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Sunday, September 28, 2014  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
In an ideal world, clinical research should drive the modes of practice we implement and provide guidance to the methods and delivery of the care we institute with our patients. However, it is often a problem when we turn to the literature to identify a solution based on clinical research only to find that nothing has been done on that topic. This is certainly true in contact lens practice. We would like to ask for your feedback on this. What are some of the big clinical dilemmas we continue to face that need solid clinical research to provide clinical guidance? Please send us your feedback at

NovaBay Pharmaceuticals Creates Optometry Advisory Board
NovaBay Pharmaceuticals, Inc. has created an Optometry Advisory Board to help oversee the development, marketing and medical use of NovaBay’s i-Lid Cleanser and other eyecare products. The five members of the new board are: Dr. Katherine M. Mastrota, Center Director of Omni Eye Surgery in New York City; Dr. Arthur Epstein, Director of the Dry Eye – Ocular Surface Disease Center and Director of Clinical Research at Phoenix Eye Care; Dr. William Townsend, Optometrist in Houston, TX; Dr. Scot Morris, owner and medical director of Eye Consultants of Colorado, LLC, in Conifer, CO; and Dr. Paul Karpecki, head of the ocular surface disease clinic and director of clinical research at Koffler Vision Group in Lexington, Kentucky.

i-Lid Cleanser is the only eye care product to contain Neutrox—pure form of hypochlorous acid (HOCl) produced by NovaBay’s proprietary and patented manufacturing process. Neutrox-containing products have been cleared by the Food & Drug Administration to clean skin and wounds. Labs tests show that Neutrox, identical to a naturally occurring substance produced by white blood cells as a first line of defense against microbial invaders, has potent antimicrobial activity, yet is non-toxic to mammalian cells. Neutrox also neutralizes bacterial toxins and breaks up biofilms. According to the company, those properties make i-Lid Cleanser ideal for the management of common eye conditions, such as blepharitis.

For a video presentation about blepharitis, meibomian gland dysfunction, and i-Lid Cleanser, click here: For additional information, visit

Duette Progressive Lens Parameters Expanded

SynergEyes, Inc. has expanded parameters for its Duette Progressive lens. Parameters are now available in 0.1mm increments, which will facilitate even more precise alignment fitting, creating optimal centration and clear, stable vision at all distances for even more patients, according to the company.

Duette Progressive combines exceptional GP optics with SoftCushion comfort technology. A patient’s initial pair of Duette Progressive lenses can be designed empirically based on a refraction and corneal curvature measurements. Utilizing a near center aspheric add zone in combination with a distance asphere, Duette Progressive provides a seamless progression of powers from distance to near, giving presbyopes GP vision at all distances along with soft lens comfort. The lens also features an 84 Dk silicone hydrogel skirt around the 130 Dk center, and includes UV-blocking materials.

More information is available at

Miraflow Now Available

After being discontinued in 2010, Miraflow, the extra strength contact lens cleaner for contact lenses, is back on the market. Dr. William R. Martin, a private practice optometrist for 35 years, has reintroduced the cleaning solution for all soft lenses, silicone hydrogels, and hard lenses. Miraflow Extra Strength Daily Cleaner is designed to remove accumulated debris such as film and deposits from contact lenses.

MiraFlow is available for purchase at Contact Dr. William Martin at 1-937-689-6006 for complete Miraflow details.

Registration Now Open for GSLS 2015

Make plans now to join us January 22 - 25, 2015 for GSLS 2015 and take advantage of Early Bird savings! The Global Specialty Lens Symposium (GSLS) is a comprehensive meeting focusing on the latest techniques and technologies for the successful management of ocular conditions using today's specialty contact lenses. The meeting includes information for vision care professionals in all disciplines, with both surgical and non-surgical options. Accredited for continuing education under COPE, NCLE, and JCAHPO, the meeting will offer approximately 30 credit hours.

Attended annually by more than 500 participants from 30+ countries it is the largest conference of its kind in the U.S.

For complete conference details and to register now, visit


Polonyi Appointed Sales and Marketing Director at Contamac

Contamac, has appointed Philipp Polonyi as Sales and Marketing Director.

