearance.

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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

Adverse Events in Contact Lens Wearing Children

With contact lenses evolving as a promising treatment for myopia progression in children, the risks of corneal infection in this group of patients is of interest. In the recent orthokeratology study discussed in my last column, the authors concluded that the overall risk of microbial keratitis during overnight corneal reshaping contact lens use was about the same overall as in traditional extended lens wear, yet the risk in children may be higher.1

Another study just released examined adverse events during 2 years of daily wear of silicone hydrogel lens use in 240 Chinese children.2 There were no events of microbial keratitis. In 14.2% of their children-participants an adverse event was noted. Specifically, about 4% experienced papillary conjunctivitis, 1.5 % had superior epithelial arcuate lesions, ~2% had a corneal erosion, and 6.5% had some form of infiltrates. Interestingly, almost 30% discontinued, with about 10% occurring in the first month of lens wear.

The authors concluded that adverse events with daily wear of silicone hydrogels in children were mainly mechanical in nature, significant infiltrative events were few, and the large number of dropouts in the early days of lens wear and their reasons for discontinuation suggest that adaptation and patient motivation are critical for survival in lens wear.

These studies are pivotal to follow as lens wear in children may be promoted as a method to slow myopia in the near future.

1. Bullimore MA, Sinnott LT, Jones-Jordan LA. The Risk of Microbial Keratitis with Overnight Corneal Reshaping Lenses. Optom Vis Sci. 2013 Jul 25. [Epub ahead of print]
2. Sankaridurg P, Chen X, Naduvilath T, Lazon de la Jara P, Lin Z, Li L, Smith EL 3rd, Ge J, Holden BA. Adverse Events during 2 Years of Daily Wear of Silicone Hydrogels in Children. Optom Vis Sci. 2013 Aug 9. [Epub ahead of print]

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Long-Term Contact Lens Wear of Children and Teens

These researchers wanted to compare current symptoms, compliance, ocular health, and previous adverse events between current successful long-term contact lens wearers fit as children or as teenagers.

People who had successfully worn soft contact lenses for at least 10 years completed an online survey about demographics, current wearing status, compliance, symptoms, and previous adverse events. A subset reported for a slit-lamp examination, autorefraction, autokeratometry, and specular microscopy. Statistical comparisons were made between those fit as children (12 years or younger) and those fit as teenagers (13 years or older).

Of the 175 subjects completing the online survey, 86 (49.2%) were fit as children and 89 (50.8%) fit as teenagers. Those fit as children wore their contact lenses for an average of 14.8 +/- 3.4 hours per day, compared with 14.7 +/- 3.6 hours per day for those fit as teenagers (P=0.74). Eighteen (20.9%) fit as children and 17 (19.1%) fit as teenagers reported ever having had a painful, red eye that required a doctor visit (P=0.76). Overall, there were no differences in ocular health between the groups. Those fit as children were more myopic than those fit as teenagers (-4.30 +/- 1.69 and -2.87 +/- 2.75, respectively; P=0.02).

The authors concluded that successful contact lens wearers fit as children are no more likely to report previous contact lens-related adverse events, problems with compliance, decreased wearing time, or worse ocular health than those fit as teenagers, so practitioners should not use age as a primary determinant in fitting children in contact lenses.

Walline JJ, Lorenz KO, Nichols JJ. Long-term Contact Lens Wear of Children and Teens. Eye Contact Lens. 2013 Jul;39(4):283-9.

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Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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