The poll results from last week turned out quite interesting regarding reasons for prescribing daily disposable lenses. The most frequent number one reason for prescribing the daily disposable modality was to optimize ocular health. Although this is your belief, I still maintain that we need contemporary clinical research data to support this notion. In our next poll, we'll likely be asking for your number one reason why you DO NOT prescribe the daily disposable modality.

The Contact Lens Manufacturers Association (CLMA) celebrated the organization's 50th anniversary at its annual meeting in La Jolla, California. The CLMA is comprised of contact lens laboratories and material, solution and equipment manufacturers in the United States and abroad. The ongoing mission of the CLMA is to increase awareness and utilization of custom manufactured contact lenses. The CLMA also supports the GP Lens Institute (GPLI), which is dedicated to providing eyecare practitioners with educational and practice-building resources.

The occasion was also marked by an awards ceremony honoring those who have made significant contributions to the contact lens industry. Awards and recipients included:

• Honorary Recognition Award, for a lifetime of dedication and service to the contact lens industry: Chip Heavican and William K. Veneman
• Industry Enhancement Award, for unselfish dedication to the CLMA and the contact lens industry: James W. Lunkley
• Trailblazer Award, for outstanding achievement in product development to the enhancement of the contact lens industry: Daniel L. Bell
• Creative Design & Process Award, for innovation in lens design and manufacturing process to the enhancement of the industry: Neal Bergman
• Dr. Josef Dallos Award, for outstanding contribution to the development and advancement of the contact lens industry and for service to humanity: Craig W. Norman, FCLSA
• GP Practitioner of the Year, for outstanding expertise in fitting gas permeable contact lenses to the benefit of the contact lens industry and corneal health, Christine W. Sindt, OD, FAAO

World Sight Day, October 13, is fast approaching but there is still time to accept the World Sight Day Challenge and support Optometry Giving Sight during October by:

• Donating your eye exam fees from World Sight Day or any other day in October
• Making a personal or practice donation
• Planning a practice celebration and inviting patient donations

You can also use the team fundraising tool to set up your own or a team fundraising page and invite others to donate.
For more information, visit www.givingsight.org.

To see the difference your support can help make, spend a few minutes with The First Optometrists to be trained in the new optometry school in Mozambique as they talk about their experiences. Or watch as optometrist, Dr. Moes Nasser, shares his life changing experience in Tanzania where he refracted a 13 year-old boy who was -24.00 D and who had been considered blind. These videos and more can be viewed at: www.givingsight.org/news/latest-videos.html.
--ADVERTISING

The CSLI will initially be launched in the U.S., followed closely by a U.K. launch. The CLSI hopes to collaborate with all of the schools and colleges of optometry around the world to provide specialty lens education through specific lectures, workshops, newsletters, scholarships, practitioner and research updates, and unique case histories. The CSLI will also introduce a residency club to help past and current contact lens residents stay connected with their peers, their educational institutions and the laboratories.

Advanced technical contact lens instruction will focus on improving clinical skills especially when managing patients having corneal irregularities such as keratoconus, corneal trauma, congenital disorders, aphakia, presbyopia, irregular astigmatism, and the specialized requirements of sports vision and the pediatric population.

Plan now to attend the Global Specialty Lens Symposium in January 2012. With an expert international faculty and a CE-accredited agenda, the 2012 GSLS will include insightful presentations by experts in the field, hands-on demonstrations of cutting-edge products as well as scientific papers and posters. Look for more detailed information in future issues of Contact Lens Spectrum and online at www.GSLSymposium.com.
--ADVERTISING

In celebration of World Sight Day on October 13, 2011, Essilor Contact Lens Specialists (ECLS) will donate a portion of their scleral lens sales, both Jupiter and Perimeter specialty lens designs, throughout the month of October in support of Optometry Giving Sight.

Manufactured by ECLS, Jupiter Scleral GP Lens is intended for high refractive errors, irregular corneas, advanced keratoconus, traumatized corneas and post surgery cases, and the Perimeter lenses is indicated for symmetrical and reasonably asymmetrical corneas unable to be adequately fit with small diameter corneal lenses. For further information or to place an order and support this important cause, please call 1-800-366-3933.

Primary Eyecare Network (PEN), the practice development division of ABB Concise, will hold its west coast program, Total Practice Success: A Symposium for Building a World Class Staff, on October 28-29, 2011, at The Claremont Hotel & Spa in Berkeley, CA.

Created by the Management & Business Academy (MBA), sponsored by Alcon and Essilor, the one and a half day program features lectures by leaders in the optometric field and California employment law, as well as an in-depth workshop on selling that is geared to the entire practice. Participants also receive a wealth of print and online resources. These resources provide benchmarks and strategies to manage staff and measure overall practice performance.

The first day of the program is geared to independent optometrists and office leaders, while the second day is designed for doctors and their staffs. For more information and to register, visit www.PrimaryEye.net/PIO or call 800-444-9230.

^ Back to top

This photograph shows a bandage soft contact lens on the left eye of a patient who has bullous keratopathy. The patient unfortunately experienced an acute angle closure attack as an infant and has never had useful vision with the affected eye. His previously high eye pressure and inflammation damaged his endothelium and he developed mild bullous keratopathy. He had been using Cosopt (Merck & Co.) b.i.d. OS and Muro 128 (Bausch & Lomb) drops OS as needed.

