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Sunday, September 14, 2014  
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Are you more likely to prescribe a contact lens that has uniformed pricing policy in place regarding its sale?

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   25.76%

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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
Technology is continually expanding and moving boundaries for us in all aspects of our lives. It is truly amazing and exciting to see the conveniences that new technologies afford us each day. On the other hand, technology creates occasional headaches--computers and other digital devices and their use, particularly over long periods of time, are clinically associated with a variety of ophthalmic-related conditions including headaches, eyestrain and fatigue, discomfort and dry eye. It is thought by some that these problems are further exacerbated by the use of contact lenses, but this is not entirely clear. There is no doubt that the optical quality and vision-related performance of a contact lens depends on a stable pre-lens tear film. Often, these problems are a challenge to manage given that employment or social needs mandate our patients’ use of technology. We as eyecare practitioners need contact lens materials and designs that will help us overcome these challenges, allowing our patients to wear contact lenses in a variety of challenging environments.

Alcon Launches National Consumer Media Campaign for Air Optix Colors

Alcon is now engaged in a major national television, online and print media campaign in support of Air Optix Colors prescription contact lenses, the first color contact lens in the U.S. to encapsulate Alcon’s 3-in-1 Color Technology in a silicone hydrogel lens.

This national media campaign is aimed at reaching the fashion-forward and beauty-savvy female consumer through TV, online and print media. Thirty-second and 15-second television spots are now airing on several major network and cable channels, including NBC, CBS, TNT, TBS, Lifetime, Oxygen and more. A full-page print advertisement also targets females through placements in fashion and beauty magazines, including Glamour, Seventeen, Nylon, Teen Vogue and OK!

The fashion-focused ads feature brown-eyed model Sofia enhancing her look with Air Optix Colors contact lenses in Sterling Gray. Consumers get a close-up look at her eyes before and after inserting the contact lens, and are encouraged to virtually try on their perfect color at www.airoptixcolors.com or by visiting an eye care professional. In addition to product promotion, the campaign is designed to help ensure that patients understand that Air Optix Colors contact lenses are prescription medical devices that require a visit to their eye doctor.

Air Optix Colors contact lenses were introduced in the United States earlier this year. Available in nine colors ranging from subtle to vibrant, the contact lenses are the first monthly replacement, daily wear color lenses available in the U.S. on a silicone hydrogel platform, allowing up to six times more oxygen through the contact lens compared to the leading, older technology color contact lens.1 The natural-looking color is contained within the innovative lens material, so that the only thing touching the wearer’s eyes is the ultra-smooth permanent plasma surface of Air Optix brand contact lenses.

Eyecare professionals may prescribe the lenses to correct vision or in plano. Importantly, there is no refit required for current Air Optix Aqua contact lens wearers.2

1. Based on the ratio of lens oxygen transmissibilities; Alcon data on file, 2013.
2. Alcon data on file, 2013.

Plan Now to Attend GSLS 2015

Plan now to attend the Global Specialty Lens Symposium to be held January 22 – 25, 2015 at Bally's 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.

Visit www.GSLSymposium.com for more information.
--ADVERTISING

Dr. Pat & Patrick Cummings Scholarship Available through Optometry Cares

Optometry Cares - The AOA Foundation calls upon fourth-year optometry students to apply for the Dr. Pat & Patrick Cummings Scholarship, which is worth $5,000.

The scholarship is in memory of AOA Past President, Pat Cummings, OD, who had a love for volunteering in his profession and making a positive impact in the community. Among many acts of philanthropy, Dr. Cummings was one of the first supporters of the InfantSEE program, which helps provide no-cost eye examinations for children during their first year of life. The Cummings family faced terrible loss when Dr. Cummings died July 11, 2009 in a private plane crash. In a separate tragedy, his son, Patrick, passed away in a car accident at age 18.

In tribute to father and son, the Dr. Pat & Patrick Cummings Memorial Fund was established through Optometry Cares. This opportunity was generously funded by numerous individual donors, as well as a large contribution from Johnson & Johnson Vision Care.

Among other qualifications, to be eligible for the Dr. Pat & Patrick Cummings Scholarship, a student must obtain one letter of recommendation from a teacher, dean or academic advisor, and submit an essay that answers the following questions:

  • Dr. Pat Cummings was passionate about improving the overall health of the public. How do you exemplify this passion and what are your goals in the area of public health?
  • Do you plan to take a leadership role in optometry? Please tell us about leadership roles you have had in optometry school and your future leadership goals.

Students must check with the student affairs office to determine the institution’s on-campus deadline. Each school and college will choose one candidate from all applications received by their on-campus deadline and forward the individual’s name and essay to Optometry Cares by November 11, 2014. The winner will be announced in January 2015.

