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Sunday, November 2, 2014  
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Results from last poll:

How often do you believe patients should replace their contact lens case?

 Every month

 Every three months

 Every six months

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
As noted in last week’s message and Quick Poll, compliance is a major challenge that presents clinically significant issues for us and our patients. One of the most common areas of non-compliance I observe is in “topping up” of care solutions. That is, not completely emptying the used care solution in the cell after the overnight soak. I have heard of novel suggestions to help prevent this, including even designing a care solution that changes color after a certain period of soak time reminding the patient to discard used solution. We would love to hear your suggestions on how you handle this issue. Please email us at

J&J Introduces Acuvue Define Eye Enhancement Contact Lenses

Johnson & Johnson Vision Care, Inc. announced the initial launch of 1-Day Acuvue Define Brand Contact Lenses with Lacreon Technology, a new category of eye enhancement contact lenses that accentuate natural beauty while helping to support a healthy eye. The innovative brand, the number-one beauty contact lens in Asia, is now available at a limited number of independent eye doctors’ offices, with expanded product availability in the United States to follow in the first half of 2015.

According to the company, 1-Day Acuvue Define addresses an unmet need for natural-looking eye enhancement: the 2013 Gallup Study of the U.S. Consumer Contact Lens Market showed that one in three vision corrected teens/adults (32%) express a strong interest in purchasing a contact lens that enhances the natural beauty of their eyes.1 The lens has sophisticated iris-inspired designs that combine an outer darker limbal ring – to give eyes greater definition by creating contrast between the iris and sclera – and an inner translucent light-effects pattern – to add depth and definition without changing the eye’s natural color. Independent research shows that people are more attracted to women and men with pronounced limbal rings, as limbal rings are associated with a healthy and youthful appearance.2 Interviews with over 40,000 women informed the design of the lens.

The 1-Day Acuvue Define lens will be available in plano and vision correction ranges from +1.00 to -9.00 with a base curve of 8.5 and diameter 14.2 mm, and is being introduced in three styles to complement all eye colors:

  • 1- Day Acuvue Define Brand Contact Lenses Natural Sparkle
  • 1- Day Acuvue Define Brand Contact Lenses Natural Shimmer
  • 1- Day Acuvue Define Brand Contact Lenses Natural Shine

According to the company announcement, 1-Day Acuvue Define provides personalized eye enhancement that uniquely interacts with each iris pattern; it is not a colored contact lens. The lens subtle, natural-looking enhancement allows the beauty of the eye to shine through. The lens also uses proprietary Beauty Wrapped In Comfort Technology that fully encloses the pattern within the ultrathin lens material of 1-Day Acuvue Moist Brand Contact Lenses, ensuring that the design pigments are not in contact with the surface of the eye or the eyelid.

The company reports that the performance of 1-Day Acuvue Define is similar to the 1-Day Acuvue Moist Brand.

Complete information is available by calling 1-800-843-2020 or by visiting

1. The 2013 Gallup Study of the U.S. Consumer Contact Lens Market. Q12a: How interested would you be in purchasing a contact lens that enhances the natural beauty of your eyes? Adults responding “extremely” or “very.”
2. Peshek D, Semmaknejad N, Hoffman D, Foley P. Preliminary Evidence that the Limbal Ring Influences Facial Attractiveness Evol Psychol. 2011. 9(2): 137-146.

CE in December at Disney in Orlando

Learn from the best. Experience the motivation. Move your practice forward. Plan now to attend the Optometric Management Symposium on Contemporary Eye Care, December 5-7, 2014 at Disney's Yacht & Beach Club Resort in Lake Buena Vista, FL.

This popular annual symposium provides the perfect balance of timely, disease management courses and practice-building courses with plentiful networking and leisure time to enjoy all that Disney resorts and theme parks have to offer.

OMS offers a comprehensive program, flexible schedule, ABO, COPE and Florida Board approved credits included 12 CEE's (TQ credits)! The education is also sponsored by a school of optometry meeting the requirements of several states. Rejuvenate yourself and expand your education while visiting exhibitors to learn about their products and services during our refreshment breaks.

For agenda, more information and to register visit


A New Era for Optometry in Vietnam

October 2014 heralded a historic moment in the growth of Vietnam’s education and eye health sectors with the official opening of Vietnam’s first optometry program at the Pham Ngoc Thach University of Medicine in Ho Chi Minh City.

A joint initiative between the Brien Holden Vision Institute, the Pham Ngoc Thach University of Medicine and the Ho Chi Minh City Eye Hospital, the school’s opening was the culmination of a ten year plan to introduce optometry to the country, with the primary goal of alleviating the burden of uncorrected refractive error in Vietnam in line with the Vietnamese National Eye Health Plan.