For more on this patient, see http://www.clspectrum.com/article.aspx?article=&loc=archive\2009\october\cls_october_a02.html

We welcome photo submissions from our 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.

The Dry Eye Seasonal Effect

With our recent move to Houston, I have been thinking about the environmental impact on dry eye (among other things). Of course, in evaluating my own ocular surface status, I comprise a small sample (n=1). However, I have noted no improvement or worsening of my eyes with a move to a much warmer, usually more humid climate. I think we tend to generalize climate, for example, it is arid in Colorado, and humid in Florida. While these generalizations can be true, the "working environment" can be much different than the "outdoor" climate. My daily office environment is cold and dry relative to the outdoor climate, and my exposure time, so to speak, is predominantly in an air conditioned, forced-air scenario—much like my "work-life" environment in Ohio.

So, when I have been asked "Is there any dry eye in Houston?" My reply is "As long as there is air conditioning, there will be dry eye!" I have also been asked why there might be a drop in sales of dry eye products, including prescriptions, during the month of July. Could it be vacations? More time outside in a humid environment? Less time spent working on a computer? Less desire to go see a clinician about dry eye? All likely play a role in the "dry eye seasonal effect."

The Latest Research in Case Care

One of the most overlooked aspects of contact lens care has been the contribution of the contact lens case—until now. Various new studies on this topic have been published of late, including two papers by Yvonne Wu and her colleagues.

The first paper looked at case contamination rates in vitro. The authors inoculated contact lens cases with Staphylococcus aureus and Pseudomonas aeruginosa and tested four different cleaning regimens for their ability to eradicate these bacteria. Ends up, for both multipurpose solutions (MPS) and types of lens case, the most effective regimen was rubbing and rinsing with MPS, wiping with a clean tissue, and then air-drying face-down on a clean tissue. This regimen removed significantly more bacteria than the method recommended by the solution manufacturers (rinse with MPS and air-dry). Another unique observation the authors made was that the level of contamination was affected by the design of the inside of the lens case; more biofilm was removed by tissue wiping smooth cases versus ridged cases. The authors suggest that the grooves in the ridged lens case were more difficult to reach during wiping, and could harbor bacteria.

The second paper compared the effectiveness of manufacturers' guidelines with alternative guidelines (the cleaning regimen listed above) in vivo. This was performed using a randomized cross-over clinical trial with two phases, utilizing 40 patients and their habitual contact lenses. The results were the same: the alternative guidelines were more effective in eliminating microbial contamination from lens cases than the current manufacturers' guidelines.

Wu YT, Zhu H, Willcox M, Stapleton F. The effectiveness of various cleaning regimens and current guidelines in contact lens case biofilm removal. Invest Ophthalmol Vis Sci. 2011; 52(8):5287-5292.

Wu YT, Teng YJ, Nicholas M et al. Impact of Lens Case Hygiene Guidelines on Contact Lens Case Contamination. Opt Vis Sci. 2011; 88(10):1180-1187.

This prospective, nonrandomized, single-center observational study was designed to report the corneal thinning during and after corneal cross-linking (CXL).

Thirty patients (30 eyes; 9 female, 21 male; age, 38 +/- 12 years) were consecutively scheduled for CXL between January 23 and July 6, 2009. Twenty-four eyes had progressive keratoconus, two had pellucid marginal degeneration, three eyes had progressive keratectasia after a LASIK operation, and one eye had pseudophakic bullous keratopathy. Riboflavin-ultraviolet A (UVA)-induced CXL included the instillation of 0.1% riboflavin drops for 30 minutes followed by riboflavin instillation combined with UVA irradiation for another 30 minutes. Corneal thickness was measured preoperatively, during CXL, and after one and six months using an ultrasound pachymeter. Changes in the endothelial cell count, corneal steepness, refraction, and visual performance are also given.

On average, the corneas thinned 87 +/- 40 mum (range, 37-206 mum; 19% +/- 7%) during a 60-minute CXL treatment. In one patient, the cornea did not swell, even with hypotonic solution such that CXL would be safe. After one month, the corneal thickness was lower than the preoperative thickness, but after six months, the corneas had regained their original thicknesses. The endothelial cell count and corneal steepness were unchanged after CXL. The UCVA (uncorrected visual acuity) and BSCVA (best spectacle-corrected visual acuity) were improved six months after CXL.

The researchers concluded that corneal thickness decreases significantly during CXL, even to a level where the health of the endothelium and cornea is jeopardized. Visual performance is improved six months after CXL.

Holopainen JM, Krootila K. Transient corneal thinning in eyes undergoing corneal cross-linking. American Journal of Ophthalmology. 2011 Oct;152(4):533-6.

^ Back to top  

A Proud Supporter of

Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

CLToday Services:
Subscribe; Unsubscribe; Submit Clinical Image
Submit news to news@cltoday.com.

Send your comments and fitting tips to cltoday@wolterskluwer.com. Please include your full name, degree or title and city/state/country.

For more information on Contact Lenses Today including archives of previous issues, please visit our website at www.cltoday.com. For the latest articles on contact lenses, important clinical information and helpful tools related to the contact lens practice visit the Contact Lens Spectrum website at www.clspectrum.com.

Contact Lenses Today and CLToday are registered trademarks of:
Wolters Kluwer Pharma Solutions VisionCare Group, 323 Norristown Road, Suite 200, Ambler, PA 19002 | 215-646-8700
© 2011 All Rights Reserved