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Sunday, December 14, 2014  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
I think it is important to remember that this is an excellent time of year to encourage parents to bring their children in for eye examinations. Indeed there is significant hustle and bustle associated with all the various holidays, but still the kids are off for the holidays so why not create some incentives to get parents to bring their kids into your office? Of course, use this as an opportunity to encourage contact lenses, for those whom this vision correcting modality is appropriate.

CooperVision Team Recognized for Manufacturing Process Improvements
In recognition of improvements to the manufacturing process of its legacy Hydrasoft custom contact lenses, CooperVision, Inc. has received the 2014 Gold Team Excellence Award from the Greater Rochester Quality Council (GRQC).

CooperVision’s Hydrasoft product line was first introduced in the early 1980s, and has remained a popular choice for eye care professionals whose patients need highly customized fits. Hydrasoft sphere and toric products offer the broadest range of contact lens parameters in CooperVision’s product portfolio, capable of providing more than 20 million prescription combinations, according to the company.

In seeking ways to continue manufacturing Hydrasoft in a way that met both customer demand and allowed it to remain competitive, CooperVision teams standardized the product’s manufacturing platform then transitioned to a fully made-to-order process while maintaining customer service levels. Concurrently, the project teams simplified the pricing structure and updated Hydrasoft packaging to align with CooperVision’s product portfolio. The transition was completed in mid-2014, on time and on budget, resulting in reduced manufacturing costs and increased customer satisfaction.

Last Day to Save - Register Now for GSLS 2015

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


Blanchard Receives Founders’ Award
Jean-Louis Blanchard, OD received the Founders’ Award from the Cornea and Contact Lens Section of the American Academy of Optometry. The award is presented to an individual, group, or company who has made an outstanding contribution to the clinical aspect of the art or science of contact lens fitting.

When Dr. Blanchard completed Optometry school in 1946, contact lenses were not yet available. When contact lenses finally became available in 1955, he saw the potential of these medical devices and how they would improve the vision of his patients. Over the years he learned to fit and troubleshoot physiological issues related to contact lens wear. Blanchard convinced colleagues to embrace this technology and educated them on this new science of “Contactology”. He was sought as a teacher in Canada, Northeastern United States, and in Europe

In 1962 Blanchard began to manufacture and modify contact lenses, for his practice and for a small group of colleagues. One year later he established Veracon, an optometrist-owned laboratory dedicated to the production of contact lenses. In 1986, Veracon became Blanchard Labs, growing to become the number one manufacturer and distributor of gas permeable lenses in Canada.

Blanchard served as a clinical instructor at the École d’optométrie de l’Université de Montréal, and held places on the boards of the Quebec Association and the College. The Association of Optometrists of Quebec, in 2005, awarded him for his contribution to the profession of optometry.

In celebration of the 100th anniversary of the Montreal School, Dr. Blanchard established a fund providing travel grants for contact lens residents to present their works and to attend specialty contact lens meetings, just as he began his career 68 years ago.

Your Interesting Case Photo Here in the Next Issue

Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in this column in the coming weeks!

We welcome photo submissions from our 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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S. Barry Eiden, OD, FAAO
Time to Redefine Things… The Role of Inflammation in Keratoconus

Keratoconus (KC) has been traditionally classified as a non-inflammatory disease. Classic signs of inflammation such as heat, redness, swelling, and pain are not usually obvious or even apparent in KC. Yet, numerous inflammatory processes have been recognized in the tears of KC patients as well as the discovery of inflammatory findings in the KC cornea.

A clinical perspective has recently been published that examines the evidence and implications pertaining to the role that inflammation plays in keratoconus.1 The roles of inflammation in corneal trauma attributed to eye rubbing and/or contact lens wear are examined as is the significance of atopy, allergic disease, dry eye disease, degradative enzyme activity, wound healing, reduced anti-inflammatory capacity, and ultraviolet irradiation. The author states that it is possible that any comorbidity that is inflammatory in nature may add synergistically to other forms of KC-related inflammation and exacerbate its pathogenetic processes. For example, some features of inflammation in ocular rosacea and associated corneal thinning and distortion could have some possible relevance to KC. An analogy is drawn with osteoarthritis, which also involves significant inflammatory processes but, like KC, does not meet all the classic criteria for an inflammatory disease. The author states that classifying KC as quasi-inflammatory (inflammatory-related) rather than a non-inflammatory disease appears to be more appropriate and may help focus attention on the possibility of developing effective anti-inflammatory therapies for its management.

