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Sunday, October 30, 2011  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

According to an article in Time Magazine (issue date October 31, 2011), it is estimated that the 7 billionth person will be born somewhere in the world on October 31. It's quite amazing to think that there are 7 billion people on this planet. If you apply estimates from epidemiological studies, about one half of the population requires some form of vision correction. Thus, there are 3.5 billion people out there with such a need. However, even the best estimates suggest that there may be approximately 120 million contact lens wearers—which represents only 3.4% of those who actually need vision correction. There is substantial growth in some "emerging" contact lens markets, but other majors are stagnant. How do we grow the contact lens market? Please send your thoughts to me at jnichols@optometry.uh.edu.


ABB Concise and Compulink Partner to Automate Contact Lens Ordering

ABB Concise and Compulink Business Systems, Inc., have announced a partnership to integrate Compulink's Electronic Health Records (EHR) and Practice Management software with ABB Concise's distribution centers. As part of this partnership, users of Compulink's Eyecare Advantage software will now be able to order lenses directly from ABB Concise's catalog of products.

According to the companies, integrating Compulink's EHR software with ABB Concise's distribution centers will create greater contact lens ordering efficiencies and eliminate double entry for staff who currently divide their time between their Compulink system and the ABB Concise website. This integration is expected to be completed before the end of this year.

This partnership is the latest addition to the ABB Concise portfolio of practice management tools for its customer base. ABB Concise also offers its customers tools such as: Quarterly Soft Contact Lens Retail Price Monitor, Profit Advisor Newsletter, Business Review, and Yourlens.com patient web store.

Richard C. Mickschl (1931 - 2011)

Richard C. Mickschl of Milwaukee, Wisconsin, passed away on October 21, 2011, at the age of 80. For over 30 years, Richard owned and operated Great Lakes Contact Lenses, a specialty contact lens manufacturing company. He was a Navy veteran of the Korean War. Richard is survived by his wife of 56 years, Suzanne, and eight children. Richard was also grandfather of 19 and great-grandfather of three.

Global Specialty Lens Symposium, January 26 - 29, 2012, Paris Hotel & Casino in Las Vegas

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.
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Global Research Shows an Opportunity to Improve Compliance Exists

New global research shows that compliance with professional and manufacturer recommendations for lens care is lacking for most contact lens users. Although compliance was slightly better in daily disposable wearers, 85% were still not fully compliant.

The independent research, funded by Bausch + Lomb, was carried out in 13 countries including: Australia, Canada, China, Germany, Spain, France, India, Italy, Japan, South Korea, Poland, Russia and the UK. The web-based survey included 4,021 contact lens users. It collected information on demographics, as well as lens and solution including daily handling details, case care and aftercare frequency. Particular attention was paid to eight modifiable compliance-related behaviors which have been shown in epidemiological reviews to increase the likelihood of contact lens associated infections. Four of these relate to the use of care regimens and the lens case, three to lens wear and one to hand-washing.

The study revealed a number of factors that influence non-compliant behavior including country, sex and age. Variations in compliance rates were seen across countries, and may be influenced by the regulated status of contact lenses within different countries. Women in general showed better compliance compared to men, with older people being more compliant than younger. Wearers were more compliant if they had consulted an eyecare practitioner more recently.

The behaviors most associated with the lowest levels of compliance were rubbing and rinsing the contact lens, hand washing, correct lens replacement and case cleaning.

More details regarding the research can be found in: Philip B. Morgan, et al. An international analysis of contact lens compliance. Contact Lens and Anterior Eye. 2011 Oct;34(5):223-228.

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Are Daily Disposables the Answer?

Daily disposable lenses are not the solution for safer lens wear. Gloves off education by ECPs and responsible package labeling by manufacturers will far exceed the supposed health benefits of daily disposables. Let's face it, the majority of contact lens wearers are in the dark when it comes to safe lens care practices. So switching patients to daily disposables will not stop them from removing contacts with unwashed hands, swimming and showering in their contacts, and wearing them dangerously past their replacement schedule.

Contact lenses are expensive for the average family in the U.S. especially when multiple family members wear them. If we swallow the pill and believe that daily disposables are the solution to lens care problems, we are simply urging patients to trade up rather than solving their lens care mishaps. When the cost of contact lenses increases, more and more patients will look to the internet for the best price and that ultimately hurts ECP lens sales.

