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Sunday, October 5, 2014  
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Results from Last Question
Do you think that myopia is a disease?



Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
I often hesitate to comment on our CL Today Quick Poll responses, but this week¹s response is quite surprising to me. Nearly 90% of respondents do not consider myopia to be a disease! Yet, by definition it really is, as it is a disorder of structure/function within the body that leads to signs or symptoms, not resultant from injury. There are diagnostic codes for myopia and refractive error and the World Health Organization recognizes refractive errors as disease states most commonly associated with visual impairment. What seems like a real disconnect to me is that we as eye care practitioners manage refractive errors daily, but yet we do not recognize them as a disease. This leads me to wonder what then eye care professionals consider myopia and refractive errors to be?

Leadership Change for Alcon US Vision Care
Alcon has appointed Eric Bruno as the new General Manager for Alcon US Vision Care. He replaces Jim Murphy, who is being promoted to President, Alcon Japan.

Mr. Bruno most recently served as the Global Franchise Head of Vision Care at Alcon. He joined Alcon in 2012 and brought together Alcon’s Vision Care under the umbrella of “Performance Driven by Science.” Prior to joining Alcon, Eric spent 16 years at Johnson & Johnson in roles of increasing responsibility, including Vice President positions, overseeing the company’s over-the-counter business and its Ethicon Endo Surgery business.
J&J Vision Care Adds -2.75 CYL for Acuvue Oasys
for Astigmatism
Johnson & Johnson Vision Care, Inc. announced that Acuvue Oasys Brand Contact Lenses for Astigmatism is now the first and only silicone hydrogel toric contact lens with -2.75 cylinder (cyl) that is readily available, with no need to special order. Acuvue Oasys Brand provides coverage for 98 percent of spherical and astigmatic patients.

Acuvue Oasys for Astigmatism parameters will now include -6.00 to +6.00 in 0.25D steps (cylinders: -0.75, -1.25, -1.75, -2.25, -2.75; Axis: Full circle in 10° steps) and from -6.50 to -9.00 in 0.50 steps (cylinders: -0.75, -1.25, -1.75, -2.25, -2.75; Axis: Full circle in 10° steps).
STAPLE Program Holds 100th Workshop
The STAPLE (Soft Toric and Presbyopic Lens Education) Program, a collaborative effort on the part of Alcon, Bausch + Lomb, CooperVision, and Vistakon, Division of Johnson & Johnson Vision Care, Inc., held its 100th workshop on Monday, September 29, 2014, at The Ohio State University. These workshops bring educators and industry together to provide 2nd and/or 3rd year optometry students with hands on experience fitting soft toric and soft multifocal lenses on actual patients in a non-competitive environment. Since the STAPLE Program held its first workshop in January 2012, nearly 7000 student encounters have taken place in the 57 toric and 43 multifocal workshops. The program, managed by Wink Productions, Inc., has become a “staple” in 21 of the schools of optometry in the U.S., Canada, and Puerto Rico.

The foundation of this program is largely thanks to coordinated support from all the industry sponsors and their genuine interest in involvement in student and eye care education. This program generates student enthusiasm and enhances their confidence in providing visual benefits of specialty soft contact lenses to their patients.

For more information, visit, or contact Ursula Lotzkat and Sue Schnell at Wink Productions, Inc., at 574-876-0475.

Register Now and Save: 10th Annual OMS – CE in December in Orlando

Learn from the best. Experience the motivation. Move your practice forward. Plan now to attend the Optometric Management Symposium on Contemporary Eye Care, December 5-7, 2014 at Disney's Yacht & Beach Club Resort in Lake Buena Vista, FL.

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.

OMS offers a comprehensive program, flexible schedule, ABO, COPE and Florida Board approved credits included 12 CEE's (TQ credits)! The education is also sponsored by a school of optometry meeting the requirements of several states. Rejuvenate yourself and expand your education while visiting exhibitors to learn about their products and services during our refreshment breaks.

For agenda, more information and to register visit

--ADVERTISING to Donate $7 to Optometry Giving Sight for Social Media Shares's #ShareForSight campaign is using social media to mark World Sight Day, October 9, and to raise money for the World Sight Day Challenge benefitting Optometry Giving Sight.

Each day from October 3-9 the site will debut a video, quiz, slideshow or article with a new post on Facebook, Twitter, Pinterest and Google+. will donate $7 to Optometry Giving Sight for every share, Like, Retweet, Repin or +1 of those posts.

To participate, simply follow on social media and share the posts leading up to World Sight Day. For more information, see

Newman Honored as 2015 GPLI Practitioner of the Year

The GPLI (GP Lens Institute) Practitioner of the Year Award is presented annually for outstanding professional expertise in fitting customized contact lenses to benefit patients with improved vision and corneal health, and to advance the contact lens field. This year the award was presented to Clarke D. Newman, OD, FAAO, during the annual meeting of the Contact Lens Manufacturers Association (CLMA) in Santa Fe, New Mexico. The GPLI is the educational division of the CLMA.

Dr. Newman, a graduate of the University of Houston College of Optometry, is in private practice in Dallas, Texas. His practice specializes in the visual rehabilitation of patients who have had corneal diseases, failed refractive surgeries, or corneal trauma. Dr. Newman is a past president of the Texas Optometric Association and a volunteer advocate for the American Optometric Association. Dr. Newman is member of the AOA's Cornea and Contact Lens Section, a diplomate in the Section on Cornea, Contact Lenses and Refractive Technologies of the AAO, and a distinguished practitioner in the National Academies of Practice.