A rethinking of classic concepts in the understanding of disease is often critical in our ability to move forward in its management. As suggested by the author, applying concepts of an underlying inflammatory mechanism, which now are felt to be critical in the pathogenesis of keratoconus, may allow clinicians to consider that appropriate KC patient management should include efforts to control all sources of inflammatory mediators that could synergistically contribute to keratoconus.

1. McMonnies CW. Inflammation and Keratoconus. Optom Vis Sci. 2014 Nov 13. Epub ahead of print.

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Katherine M. Mastrota, MS, OD, FAAO


Smoking, as we all are aware, is detrimental to overall health and is associated with ocular surface disease. What about the use of electronic cigarettes that have become popular? An electronic cigarette (e-cig or e-cigarette) or electronic nicotine delivery system (ENDS) is a battery-powered vaporizer which simulates tobacco smoking. Electronic cigarettes do not contain tobacco, although they do use nicotine from tobacco plants. They do not generate cigarette smoke but rather an aerosol (mist), which is frequently but inaccurately referred to as vapor. An aerosol is a suspension of fine particles of liquid, solid or both in a gas. Both the particulate and gas phases are mixtures of chemical substances in e-cigarette aerosols.1

Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data.2

A PubMed “e-cigarette dry eye/ocular surface” search on 12/08/2014 yields no results. I eagerly await studies on this topic and until then suspect that the use of ENDS negatively impacts the ocular surface environment.

1. Tianrong Cheng. Chemical evaluation of electronic cigarettes. Tob Control. May 2014; 23(Suppl 2): ii11–ii17.
2. Callahan-Lyon P. Electronic cigarettes: human health effects. Tob Control. 2014 May;23 Suppl 2:ii36-40.

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Oxygen Diffusion and Edema with Modern Scleral Rigid Gas Permeable Contact Lenses
Effects of Long-Term SCL Wear on the Corneal Thickness and Corneal Epithelial Thickness of Myopic Subjects

To perform safe and successful corneal refractive surgery on myopic patients, corneal thickness (CT) and corneal epithelial thickness (CET) must be accurately measured. Numerous individuals with myopia wear soft contact lenses (SCLs) for the correction of visual acuity but may subsequently undergo corneal refractive surgery. The aim of the present study was therefore to investigate the effects of long-term SCL wear on the CT and the CET of myopic subjects in order to guarantee the safety and accuracy of subsequent corneal refractive surgeries.

Fifty-six subjects prepared to receive refractive surgery at Jinan Mingshui Eye Hospital (Zhangqiu, China) from April to July 2013 were included in the study. CT and CET were measured in subjects immediately following discontinued SCL wear (group I, 56 eyes), and subsequently following >two weeks of discontinued SCL wear (group II, 56 eyes). Ninety-four subjects with no history of corneal contact lens wear were enrolled as a control group.

The CT and CET were measured at positions with a radius of 0.0-1.0, 1.0-2.5 (divided into eight quadrants) and 2.5-3.0 mm (divided into eight quadrants) away from the corneal center using the RTVue-100 Fourier-domain anterior segment optical coherence tomography system. A significant decrease in the CT of the subjects in group II was observed, compared with that of group I and the control group (P<0.05). A significant decrease was observed in the CET of groups I and II compared with that of the control group (P<0.05). Following discontinuation of SCL wear, CET increased. However, the increased CET was unable to reach the normal range exhibited by the control group. Edema and thinning of the corneal stroma, as well as thinning of the corneal epithelium were observed in groups I and II.

In conclusion, it was proposed that in clinical practice, for myopic patients following long-term SCL wear, CT and CET should be determined >=two weeks following discontinuation of SCL wear, once a stable CT and CET are obtained.

Lei Y, Zheng X, Hou J, Xu B, Mu G. Effects of long-term soft contact lens wear on the corneal thickness and corneal epithelial thickness of myopic subjects. Mol Med Rep. 2014 Nov 17. [Epub ahead of print]

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