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Sunday, October 26, 2014  
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How often do you believe patients should replace their contact lens case?

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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
One of the long-term problems with some of our contact lens patients is compliance with lens care. The problem is perhaps multifactorial in the sense that patient behaviors contribute to the problem, complexity with instructions or “steps” presents a challenge, and WE often don’t do enough to promote full compliance in our offices. Some people are predicting that the market will move more and more toward daily disposables due to some of these issues, and while we are seeing a shift, it is yet to be seen just how far that pendulum will swing.

B+L Announces Three Appointments to U.S. Professional Strategy and Sales Teams

Bausch + Lomb has appointed Jill Saxon, OD, and Todd Love as directors of Professional Strategy. Saxon and Love will coordinate the company’s eyecare professional outreach efforts across the Vision Care business through a wide range of initiatives including strengthening its focus and support of academic optometry colleges and universities across the nation. The company has also named Tony Sommer as head of sales for its U.S. Vision Care division. Mr. Sommer will be responsible for managing the U.S. sales function for B+L’s Vision Care business.

Immediately prior to joining B+L, Saxon served as an optometrist at the Randolph Eyecare Center in Randolph, NJ. Earlier in her career, she worked at the National Naval Medical Center (NNMC) in Bethesda, MD as a Lieutenant in the United States Navy. While there, Saxon distinguished herself as a noted lecturer in the area of optometric practice. She was also the coordinator of the Optometry School Externship program and earned the title of adjunct assistant clinical professor from SUNY College of Optometry, Pennsylvania College of Optometry, Southern California College of Optometry, and Southern College of Optometry.

A member of the Armed Forces Optometric Society and the American Optometric Association, Dr. Saxon is a graduate from the State University of New York, College of Optometry.

Love’s extensive experience in the optometric industry spans more than 15 years in a wide variety of sales, marketing, and professional development leadership roles. Immediately prior to joining B+L, Love served as the director, market development at Alcon Laboratories, where he focused on driving Alcon’s U.S. vision strategy and outreach for the company’s key opinion leaders program. During his tenure at Alcon, he held several positions of increasing responsibility, including global marketing director, contact lens care, and senior brand manager, U.S. contact lens care.

Sommer has nearly two decades of diverse experience in the packaged goods, healthcare and medical device industry where he’s served a variety of U.S. and international roles across a number of business divisions with leading companies including General Mills, Coca Cola, and CIBA Vision/Novartis. Immediately before joining B+L, Sommer was head of sales, consumer healthcare, for Meda Pharmaceuticals, Inc., in Atlanta, GA. Prior, he was the vice president, sales and marketing at SoloHealth. From 2004 to 2010, Sommer served in multiple roles with CIBA Vision, including brand marketing director and executive sales director, key accounts.

New 90 Pack for Proclear 1 Day Multifocal Lenses

CooperVision, Inc. announced the addition of a 90 pack configuration for Proclear 1 day multifocal daily disposable contact lenses.

Originally launched in May 2012, Proclear 1 day multifocal lenses appeal to both daily and occasional wearers due to its healthier modality, excellent visual acuity, and comfort. Having both 90 pack and 30 pack configurations available will allow eye care professionals to more easily dispense Proclear 1 day multifocal lenses.

For more information on Proclear 1 day multifocal lenses visit

Register Now for GSLS 2015 and Save

Join us January 22 - 25, 2015 for the Global Specialty Lens Symposium at Bally’s Hotel & Casino in Las Vegas. The GSLS is a comprehensive meeting focusing on the latest techniques and technologies for the successful management of ocular conditions using today's specialty contact lenses. The meeting includes information for vision care professionals in all disciplines, with both surgical and non-surgical options covered. Accredited for continuing education under COPE, NCLE, and JCAHPO, the meeting will offer approximately 30 credit hours.

Attended annually by more than 500 participants from 30+ countries it is the largest conference of its kind in the U.S.