Polonyi was born and brought up in Giengen an der Brenz in the South of Germany, and joined Contamac in January 2011. Over the past two years he has been the company’s Business Development Manager bringing many new opportunities to the business. This new appointment is in line with the company’s succession planning strategy and allows for restructuring to take place within the sales and marketing team as a whole.

Novaliq Reports Positive Results from CyclASol Eye Drops Phase 1 Study

Novaliq GmbH, a drug delivery company with focus on the topical application of ophthalmic technologies for poorly soluble drugs, reported positive phase 1 results with the first and only clear cyclosporin solution eye drop formulation in clinical development for patients with dry eye syndrome.

CyclASol, a 0.05% cyclosporin solution based on Novaliq’s proprietary EyeSol platform technology, is developed as a clear solution in multi-dose, preservative free bottles for patients with dry eye syndrome and has demonstrated long term stability plus preclinical superior wettability, pharmacokinetics and biocompatibility compared to conventional emulsions.

Objectives of the 18 patient phase 1, double-blind, randomized, placebo-controlled cross-over study were to investigate safety, local tolerability and systemic exposure of CyclASol eye drops and vehicle following single and multiple ocular doses in healthy volunteers.

No drug-related signs or symptoms of ocular discomfort or irritation were reported, in particular no dryness, grittiness, burning, stinging, tiredness, blurred or foggy vision, redness, watery eyes, eye mucus or crusting. In slit-lamp examinations, no subjects revealed any clinically abnormal signs of the anterior and posterior eye structures. With dosing of up to 4 drops per eye per day, no systemic levels of cyclosporin were detected after any dose or at any time point when using a highly sensitive assay with a LLOQ as low as 0.1 ng/ml.

Essilor Announces AskAboutEyes Mobile App

Essilor of America announces the development of a new mobile application for consumers, the AskAboutEyes app. Once launched, the app will help consumers find relevant information on individual issues or concerns about their eyes prior to visiting their eyecare practitioner (ECP).

AskAboutEyes will be available as a Smartphone app, and the identities of the consumer and the eyecare professional (ECP) will not be identified. This will allow consumers to ask individual questions and even send photographs to an ECP for additional details and guidance. To develop the most comprehensive content, Essilor partnered with, an independent resource providing consumers with hundreds of pages of trustworthy, up-to-date information on vision correction and eye health. Launched in 2000, the site is certified by the Health on the Net Foundation and serves more than 600,000 weekly unique visitors, measured by Google Analytics.

AskAboutEyes will be led by Paul Karpecki, OD, FAAO, who will manage a network of ECPs across the country to ensure users are receiving precise and timely answers and advice. The app is not intended to be a diagnostic tool or to usurp the independent ECP. It is to serve as a trustworthy informational resource that will drive more consumers to their eyecare practitioners for comprehensive eye exams and treatment, as well as products and other valuable services.

Expected to launch later this year, the AskAboutEyes app will be highlighted on the Essilor Newsroom at and available free for download on the App Store and Google Play. To find more information on AskAboutEyes, email Essilor at

Soft Lens Fold on an Irregular Cornea
Jaime Ibanez, OD, Villavicencio, Columbia

This is a flat lens (low sag value) on a highly irregular, steep cornea (high sag value) which decentered superiorly. The patient required a 1.2 mm steeper base curve, custom made lens to obtain better centration and alignment of the optical center with the visual axis. Needless to say, the visual acuity was better than expected due to the lowering of the optical aberrations.

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 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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Katherine M. Mastrota, MS, OD, FAAO
More on “Ocular Surface Wellness”

In my previous Ocular Surface Update installment I discussed the idea of “Ocular Surface Wellness (OSW)”. I asked how you, my colleagues, thought about OSW. I was pleased to receive the following comment from Daniel Fuller, OD, Faculty Chair and Chief of the Cornea and Contact Lens Service at The Eye Center at Southern College of Optometry.

“I would suggest a simple approach to answering the questions of how a practitioner could think about and promote ‘ocular surface wellness’… it might be the following: Understand ‘ocular surface wellness’ is the absence of ocular surface disease (OSD),” says Dr. Fuller.