Twenty new optometry students will commence their program at the Pham Ngoc Thach University of Medicine in November 2014.

For the full story visit:

Post-LASIK Epithelial Ingrowth
Michael Harmon, OD, Clovis, CA

This image is a dramatic presentation of post-LASIK epithelial ingrowth.

We thank Dr. Harmon 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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David Kading, OD, FAAO

When the Material Is Not Enough

Nadine is a 38 year old patient. She comes into her exam and reports that her contact lenses are doing fine. Upon further questioning, she reports that her contact lens comfort is 8/10 at the beginning of the day and drops to 5/10 at the end of the day. When asked why she said they were “fine” when they were indeed dry at the later stages, she reported that the lenses that she is currently wearing are the best lenses she has ever worn, thus she thought they were “fine”. Her provider has switched her into new lenses every other year for the last eight years; her contact lens solution has been upgraded as new technology comes available.

Nadine is just like hundreds of my patients and yours. Recently, I had to ask myself, what is the purpose of just switching her to a new and updated contact lens material? She may report improved comfort, but if we fail to treat the underlying cause of her progressive decrease in comfort, I fear that she will return again in two years with a similar situation. Then eventually, she may turn into a contact lens drop out statistic.

If you have a patient that reported increased wearing time and comfort in the past when you made a switch, but now the patient has lost that comfort and wearing time, may I assure you, it isn’t the material of the contact lens that has changed, it's the ocular surface. If your patient is uncomfortable and isn’t in the most up to date material or design, switch them, but move your focus onto the underlying ocular surface, rather than the success of the lens alone.

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Susan J. Gromacki, OD, MS, FAAO

Cleaning and Disinfecting Today’s Hybrid Contact Lenses

Modern hybrid lenses present new challenges in lens care as some of today’s hybrids include high Dk gas permeable centers and silicone hydrogel skirts.

These special lenses require special care. It is recommended that patients digitally rub the lens, front and back, with a daily cleaner approved for silicone hydrogel (soft) lenses, then rinse off the cleaner with non-preserved saline. Many multipurpose care solutions are approved for use with hybrids, but the lens manufacturer prefers hydrogen peroxide for disinfection. In addition, patients who are prone to heavy protein deposition may use an enzymatic cleaner once per week or more.

Note that a digital rubbing step is always required with these lenses, as they have a six month replacement schedule. Due to their hydrophilic skirt, solutions designed for gas permeable lenses are contraindicated.

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Prevention and Removal of Lipid Deposits by Lens Care Solutions and Rubbing

Prevention and Removal of Lipid Deposits by Lens Care Solutions and Rubbing

Despite the prevalence of silicone hydrogel (SiHy) contact lenses, there are relatively few studies that evaluate the efficacy of multipurpose lens care solutions (MPSs) in reducing lipid deposition on these lenses and the effect of rubbing on the removal. Therefore, the researchers used an in vitro soaking and rubbing model to compare the effectiveness of borate buffered saline (BBS) and two commercial MPSs, PureMoist and Biotrue, in preventing sorption of representative polar and nonpolar lipids.

Radiolabeled cholesterol (CH) and dipalmitoylphosphatidylcholine (DPPC) were sorbed on two SiHy lenses (senofilcon A and balafilcon A) from an artificial tear fluid. Deposition and removal were evaluated by quantitative solvent extraction and scintillation counting.

The efficiencies of the MPSs in reducing lipid deposition are somewhat dependent on lens material. Both DPPC and CH sorption on senofilcon A are greater when lenses are preconditioned in BBS compared with preconditioning in either MPS (p < 0.05). However, neither MPS affects lipid sorption on balafilcon A lenses (p > 0.05). As for removal of presorbed lipids, neither PureMoist, Biotrue, nor BBS removed CH in the absence of rubbing. When a simulated rubbing protocol was used, minimal but detectible CH was removed (p < 0.05) from senofilcon A and balafilcon A lenses (likely only from the lens surface). These commercial solutions were not substantially better than BBS in removing DPPC, with or without rubbing (p > 0.05).

These data suggest that MPSs do not appreciably alter lipid sorption. Rubbing lenses removes a small amount of sorbed lipids. Yet, we recommend that MPSs be used as they may disinfect SiHy lenses and may clean their surfaces of large particles.

Tam NK, Pitt WG, Perez KX, Hickey JW, Glenn AA, Chinn J, Liu XM, Maziarz EP. Prevention and Removal of Lipid Deposits by Lens Care Solutions and Rubbing. Optom Vis Sci. 2014 Oct 16. [Epub ahead of print]

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