For more information about the scholarship and Optometry Cares, visit www.aoafoundation.org.

Industry and Profession Continue Coalition Efforts in Support of the World Sight Day Challenge

Members of the U.S. eyecare industry and professions will again join forces in a Coalition to celebrate World Sight Day, October 9th, and to support Optometry Giving Sight and its annual fundraising campaign, the World Sight Day Challenge. Coalition members include ABB Optical Group, Alcon, AllAboutVision.com, CooperVision, Essilor of America, TLC Laser Eye Centers, Transitions Optical, Vision Source, ZeaVision, Zeiss, and VSP Global businesses Eyefinity, Marchon Eyewear, VSP Optics Group, and VSP Vision Care.

Below are some of many organized a series of activities of Coalition members on and around World Sight Day.
  • VSP Global will host a weeklong outreach event offering comprehensive eye exams and new glasses to 2,500 local residents, including veterans, at its Sacramento headquarters from October 6-10.
  • The Special Olympics Opening Eyes program and Essilor Vision Foundation are coordinating a screening in Dallas, in partnership with Lions Clubs International and the Alcon Foundation.
  • TLC Laser Eye Centers will announce the winners of their Operation TLC promotion on World Sight Day, which will see a team of 20 ODs and support staff undertake an outreach visit to the Dominican Republic in January 2015.
  • CooperVision, a Global Sponsor, is conducting its “Fight for Sight” global campaign, in which all employees are encouraged to participate in fundraising events organized at their local CooperVision sites and donate to Optometry Giving Sight. Employee donations will be matched by The Cooper Companies, CooperVision’s parent company.
  • ABB Optical is encouraging all their customers to purchase and distribute Optometry Giving Sight wristbands and their staff will raise funds in September.
  • Vision Source, a Platinum In Kind sponsor, will encourage all its members to make a personal or practice donation and involve their staff and patients throughout September and October, and match all donations to an agreed limit.
  • AllAboutVision.com will be conducting “Share for Sight,” a social media campaign to promote eye health and Optometry Giving Sight, during the week leading up to World Sight Day. Each share of a post will generate a donation to the World Sight Day Challenge.
  • Vision Expo West exhibitors are being invited to support the World Sight Day Challenge by making a small donation to Optometry Giving Sight to purchase “people power” wristbands that can be worn by staff and given to booth visitors.
  • New National Sponsor, ZeaVision, will be making a donation related to product sales at Vision Expo West and raising funds through staff led fund raising initiatives; while Zeiss and Transitions Optical will both be encouraging their corporate and manufacturing staff to raise funds, which the companies will match.

For more information about the World Sight Day Challenge, please visit www.givingsight.org.


From GP Intralimbal to Feather-Weight Scleral Lens
Jaime Ibanez, OD, Villavicencio, Columbia

This is a 19 year-old female (-8.00-2.50 x 165 vertexed @ 12 mm), non-ectatic, irregular cornea case. This case was taken on in 2012 (upper right) and we switched her corneal lenses to a custom designed GP intralimbal reversed geometry lens in 2013 (lower left). The goal was accomplished: good visual acuity, excellent comfort (better centration and apical clearance) and a healthy lens-cornea relationship. In 2014 (lower right), a scleral lens was custom-designed in response to her request to wear stable lenses in sport activities. In my opnion, scleral lenses are a safer solution in outdoor circumstances.

We thank Dr. Ibanez for these images 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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RESEARCH REVIEW
S. Barry Eiden, OD, FAAO

Infectious Keratitis Associated with Corneal Reshaping – It’s Important to Look at the Details

A review of cases of infectious keratitis associated with the use of Orthokeratology (corneal reshaping) contact lenses treated at a tertiary care clinic in Hong Kong was recently published.1 Data analyzed included clinical features, microbiological evaluation, and treatment outcomes. 23 patients were included (mean age, 15.0 ± 4.2 years; range: 9 to 23 years). All patients were using overnight corneal reshaping / Orthokeratology contact lenses for an average of 2.7 ± 2.8 years (range: 3 months to 10 years) before the onset of infection. Fifteen eyes (65.2%) had a positive microbiological culture obtained from corneal scrapings. The most commonly isolated organism was Pseudomonas aeruginosa (n=6) followed by coagulase-negative Staphylococcus (n=5) and Acanthamoeba (n=3). Five cases of Pseudomonas aeruginosa and 5 cases of Acanthamoeba were identified from contact lenses or contact lens solution. All patients responded to medical treatment, and no surgical intervention was needed. The best-corrected logMAR visual acuity improved significantly from 0.62 ± 0.51 (20/83 Snellen) to 0.15 ± 0.20 (20/28 Snellen) (Wilcoxon signed rank test, p < 0.001). The authors stated that corneal reshaping / Orthokeratology-associated infectious keratitis is a serious problem especially in regions with high prevalence of myopia (such as Asia). Early clinical and microbiological diagnosis and intensive treatment can improve final visual outcomes.

