CONTACT LENSES TODAY
September 24, 2006
Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches more
than 12,000 readers in 74 countries.
Contact Lens Consumer Health Protection Act
Representative Ed Whitfield (R - KY) has introduced H.R. 6117, the Contact Lens Consumer Health Protection Act, a bill to protect consumers
who buy contact lenses from third-party vendors. The bill would amend the Fairness to Contact Lens Consumers Act (FCLCA) and establish a
toll free Patient Safety Hotline for eye care practitioners with patient health concerns related to a prescription verification request. A call to the hotlines would
suspend the transaction until the vendor addresses the specific health concern. It would further allow providers to specify their preference for fax, e-mail or telephone
for prescription verification purposes. The vendor would then have to attempt at least two of the three communication choices. Vendors who fail to comply would be subject
to fines up to $100,000
per violation. The American Optometric Association (AOA), American Academy of Ophthalmology (AAO) and the Kentucky Optometric Association (KOA) have endorsed the
legislation. The AOA is urging members to contact their senators and ask that they co-sponsor the legislation. Visit
http://capwiz.com/theaoa/home/ for more information.
“Third-party vendors that overfill prescriptions
or … do not verify the prescriptions they are filling endanger the health and welfare of the customers they purport to serve. My legislation will ensure the proper balance
of consumer choice and the health and safety of the American public,” Mr. Whitfield says.
The introduction of this legislation follows a Sept. 15
hearing on H.R. 5762, the Contact Lens Consumer Protection Act, before the Energy and Commerce Subcommittee on Commerce, Trade and Consumer Protection. H.R. 5762 would
amend the FCLCA and require manufacturers to make any contact lens they produce, market, distribute or sell available to specified alternative channels of
distribution.
Wiley Curtis, O.D., testified on behalf of the AOA and said the group has received hundreds of FCLCA violation complaints about
sellers. Dr. Curtis went on to describe his experience with a particular Internet retailer, “Over the course of this year, I have tracked 18 contact lens orders placed
with 1-800 CONTACTS. I am saddened to report that the first 17 orders were all filled by the company without any verification contact with my office, in apparent violation
of the FTC,” Dr. Curtis said. “In light of … new complaints about deficient verification practices, the AOA is urging a crackdown on unscrupulous contact lens
sellers.”
Testifying on behalf of the AAO, Oliver Schein, M.D., said, “Passive verification is a flaw in the FCLCA that the [AAO] believes lowers
the bar for patient safety and opens the door for prescription verification failures that can ultimately result in patient harm.” Dr. Schein also described his experience
with non-compliant contact lens patients and suggested positive verification is necessary. “The Academy believes that in the interest of patient safety, contact lens
prescriptions should … be positively verified prior to being dispensed to the contact lens wearer.” Gregory Fryling, COO of CooperVision,
also testified against H.R. 5762.
Jonathon Coon, Chairman and CEO of 1-800 CONTACTS, and Wayne Klein, Assistant Attorney General for the state of
Utah, testified in favor of the bill.
“To date there has been no meaningful evidence that the [FCLCA] is not working or that passive verification is not the right
system to manage the conflict
of interest of a doctor selling what they prescribe,” said Mr. Coon. He also referenced a “loophole” in the law that he said allows doctors to comply with the law but
avoid its intent, “H.R. 5762 would protect consumers and promote competition and would remove the ability of any manufacturer to entice doctors with offers of increased
profits by restricting consumer choice.”
Transcripts are available
at http://energycommerce.house.gov/108/Hearings/09152006hearing2023/hearing.htm.
J&J World’s Most Respected Company
Johnson and Johnson (J&J) scored the number one ranking in
Barron’s second annual survey of the world’s most respected companies. Barron’s teamed with Beta Research to conduct the online survey and tabulate the
results. They queried a cross-section of the nation’s institutional money managers with some 85 investors responding. Investors were asked to denote the level of their
respect for the world’s 100 largest companies as measured by market capitalization. The results of the survey were published in the Sept. 11 edition of the magazine.
CLMA Offers Free Video on CL Myths
The Contact Lens Manufacturers Association (CLMA) is offering eye care practitioners a free copy of a recent PBS broadcast that investigated
and explored contact lens myths. The video addresses commonly held myths about vision and informs patients how specialty contact lenses can address their unique needs with
options like overnight contact lens corneal reshaping, GP and multifocal contact lenses for presbyopia and explains the long-term comfort and advantages of GP lenses.
Visit http://www.gpli.info to request a free copy.
Because the World Is a Very Dry Place
Whether they’re staring at a computer or feeling the effects of dry heat or air conditioning, contact lens wearers face daily challenges to
keep their eyes comfortable. Forty-two percent of all contact lens wearers use rewetting drops at least once a day. Challenging environments can leave eyes feeling tired
and dry. ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR™ Plus, the next step in the ULTRA COMFORT SERIES™, offers Eye Care Professionals a way
to keep these sufferers and potential dropouts wearing contact lenses. The ultra breathable lens (Dk/t = 147) keeps feeling fresh even in adverse environments, leading to
greater patient satisfaction.
