Lens Dynamics, Inc. and Firestone Optics, Inc. announced that they have agreed to merge. Effective January 1, 2010, Lens Dynamics will become a wholly owned subsidiary Firestone Optics, Inc. Al Vaske will continue in his current role as President of Lens Dynamics and Kathy Vaske will continue as head of Lens Dynamics customer service. Both will also continue to be based in Denver, Colorado.
     Manufacturing of the Lens Dynamics specialty GP contact lenses, including their line of unique semiscleral, multiquadrant (Quad) lenses and keratoconus lenses, will be transferred to Firestone's Kansas City, Missouri laboratory. Firestone's award winning manufacturing facility is ISO and CMDAS certified. Firestone currently manufactures the Tangent Streak family of lenses in addition to many specialty and GP single vision lenses, and is also an authorized distributor of all major brands of soft contact lenses.

ARBO and its COPE Committee released the new COPE Standards for Commercial Support on December 15, 2009. Changes in the new regulations include:
  - COPE-Accredited CE must be identified, developed and presented free from the control of a commercial interest.
  - All commercial support must be in the form of an educational grant to the COPE Approved Administrator/Provider.
  - There must be a clear separation of any type of product, service, and instrument or device promotion with COPE-Accredited Courses. All commercial exhibits and advertisements must be physically separated from COPE-Accredited Courses.
  - COPE-Accredited Courses cannot deliver specific proprietary business interests and must give balanced coverage to treatment options.
  - Financial relationships with commercial interests of any persons in a position to impact or control the educational content must be disclosed to the learners and to COPE.
     January through June 2010 will be a six-month training period, followed by a six-month implementation phase. Oversight and enforcement during 2010 will consist of notification of non-compliance and assistance with compliance issues. Full compliance to the standards for all COPE accredited CE will be required as of January 1, 2011.
     To review the standards, implementation timeline, processes and toolkit, go to http://www.arbo.org/proposed_new_standards_for_industry_support.php.

The CIBA Vision Academy for Eyecare Excellence (www.cibavisionacademy.com) has expanded the breadth and reach of its professional education programs with new online learning modules and an app for iPhone users. The app is a no-cost download for ECPs who are iPhone users. Once it is installed on the iPhone, the user can access the Academy for Eyecare Excellence tools and education from their iPhone.
     Eleven online learning modules cover topics ranging from ocular anatomy to multifocal soft lens fitting. Some courses are designated for eye care practitioners and others are designed for staff members.
     Each learning module takes about 40 minutes to complete, although the user may pause the program at any time, allowing busy practitioners and staff members to complete the work in shorter increments. At the end of the module, the user takes an online test, which is scored instantly. After scoring is complete, the user can print out a certificate of completion that is suitable for framing.
     "As a leading partner with ECPs around the world, CIBA Vision is continuing to enhance Academy for Eyecare Excellence offerings through ease of access. We are listening to the needs of the ECP and responding in a way that delivers relevant content in a technology format that is most convenient for them," said Dwight H. Akerman, OD, FAAO, Director of Professional Programs for CIBA Vision. "Technology is a powerful tool that allows us to overcome concerns of time, money and travel so that more optometrists, staff and their patients receive the benefit of high-quality education."
     To learn more about Academy for Eyecare Excellence or to participate in online learning, visit www.cibavisionacademy.com.

Your contact lens patients may be suffering in silence when it comes to comfort. Though 90% of patients state that they are satisfied with contact lenses,¹ almost 1 in 5 contact lens wearers are considering dropping out.² The primary reason? Discomfort.² But there's hope. Just by asking the right questions, you can reveal those patients who are experiencing discomfort in their current contact lenses. And by recommending ACUVUE® OASYS™ Brand Contact Lenses, you can open their eyes to a new world of comfortable, healthy, contact lens wear!

$100 rebate for new wearers! Good when patients get an eye exam and purchase 8 boxes of ACUVUE® OASYS™ (spherical product only). Visit jnjvisioncare.com/rebate for more details.

1. Contact Lens User and Engagement Study, Jan-Oct 2008 & US Government Census Data. 2. 2008 Gallup study of the consumer contact lens market.
     ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from VISTAKON®, Division of Johnson & Johnson Vision Care, Inc., by calling 1-800-843-2020 or by visiting jnjvisioncare.com.
     HYDRACLEAR® Plus is our brand name for the next generation of our proprietary technology that allows us to use a higher volume of a moisture rich wetting agent in a state of the art formulation. This creates a more wettable, ultra smooth contact lens, especially for challenging environments that make eyes feel dry.
     ACUVUE®, ACUVUE® OASYS™, HYDRACLEAR®, and VISTAKON® are trademarks of Johnson & Johnson Vision Care, Inc.
© Johnson & Johnson Vision Care, Inc. 2009
--ADVERTISING

On December 16, President Obama signed into law a measure that provides nearly $600,000 in new federal resources to help expand the scope and impact of InfantSEE - the signature public health program of the American Optometric Association (AOA) administered by Optometry's Charity, the AOA Foundation. Designed to ensure that eye and vision care become an integral part of infant wellness and improve a child's quality of life, doctors of optometry provide one eye and vision assessment to infants free-of-charge regardless of socioeconomic status.
     The FY 2010 Consolidated Appropriations Act of 2009, which provides funding for the operations of many areas of the federal government, includes $590,000 in new direct appropriations. The first direct appropriation, sponsored by Sen. Robert C. Byrd (D-W.Va.) totaled $500,000 and is aimed at supporting expansion and outreach of the program. The second direct appropriation totaling $90,000 was sponsored by Sen. Tom Harkin (D-IA) and will support program expansion through outreach in Iowa.
     The InfantSEE program previously received a direct appropriation sponsored by Sen. Byrd in the fall of 2008 and implemented in 2009. Data collected from the 2009 project display an overall prevalence rate of one in six infants exhibiting a cause for concern (in need of follow-up care or referral to an eye doctor). The data also identified two groups at greatest risk for abnormal vision status: premature and minority infants.
     To learn more about InfantSEE visit www.InfantSEE.org. 

