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Sunday, November 16, 2014  
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Results from last poll:

How often do you think your full time contact lens patients “top-off” their contact lens care solution?

 Rarely (1 day/month)

 Sometimes (~5-7 days/month)

 Frequently (> 5 days/week)

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
A recent visit to a new dentist's office made me rethink concepts about compliance that seemingly all healthcare practitioners face. My hygienist was complimentary of my oral hygiene and commented that she wished all her patients were as diligent in their dental care—she remarked that many of her patients’ mouths were disgusting! She then went on to talk about her contact lenses with me, saying she usually replaces her planned replacement contact lenses when she they start to feel uncomfortable. How ironic! It goes to show that human nature usually leads one to the down the path of least resistance—until a problem occurs.

CDC Reports on Estimated Burden of Keratitis in United States

The CDC has published a report on the first estimate of the burden of keratitis, including microbial keratitis, and contact lens disorders in the United States, using data from national outpatient and emergency department databases. The report finds that episodes of keratitis and contact lens disorders result in an estimated 930,000 outpatient visits and 58,000 emergency department visits annually that cost $175 million in direct health care expenditures.

Established, modifiable risk factors for microbial keratitis, such as overnight contact lens wear, poor contact lens storage case hygiene, and infrequent storage case replacement indicate that this serious and costly eye infection is largely preventable. As such, patient education about healthy contact lens wear and care practices is essential and warranted, according to the report.

The complete study as published in the latest issue of Morbidity and Mortality Weekly Report (MMWR) can be viewed here:

To mark the first annual Contact Lens Health Week, in close collaboration with partners from clinical, public health, industry, and regulatory sectors, CDC has developed a campaign to promote healthy contact lens wear and care practices that can help reduce the risk for eye infections and complications associated with poor contact lens hygiene. Additional information for consumers on Contact Lens Health Week and the proper wear and care of contact lenses is available at

Alcon Launches Online Guide to Clinical Contact Lens Management

Alcon has launched a web-based Guide to Clinical Contact Lens Management for contact lens practitioners. The guide is available on and provides a compact summary of signs, symptoms and management options of a broad range of anterior segment and contact lens-related conditions.

The easy-to-use guide has been updated to include more conditions, images and videos than previous print versions. Conditions are easily searched by anterior segment anatomy, including cornea, limbus, conjunctiva, and lid, or by the accompanying signs and symptoms. There is also a section specific to contact lens fitting complications.

The guide is edited by Dr. Lyndon Jones, Director of the Centre for Contact Lens Research at the University of Waterloo School of Optometry & Vision Science.

This web-based resource is a dynamic source of information, which will be frequently updated with new images, videos and treatment suggestions. It is designed to be a helpful source of information for practitioners, educators and students and to become the ‘go-to’ resource when dealing with contact lens complications.

The Guide to Clinical Contact Lens Management is one of many resources available to eye care and health care practitioners on

Still Time to Register – 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


Industry Pioneer, Lynda Baker, to Retire

ABB Optical Group announced that industry pioneer Lynda Baker is retiring on December 1, 2014. Currently executive vice president of ABB Optical Group, Baker was instrumental in the 2007 merger of ABB Optical and Con-Cise Contact Lens Company, where she began her career in 1965.

Baker started her career as a contact lens technician at Con-Cise before there was a soft contact lens market. One of seven employees, Baker was responsible for manufacturing hard lenses. As the company grew, her role developed into managing a wide variety of functions within the organization, from customer service to consulting and more.

In 1976, Con-Cise became the first soft contact lens distributor in the U.S. with the Softcon lens from Warner-Lambert, followed by AO Soft, and Baker spent most of her time managing the company's soft lens inventory and sales. In 1980, she took an equity and leadership role as vice president/general manager, and was promoted to executive vice president in 1985.

Baker's role in the industry beyond Con-Cise included serving as the clinical monitor for the Food and Drug Administration’s approval of Paragon Vision's gas permeable material in 1981, and in 1987, serving as one of the first members of Ciba Vision's Authorized Distributor Advisory Board. Over the years, Baker has served on 14 soft lens manufacturer advisory panels, and she continues to serve on the Alcon Advisory Panel today.

Among Baker’s other accomplishments are the passing the first National Contact Lens Exam (NCLE) in the late 1970s and serving on the board of directors for the Pacific Coast Contact Lens Society for 12 years, including as its first female president. She also taught a contact lens course at Canada College in Redwood City, California and later served on the college's board of directors. Baker was honored with Vision Monday's Most Influential Women in Optical award in 2005.

B+L Offers ECPs Convenience Pack

Bausch + Lomb (B+L) introduced a new convenience pack for eye care practitioners (ECPs) and their patients. Combining B+L’s Ultra contact lenses and Biotrue multi-purpose solution, the convenience pack provides eye doctors and their offices a tool to help improve patient compliance and annual supply purchase rates. With the purchase of an Ultra contact lens inventory, offices will receive:

       · 24 convenience pack boxes
       · 24 Biotrue multi-purpose solution samples (10 oz.) with accompanying lens cases
       · One pad of B+L Ultra consumer rebates ($60 rebate with the purchase of an annual supply of Ultra contact lenses)

The convenience pack box will also include a built-in business card holder and referral reminder to encourage patients to refer friends and family to their eye doctor’s office.

