Sunday, October 19, 2008 A free weekly e-mail newsletter brought to you by: 
CLToday Contact Lens Spectrum
Edited by Jason J. Nichols, OD, MPH, PhD, FAAO and the staff of Contact Lens Spectrum
This week CLToday® reaches more than 14,000 readers in 74 countries. 
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Menicon Acquires Rose K

Menicon Co., Ltd. and Rose K International Limited reached an agreement for Menicon to acquire ownership of Rose K, effective October 1, 2008. With this acquisition, Dr. Paul Rose and Mr. Ian Jennings, founders and owners of Rose K International Limited, will join the global Menicon group and continue to be active in global Rose K operations. Menicon will allocate substantial resources to further grow the Rose K business world wide, while maintaining and reinforcing the business relationship with contact lens laboratories currently involved with Rose K.
     Dr. Hiderani Tanaka, President of Menicon Co., Ltd., commented: "Over the years, we have seen Rose K grow to become the number one brand for keratoconus, and we have tremendous respect for Dr. Rose, Mr. Jennings, the Rose K brand and all their labs and suppliers. The quality of its products and the business model fit very well into our company culture. We are extremely pleased to be able to work with Dr. Rose, Mr. Jennings, and their labs for the care of keratoconus patients. I am sure that both Menicon and Rose K will substantially benefit from the synergy of working together as part of the same family. We see this new acquisition as an excellent opportunity to expand our presence in the global GP contact lens market."
     Dr. Rose and Mr. Jennings added, "We have developed Rose K to a level that now requires the diverse skills, expertise and resources that a growing multinational company like Menicon can bring. Now, we can provide even better service to our customers including all the labs, eye care practitioners and patients, and expand the Rose K brand to bring its benefits to many more keratoconus patients worldwide."     

AOF Announces 2008 B&L William C. Ezell Fellowships

The American Optometric Foundation (AOF) in conjunction with Bausch & Lomb (B&L) announced recipients of the 2008 Bausch & Lomb William C. Ezell Fellowships. The fellowships, prized at $8,000 for one year, are designed to encourage gifted post-graduate students to pursue full-time careers in optometric research and education. Each Ezell Fellow also receives a $750 travel grant to attend the annual meetings of the American Academy of Optometry and the Association for Research in Vision and Ophthalmology. Since 1998 B&L has provided more than $100,000 in support to Ezell Fellows. 
     The 2008 recipients of the B&L Ezell Fellowships are: Jessica Mathew, OD, University of Houston, College of Optometry, TX and James Su, MEng, University of California, Berkeley, CA.
     Dr. Mathew received her Doctorate of Optometry in 2005 from the University of Houston, College of Optometry (UHCO), and is currently a PhD Candidate in the Graduate Program for Physiological Optics and Vision Science (POVS). The focus of her research is to advance the current knowledge of normal corneal stromal lamellar architecture and to understand what happens to its structural integrity in keratoconus.
     James Su is a graduate student at UC Berkeley conducting experiments to elucidate the interplay between myopia, hyperopia, and the mRNA expression levels of a class of proteolytic enzymes known as matrix metalloproteinases (MMPs). He also conducts biomaterials experiments working on the design and development of novel biomimetic hydrogels for the treatment of high myopia.

Contamac Appoints Bear Global Account Executive

Contamac, Ltd., UK based developer of specialist polymers and global provider of contact lens and intraocular lens materials, has announced the appointment of Jeanne A. Bear as Global Account Executive.  
     Ms. Bear has been active in the international ophthalmic business for the last 20 years, and has worked in global business since completion of her graduate degree in international management. Her sales and business development experience includes key global positions with Menicon, SynergEyes, Paragon Vision Sciences and Pilkington Barnes Hind. Jeanne will also serve as President of the European Federation of the Contact Lens Industry (EFCLIN) for 2008-2009. 
     Her new responsibilities with Contamac include key account sales, marketing and new business development, both in the USA and throughout designated global markets. John McGregor, Managing Director of Contamac commented, "I am delighted to welcome Jeannie to the Contamac sales and marketing team, her wealth of experience will further enhance our sales and professional services support on a global basis. Jeannie's exceptional reputation in the industry is a very valuable asset both to the company and our customers. We look forward to offering this resource to our customers and the industry as a whole."

