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Sunday, December 7, 2014  
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Results from last poll:
How many TOTAL hours per year do you estimate that you spend clinically managing contact lens-related microbial keratitis (MK)?

 None (I never see MK)

 1-10 Hours

 11-20 Hours

 21-30 Hours

 > 31 Hours
Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
As the year comes to an end, we are ramping up on our editorial materials for 2015, including our widely read Annual Report “Contact Lenses 2014”—our year-end review evaluating trends in our field. As always, we would like to hear from you about topics you would like to hear more about in our publication. Please do not hesitate to reach out at

National Optometry Hall of Fame Accepting 2015 Nominations

Optometrists may now be nominated for the 2015 National Optometry Hall of Fame, a tremendous honor for doctors who have made a significant and long-lasting impact on the profession. Inductees will be honored at Optometry’s Meeting in June 2015 in Seattle, Washington. The National Optometry Hall of Fame is administered by the American Optometric Association’s (AOA) charitable foundation, Optometry Cares.

New this year, there are two categories for the award – one for optometrists who work in the academic field of the profession, and the other for optometrists who work in private practice or federal service. There will be a minimum of one person inducted from each category.

Each nomination is valid for National Optometry Hall of Fame consideration for four consecutive years, and optometrists nominated for the 2014 AOA Distinguished Service Award will be placed into the National Optometry Hall of Fame selection pool for 2015.

To be eligible for the National Optometry Hall of Fame, an optometrist must have records of dedicated service, lifetime achievements and enduring lifetime contributions, as well as involvement in the profession of optometry for more than 30 years. Specific criteria for nominations can be viewed here.

The deadline for online submissions is January 15, 2015. To access the nomination forms and criteria, visit

Register for GSLS 2015 by December 15th and Save!

Join us January 22 - 25, 2015 for Global Specialty Lens Symposium at Bally’s Hotel & Casino in Las Vegas. The GSLS is a comprehensive meeting focusing on the latest techniques and technologies for the successful management of ocular conditions using today's specialty contact lenses. The meeting includes information for vision care professionals in all disciplines, with both surgical and non-surgical options covered. Accredited for continuing education under COPE, NCLE, and JCAHPO, the meeting will offer approximately 30 credit hours.

Attended annually by more than 500 participants from 30+ countries it is the largest conference of its kind in the U.S.

Register before December 15th and save! For complete conference details and to register now, visit


ABB Optical Group Announces $25,000 Match for Donations to Optometry Cares

ABB Optical Group, in recognition of the company’s 25th anniversary, intends to match all donations up to $25,000 made to Optometry Cares—The AOA Foundation now through December 31st.

The ABB OPTICAL GROUP matching gift will help bolster AOA members’ contributions to ensure support of valuable Optometry Cares programs, such as:

  • InfantSEE
  • Healthy Eyes, Healthy People
  • Camp Courage: A Helen Keller Experience
  • Optometry’s Fund for Disaster Relief
  • Endowment and Scholarship Funds
  • National Optometry Hall of Fame
  • Archives & Museum

Donations to Optometry Cares—The AOA Foundation are tax-deductible and help expand eye health and vision care access for people nationwide. For more information or to make a donation, visit

Bedell Named Executive Director of OWL

Ophthalmic Women Leaders (OWL) announced the appointment of Angela Bedell to the role of Executive Director. In this role, Ms. Bedell will be responsible for all OWL activities, including strategic planning, financial management of the organization, fund-raising, and program development and implementation.

Ms. Bedell brings 20-years of comprehensive experience in association management to the position, working primarily in healthcare organizations, including the American Nurses’ Association, the American Academy of Family Physicians, the American Society of Plastic Surgeons, and the Society of Teachers of Family Medicine. Her professional passion is developing revenue for non-profit organizations and growing membership beyond expectations.

Bedell is a Certified Association Executive (CAE), is the Vice Chair of the Marketing Section Council for the American Society of Association Executives (ASAE), and has served in leadership roles on the Membership Council and the Healthcare Committee of the ASAE. Bedell has been published in national non-profit magazines and has presented at many international conferences. She was recently selected as the "Distinguished Association Executive" by the Kansas City Society of Association Executives.

Angry Limbus
Boris Severinsky, MOptom, Boston, MA

This image represents an “angry limbus” appearance caused by tightly fitted scleral zone of 16.50mm mini-scleral lens. Note an absence of fluorescein depletion in the pre-corneal tear film. The image was taken three hours post lens insertion. This patient developed keratoconus at the age of 44 years and has a background of Grave’s disease.

We thank Boris Severinsky 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

Three Success Strategies for NOW

As we look at the last 11 months and what our practices have been through, an important thing to review is, are my patients wearing the lens I think they are?

I propose three tips for you.

