In continuing education courses lecturers often discuss clinical tests that should be included in the "ocular surface exam." In most cases, the exam sequence looks like this: an assessment of symptoms, a slit lamp examination of the ocular surface, lid margins and lashes, corneal fluorescein staining, lissamine green conjunctival staining, fluorescein tear break up time, and the Schirmer test. While each test has clinical merit, I would guess that less than 10% of clinicians do this battery of tests when examining patients with suspected ocular surface disease.

A number of years ago we performed a retrospective chart review to examine the tests performed in charts of patients with a diagnosis of dry eye (ICD-9 code 375.15) (Cornea. 2000 Jul;19(4):477-82). We found that assessment of symptoms was the most commonly recorded clinical "test" when making a dry eye diagnosis. Tear break up time and fluorescein staining were also frequently performed. Additional dyes, such as rose bengal and lissamine green were infrequently used, and the Schirmer test was rarely performed. Given we have not widely adopted any new dry eye diagnostic tests, I question whether the results would be markedly different today, although education about clinical dry eye has significantly increased. Ask yourself about your "ocular surface exam," if it has changed, and why--you may be surprised by your answer.

In the October 31 newsletter, the Editor's Commentary, Quick poll, and highlighted Abstract all discussed the same topic: contact lens noncompliance. In addition, of the 25 scientific presentations on contact lens care at this week's American Academy of Optometry Annual Meeting, there are seven on compliance. (See my December column in Contact Lens Spectrum.)

Why study compliance? First, there is no denying that increased bioburden increases the potential for infection. Second, knowing how many of our patients fail to replace and clean their lenses and cases as prescribed helps us to appropriately formulate strategies to enhance compliance.

Interestingly, there are differences in these studies' results. As observers, it may be important to note who sponsored the research. These are all actual studies, but a company is more likely to publish data that supports its own product philosophies. Also, we should note the study setting(s) and method(s) of data collection. One consistency: the data was collected from patients' own subjective responses. Attempts to measure human behavior can be tenuous, especially when the human element is involved in recording it. Nevertheless, we are thankful for all of this new compliance research and look forward to more in the future.

Menicon Expands Partnership with Optimed in North America

Menicon Co., Ltd., announced its agreement with Optimed Ltd. to become the exclusive distributor for Optimed's CAPTIV8 communication services and i-Vue content-driven digital signage software for North America. Earlier this year, Menicon obtained exclusive distribution rights for Optimed's products in Japan and Taiwan.

CAPTIV8 is Web-based 3D animation software that an eyecare practitioner can use chair-side to enhance communication with patients. The technology further enables patients to view the content on their computers and mobile devices and share it with family and friends.

i-Vue is a digital display system, normally located in the practice waiting room, that uses 3D animation to educate and inform patients about products and services. i-Vue allows users to easily and quickly modify playback content from any remote location, useful for multiple location practices.

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AOS Announces New Award for Students

The American Optometric Society (AOS) announced an annual award in honor of Dr. Harvey Yamamoto. The monetary award of $1,000 will be given to a senior optometric student from a school or college of optometry in the United States and its territories at the AOS Annual Meeting and Continuing Education Seminar to be held in Tampa, Florida, April 1-3, 2011.

Recognizing Dr. Yamamoto's lifetime of contributions to the profession and his community, the award is based on an original essay of not more than 1,500 words highlighting how the individual plans to give back to the profession of optometry as well as the community after graduation.

The recipient will receive transportation to attend the AOS Meeting, hotel room, a year's paid membership in the American Optometric Society, and a certificate, in addition to the $1000 cash award. All entries must be submitted by Feb. 1, 2011 and the decision of the judges is final. Full details on the award and how to submit entries are available on the student link found on the AOS website at www.optometricsociety.org.

AOA Seeks Nominees for Paraoptometric Award

The American Optometric Association's (AOA) Paraoptometric Section is seeking nominations for the Paraoptometric of the Year Award (POY).

The award is given annually to the optometric assistant or technician who has made outstanding contributions to the profession of optometry, paraoptometry, and the public. The nominee's accomplishments are reviewed in the following categories: service to optometry and paraoptometric associations; participation in public service activities; personal endorsement by the nominating individual.

Nominations must be received by AOA on or prior to Feb. 1, 2011. The 2011 award for the 2011 winner will be presented on June 16, 2011 during Optometry's Meeting in Salt Lake City, Utah. The winner will be featured in a video and will receive a plaque, round-trip airfare to Optometry's Meeting, three nights' lodging at the headquarters hotel, and $500 to help defray the travel expenses.

The award has been funded courtesy of Ciba Vision. For a nomination form or more information, contact the AOA Paraoptometric Section at 800-365-2219, ext. 4108 or e-mail JMAprahamian@aoa.org.

