It is hard to believe that we are already in the fourth quarter of 2011, which is when we begin editorial planning for the next calendar year. One of the most important items we do at the beginning of each year is our Annual Report, which summarizes the prior year's events in the field. Our market research team organizes a critically important survey that we would love for each of you in practice to complete, as this information helps us evaluate the aforementioned trends. We'd appreciate if you go to the following link and complete the survey—we're anxious to see the trends and report them to you in January.

Link to the survey: https://www.surveymonkey.com/s/Contactlensspectrum

Bausch + Lomb (B+L) launched PureVision2 for Astigmatism with High Definition Optics contact lenses at the American Academy of Optometry (AAO). PureVision2 HD for Astigmatism lenses feature HD Optics, which provide clarity and meet the special vision correction needs of patients with astigmatism, per the company.

B+L reports that the lens also incorporates Auto Align Design, a stabilization system optimized to deliver consistently crisp, clear vision all day, every day with excellent stability and comfort. The optimized thickness profile has a combination of prism and peri ballasting for enhanced stability. The large lens diameter of 14.5mm provides more area for effective ballasting and improves centration for excellent visual quality, giving patients stable vision throughout the day.

PureVision2 HD for Astigmatism lenses reduce spherical aberration across both the cylinder and sphere meridians, as well as across the entire power range, thus helping to reduce halos and glare in low-light conditions. The lenses provide high levels of oxygen transmissibility during wear and are packaged in a moisture rich packaging solution.

For additional information, please visit www.bausch.com.

On the new edition of Healthy Vision with Dr. Val Jones, a program supported by Acuvue brand contact lenses, optometrist and researcher Graham Erickson, OD talks about the relationship between vision and sports performance. Also, Olympic champion sprinter Allyson Felix tells Dr. Val that having as few visual distractions as possible is a critical part of helping her perform at a high level.

Free podcasts of Healthy Vision with Dr. Val Jones can be found in the iTunes Store. You will find it in LifeMinute.TV Health), BlogTalk Radio (www.blogtalkradio.com/healthyvision) and on http://getbetterhealth.com/healthyvision. A link is also available at www.acuvue.com/healthyvision.

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

CooperVision, Inc. is continuing to work with the FDA, distributors, customers, eyecare practitioners and lens wearers to complete the recall initiated on August 19, 2011 on certain lots of Avaira Toric contact lenses. The company wants to ensure that all consumers are aware of this action and know where to go for more information.

CooperVision recommends that patients who wear Avaira Toric contact lenses and experience any symptoms should stop wearing the lenses immediately and contact their eyecare practitioner.

For patients who wear Avaira Toric contact lenses and are not experiencing symptoms, CooperVision recommends that they go to the CooperVision recall web page at www.coopervision.com/recall, and enter the lot number of the package to determine whether lenses have been recalled, or contact the toll-free consumer hotline (1-855-526-6737). Recalled lenses should be returned eyecare practitioners or point of purchase.

According to the company, the recall was initiated because of the unintended presence of a residue on certain lots of Avaira Toric lenses, which may cause temporary hazy vision and discomfort. Not everyone experiences the same symptoms. Since the initiation of the recall the company has received some additional complaints of severe eye pain. Avaira Toric contact lens wearers that experience any symptoms should stop wearing the lenses immediately and speak with their eyecare practitioner.

To date the recall has impacted approximately 600,000 Avaira Toric contact lenses in the U.S.

Alden Optical, Inc entered the keratoconic segment of the contact lens market with the launch of NovaKone soft contact lens.

The company reports that, at the core of NovaKone is a novel lens design that offers the comfort and ease of fit associated with soft lenses. The lens employs a sophisticated posterior design to neutralize irregular astigmatism and optimize physical fit. Front surface toricity is then applied to correct for residual regular astigmatism, while Alden Optical's proprietary Dual Elliptical Stabilization ensures excellent rotational stability, according to the company.

The company offers a comprehensive fitting guide and consultation to aid in first fit selection and refinement. Diagnostic fitting is critical to success and sets are available at a nominal fee.

For more information, contact Alden Optical at 800-253-3669.

In over 25 years of practicing optometry, Drs. Barry Tannen and Nick Despotidis, have developed systems that have allowed them to flourish in all economic climates. In the evolution of their practice they have taken advantage of changes in medical/optical insurance reimbursement, discount glasses, LASIK and mail order contacts.