Comfort for Performance

Now is the perfect time to fit more of your patients in ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR® Plus for all-day comfort and Class 1 UV blocking* for great protection against UV rays. To learn more about our innovations in comfort, vision and health, go to:
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New Alcon Agreements Designed to Expand Its Future Drug Portfolio

Alcon, Inc. announced that it has executed a new agreement and broadened an existing agreement with two different companies to expand its products under development. Alcon entered into a licensing agreement with GlaxoSmithKline (GSK) for global ophthalmic rights to cilomilast, a phosphodiesterase IV inhibitor. Alcon also expanded its existing drug research alliance with Origenis GmbH with a focus on the discovery and development of the small molecules that might one day have a role in the treatment of eye diseases. Both agreements were signed by Alcon's affiliate, Alcon Research, Ltd.
     "Alcon's focus is on expanding our research pipeline through targeted collaborations," said Sabri Markabi, MD, Alcon's Senior Vice President of Research and Development and Chief Medical Officer. "We believe the cilomilast compound has potential for treating dry eye as well as other ophthalmic conditions. The expansion of our already successful arrangement with Origenis will also help Alcon add more early-stage compounds to our exploratory efforts."

The Vision Council Releases "Vision Coverage" Report

According to a new report issued by The Vision Council, Vision Care: Focusing on the Workplace Benefit, two-thirds of Americans say they would be more willing to get an eye exam if they had some coverage, yet only 17 percent of employers report offering vision insurance. According to the Vision Council, vision benefits lag behind health and dental benefits, with as many as 44 percent of employers offering dental coverage.
     "We know that in today's tough economy everyone is taking another look at their finances," said Ed Greene, Chief Executive Officer for The Vision Council. "As the second most prevalent health condition in the country, vision disorders affect individuals and businesses, making vision coverage an important benefit for both groups."
     Vision health is highly valued by most Americans according to the National Eye Institute. When asked what conditions would most affect their day-to-day living, a majority of Americans rated loss of eyesight as a 10 on a scale of 1 to 10. While Americans place a high value on healthy vision, many have real concerns about paying for vision care. Nearly 40 percent fear they cannot afford adequate treatment. Sixty-three percent say they would sign up for vision care coverage if given the opportunity, even if it meant paying a small amount each month.
     With 11 million Americans living with an uncorrected vision problem, a number expected to rise as the population ages, the expense to businesses can also be severe. According to the report, the annual financial burden to the U.S. economy of major adult vision disorders exceeds $35 billion, including an estimated $8 billion in lost productivity.
     For a copy of the full report, visit www.thevisioncouncil.org/consumers.

Early Bird Registration Deadline is December 12th!

Join Contact Lens Spectrum and the Health Care Conference Group for the Global Specialty Lens Symposium (GSLS), January 15-18, 2009, at Bally's Hotel and Casino in Las Vegas, NV. The GSLS will include presentations on the latest techniques and technologies for the successful management of ocular conditions - from presbyopia to pediatric vision correction - using today's specialty contact lenses. Truly an international meeting, GSLS will provide insights of experts from around the globe and hands-on access to the most current products available. The program will be accredited for continuing education under COPE, NCLE and JCAHPO, offering 17+ credit hours. 
     Visit www.GSLSymposium.com for more information or to register for this unique meeting. Companies interested in exhibiting should contact Sean Casey at 732-483-4302 or sean.casey@wolterskluwer.com.
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Abstract: Mucins and Ocular Signs in Symptomatic and Asymptomatic Contact Lens Wear

