CONTACT LENSES TODAY

October 8, 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.

Kids Vision Care Act Introduced in House
On Sept. 28, House Representative Vito Fossella (R-N.Y.) introduced H.R. 6227, the Kids Vision Care Act of 2006, a bill that would allow the Secretary of Health and Human Services to provide federal grants to states to provide eye exams and follow-up treatment to children identified through a vision screening or eye exam. It would also allocate funds for developing and disseminating educational materials on recognizing signs of visual impairment in children.
    ”There are 11 million children currently without health insurance in the United States. Many of these children suffer from correctable vision disorders, but simply cannot afford the treatment they need. These vision disorders serve as a significant impediment to normal learning development, and can cause irreversible damage if left untreated,” says Mr. Fossella.
    The bill has been referred to the Committee on Energy and Commerce.
Survey Shows O.D.s Don’t Implement Expert’s Recommendations
An ongoing survey conducted by the Management & Business Academy (MBA) shows the majority of independent O.D.s do not adopt many of the “best practices” recommended by leading consultants to improve financial performance. The MBA’s database included information on nearly 500 of the largest practices in the country. The survey shows:
• Financial management is a weakness for most independent O.D.s. Only 21% develop a written annual budget and 47% do not define annual revenue goals. Only 14% of respondents says they are “very satisfied” with the net return of their practice.
• Most independent O.D.s spend little for marketing and promotion with the median percent of gross revenue spent on marketing at only 1.2%. About 77% of practices have a website, but 74% update it infrequently.
• Independent O.D.s say staff management is their biggest challenge with average annual staff turnover at 17%, meaning about one in six employees leaves the practice a year. Half of owners do not regularly share financial performance data with the staff and 89% have not developed written qualifications for each position. A little more than half of practices do not provide annual written performance appraisals and 33% conduct infrequent staff meetings — quarterly or less often.
    The MBA has a repository of staff management tools and guidelines available free of charge at http://www.mba-ce.com. The MBA is a professional education initiative launched by CIBA Vision and Essilor of America in 2005.
AOA Gets Support for Low Vision
Kemin Health, manufacturer of FloraGLO Lutein, has awarded an unrestricted educational grant to the American Optometric Association’s (AOA) Low Vision University. The grant will fully fund the program for 18 months, making it free to state optometric associations. The organization’s educational objectives for the low vision care process include understanding how low vision rehabilitative treatment approaches must be modified based on the patient’s disease and the evaluation of visual acuity and visual field for disability determination by Social Security.
Wet Lens, Patient Satisfaction Among those ages 35-49, 65% of patients who consider dropping out of contact lens wear cite dryness sensation as a key reason. ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR™ Plus are made from senofilcon A, a next generation silicone hydrogel material. The proprietary formulation includes a remarkable moisture-rich wetting agent and no surface coating. The senofilcon A material balances properties to meet the demands of contact lens wearers in environments that can make eyes feel tired and dry. This breakthrough material creates a lens so moist and smooth that an eyelid glides effortlessly over it. ACUVUE® OASYS™ Brand Contact Lenses can help keep your patients in contact lenses by increasing their comfort and also giving them crisp vision and healthy lens wear.
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Global Keratoconus Congress 2007 Register now for the first-ever Global Keratoconus Congress to be held January 26-28, 2007 in Las Vegas. This meeting will be hosted at Bally’s on the Las Vegas Strip. Please visit http://www.gkc2007.com. There you will find the most up-to-date educational program agenda and information on hotel accommodations, as well as the ability to register for the event.
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Acuvue Advance for Astigmatism
Tracking data from Health Products Research (HPR) shows Vistakon’s Acuvue Advance for Astigmatism contact lenses are the most widely prescribed contact lenses for patients with astigmatism. Less than a year ago, the lenses were shown to be the most-widely prescribed toric for new contact lens or new toric lens wearers.
Abstract: Resolution of Corneal Edema After Long-term CL Wear
Researchers at Shahid Beheshti University of Medical Sciences’ Department of Ophthalmology in Tehran, Iran, recently evaluated the corneal thickness changes after soft contact lens removal in LASIK candidates. Participants included 100 eyes on a daily-wear schedule for at least six months. Investigators used pachymetry to measure central corneal thickness (CCT) immediately after lens removal and daily until it stabilized.
    CCT measured 557.4 +/-32 microns immediately after lens removal, and 521.8 +/-25 microns after the edema resolved, which took two to fifteen days after discontinuation of lens wear. Corneal thickness stabilized in 74% of patients within the first week and 26% during the second week. Older patients and patients with more primary corneal edema needed longer to recover.
    The authors of the study recommend discontinuing soft contact lens wear at least 15 days before keratorefractive surgery to achieve accurate pachymetry.
Nourouzi H, Rjavi J, Okhovatpour MA. Time to resolution of corneal edema after long-term contact lens wear. Am J Ophthalmol. 2006 Oct;142(4):671-3.
Editor's Commentary: Not-So-Best Business Practices
Our story about the MBA survey above is not a great surprise, but it is a great concern. I truly believe that the better your business practices, the more capable you are of providing better care (for example, buying better instrumentation) and the more eye care service you can provide (such as seeing more patients due to good internal or external marketing).
    Having spent many hours this past year learning more about our own clinical business from a great new fiscal officer, reviewing our business curriculum extensively and spending a good 30+ hours in business courses, I assure you, I feel like we are providing more and better care while we see more patients. The key is not so much learning what to do, but doing it. Design your business plan and make it work.
Fitting Tip: Comet for Contacts
For my patients who are more prone to contact lens deposits (especially with silicone hydrogel lenses), I recommend using Lobob SOF/PRO soft contact lens cleaner. I call it “Comet for contacts.” I suggest using it once weekly before storing the lenses.
    It’s important to tell the patient to thoroughly rinse the cleaner off the lenses before storing or it may burn. My patients who were previously unable to use lenses for the recommended wear schedule were able to do so with this regimen.
Joshua Coleman, O.D.
Paris, Tenn.
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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