  1. Do a review of your materials. You should be able to do this through an evaluation from your distributor or through your practice management system. As most of you know, I am passionate about single use lenses. Yesterday I ran a review of my contact lens sales in my practice management system. I was happy to see that the materials that we are selling, reflects my passion. Our top five lenses are all single use. This matches where I want to be. How do your sales match up?
  2. Look at your designs. I know that I do a lot of sclerals. As a specialty referral practice, many practitioners in Washington refer their patients to our practice. But being a practice that does “a lot” of lenses is not really measureable. I went through and reviewed the number of scleral lenses that I sold this past year. I was happy to see where these numbers are, and now as I look at the next year, I can set targets both for where I can the practice to be financially, and more importantly, for how many patients we can help. This holds true for all our designs: corneal GP, Scleral, Custom Soft, and disposable lenses.
  3. Look at your targets for 2014 and see if you have met them. For this example, let’s use Orthokeratology. I love doing Orthokeratology. I think that beyond its benefits for the reduction of glasses and contact lenses, its anticipated help in slowing down the progression of myopia in kids makes it a phenomenal addition to any practice. I ran the numbers; I did well, but would love to have done better. As I look to 2015, this gives me some new targets.

It’s never too late or too early to review your performance. Having a good look at the “scoreboard” is an excellent way to know where you rate. As the year is drawing to a close, don't relax in your patient discussions. Push for progress and better performance for your patients.

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Susan J. Gromacki, OD, MS, FAAO

Tear Film Debris in a Scleral Lens Wearer? Try a “Cocktail”.

A 60 year-old speech pathologist reported for her 3 month scleral gas permeable (GP) contact lens follow-up. Her new lens provided superior vision and comfort as compared with her previous small diameter GP contact lens. However, her vision was becoming increasingly cloudy over minutes to hours, and the only way to resolve it was to remove the lens, clean it, and refill it with non-preserved artificial tears 3-4 times per day.

Biomicroscopy showed a healthy contact lens fit and anterior segment, and, as expected, moderate under-lens tear debris. There are many theories as to the origin of this debris in scleral contact lens wearers, but one thing is for certain: it is not uncommon. It may have something to do with a patient’s ocular surface. This patient, in addition to her keratoconus, demonstrated meibomian gland deficiency, anterior basement membrane dystrophy, endothelial guttata, and her eye had already endured a cataract surgery with a posterior chamber IOL. Since her lens fit and her lens care compliance were acceptable, I changed the solution with which she was filling her lens every morning.

I recommended that she make a “cocktail” to fill the lens, beginning with two to four drops of a clear, non-preserved, viscous carboxymethylcellulose followed by 0.9% sodium chloride inhalation solution to the top of the lens’ rim. Within days, she noted that the cloudiness had diminished and that she only needed to remove the lens once per 12-hour day to refill it.

While this “cocktail” may not solve every patient’s clouding dilemma, it helped in this case. Although it is uncertain who originally devised this method, I would like to thank Drs. Greg DeNaeyer and Pam Satjawatcharaphong for communicating it to me.

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Myopia Control during Orthokeratology Lens Wear in Children Using a Novel Study Design

The purpose of this study was to investigate the effect of overnight orthokeratology (OK) contact lens wear on axial length growth in East Asian children with progressive myopia.

A prospective, randomized, contralateral-eye crossover study conducted over a 1-year period. Researchers enrolled 26 myopic children (age range, 10.8-17.0 years) of East Asian ethnicity.

Subjects were fitted with overnight OK in 1 eye, chosen at random, and conventional rigid gas-permeable (GP) lenses for daytime wear in the contralateral eye. Lenses were worn for 6 months. After a 2-week recovery period without lens wear, lens-eye combinations were reversed and lens wear was continued for a further 6 months, followed by another 2-week recovery period without lens wear. Axial eye length was monitored at baseline and every 3 months using an IOLMaster biometer. Corneal topography (Medmont E300) and objective refraction (Shin-Nippon NVision-K 5001 autorefractor) were also measured to confirm that OK lens wear was efficacious in correcting myopia.

Axial length elongation and myopia progression with OK were compared with conventional daytime rigidcontact lens wear. After 6 months of lens wear, axial length had increased by 0.04±0.06 mm (mean ± standard deviation) in the GP eye (P = 0.011) but showed no change (-0.02±0.05 mm) in the OK eye (P = 0.888). During the second 6-month phase of lens wear, in the OK eye there was no change from baseline in axial length at 12 months (-0.04±0.08 mm; P = 0.218). However, in the GP eye, the 12-month increase in axial length was significant (0.09±0.09 mm; P < 0.001). The GP lens-wearing eye showed progressive axial length growth throughout the study.

The authors concluded that these results provide evidence that, at least in the initial months of lens wear, overnight OK inhibits axial eye growth and myopia progression compared with conventional GP lenses. Apparent shortening of axial length early in OK lens wear may reflect the contribution of OK-induced central corneal thinning, combined with choroidal thickening or recovery due to a reduction or neutralization of the myopiogenic stimulus to eye growth in these myopic children.

Swarbrick HA, Alharbi A, Watt K, Lum E, Kang P. Myopia Control during Orthokeratology lens Wear in Children Using a Novel Study Design. Ophthalmology. 2014 Nov 6. [Epub ahead of print]

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