Dr. Newman was instrumental in development of the Coding and Billing module which resides on the website. He continues to update this educational tool with current medical codes and has led webinars on behalf of the CLMA / GPLI with emphasis on specialty lens coding - resulting in record attendance to these educational webinars. He writes and lectures frequently on a wide range of anterior segment and contact lens topics.

Moldy Appliances
Dennis Bunz, Buffalo, NY

This is a classic example why contact lenses and materials should not be stored in the bathroom. This applicator and remover were being actively used by a scleral lens patient. I discovered them in her care kit during a routine follow up exam.

We thank Dennis Bunz 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 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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David Kading, OD, FAAO

A Hyperope from Berkeley with Curved Corneas

I was at UC Berkeley College of Optometry recently speaking to our future colleagues about their future careers. Afterwards, I was sitting around with a group of students and one exceptional student made a very depressing statement; "I’ll never be able to wear single use lenses." (If you have read my columns over the past 10 months, many of you will understand why my ears perked up.) She went on to say that she was a very high hyperope with two diopters of astigmatism. My response, "Oh?" (spoken somewhat melancholy and sadly). The astigmatic hyperope has been a challenge for many of us in our career. I reckon that every contact lens practitioner can think of at least one hyperope that they have walked through the CL fitting process with and can relate to the struggles.

We then started discussing options. Gas permeable lenses still remain an incredible opportunity for patients. They work exceptionally well for individuals with high amounts of ametropia. Given the effects with vertex distance, they work exceptionally well for hyperopes to reduce accommodative demands. Beyond that, we certainly can look to scleral lenses. Some may think that is a bit complicated, but if corneal GP lenses are out and a patient struggles with rotation of soft or comfort with hybrid lenses, sclerals are a choice that we are turning to more and more for patients with regular corneas. Hybrid lenses are also a good solution due to their comfort/vision benefits and they tend to have a large power range.

Lastly, one more tip is to evaluate these patients HVID (Horizontal Visual Iris Diameter) and keratometry readings more closely than other patients. They may have struggled with off the rack products (if in their power range) in the past due to a fitting issue. Discuss with your soft lens laboratory of choice the power and, more importantly, the parameters of the eye when ordering to ensure a centered, properly moving soft lens. Although our very bright future colleague from Berkeley may be sunk with daily disposable at the moment, she has an ever expanding world of exceptional contact lens options. Happy Fitting.

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Susan J. Gromacki, OD, MS, FAAO

2014 Contact Lens Microbiology Workshop: Revamping Microbiological Test Methods for Contact Lenses, Products, and Accessories to Protect Health and Ensure Safety

On September 12, 2014, the United States Food and Drug Administration (FDA) co-sponsored a workshop with the American Academy of Ophthalmology, the American Academy of Optometry, the American Optometric Association, and the Contact Lens Association of Ophthalmologists. The purpose was to bring together researchers and others affected by FDA’s former and potential actions regarding:
1. Emerging pathogens in contact lens-related keratitis
2. The role of organic soil models in disinfection efficacy testing
3. The development of a test method for disinfection efficacy tests for Acanthamoeba

The FDA sought to procure discussion and input on these issues. The meeting minutes have not yet been posted, but FDA Press Officer Jennifer Rodriguez states that the FDA is planning to write a publication this year summarizing the consensus points/results of the workshop. She also states, “We are considering the information obtained both from the May 2014 Ophthalmic Advisory Panel Meeting and this workshop as we consider any potential updates or revisions to our guidance documents for daily wear contact lenses and their accessories.”

We at Contact Lenses Today will keep you posted!

1. Personal communication, Jennifer Rodriguez, September 24, 2014.

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Effect of Optical Defocus on the Kinetic Perimetry in Young Myopic Participants
The prospective study evaluated the effects of optical defocus on kinetic sensitivity using automated kinetic perimetry.

The 17 eyes of 17 healthy young participants were evaluated. All of the participants had myopia (>= -5.00 D) and mild to no astigmatism (<1.00 D). Automated kinetic perimetry was performed using the Octopus 900 perimeter with Goldmann stimuli III4e, I4e, I3e, I2e, and I1e, with stimuli presented at 14 predetermined meridians, and a velocity of 3°/s. Optical defocus was induced with soft contact lenses, and varied in 1 D increments between 0 and +7 D. Kinetic sensitivity at each defocus was evaluated and compared to sensitivity with no defocus.

Although kinetic sensitivity with the III4e and I4e stimuli decreased slightly at the inferior nasal, total kinetic sensitivity measured with the III4e and I4e stimuli was unaffected by optical defocus. Conversely, kinetic sensitivity measured with the I3e, I2e, and I1e stimuli decreased at defocus greater than +6 D (p < 0.05), + 3 D (p < 0.01), and at a defocus greater than +1 D (p < 0.01), respectively.

Kinetic sensitivity was unaffected by defocus when measured with III4e and I4e stimuli. However, measurements with I3e, I2e, and I1e stimuli were affected, in particular measurements with I2e and I1e stimuli. Therefore, the researchers concluded that optimal refractive correction with a contact lens or a spectacle lens is required in order to obtain accurate kinetic perimetry results, particularly for lower intensity stimuli.

Hirasawa K, Shoji N. Effect of Optical Defocus on the Kinetic Perimetry in Young Myopic Participants. Curr Eye Res. 2014 Oct 1:1-6. [Epub ahead of print]

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