Allergan Introduces Online Tool

Allergan announced a new digital tool designed to help practitioners quickly and easily determine patient co-pays when prescribing Restasis. The online Restasis Co-pay Lookup tool allows practitioners to enter a patient's ZIP code and immediately obtain the average co-pay for the top managed care providers in the area.

The tool is designed to help improve the dialogue between practitioners and patients around dry eye management, which may include Restasis. The co-pay tool enables practitioners to provide more specific, on-the-spot estimates of the expected co-pay based on plan and geographic area. The online tool is optimized for smart phone access, providing the added flexibility of accessing the tool away from the computer. The feature is available online at www.RESTASIScopay.com.

Global Specialty Lens Symposium, January 27-30, 2011, Paris Hotel & Casino in Las Vegas

Plan now to attend the Global Specialty Lens Symposium in January 2011. With an expert international faculty and a CE-accredited agenda, the 2011 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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Dry Eye Treatment Focus of Agreement

Resolvyx Pharmaceuticals Inc., a developer of anti-inflammatory drugs, and Celtic Pharma have entered into an agreement relating to Resolvyx's dry-eye syndrome treatment. The deal gives Celtic Pharma an exclusive option to acquire and license rights to RX-10045, the late-stage treatment for dry eye syndrome developed by Resolvyx. Celtic Pharma also has the option to license rights to another eye treatment. No financial details of the agreement were disclosed.

Resolvyx's RX-10045, which won a United States patent in 2009, is set to begin a Phase 3 study next year. The treatment is given in the form of eye drops, made of a resolvin, which is designed to have a potent effect on such diseases as rheumatoid arthritis, asthma, inflammatory bowel disease, dry eye and retinal disease.

Ocusoft Recognized for Work Environment

Ocusoft, Inc. was named one of the Top Workplaces by the Houston Chronicle. The Top 100 Workplaces recognizes businesses in the Houston area nominated by their own employees and based on employee opinions about company leadership, compensation and training, career development, family friendly flexibility, and values and ethics. Private, nonprofits and publicly-held businesses were included in the analysis.

The rankings in Top Workplaces are based on survey information collected by Workplace Dynamics.

As you have noted, the last two Contact Lenses Today Quick Polls have focused specifically on the rub step in the care regimen. In summary, it is clear that you believe in the rub step as more than 90% of you regularly tell your patients to rub their lenses while caring for them (see results of last week's Quick Poll in this edition of the newsletter). What is also clear is that while you actively tell your patients to rub their lenses, many don't do it-55% of you said only some of them do it and 8% of you said that none do it. With regulatory agencies again looking at the rub step in terms of product labeling, it will be interesting to see the impact of these regulatory decisions on the behaviors of our patients.

Mechanical Superficial Keratectomy for Corneal Haze After Photorefractive Keratectomy With Mitomycin C and Extended Wear Contact Lens

The purpose of the study was to evaluate the clinical results of a mechanical keratectomy with mitomycin C (MMC) and extended wear contact lens (EWCL) for the treatment of corneal haze after photorefractive keratectomy (PRK) of high myopia. The setting was the Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Iran.

In a retrospective interventional case series, researchers enrolled 15 eyes of 9 patients who previously underwent PRK for high myopia and developed corneal haze and regression. Mechanical removal of corneal haze was done by using a surgical blade number 15. Then, MMC (0.02%) was used for two minutes. An EWCL was applied for one month. The main outcome measures were uncorrected visual acuity, best-corrected visual acuity, spherical equivalent (SE), and corneal haze grade. All patients were followed for a minimum of six months. The mean age of the patients was 25.66 +/- 7.03 years; seven patients were men and two patients were women. The mean best-corrected visual acuity before superficial keratectomy was 20/80 (range, 20/200-20/50) and improved to 20/20 after treatment (P < 0.05). Thirteen eyes (86.6%) achieved an uncorrected visual acuity of at least 20/40. The mean preoperative SE was 3.91 +/- 1.30, and the mean final postoperative SE was -0.85 +/- 1.19 (P < 0.05). Eight eyes (53%) were within 1 diopter of emmetropia. Corneal haze in all patients declined to a trace haze or complete clearness. No recurrence occurred during the mean follow-up time of 12 months.

The authors concluded that superficial keratectomy with MMC and EWCLs is effective in reducing persistent and refractory corneal haze after PRK.

Khakshoor H, Zarei-Ghanavati M, Saffarian L. Mechanical Superficial Keratectomy for Corneal Haze After Photorefractive Keratectomy With Mitomycin C and Extended Wear Contact Lens. Cornea 2010.