I've both surveyed practitioners
and seen a tremendous amount of data over years on lens care prescribing habits
of eyecare practitioners. A small percentage of practitioners are very proactive
about prescribing a specific lens care system, in addition to promoting high standards
of lens care habits within their staff's training and directly to patients. Alternatively,
a large percentage of practitioners do not do either of these things. Why have the
masses become complacent about lens care? We'll address this and other related matters
in future issues of this newsletter and Contact Lens Spectrum.
Joseph T. Barr, OD, longtime Ohio State College
of Optometry faculty member and former editor of Contact Lens Spectrum and Contact
Lenses Today, is a recipient of the Ohio State Alumni Association's 2013
Ralph Davenport Mershon Award. The Mershon Award is presented to alumni who have
demonstrated exceptional leadership and service to Ohio State.
Barr received two degrees from Ohio State's College of Optometry – an OD and
an MS in physiological optics. Barr's first job after graduating was with Dow Corning,
where he managed clinical and material research and helped bring to market a silicon-based,
gas-permeable lens that was thinner and more comfortable for patients, including
one for babies who had had congenital cataracts removed.
In 1983, Barr joined the Ohio State faculty as chief of the contact lens service
at the College of Optometry and then as chief of optometry clinical services. By
2000, he was a professor of optometry and physiological optics. Over the years he
served as assistant and then associate dean, both for clinical affairs and for clinical
services and the professional program. During his tenure, he was the E.F. Wildermuth
Foundation Professor in Optometry, advised graduate students, and served on the
Council on Student Affairs.
In 2008 Barr took a position at Bausch + Lomb. While there, he has led a major effort
in collaboration with the Lions Club International Foundation and the Pediatric
Cataract Initiative to sponsor studies in Nepal, India, Nigeria, South Africa, and
China with the goal of eliminating childhood blindness from cataracts.
Barr has served his profession as a long-time Fellow of the American Academy of
Optometry; editor of Contact Lens Spectrum for 20 years; and founding editor
of the Contact Lenses Today. He has garnered many awards—from Ohio
State, the American Academy of Optometry, the European Federation of the Contact
Lens and IOL Industries, and the National Eye Research Foundation, to name a few.
The Vision Care Institute, LLC (TVCI), a Johnson
& Johnson Company, has launched The Vision Care Institute Clinical Grading Scales
App, an educational tool designed to help eyecare practitioners assess the severity
and evaluate the progression of complications associated with contact lens wear.
Based on the clinical assessment guide derived from the grading scales developed
by Prof. Nathan Efron, eyecare professionals can use this innovative, easy-to-use
resource during patient evaluations and follow-up.
The new app allows users to do the following:
The Vision Care Institute Clinical Grading Scales is a free app, compatible with
the iPhone, and can be downloaded via the Apple App Store. It is not intended as,
and does not constitute medical or optometric advice. It is only available in the
U.S. App Store at this time.
- Evaluate nine common eye conditions (bulbar redness, corneal staining, lid redness,
lid roughness, limbal redness, meibomian gland dysfunction, pterygium, pinguecula,
cortical cataract) with severity levels that lessen and increase with real-time
animation based on touch.
- Evaluate the progression of complications by comparing severity levels in 0.1 increments
- Demonstrate clinical assessment to patients.
- Export a report for office records without collecting personal data.
- View a comprehensive assessment guide including slit lamp illumination techniques,
corneal inflammation vs. infection, signs of oxygen deficiency, staining and lid
assessments and more.
Register Now for Global Specialty Lens Symposium
– January 23 - 26, 2014
Plan to attend the
Global Specialty Lens Symposium to be held January 23 - 26, 2014 at the Rio All
Suites Hotel and Casino in Las Vegas, Nevada. This meeting will include insightful
presentations by international experts in the field, hands-on demonstrations of
cutting-edge products and valuable continuing education credits.
for more information and registration.
After expanding its Avaira toric lens parameters
with plus powers this summer, CooperVision Inc. is launching a -2.25 cylinder power
to further broaden the brand's range and potential wearer base. This allows potential
contact lens wearers with more significant astigmatism to wear Avaira toric lenses.
With this addition, Avaira toric lenses are available in sphere powers of -6.00D
to +6.00D in 0.25 steps; -6.50D to -10.00D in 0.50 steps; cylinder powers of -0.75,
-1.25, -1.75, and -2.25; and axes from 10 degrees to 180 degrees in 10 degree steps.