Dr. Fuller states that “As an educator, clinician and one who performs clinical research, I find it is critical to train neophyte practitioners in the findings of (these) studies (DEWS, MGD and CLD Workshops) and their clinical application. Each patient is unique and we (can only) find what we look for. Heightening our vigilance as we search for the contributory causes of OSD in individual patients allows us to promote the public health through individualized treatment plans.”

Dr. Fuller and the eye care community at large look forward with great anticipation to an update of the DEWS report as we learn more about the complexities of the ocular surface.

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S. Barry Eiden, OD, FAAO

Perhaps It’s Time to Look Across the Pond. Influence of Monthly Automated Payment Plans on Contact Lens and Professional Service Purchase Behaviors.

A recent retrospective study was conducted that compared the purchase behaviors of contact lens wearers who were fit into daily disposable contact lenses at a British eye care practice. One group was placed on an automated monthly debit payment plan and the other group was charged fully at time of service. The study was designed to compare behavioral loyalty between monthly payment plan members and non-members.

The study looked at 38 patients who enrolled in the monthly payment program (mean age ±SD: 42.7±15.0 years) and 30 patients who did not enroll in the program (mean age ±SD: 40.8±16.7 years). Revenue and profits generated, service uptake and product sales between the two groups were compared over a fixed period of 18 months. The results found that monthly payment plan members generated significantly higher professional fee revenue (P<0.001), £153.96 compared to £83.50, and profits (P<0.001). Plan members had a higher uptake of eye examinations (P<0.001). The 2 groups demonstrated no significant difference in spectacle sales by volume (P=0.790) or value (P=0.369). The plan group incurred higher contact lens costs (P=0.037), due to a greater volume of contact lens purchases, 986 units compared to 582 during the same time period.

The authors concluded that monthly payment plans improve loyalty among contact lens wearers, particularly relative to service uptake and volume of lens purchases. Additionally the greater professional fees generated render monthly payment plans an attractive business model and practice builder.

The concept of automatic monthly debit payment plans for contact lens materials and out of pocket professional eye care services has been highly successful overseas for quite some time. Attempts in the past at bringing this concept here to the United States never gained traction. However with the introduction of premium daily disposable contact lens designs along with their significantly higher costs, it may be time to revisit this concept. We have become quite accustomed to automatic monthly payment programs when it comes to other services such as internet and cable television fees, so perhaps today the concept as applied to contact lenses and other associated professional services that are provided outside of managed eye or vision care may be met with more interest. The outcome may prove to increase the number of our patients willing to take advantage of these new and beneficial technologies.

Patel NI, Naroo SA, Eperjesi F, Rumney NJ. Customer loyalty among daily disposable contact lens wearers. Cont Lens Anterior Eye. 2014 Sep 12. [Epub ahead of print]

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The Conjunctival Sensitivity in Soft Contact Lens Wearers

These researchers set out to determine the influence of soft contact lenses (SCLs) on conjunctival sensitivity. A total of 26 volunteers (11 males, 15 females; mean age 28.3 ± 4.6 years; range 22-39 years) without dry eye were enrolled in the study. Subjects with a low corneal touch threshold, atopic keratoconjunctivitis, or vernal keratoconjunctivitis were excluded. In 26 participants, 12 were disposable SCL wearers. Touch thresholds were determined using a Cochet-Bonnet esthesiometer with a 0-60 mm nylon monofilament in 5 mm increments. The length (mm) was converted to tension (g/mm2). Mean touch sense thresholds in the SCL wearers (n = 12) and non-wearers (n = 14) were 10.7 ± 2.57 and 24.6 ± 7.3 g/mm2 in the whole conjunctiva, and 9.07 ± 3.02 and 19.2 ± 7.8 g/mm2 in the upper palpebral conjunctiva, respectively. Significant differences were observed in all locations (p < 0.01).

The researchers concluded that the enhanced conjunctival sensitivity associated with SCL use may contribute to the dry eye-like symptoms in SCL users who do not have dry eye.

Igarashi T, Ono M, Fujimoto C, Suzuki H, Takahashi H. The conjunctival sensitivity in soft contact lens wearers. Int Ophthalmol. 2014 Sep 7. [Epub ahead of print]

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