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Sunday, November 10, 2013  
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In the last year, approximately how many contact lens dropouts have you been able to successfully fit in daily disposables, if even for part-time wear?





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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
Each January, we publish our Annual Report in Contact Lens Spectrum that summarizes the contact lens market as best we can for the prior year. We also publish the "Contact Lens Event" of the prior year—something that we think stands out in the field of contact lenses. It's traditional for us to solicit for nominations for this event from our readership. If you have a nomination—something you think is substantial in the contact lens field and occurred in 2013—please let us know by emailing me directly at jnichols@optometry.uh.edu.

AOA Launches “See Clearly, America” Campaign

The American Optometric Association (AOA) today announced that it has launched the “See Clearly, America” public education campaign to highlight how doctors of optometry possess the education, skills, and training to provide quality eye care and help meet America’s rising eye care needs.

As part of this campaign, the AOA determined that Americans were not aware of the extensive clinical training and education that the approximately 36,000 doctors of optometry have received. Dr. David Cockrell, AOA President-Elect noted that at a time when our country faces growing eye care and health care demands, optometrists need to change that mindset, and individual state laws, to ensure that all highly trained, skilled and qualified Doctors of Optometry can help Americans see clearly.

The centerpiece of the “See Clearly, America” campaign is a new website, www.AmericasEyeDoctors.com. The website provides information about optometrists, issues of importance and ways to get involved.

Alden Optical and Medmont Announce Soft Lens Fitting Module

Alden Optical and Medmont recently announced a new topography based method that allows for precise fitting of Alden Optical custom soft lenses. By incorporating topographical data with proprietary insight of the optimal corneal to Alden lens sagittal relationship, the two companies have created a new fitting algorithm that will ultimately allow practitioners to effortlessly determine the optimal base curve and diameter of an Alden Optical lens. The companies expect this method to significantly improve lens fitting which will in turn provide better lens stability, vision, comfort and corneal health.

Research conducted at Pacific University under the direction of Patrick Caroline, FAAO demonstrated the remarkable accuracy of calculating corneal sagittal depth to 15 mm by precisely measuring sagittal depth and scleral angle at 10 mm using the Medmont E300 Corneal Topographer.

Currently practitioners can take advantage of this method by transmitting their Medmont maps to Alden Optical’s consultation team who will make the necessary calculations and recommend the best fit lens. Ultimately, Alden and Medmont plan to release AldenFit, a dedicated software module that automates the entire process. Practitioners would simply take standard Medmont topographical measurements, engage the AldenFit module which would then calculate the best fitting lens specific to that patients HVID, and corneal sagittal depth. The companies expect the AldenFit software module to be available in the 4th quarter of 2013.

Don’t Miss the 2013 Optometric Management Symposium
Plan now to attend the Optometric Management Symposium on Contemporary Eye Care, December 6-8, 2013 at Disney's Contemporary Resort in Lake Buena Vista, Florida. 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.

The educational program is presented by the Pennsylvania College of Optometry, Salus University. For agenda, more information and to register, visit www.OMConference.com.
Call for BCLA 2014 Conference Papers and Posters

The British Contact Lens Association (BCLA) is calling for submissions of scientific papers and posters to be presented at its 2014 Clinical Conference and Exhibition, taking place from June 6-9 at the ICC Birmingham, UK.

Authors submitting scientific papers and/or posters before November 29, 2013 will be able to take advantage of a prescreening service. The service, introduced last year, will give authors the chance to obtain feedback about their paper/poster from members of the BCLA Academic Committee. The final deadline for submitting papers and posters is January 24, 2014.

Scientific abstracts are considered on any topic related to contact lenses and/or the anterior eye, and authors can choose between “poster only” and “poster/oral presentation” at the point of submission. Clinical case studies may also be submitted in this category, again with the same options.

Research papers accepted for publication in the Association’s journal, Contact Lens & Anterior Eye, within a year of the 2014 Clinical Conference will be awarded a voucher of £100 towards the first author’s full delegate fee at the 2015 Clinical Conference.