The Avaira brand has polyethylene glycol (PEG) bound at the lens surface and throughout
the interior. This provides a distinct comfort advantage, not only at the end of
each day, but during the entire wearing cycle, according to the company. The benefit
is due in part to the compound's well-established ability to tightly bind water
and help maintain hydration. Avaira toric lenses with Aquaform Technology also incorporate
a high level of oxygen transmissibility (91 Dk/t), rounded edges that promote minimal
lid interaction, and a smoother lens surface. The lenses feature optimized lens
geometry, uniform horizontal ISO thickness and wide ballast design, plus a larger
toric optic zone that provides astigmatic patients with stability and visual acuity.
An ultraviolet radiation blocker helps protect wearers' eyes, limiting 75 percent
of UVA and 99 percent of UVB rays.
For more information, please visit www.CooperVision.com/contact-lenses/avaira-toric.
EyeXam, the leading mobile eye care app with
over a million free downloads to date, was featured on ABC World News with Diane
Sawyer in its popular 'Real Money' series. The segment headlined a family using
the EyeXam app on their smartphones and tablets. Family members downloaded it for
free, took a free self-guided vision screening, found a local eye care provider
and saved money on their eye care purchases.
One of the tips ABC reporter Paula Faris emphasized involved the free vision screening
on the EyeXam app. The purpose of the screening is to motivate consumers to visit
an eye care professional, as the family's mother did when she visited a local Vision
Source office, a VSP provider, for a comprehensive eye exam. The app also makes
it easier and more convenient to find an eye doctor, make an appointment, see promotions
and communicate with the doctor.
The Cooper Companies, Inc. announced the appointment
of Daniel G. McBride to executive vice president, chief operating officer and general
counsel, effective November 1, 2013.
Mr. McBride most recently served as vice president, general counsel and chief risk
officer and has held positions of increasing responsibility within the legal organization
focusing on operations, business development and long-term growth. Prior to joining
Cooper in February 2005, Mr. McBride was an attorney with Latham & Watkins LLP
concentrating on mergers and acquisitions and corporate finance.
Cooper operates through two business units, CooperVision and CooperSurgical.
Professor Brien Holden has been awarded the
inaugural Optometry Giving Sight Humanitarian Award in recognition for his outstanding
contribution in support of global efforts to help eliminate avoidable blindness
and impaired vision and reduce the disability, poverty and lack of opportunity associated
with vision loss.
Professor Holden received the award at a dinner held in Seattle, Washington, where
he also announced that he would be stepping down as Executive Chair of Optometry
Giving Sight after 10 years.
Professor Holden said that while he would stay on the Board, it was now time for
someone new to take on the role of Chair. He announced that the Directors have elected
Dr. Juan Carlos Aragon to succeed him as Chair of Optometry Giving Sight. Dr. Aragon
is currently Chair of Optometry Giving Sight's Global Development Board and Senior
Vice President, Global Professional & Clinical Affairs, CooperVision.
By Jaime Ibanez, OD, Villavicencio,
This image depicts invasive pterigia over the nasal and temporal quadrants of the
corneo-conjunctival areas. Even though the pupillary area is unaffected, the head
(apex) of these benign growths are located onto the mid-periphery sector of the
cornea which induced a surface irregularity and prevented the appropriate fitting
of a contact lens.
We thank Dr. Ibanez 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 http://www.cltoday.com/upload/upload.aspx 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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Instructions for Scleral Lens Application
In my previous two columns, I discussed the importance of providing patients with
written educational materials. This is especially important for the care and handling
of scleral gas permeable (GP) lenses. Both new wearers and existing corneal GP patients
benefit from verbal and written instructions on their new scleral lenses.
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The explanations should be thorough enough to benefit a new wearer, but brief enough
that s/he will read them. The following are the lens application instructions from
my own Scleral Lens Care and Handling Guidelines.
ALWAYS WASH YOUR HANDS
with a lotion-free soap before handling your lenses. This will minimize the potential
for eye infection.
1. DRY YOUR HANDS AND EYELIDS with a clean, lint-free towel. It is easiest to control
your eyelids with clean, dry fingers.
2. Remove your contact lens from its case and rinse with nonpreserved artificial
tears or saline.
