CONTACT LENSES TODAY

October 19, 2003

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches nearly 10,000 readers in 74 countries.

Reason to Keep Warning Patients of the Dangers of OTC Lenses
The October issue of Eye & Contact Lens cites case reports of six patients between the ages of 14 and 32 who suffered from bacterial infections, corneal abrasions, corneal scarring and other side effects of wearing OTC cosmetic lenses. The report also says that the demand for decorative contact lenses continues to increase and because of the growing market, the report states, "American young people remain at risk as a major target of the unauthorized sale of decorative contact lenses."

AOA Convenes to Clarify Terms of CL Rx Bill
As many of you know, on October 1, 2003, the House Energy and Commerce Committee approved the passage of a revised version of The Fairness to Contact Lens Consumers Act (HR 3140). The American Optometric Association (AOA) recently held a conference call to answer questions about the bill and to clarify its terms. According to J. Pat Cummings, O.D., immediate past president of the AOA, "Most significant changes include action taken against sellers for selling lenses without valid prescriptons and the establishment of a logical verification process." Among its many provisions, the approved, revised HR 3140 states that contact lens sellers are specifically prohibited from providing lenses without a prescription, that prescribers would be guaranteed a reasonable time in which to respond to requests, and, among other things, that sellers would be specifically prohibited from altering a contact lens prescription. Says Jeff Mays, deputy executive director of the AOA Washington, DC, office, "We anticipate that the House will consider both this bill and the decorative contact lens bill before the end of the month."

NOT ALL LENS CARE SOLUTIONS ARE THE SAME! Opti-Free Express MPDS contains POLYQUAD as the preservative system. Most competitive lens care solutions contain PHMB as the preservative. PHMB is an abbreviation for polyhexamethylene biguanide. Other PHMB ingredient names may include polyaminopropyl biguanide (DYMED*) and polyhexanide.

Several recent contact lens clinical studies have demonstrated differences in corneal staining between formulations containing PHMB and Opti-Free Express with POLYQUAD.^1,2 Opti-Free Express is formulated to minimize preservative uptake and release.

Recommend PHMB-Free Opti-Free Express to all of your soft contact lens patients.

Reference:
¹Jones, L, et al. Asymptomatic Corneal Staining Associated with a Polyaminoprpyl Biguanide Preserved Care Regimen. Opt Vis Sci. 2002; 79:753-761.
²Pritchard, N.; Young, G, et al. Image Analysis of Corneal Staining Related to Multipurpose Disinfecting Systems. CLAE March 2003.
*Trademark of another company.
--ADVERTISING

Odyssey Extends New Offer
Odyssey Medical is now offering its portable Dry Eye Management Kit to practitioners. The kit includes two pairs of the Odyssey Parasol Punctal Occluders, one box of Lissamine Green diagnostic strips, one box of Zone Quick Diagnostic Threads, one box of BioGlo Diagnostic Fluorescein Strips, one box of .3mm Temporary Collagen Implants, an instructional video and other marketing materials. To learn more about this kit, which costs $300, call Odyssey's customer service at (888) 905-7770 or visit http://www.odysseymed.com.

FDA Approves B&L's Personalized Vision Correction System
The FDA has approved Bausch & Lomb's Technolas 217z Zyoptix Personalized Vision Correction System, which surgeons have used to successfully perform approximately 100,000 LASIK procedures in Europe, Asia, Latin America and Canada since 2001. According to Bausch & Lomb, potential practice benefits that may result from using the Zyoptix excimer laser system include: providing improved patient management as demonstrated by clinical study outcomes; permitting faster treatment and a smoother surface and enabling doctors to treat more than 90% of LASIK patients and effectively remove astigmatism as a result of the widest range of approved treatment (sphere up to -7.00D and cylinder up to -3.00D) and ability to treat higher-order aberrations. In clinical trials with 340 eyes that had a combination of myopia and astigmatism, 92% of patients had unaided 20/20 vision or better and 70% of patients had unaided 20/16 vision.

Abstract: Examining the Effects of Soft Lenses on the Ocular Surface
Using impression cytology, researchers evaluated conjunctival changes, tear break-up time (TBUT) and Schirmer test function alterations to examine the effects that soft contact lens wear has on these factors. In their conclusion, the researchers suggest that practitioners carefully monitor TBUT and Schirmer test results in contact lens wearers. Also, that you may use impression cytology as a safe, simple and noninvasive method in the diagnosis of ocular surface alternations in patients who experience contact lens intolerance.
Cakmak, SS; Unlu, MK; Karaca, C; Nergiz, Y; Ipek, S. Effects of Soft Contact Lenses on Conjunctival Surface. Eye & Contact Lens. 2003 Oct;29(4):230-233.

Readers Write Back: Try Persistent Hygiene Maintenance Instead of Drops
In response to your October 12, 2003 editorial, "Don't Drop the Lens Drops," I couldn't agree more! I also find that the condition of the meibomian glands and lid margins in general is more important than the decision whether to recommend eye drops. I examine those areas carefully to advise the patient about warm compresses and/or lid scrubs (persistent hygiene maintenance). Most patients have never heard of their tears and aren't aware that they can be instrumental in maintaining the proper function of these glands. One way that I put it to the patient is that using warm compresses and lid scrubs don't cost them anything except time -- and they tend to understand the importance of building this process into their schedules and that they'll get comfort out of doing it. I also explain that this regimen may free them from having to use rewetting drops (if it's already difficult to fit into their schedule).
--Cynthia H. Green, OD
President, NOA
Columbus, Ohio

Editor's Commentary: Shrink Wrap Gripes
I hate whining, but don't you hate the shrink wrap covers on eye drop bottles? They are hard to get off and are a nuisance. All of this started when some idiot psychopath tainted some pain relievers a couple of decades ago and ruined life for the rest of us. Can't someone invent a more user friendly way to keep bottles safe and secure until someone opens them? Or can someone tell me a better way to remove the shrink wraps?

Fitting Tip: Work with What You Have
If you own a Nikon FS-3 photo slit lamp, then you're likely frustrated with the lack of support now that Nikon has pulled out of the opthalmic instrument business. You're probably also frustrated if you've tried to convert this wonderful instrument for digital technology. You may be relieved to find out that there is a way to use a NIkon D100 on the FS-3 slit lamp. This allows digital conversion of this instrument. Here's how:

Keep the three-end cable set up that's attached to the battery pack for the original 35mm camera. Remove the batteries from that set up. Purchase the D100 camera, the MB-D100 battery pack accessory and the MC-25 adapter cord. Attach the MB-D100 to the camera and attach the adapter cord to the port on the battery pack. Using the old three-end cable, attach the end that was attached to the old camera to the adapter cord. Attach the others to the flash shoe and the instrument as before.

You'll need to switch the camera to manual mode, which works just fine. Interestingly, Nikon and several large ophthalmic instrument companies told me that there was no way to do this.
--Peter Bergenske, OD
Forest Grove, Ore.

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