Visit www.bcla.org.uk, email events@bcla.org.uk or call 020 7580 6661 for more information on how to make your submission and take advantage of the prescreening service.

CLMA Presents Awards

During the recent 52nd Annual Contact Lens Manufacturers Association (CLMA) Meeting & Exhibition held in Savannah, Georgia, the organization bestowed following awards.

  • 2013 Honorary Recognition Award, in appreciation for a lifetime of dedication and service to the contact lens industry: Fadi G. Achkouti, Sales Director; Sterling Ultra Precision, a division of Ametek Precitech, Inc.
  • 2013 Industry Enhancement Award, for unselfish dedication to the CLMA and the contact lens industry: Janice Y. Adams, President, Valley Contax, Inc.
  • 2013 Trailblazers Award, for outstanding achievement in product development to the enhancement of the contact lens industry: Naomi J. Svochak, President, Tru Form Optics, Inc.
  • 2014 GPLI Practitioner of the Year Award, for outstanding professional expertise in fitting customized contact lenses to benefit patients with improved vision and corneal health, and to advance the contact lens field: Michael A. Ward, MMSc, FAAO, FCLSA, Emory University

The awards event concluded with attendees donating over $1,000 to Optometry Giving Sight. The CLMA has designated Optometry Giving Sight as its International Charity of Choice.

Students at the Core of Optometric Profession’s Advocacy Event

Optometry students were at the forefront during the AOA’s Congressional Advocacy Conference in Washington, DC. More than 250 members of the American Optometric Student Association (AOSA) traveled to our nation’s capital to ensure the future of the profession is well represented.

In a video jointly produced by AOSA and OptometryStudents.com, students and practitioners share their perspective on advocacy and the issues that face the profession. The video is available on AOSA’s website at http://www.theaosa.org/ and http://www.optometrystudents.com. The project marks the first formal collaboration between the two organizations, and signals the importance of the Congressional Advocacy Conference to students.

For a broader perspective on the Congressional Advocacy Conference, the AOA’s Washington office has produced a short video as well, available at http://bit.ly/19E4L6M.

Asymptomatic Conjunctival Foreign Body
Brad A. Altman, OD, Mt. Juliet, TN

This is an 18mm scleral lens on an eye with keratoconus. The patient was unaware of the large lash behind the lens. It is not uncommon to find mucus debris or other matter floating behind a scleral lens, especially larger diameter sclerals. This patient reported comfortable lens wear.

We thank Dr. Altman 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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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

Scleral Lens Papers at AAO Meeting

This year’s American Academy of Optometry meeting included some unopposed research paper sessions on hot topics. Scleral lenses were included in a 1-hour session attended by clinicians and researchers alike. One of the papers presented by Matthew Kaufmann from the University of Missouri, St. Louis, reported on a comparison of rates of short-term settling of three scleral lens designs.1

The authors quantified the mean total (and rates of) settling or reduction in tear film clearance for three types of scleral gas-permeable contact lenses: Onefit (Blanchard Contact Lens, Inc.), Mini Scleral Design (Blanchard Contact Lens, Inc.), and Jupiter (18.2 mm diameter, Essilor of America, Inc.). They had each of nine subjects fit with these three scleral lens designs and at each visit central clearance values were measured using Cirrus optical coherence tomography (Carl Zeiss Meditec, Inc.) at the following time intervals following lens insertion: 0 min., 15 min., 30 min., 45 min., 1 hr., 2 hr., 4 hr., 6 hr., and 8 hr.

They found a significant difference between the total amount of lens settling between the three designs. On average, the Onefit, MSD, and Jupiter lenses settled a total of 110.88 µm, 126.75 µm, and 91.13 µm, respectively. Approximately 70% of total lens settling occurred within the first two hours of wear time. Interestingly, clearance values of all three lens designs were still decreasing at the eight hour measurement.