We need solution and contact lens manufacturers to include promotional booklets on lens care tips within their packaging. Booklets that clearly tell patients why they need to care for their lens wear properly. ECPs see their patients once every 12-16 months. Patients interact with solution and lens packaging 6-10 times per year. The frequency of proper lens care messaging would increase 6-10 times. This is a solution that will make a difference with patients rather than switching them to a different and more expensive product.

Daily disposable lenses are great for some patients, especially those patients where money is not a problem, but most patients are on a budget. Doesn't it make better sense to change lens care behavior and prescribe the best modality at the best price?

John O'Hara
President, LensAlert!

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

Consumer Contact Lens Questions Researched and Answered by a Joint AAO-AOA Panel

The American Optometric Association (AOA) launched www.ContactLensSafety.org, a new, easy-to-use website to help answer consumer questions about contact lens safety. The AOA Contact Lens and Cornea Section (CLCS) created the site with the assistance of the American Academy of Optometry (AAO) Section on Cornea, Contact Lenses and Refractive Technologies.

The site is composed of commonly asked consumer questions with evidenced based research as supporting answers. For example, questions include "What is the danger of wearing contact lenses longer than the prescribed time?" and "What organisms are most dangerous to the eye?" The responses are well researched and the references pop up when the cursor hovers over them so that the consumer or practitioner can look into the supporting research themselves. Also included is the "Ask the Expert" section where consumers can submit their contact lens question to a panel of experts.

Check it out! It was debuted at the recent AAO Annual meeting with a kick-off lecture given by the authors of the questions: Drs. Thomas Quinn, Christine Sindt, Edward Bennett and myself, and it was very well received.

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MATERIALS & DESIGNS
Ronald K. Watanabe, OD, FAAO

Academy Report

The American Academy of Optometry met in Boston two weeks ago, and as usual, it was rich in education and new information. I attended a paper session that presented interesting research on contact lens design and materials.

One paper presented by Carol Lakkis showed that silicone hydrogel lenses infused with silver iodide were well tolerated by subjects with no significant differences in comfort or ocular physiology as compared to control lenses. In previous presentations at ARVO and BCLA, the silver-infused lenses demonstrated a decrease in pathogen adherence to the lens surfaces, which shows that this may be an anti-microbial contact lens of the not-too-distant future.

Other papers addressed myopia control in children. Jeff Walline presented a 2-year study that followed children wearing soft distance-center bifocal contact lenses (Proclear Multifocal) as compared to single vision soft lenses. Overall, they found a -0.53D increase in the test group and a -1.03D increase in the control group, suggesting 40% better myopia control with the bifocal lenses. This is roughly equivalent to the effects found with orthokeratology in other studies.

It's great that we have meetings like this that stimulate the dissemination of new information that helps change clinical practice for the better.

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Combined Application of Autologous Serum Eye Drops and Silicone Hydrogel Lenses for the Treatment of Persistent Epithelial Defects

The authors investigated the utility of a combination of autologous serum eye drops and a silicone-hydrogel (SH) lens in the treatment of persistent epithelial defects (PEDs).

Eight patients who had distinct PED conditions were treated with 50% (v/v) autologous serum eye drops in combination with silicone hydrogel contact lenses and prospectively observed.

The pathogenesis of PEDs included Sjogren-type dry eye syndrome, graft-versus-host disease, toxic keratitis, limbal cell deficiency, superior limbic keratoconjunctivitis, and neurotrophic keratitis. The patients had PEDs for 90+/-81.76 days (range: 30-240 days). Before the initiation of the combined treatment, three patients had already been unsuccessfully treated with SH lenses, and five patients had received serum eye drops alone. The PEDs of the eight eyes healed after a treatment period of 11.8+/-4.9 days. No visible deposits were noted on the surface of any contact lens.

The authors concluded that these findings demonstrate that the combination of an SH lens and serum eye drops may be effective in the treatment of intractable PEDs.

Choi JA, Chung SH. Combined application of autologous serum eye drops and silicone hydrogel lenses for the treatment of persistent epithelial defects. Eye & Contact Lens. 2011 Nov;37(6):370-3.

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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/.

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