Lid wiper epitheliopathy (LWE) and lid parallel conjunctival folds (LIPCOF) are related to dry eye symptoms in contact lens wearers. Both clinical signs are assumed to be related to mechanical forces during blinking. As the mucus layer is a protector of the ocular surface tissue, this study investigates whether any alterations of mucins are detectable comparing symptomatic and asymptomatic soft contact lens wearers.
     Comfort was evaluated using the Contact Lens Dry Eye Questionnaire. Corneal staining, LWE, and LIPCOF were assessed in the right eyes of 50 (19 men, 31 women; mean age, 32.1 +/- 11.4 years) experienced lens wearers. The tear film was sampled using Schirmer strips pressed onto the temporal conjunctiva and from harvested contact lenses. Mucins were assessed in dot-blots and Western blots after electrophoresis on 1% agarose or 4 to 12% NuPAGE Gels. Non-parametric analyses were used to study differences between groups and correlations between objective tests, mucins, and symptoms.
     Thirty-one subjects were classified asymptomatic and 19 symptomatic by the questionnaire. LWE and LIPCOF were significantly increased in the symptomatic group (p < 0.035). MUC5AC reactivity was significantly decreased in symptomatics (p = 0.050). MUC4 was correlated to temporal LIPCOF and LWE, (r = -0.47 and -0.46; p < 0.01). MUC16 and MUC5AC correlated with corneal staining (0.36 < r < 0.53; p < 0.04).
     According to the researchers' conclusions, symptomatic contact lens wearers exhibit significantly more LWE and LIPCOF, as well as decreased MUC5AC reactivity. LWE and LIPCOF are significantly correlated; this may reflect their common frictional origin. Increased friction might follow from insufficient mucins, or an altered composition of the resident mucins at the ocular surface. In this study, decreased mucin production is associated with the severity of LWE and LIPCOF.
Berry M, Pult H, Purslow C, Murphy PJ. Mucins and ocular signs in symptomatic and asymptomatic contact lens wear. Optom Vis Sci. 2008 Oct;85(10):E930-8.  

Reader Commentary: Your Thoughts on Corneal Staining

We received a lot of reader feedback in response to last week's editorial about the debate within the industry on the role of corneal staining in the comfort, health and safety of contact lens patients. The following are representative of these comments; we will print more in the coming weeks.
    
Corneal staining has been brought to the forefront of attention to the optometric community due to the marketing efforts of some. While this has provided many thought provoking articles and theories, it is taking attention away from the most important issue of our practices, namely how we can keep our patients in lenses. Many practitioners whom I see speak in various locations across the country feel contact lenses are not worth the trouble of fitting. Many feel spectacles are more profitable and are less of a hassle. The real issues we should be spending this time and effort on are how to keep our patients from dropping out of lens wear (about 20% annually) and how to grow this worthwhile means of vision correction.
     The issues we need to really study are dry eye, meibomian gland disease, and allergic conjunctivitis. These three problems account for most of the problems I see in my contact lens practice. What a shame the industry is in a tit for tat fight rather than pouring their efforts on these problems to grow the market and increase all their market shares! Our industry is looking more and more like a political election than a profession. 
David I. Geffen, OD, FAAO
San Diego, CA

I use the staining grid to assess the potential for solution-induced staining for all my contact lens wearers. On several occasions I have recommended solution changes for patients who later told me that they never realized that the right solution could improve comfort so much. Also, I regard the debate as to whether solution-induced staining increases the risk for infection as pointless and academic. Regardless of infection risk, what do my patients (and I) have to gain from a cornea covered with staining on a daily basis if it can be avoided?
Jordan D. Rosen, OD
Midlothian, VA


The information related to the topic of corneal staining that has been most influential over the years has been...reality! If, as implied, increased corneal staining leads directly to increased risk of infection, we should be seeing a devastating number of serious eye infections on a regular basis. This simply has not happened. I would like to see a controlled study which tightly controls the digital cleaning, proper rinse, and storage of lenses in clean cases, with lenses disposed as intended, and then compare staining results. I suspect that there will be a percentage of patients who are susceptible to staining leading to infection, and many more who are not.
Michael Raff, OD
Brockport, NY

Editor's Commentary: Engaging Topic for Discussion

We received numerous responses from my editorial comments last week about corneal staining. As I mentioned, it comes as no surprise that many of you are quite passionate about the topic. Responses seemed to fall into three areas: 1) those who felt that corneal staining associated with lenses-care solutions was very important in your clinical practice, 2) those who acknowledged that corneal staining can be associated with lenses-care solutions, but believe it makes little difference in your clinical practice, and 3) those who felt the topic has run its course and is detracting from our profession moving forward. We will keep these comments in mind as we move forward in providing comprehensive clinical materials to you.
Jason J. Nichols, OD, MPH, PhD, FAAO

This month at www.siliconehydrogels.org: multipurpose solutions, one- and two-step peroxide solutions and the effect of continuous wear on epithelial barrier function.

Report adverse contact lens reactions here: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.

Report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule at: https://www.ftccomplaintassistant.gov/.
Send your favorite tips to tips@cltoday.com. Your tip may be selected as best of the month. See http://www.CLToday.com for details. Please include your full name, degree or title and city/state/country.
For more information on Contact Lenses Today including archives of previous issues or to subscribe to this newsletter, 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.
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