The authors concluded that the amount of settling of all three scleral lens designs tested in this study varied significantly and was not directly related to lens diameter. Important take home points for clinicians are to fit these lenses with increased vault at the fitting visit to allow for potential lens settling and reduction of vault to maintain your desired fitting relationship. Other large diameter lens designs fit differently may not have this same effect.

1. Kaufmann, M et al. A Comparison of the Rates of Short-Term Settling of Three Scleral Lens Designs. Program Number 130185. AAO 2103 Annual Meeting.

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Materials & Designs
Ronald K. Watanabe, OD, FAAO

Extended Parameter Contact Lens Options

The Biofinity (CooperVision) line of lenses has a new addition: Biofinity XR. CooperVision has been very progressive in terms of extended parameter ranges for their disposable soft lens options. Starting with Frequency 55 and Proclear XR lines, they have provided monthly disposable options for patients with extreme refractive errors. While most disposable soft lenses are available up to about -12.00 D and +8.00 D, Biofinity XR is now available up to -20.00 D and +15.00 D, giving us a simple high Dk (128) option for our high myopes and hyperopes.

Biofinity is still only available in one base curve and diameter. Several smaller manufacturers also have wonderful custom options available in very high parameter ranges, some with silicone hydrogel materials available. For example, Unilens, X-Cel, Metro Optics, and Art Optical can make very high powered lenses in a wide range of base curve / diameter combinations in Definitive material. Others have the ability to make a variety of hydrogel materials into lenses with up to +50 and -75 D of power, base curves as steep as 4.1 mm and as flat as 22.0 mm, and diameters as small as 6.0 mm and as large as 24.0 mm. We have an amazing range of options available to us for virtually any size and shape of eye we may encounter.

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Randomized, Double-Masked Study to Evaluate the Effect of Omega-3 Fatty Acids Supplementation in MGD

Dysfunction of the meibomian gland (MG) is among the most frequent causes of ophthalmological symptoms. The inflammation seen in meibomian gland dysfunction (MGD) is part of its pathogenesis, and evidence of the antioxidant-inflammatory properties of omega-3 fatty acids suggests this to be an appropriate treatment for MGD.

These researchers aimed to assess the effectiveness of omega-3 fatty acids versus placebo, in improving the symptoms and signs of MGD.

The researchers conducted a randomized and double-mask trial of 3 months duration. They enrolled 61 patients who presented with symptomatic MGD and no tear instability (defined as tear breakup time [TBUT] <10 seconds). Participants were randomly assigned to two homogeneous subgroups. For patients in group A, the study treatment included cleaning the lid margins with neutral baby shampoo and use of artificial tears without preservatives, plus a placebo oral agent. For patients in group B, the study treatment included cleaning the lid margins with neutral baby shampoo and use of artificial tears without preservatives, plus oral supplementation with omega-3 fatty acids. The researchers performed the following tests: (1) TBUT; (2) Schirmer I test; (3) Ocular Surface Disease Index (OSDI; Allergan, Inc., Irvine, CA, USA); (4) MG expression; (5) evaluation of lid margin inflammation; and (6) interpalpebral and corneal dye staining.

After 3 months of evaluation, the mean OSDI, TBUT, lid margin inflammation, and MG expression presented improvement from the baseline values, in group B (P < 0.01, P < 0.001, P < 0.0001, P < 0.0001, respectively). The Schirmer test results were also improved and statistically significant (P < 0.01).

The authors concluded that oral omega-3 fatty acids, 1.5 grams per day, may be beneficial in the treatment of MGD, mainly by improving tear stability.

Oleñik A, Jiménez-Alfaro I, Alejandre-Alba N, Mahillo-Fernández I. A randomized, double-masked study to evaluate the effect of omega-3 fatty acids supplementation in meibomian gland dysfunction. Clin Interv Aging. 2013;8:1133-8. doi:10.2147/CIA.S48955. Epub 2013 Aug 30. Source: Department of Ophthalmology, Jiménez Díaz Foundation, Madrid, Spain.

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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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