Register before December 15th and save! For complete conference details and to register now, visit


Alden Optical Becomes Platinum Level Sponsor of Scleral Lens Education Society

Alden Optical announced that it has become a Platinum Level Sponsor of the Scleral Lens Education Society (SLS). The SLS is a non-profit organization committed to teaching contact lens practitioners the science and art of fitting all designs of scleral contact lenses for the purpose of managing corneal irregularity and ocular surface disease. SLS supports public education that highlights the benefits and availability of scleral contact lenses.

This sponsorship represents an investment by the company to build the scleral lens category and increase fitting. More information on the SLS is available at More information on Zenlens, Alden’s new scleral, is available at

CDC Offers Timely Ebola Updates for Health Care Professionals

As concerns continue over infection control protocols after health agencies announced the largest Ebola outbreak in history is expected to worsen and additional U.S. cases are possible, the American Optometric Association (AOA) advises optometrists and optometric staff to be informed from the most authoritative source on recent protocols and information, the Centers for Disease Control and Prevention (CDC).

The recent case of U.S. transmission of the virus to a Texas hospital worker has caused health care workers to seek more information on how to further mitigate risks of contracting the disease that spreads through contact with bodily fluids of an infected person. While officials contend that a widespread Ebola outbreak across the United States is unlikely, greater awareness about the current Ebola situation and preparedness for all doctors is stressed.

Beth Kneib, OD, AOA Clinical Resources Group director, recommends that clinicians frequently search and reference the CDC website for important updates and health care messages. The AOA points to the following CDC sites with specific material regarding controlling the spread of infectious disease:

  • Click here to find the latest updates from the CDC regarding the Ebola outbreak and other important infection control messages.
  • Click here to find information about sterilization of vision care instruments, hand washing and other topics for general patient safety.
  • Click here for Ebola information relevant to clinicians working in U.S. health care settings, including guidance and recommendations, general disease information and protection protocols.

The CDC suggests that practitioners be wary of patients presenting with common Ebola symptoms, in conjunction with a recent travel history to West Africa within 21 days of symptom onset.

For additional resources from the HHS Office of the Assistant Secretary for Preparedness and Response website, visit

Pyogenic Granuloma
Tiffany Gates, OD, Fullerton, CA

In this image a pyogenic granuloma is shown with lid eversion secondary to irritation from a suture adjacent to the superior limbus. The patient had a congenital cataract with subsequent removal of the IOL after trauma. The patient was referred for excision of the granuloma prior to contact lens fitting.

We thank Dr. Gates for this image and we welcome photo submissions from our other readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit to upload your image. Please include an explanation of the photo and your full name, degree or title and city/state/country.

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Katherine M. Mastrota, MS, OD, FAAO

Ocular Surface Wellness: Part 4

A number of weeks ago I solicited your comments on how the concept of “ocular surface wellness” fits into your clinical thinking. From Mark Roark, OD at Allisonville Eye Care Center, Inc. in Fisher, IN, I received the following thought:

“As far as a definition of OSW, the first thing I think of is how many coordinated and intricate contributions there are from different anatomical structures. The cornea, conjunctivae, eyelids and nasolacrimal system are amazingly fine-tuned to provide for optimal health of the ocular surface. They are quite simply working as designed when OSW is present. Therefore, OSW occurs when these systems are functioning within a range where tear production and quality, evaporation and outflow are in proper balance.”

Interestingly, the nasolacrimal system is included in Dr. Roark’s definition of ocular surface wellness. It is important to consider that drainage of the tears via the nasolacrimal system may be part of a feedback loop that regulates tear production.1

1. Paulsen FP, Schaudig U, Thale AB. Drainage of tears: impact on the ocular surface and lacrimal system. Ocul Surf. 2003 Oct;1(4):180-91

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S. Barry Eiden, OD, FAAO

Can we all just get along? LASIK for the reduction of post penetrating keratoplasty induced astigmatism and improved contact lens tolerance.