They have summarized their systems for corneal reshaping and vision therapy, into SuperCharge Your Practice, a course that will be presented October 28 at the annual COVD meeting in Las Vegas. The workshop will be followed with two web seminars, Staff Management: Vision Therapy and Staff Management: CRT, to assure solidification of the systems.

Eyecare practitioners can benefit even if they don't provide either service presented in the system. For tuition and details: www.SuperChargeYourPractice.com.

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Spooky Red Eyes

Halloween's around the corner. That means lots of little witches and monsters running around the neighborhood collecting bagfuls of candy. But it also means teens and young adults dressing up in all sorts of creative costumes to celebrate the festivities. For some, this includes cosmetic contact lenses. We all know that plano colored contact lenses are medical devices and require fitting and prescribing by an eye care practitioner. But we also know that some folks consider them "decorative" and sell them (illegally) without a prescription. Though we can report illicit sellers to the FTC, we know that this won't stop the majority from selling these lenses.

So what can we do? Educate your patients that even plano cosmetic contact lenses are medical devices and need proper fitting to prevent ocular complications. Reinforce the importance of proper cleaning and disinfection, and discourage the use of lenses that were used once last year and have been sitting in solution since then. Make sure that teens are not sharing lenses. Finally, let them know that you are happy to properly fit and manage their cosmetic lenses so that they can enjoy the holiday without worrying about their eyes.

RESEARCH REVIEW
Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

IOP Monitoring Contact Lens

A group from Spain has published on an adapted contact lens that allows for continuous monitoring of IOP. Sanchez et al report on a new sensor based on a flexible nanocomposite all-organic bi-layer adapted to a contact lens for non-invasive monitoring of intraocular pressure. They designed a rigid gas-permeable contact lens in a doughnut shape with hole of a 3 mm, where the bi-layer film-based sensor was incorporated. The sensor was a polycarbonate film coated with a polycrystalline layer of the molecular conductor which can detect deformations caused by pressure changes of 1 mm Hg.

The lens has been tested on pig eyeballs and a human volunteer on the research team. They found good correlation between the sensing contact lens electrical response and IOP changes in pig eyes, with a sensitivity of 0.4 Ω/mmHg. The human eye test also showed high potential of this new sensor as IOP variations caused by eye massage, blinking, and eye movements were registered.

They conclude that this device will be useful for glaucoma diagnosis and treatment.

Sánchez I, Laukhin V, Moya A, Martin R, Ussa F, Laukhina E, Guimera A, Villa R, Rovira C, Aguiló J, Veciana J, Pastor JC. Prototype of a nano-structured sensing contact lens for noninvasive intraocular pressure monitoring. Invest Ophthalmol Vis Sci. 2011 Sep 22. [Epub ahead of print]

These researchers wanted to assess long-term morphological and biometric corneal changes produced by overnight orthokeratology and to examine their recovery after cessation of contact lens wear.

This was a prospective, single-center, longitudinal trial. Fifteen right eyes with low to moderate myopia underwent overnight orthokeratology for one year. The central cornea was examined using a confocal microscope and changes determined in visual acuity, refractive error and corneal topography. Cell counts were performed using both the confocal microscope's software and the image analysis software of the USA Health Institute. All measurements were made during orthokeratology treatment and one month after discontinuing treatment.

No significant changes in endothelial cell density were observed over time but polymegethism increased significantly and baseline values were not recovered (p < 0.01). Stromal cell density remained unchanged though numbers of activated keratocytes increased during the study and returned to baseline when lens wear ceased. Basal epithelium cell densities significantly fell (p < 0.01) and epithelial wing and superficial cells showed enhanced visibility (p < 0.05). Superficial cells increased in height and width; this width increase being significant after 1 year of orthokeratology (p < 0.01). All epithelial cell changes returned to baseline. Corneal thickness, Bowman layer thickness, subbasal plexus thickness and epithelial thickness were reduced in the central cornea but the stroma was thickened. Of these changes, the decrease in epithelium thickness reached statistical significance (p < 0.01) and baseline values were not recovered.

The authors concluded that overnight orthokeratology induces structural and optical changes particularly in the central corneal epithelium during myopia treatment. If confirmed, the irreversible changes detected indicate a need for further investigation.

Nieto-Bona A, Gonzalez-Mesa A, Nieto-Bona MP, Villa-Collar C, Lorente-Velazquez A. Long-term Changes in Corneal Morphology Induced by Overnight Orthokeratology. Current Eye Research. 2011 Oct;36(10):895-904.

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