For more information on B+L ULTRA contact lenses and Biotrue multi-purpose solution, visit

Alcon Marks Five Years of Support for CLAY Team

Alcon is marking five years of unrestricted grant support for the Contact Lens Assessment in Youth (CLAY) team. Alcon has provided nearly $700,000 to advance the important research of the CLAY team since 2009.

The team’s early research focused on determining whether youth is an independent risk factor for contact lens complications, and has since expanded toward understanding risk factors associated with contact lens complications in both children and adults to promote healthy contact lens wear for all ages.

Since CLAY was first formed in 2008, researchers have generated six peer-reviewed manuscripts and over 20 conference presentations. Two presentations were shared at the Annual Meeting of the American Academy of Optometry in Denver.

Some other key areas of learning from the CLAY study team projects include the development of a standardized contact lens risk survey (CLRS), as well as a greater understanding of contact lens wear, care and access and behaviors unique to college wearers.

The CLAY team is comprised of cornea and contact lens researchers in academic centers across North America and was formed at the 2008 AOA-AAO Summer Research Institute. The group aims to understand risk factors associated with contact lens complications, and to explore means to modify them in order promote healthy contact lens wear for all ages.

Back Toric Scleral Lens on a WTR Asymmetric Sclera
Jaime Ibanez, OD, Villavicencio, Colombia

Toric back surface or toric peripheral curves are effective means for keeping the lenses on the desired axis. This is a case with a rotationally asymmetric sclera (with-the-rule pattern) with a meridional/sectorial blanching (left image) produced by a back spherical scleral lens. A toric back surface lens, rotationally stable (right image) was remade in order to relieve the pressure on the horizontal meridian. The sectorial blanching disappeared and the comfort was inmmediate.

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 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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Susan J. Gromacki, OD, MS, FAAO

CDC “Contact Lens Health Week”

November 17-21, 2014, is “Contact Lens Health Week” for the United States Centers for Disease Control and Prevention (CDC) and its partners. The theme is “You only have one pair of eyes, so take care of them!” and the primary focus of the education is contact lens care and compliance.

Their website1 states, “When cared for properly, contact lenses can provide a comfortable and convenient way to work, play, and live for the 30 million plus people in the U.S. who wear them. While contact lenses are usually a safe and effective form of vision correction, they are not entirely risk-free—especially if they are not cared for properly. Contact lenses are medical devices, and failure to wear, clean, and store them as directed can increase the risk of eye infections, such as microbial keratitis. To reap the benefits of wearing contact lenses, it is essential to practice healthy habits. Remember: Healthy Habits = Healthy Eyes.” It also contains resources for practitioners, including sample newsletter blurbs; posters, flyers and web buttons; and a comprehensive list of references.

I, for one, applaud CDC’s new efforts to educate both professionals and public alike on the importance of healthy contact lens wear and care.


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David Kading, OD, FAAO

A Sleeping Elephant in the Room

YOU: Do you sleep in your lenses?
YOU: Ok, good. But let me ask, how many times a week do you sleep in your contact lenses?
PATIENT: Well, sometimes I fall asleep in them and forget to take them out.
YOU: How often is that?
PATIENT: About two nights a week, but it’s just because I forget, I don’t mean to do it.

So what do you do now? Do you treat this patient as a sleeper or a non-sleeper? May I remind you that we have several contact lenses approved for overnight wear. Monthly lenses have either 30-day extended wear or weekly overnight wear with a night break. Also, don't forget that two-week lenses have overnight wear approval as well. Most are labeled as a two-week lens when our patients wear them daily, but if they sleep in the lenses, they become a weekly lens requiring our patient to discard them after a week.

When I encounter a sleeper, my guess is that they may be sleeping in their lenses more often than they are telling me. I approach the situation and explain to them, that there is no punishment, but it just has heightened risk factors. Then I explain that I am moving them into a lens that has approval for overnight wear and then discuss it with them.

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Advances in the Technology of CLX for Keratoconus
Corneal cross-linking (CXL) with ultraviolet-A (UVA) and riboflavin was introduced over 15 years ago and has been widely adopted as a treatment for keratoconus. Several studies have demonstrated the safety and efficacy of the procedure performed according to a standard protocol.

Recent scientific and technological advances have highlighted the opportunity for optimization of the CXL procedure through modifications to this protocol. Advances in the technology of CXL include new riboflavin formulations, higher irradiance UVA sources, and programmable UVA illumination patterns. Several laboratory and clinical studies demonstrate that these modifications may provide equivalent treatment effect in shorter total treatment times.

Additionally, although the original purpose of CXL was to stabilize the cornea and prevent further visual loss in keratoconus, patient-specific computational modeling and customized CXL with programmable UVA treatment patterns demonstrate the potential for CXL to be used as a means of improving corneal topography to maximize visual rehabilitation in patients with keratoconus.

This review aims to provide an overview of these advances in CXL technology designed to optimize the efficiency or efficacy of the clinical CXL procedure.

Lytle G. Advances in the Technology of Corneal Cross-Linking for Keratoconus. Eye Contact Lens. 2014 Oct 15. [Epub ahead of print]

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