Prior work by Watt & Swarbrick2 did a comprehensive literature review of microbial keratitis cases reported with Orthokeratology and found that most cases occurred in East Asia (specifically China and Taiwan) and that most occurred during a short time period associated with lack of regulation of Ortho-K fitting in those regions. Risk factors determined in this study were inappropriate lens care, patients not following practitioner’s instructions, and continuation of lens wear despite discomfort. A post market study of Orthokeratology conducted by the FDA and the Ohio State University showed an incidence of microbial keratitis of 7.7 per 10 000 person-years of wear, making Orthokeratology wearers only slightly more susceptible to infection than daily wear soft contact lens wearers at 4.1 per 10 000.3 This rate is lower than that found with continuous wear of soft contact lenses which range from about 18 to 20 per 10 000.4

What we can say is that microbial keratitis is a risk factor for all forms of contact lens wear. Overall corneal reshaping / Orthokeratology has a similar risk for MK as with other modalities of contact lens wear. It is critically important to realize that many of our corneal reshaping patients are children and that special care is needed to avoid any complications that could potentially lead to any degree of vision loss. Strict attention to lens care, lens hygiene and use of approved materials and designs will continue to allow practitioners to provide an effective and safe modality of vision correction for our patients undergoing corneal reshaping / Orthokeratology treatment.

1. Chan TC, Li EY, Wong VW, Jhanji V. Orthokeratology-associated Infectious Keratitis in a Tertiary Care Eye Hospital in Hong Kong. Am J Ophthalmol. 2014 Aug 22. pii: S0002-9394(14)00528-5. [Epub ahead of print]
2. Watt KG, Swarbrick HA. Trends in microbial keratitis associated with orthokeratology. Eye Contact Lens. 2007 Nov;33:373-7.
3. Bullimore MA. Optom Vis Sci. 2009;86:E-Abstract 90583.
4. Schein O, McNally J, Katz J, Chalmers R, Tielsch J, Alfonso E, et al. The incidence of microbial keratitis among wearers of a 30-day silicone hydrogel extended-wear contact lens. Ophthalmology. 2005;112(12):2172–2179.

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OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD, FAAO
What is “Ocular Surface Wellness”?

How do we define, assess and maintain ocular surface wellness (OSW)?

In early 2014, Alcon convened an advisory board meeting of experts in ocular surface care to discuss these questions.

Moderated by Dr. Kelly Nichols, the Alcon-sponsored advisory board aimed first to outline OSW. Via consensus, OSW was defined as follows:

“Ocular surface wellness, a prerequisite for ocular comfort, clear vision, and healthy looking eyes, is promoted through engaging eye care practitioners, patients, and the public in education and awareness activities, encouraging early detection and management, and efforts to preserve lifelong ocular surface health.”

Numerous barriers remain as clinicians forge ahead in the OSW concept: the need for agreed-upon protocols for screening, diagnosis, and evidence-based management of ocular surface conditions remain as major concerns.

How do you think about ocular surface wellness? How would you promote it? Email me at katherinemastrota@msn.com to share your thoughts.

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Citation Parameters of Contact Lens-Related Articles Published in the Ophthalmic Literature

This study aimed at exploring the citation parameters of contact lenses articles published in the Ophthalmology thematic category of the Journal Citation Reports (JCR).

The Thompson Reuters Web of Science database was accessed to record bibliometric information and citation parameters of all journals listed under the Ophthalmology area of the 2011 JCR edition, including the journals with main publication interests in the contact lens field. In addition, the same database was used to unveil all contact lens-related articles published in 2011 in the same thematic area, whereupon differences in citation parameters between those articles published in contact lens and non-contact lens-related journals were explored.

Significant differences in some bibliometric indicators such as half-life and overall citation count were found between contact lens-related journals (shorter half-life and fewer citations) and the median values for the Ophthalmology thematic area of the JCR. Visual examination of all Ophthalmology journals uncovered a total of 156 contact lens-related articles, published in 28 different journals, with 27 articles each for Contact Lens & Anterior Eye, Eye & Contact Lens, and Optometry and Vision Science. Significant differences in citation parameters were encountered between those articles published in contact lens and non-contact lens source journals.

The authors concluded that these findings, which disclosed contact lenses to be a fertile area of research, may be of interest to researchers and institutions. Differences in bibliometric indicators are of relevance to avoid unwanted bias when conducting between- and within-discipline comparisons of articles, journals, and researchers.

Cardona G, Sanz JP. Citation parameters of contact lens-related articles published in the ophthalmic literature. Eye Contact Lens. 2014 Sep;40(5):301-4.


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