3. To support the lens, place it on a "tripod" of your thumb, index, and middle
fingers (or maybe your ring finger), or on a lens insertion tool (a large suction
cup with the bottom cut off or a ring-like tool).
4. Fill the lens to the top with nonpreserved artificial tears or saline. (Overfilling
is fine to avoid bubbles; underfilling is not.)
5. Place your head down, parallel to the horizontal plane (typically a table or
a sink with the drain closed).
6. Spread your top and bottom eyelids wide with your fingers from one hand. Don't
blink, and insert the lens by placing it gently onto the center of your eye. (Fluid
from the lens may spill.) Let go of the lower eyelid first, then the upper eyelid.
7. Move your head upright and gently blink. Look into a mirror to ensure uniform
lubrication and no bubbles. A small blurry spot in your vision is most likely a
bubble. If present, or if the lens feels uncomfortable, remove and reinsert the
For more information on scleral lens application visit: http://www.sclerallens.org/scleral-contact-lens-insertion-removal-troubleshooting-and-lens-care.
OCULAR SURFACE UPDATE
Katherine M. Mastrota,
MS, OD, FAAO
Effects of Chronic Smoking
A study from Turkey published in the Cutaneous and
Ocular Toxicology journal examines the effect of chronic smoking on central
corneal thickness, endothelial cell and dry eye parameters. In this prospective
cross-sectional case series 49 eyes of 49 chronic smokers (smoker group) and 53
eyes of 53 age-matched, healthy non-smokers (non-smoker group) were enrolled. All
participants underwent measurements of tear breakup time (TBUT), central corneal
thickness (CCT) measurements with contact pachymeter and Schirmer test with anesthesia.
Corneal endothelial cells were evaluated by non-contact specular microscopy and
photographed for analysis of cell density and hexagonality and the coefficient of
variation (CV) in cell size. The study results demonstrated that the mean Schirmer
score and TBUT value were significantly lower in the smoker group compared to the
non-smoker group. No statistically significant difference was found in the mean
CCT, mean endothelial cell density, endothelial cell size, SD of size, and CV of
size between smokers and non-smokers. However, a lower percentage of endothelial
hexagonal cells were observed in smokers than non-smokers. The authors' results
suggest that cigarette smoking seems to affect the Schirmer score, TBUT value, and
hexagonal cells of the corneal endothelium.
Sayin N, Kara N, Pekel G, Altinkaynak H. Effects of chronic
smoking on central corneal thickness, endothelial cell, and dry eye parameters.
Cutan Ocul Toxicol. 2013 Oct 22. [Epub ahead of print]
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Optical Properties of Soft Contact Lenses On and Off the Eye
The purpose of the current study was to examine the on-
and off-eye optical performance of two types of soft contact lenses (hydrogel and
The monochromatic aberrations (lambda = 850 nm) of contact lenses were measured
on-eye using a clinical Shack-Hartmann ocular aberrometer. In addition, the researchers
used an off-eye single-pass contact lens aberrometer (lambda = 540 nm) in which
the soft contact lens was placed within a wet cell. Comparison of the lower and
higher order aberrations measured with these two methods required compensation for
different wavelengths and knowledge of the refractive index of the contact lens
The measured on-eye sphere and spherical aberration values were generally similar
to those measured off-eye and those specified by the lens manufacturers for both
types of soft contact lenses. However, there were notable differences, especially
for high plus-powered lenses, which typically exhibited lower sphere power on the
eye than expected from the lens specifications and from the off-eye measured powers,
both of which were almost identical. Longitudinal spherical aberration varied with
lens power in the hydrogel lenses, as expected from geometric optics theory. Longitudinal
spherical aberration measurements on- and off-eye, however, deviated significantly
from that expected of a thin lens with spherical surfaces due to surface asphericities.
The difference between on- and off-eye optics can be modeled as a tear lens or as
relative lens thickness changes caused by lens flexure.
The authors concluded that the results of the current study reveal that the major
difference between the on-eye lens optics and the manufacturers' specifications
is not due to lens errors but due to eye-lens interactions, which could be either
lens flexure or a tear lens forming behind the soft contact lens.
Kollbaum PS, Bradley A, Thibos LN. Comparing the Optical
Properties of Soft Contact Lenses On and Off the Eye. Optom Vis Sci. 2013
Jul 25. [Epub ahead of print]
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