--ADVERTISING
Global Keratoconus Congress – OCTOBER 1 DEADLINE FOR PAPERS AND POSTERS
The Educational Program Committee of the Global Keratoconus Congress invites the submission of abstracts for the Free Papers and Scientific
Posters Competition to be held January 26-28, 2007 in Las Vegas. Papers and Posters related to keratoconus, corneal topography, post penetrating keratoplasty or related
irregular corneal surface, gas permeable lens and lens care topics are welcome. Please visit https://www.gkc2007.com for
information
--ADVERTISING
Biomimetic Hydrogel Shows Promise for Use in Artificial Corneas, CLs
At the annual meeting of the American Chemical Society on Sept. 11, 2006, researchers at Stanford University presented a novel biomimetic
material that can swell to a water content of 80% — about the same as biological tissue — and may be used as an artificial cornea. The material, called Duoptix, is made
of two interwoven networks of hydrogels; one made of polyethylene glycol molecules that resists the accumulation of surface proteins and inflammation, the other is made of
polyacrylic acid molecules, a relative of the absorbent material found in diapers. The biocompatible hydrogel is transparent and permeable to nutrients, including
glucose.
Creators were aiming to design, fabricate and characterize a bioengineered cornea based on the dual-network hydrogel. The result was a
disc with a clear center and tiny pores populating the periphery. Collagen binds to the edge of the synthetic disc and forms a junction between natural and synthetic
tissues. Then a clear layer of epithelial cells grows over the disc.
There are also other potential applications for the material. Onlays of
hydrogel lenses could serve as extended-wear contact lenses. Inlays may be used to replace damaged epithelial cells.
Alcon Gets FDA-Approval for New Travatan, Licenses Anti-Infective Compound
The FDA has approved Alcon’s Travatan Z (travoprost ophthalmic solution) 0.004% for the reduction of elevated IOP in patients with open-angle
glaucoma or ocular hypertension, who are intolerant of, or insufficiently responsive to other IOP lowering medications. Travatan Z replaces the benzalkonium chloride (BAK)
from the original formulation of the drug with Sofziatm, a robust ionic buffered preservative system the company says is gentle to the ocular system.
Alcon also announced last week that one of its affiliates has signed a collaboration and license agreement with NovaCal Pharmaceuticals to research, develop and
commercialize the company’s Aganocide compounds to treat infections of the eye, ear and sinus. Alcon believes the compound has the potential to be important in the
treatment of infections due to their broad application to bacterial, viral and fungal infections.
Alcon will provide research funding to NovaCal
as part of a collaborative research program and will be responsible for all clinical development costs. NovaCal will receive royalties on the sales of products containing
any Aganocide compound.
B&L to Eliminate 400 Positions
Bausch & Lomb announced last week that it will make adjustments to its worldwide contact lens manufacturing workforce in European and U.S.
manufacturing plants over the next several months, reducing about 400 positions, the majority of which the company says are temporary jobs. The company will continue to
adjust its temporary workforce to meet changing business conditions and expects to rehire some of these positions in 2007. B&L had previously added to its temporary
workforce to ramp up production of its PureVision contact lenses. They company is also transitioning its contact lens lines to new designs made using more automated,
advanced manufacturing technology.
Abstract:
Large-Diameter Bandage CLs for Refractory Vernal Ulcers
British researchers at Royal Liverpool University Hospital’s St. Paul’s Eye Unit recently reported two cases of refractory vernal ulcers
for which the fitting of a large-diameter (22mm) hydrogel (Contaflex T75) bandage contact lens (BCL) ameliorated the signs and symptoms of the
condition.
The first patient is a 10-year-old boy who had previously been treated unsuccessfully with topical prednisolone 0.5% and olopatadine
for a left vernal corneal ulcer. The ulcer resolved two weeks after they fit him with a large-diameter BCL. The second patient is a 4-year-old boy who had been
intolerant of all previous topical medications, in part due to his discomfort. Investigators also fit this patient’s right eye with a large-diameter BCL. The lens was
removed two weeks later and the ulcer healed completely. The patient was then able to tolerate prednisolone 0.5% drops. The authors conclude that large-diameter BCLs
may be a useful treatment option for managing refractory vernal ulcers.
Quah SA, Hemmerdinger C, Nicholson S, Kaye SB. Treatment of Refractory Vernal Ulcers with Large-Diameter Bandage Contact Lenses. Eye Contact
Lens. 2006 Sep;32(5):245-7.
Editor's Commentary:
Worst of Times and Best of Times
I've tried to stay out of the recent past and current political struggles between O.D.s and M.D.s. In my nearly 30 years of experience in
optometry, I have developed many very good relationships with ophthalmologists. But, I now feel we are witnessing some of the worst examples of political fighting we
have ever seen. Interestingly, as I travel around the country and visit with both optometrists and ophthalmologists, I find that they are working together in patient
care better than ever with great mutual appreciation. None of this surprises me, but the contrast is very substantial — the worst political fights and yet the best
of collaborative care for our patients. There’s at least one other issue that we all seem to agree on: Letting our patients buy contact lenses without being sure
they have a valid prescription makes us nervous about our patients' safety and our professional liability.
Fitting Tip:
More on High Minus Lenses
Following the editors concerns of high minus lens binding on the cornea (see CLToday, June 11, 2006), this may be due to the traction
between the lid and the lens being too low, which is why going to a treated surface could make it worse. Try altering the edge profile to one that will allow the upper
lid to pick up the lens, even when the patient looks down and blinks. If this fails, try putting a groove into the anterior surface about 1.0mm from the edge so that the
lid will use this to pick up the lens. If this is not sufficient, try two grooves or better still a 13.5mm or 14mm lens.
Mike Stoker,
Custom Contact Lenses,
Toronto
This month at http://www.siliconehydrogels.org, get an update of silicone hydrogels at ARVO 2006 and review ‘oxygen flux‚’
as well as the cornea’s response to different levels of oxygen transmissibility.
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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