A study was conducted to determine the effectiveness of laser-assisted in situ keratomileusis (LASIK) in the treatment of astigmatism following penetrating keratoplasty (PK).1 The researchers conducted a retrospective review of medical records of patients (52 eyes) who underwent LASIK following PK and had over 1 year of follow-up data. The indication for LASIK in these patients was intolerance to wearing either contact lenses or spectacles. The results found that following LASIK at the 12 month follow up visit the mean manifest refraction spherical component was +0.98D +/- 1.86D and the mean cylinder component was 2.40D +/- 1.25D. The mean cylinder was reduced by 2.4 diopters and mean reduction of cylinder after LASIK was 65.4% from the preoperative values at the 12 month follow-up visit. Uncorrected visual acuity became 20 / 50 or better in 69.2% of the eyes after LASIK. Best-corrected visual acuity became 20 / 50 or better in 73.1% of the eyes after LASIK. All cases were intolerable to contact lenses before LASIK. After LASIK, 23.1% did not need to use contact lenses and 69.2% were tolerable to using contact lenses or spectacles. Only 7.7% of patients remained contact lens intolerant following LASIK at the 12 month final visit. The authors concluded that LASIK is effective in the treatment of astigmatism following PK and increases contact lens and spectacle tolerance.

Often patients are faced with limited options for the management of their corneal disease and require penetrating keratoplasty in order to achieve functional vision. Although surgical techniques and outcomes continue to improve with modern PK, the procedure still suffers from significant limitations and challenges such as graft failure / rejection, need for repeat grafts, secondary glaucoma, risk of blindness and extended convalescence. Additionally visual challenges are commonly faced following PK such as high post PK astigmatism and anisometropia that result in both contact lens and spectacle intolerance. These challenges are often faced by the optometrist. Looking at options that are potentially synergistic, such as post PK LASIK to reduce astigmatism, can often improve contact lens and spectacle lens tolerance as evidenced by the results of this study. Cooperative case management between the ophthalmic surgeon and the optometrist that incorporates both surgical and optical technologies will allow patients to achieve optimal outcomes and improved quality of life.

1. Park CH, Kim SY, Kim MS. Laser-assisted In Situ Keratomileusis for Correction of Astigmatism and Increasing Contact Lens Tolerance after Penetrating Keratoplasty. Korean J Ophthalmol. 2014 Oct;28(5):359-63. Epub 2014 Sep 18.

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Effect of Low-Addition Soft Contact Lenses with Decentered Optical Design on Myopia Progression in Children: A Pilot Study

The purpose of this study was to investigate the effect of low-addition soft contact lenses (CLs) with decentered optical design on the progression of myopia in children in a pilot study.

Twenty-four Japanese children age 10-16 years with baseline myopia of -0.75 to -3.50 D sphere and ≤1.00 D cylinder were studied. The new CLs were designed to have a nasal decentration with the optical center centered on the line of sight, and with progressive-addition power of +0.5 D peripherally. Monofocal soft CLs were used as controls. A pair of new CLs or control CLs was randomly assigned to the children, and they wore the lenses for 12 months during the first phase. Then, the type of CLs was changed, i.e., a crossover design, and the children were observed for another 12 months during the second phase. The end points were changes in axial length and refractive error (spherical equivalent) under cycloplegia.

The change of axial length in the new-CL and control-CL groups was not different between 12 months and baseline, the change of axial length between 12 months and 1 month in the new-CL group (0.09±0.08 mm) was significantly smaller (47%) than that in the control-CL group (0.17±0.08 mm, P<0.05). During the same period, the change of refractive error in the new-CL group was not significantly different from that in the control group. Neither the change in axial length nor refractive error in the new-CL group was significantly different from those in the control-CL group in the second phase.

The researchers concluded that this pilot study suggests that low-addition soft CLs with decentered optical design can reduce the degree of axial elongation in myopic children after an initial transient phase of CL wear. The reduction of the progression of myopia by low-addition soft CLs warrants further investigations.

Fujikado T, Ninomiya S, Kobayashi T, Suzaki A, Nakada M, Nishida K. Effect of low-addition soft contact lenses with decentered optical design on myopia progression in children: a pilot study. Clin Ophthalmol. 2014 Sep 23;8:1947-56. doi: 10.2147/OPTH.S66884. eCollection 2014.

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