Thanks to the support of the global optical profession, Optometry Giving Sight is co-funding the Schools of Optometry Program in Malawi. This exciting program aims to provide a sustainable solution to the deficit of skilled eye care personnel in Southern Africa by training local people to become optometric technicians and optometrists. It is funded in conjunction with implementing partners: the International Centre for Eyecare Education (ICEE), Sightsavers International, Mzuzu University and the Malawi College of Health Sciences.
     Over the next three years the program aims to train 40 optometric technicians and eight optometrists across two campuses in Malawi. This multiple entry and exit model will allow graduates from the diploma program to re-enter the system midway to gain the full degree qualification which will be recognized regionally. The program will create local employment and career paths for the eye care professionals themselves and access to eye care for people in need.
     In addition to training of eye care professionals the program will establish two optometry clinics.
     For more information on this and other Optometry Giving Sight programs, as well as information on how you can support these programs, please visit www.givingsight.org. 

Luxottica Group and drugstore.com, Inc. announced a strategic, multi-year ecommerce alliance to expand consumer online access to contact lenses in the North American market.
     Valerio Giacobbi, Executive Vice President, Business Development, Luxottica Group, commented: "This agreement is a key step in Luxottica's goal to increase consumers' awareness of contact lenses as an important vision care option. Together with annual eye exams and high-quality eyewear and sunglasses, contact lenses are an excellent alternative for total eye health in a way that suits consumer's differing lifestyles and needs."
     Under this exclusive agreement, Vision Direct, Inc., a leading online contact lens retailer and a wholly-owned subsidiary of drugstore.com, will collaborate with Luxottica Group to develop branded, contact lens ecommerce sites for the company's North American business, and provide customer care and fulfillment services. In addition the two companies will pursue synergies such as purchasing contact lenses on behalf of the alliance and plan to cooperate in a number of other related areas, including Luxottica's North America-based wholesale business.
     As of September 30, 2009, Luxottica operated 2,939 optical stores across North America, including LensCrafters and Pearle Vision. The new contact lens ecommerce services are expected to launch in mid-2010.

Global Specialty Lens Symposium, January 28-31, 2010, Bally's Hotel & Casino, Las Vegas
With an expert international faculty and a CE-accredited agenda, the 2010 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.
--ADVERTISING

During the 5th International Congress of Corneal Cross Linking for Keratoconus in Leipzig, Germany, Avedro, a privately held medical device company based in Waltham, MA, presented encouraging early clinical results for treating keratoconus. The procedure, known as Keraflex KXL, is non-incisional and reshapes the cornea without removing any tissue. Avedro is developing the science of Thermo-biomechanics for therapeutic medical applications. Keraflex KXL is currently under clinical investigation in Europe for treating myopia and keratoconus.    
     According to the company, because it is non-incisional and preserves the biomechanical integrity of the cornea, Keraflex KXL is anticipated to substantially broaden the surgical vision correction market by appealing to people with low to moderate myopia who have never considered LASIK or who have opted out of LASIK.
     Initial treatment results from the first group of Keraflex KXL patients, treated by Prof. Omer Faruk Yilmaz, MD of Beyoglu Eye Research and Training Hospital in Istanbul, Turkey, were presented by Prof. John Marshall, PhD, FRCPath, FRCOphthal (Hon), Emeritus Professor of Ophthalmology King's College London; and Dr. Peter Hersh, Professor of Ophthalmology UMDNJ, New Jersey Medical School and Director, Cornea and Laser Eye Institute, CLEI Center for Keratoconus in New Jersey. In their presentations, the doctors reported significant corneal flattening and improved corneal smoothness and regularity in all keratoconus subjects.
     Dr. Hersh remarked, "Keraflex KXL is a promising new technology to decrease the protruding cone of keratoconus and make the irregular cornea smoother. Our early experience shows improvements in the keratoconic cornea that we have not seen with past technologies. This should help improve vision in patients with keratoconus, a cornea problem that is difficult to correct, as well as improve contact lens wear and vision with glasses." Dr. Marshall added, "It has particularly important consequences for the treatment of keratoconus whereby not only can it flatten the cornea, it also has the potential for correcting associated refractive errors without any biomechanical weakening and most unexpectedly, it strengthens the cornea and should prevent or delay any further corneal distortion."
     For more information on Avedro, visit www.avedro.com.

The purpose of this study from a university-based academic practice in Ann Arbor, Michigan, was to determine whether corneal sensation and dry-eye signs and symptoms after myopic laser in situ keratomileusis (LASIK) surgery with a femtosecond laser are affected by varying hinge position, hinge angle, or flap thickness.
     This prospective randomized contralateral-eye study evaluated eyes after bilateral myopic LASIK with a femtosecond laser (IntraLase). Superior and temporal hinge positions, 45-degree and 90-degree hinge angles, and 100 mum and 130 mum corneal flap thicknesses were compared. Postoperative follow-up at 1 week and 1, 3, 6, and 12 months included central Cochet-Bonnet esthesiometry, the Ocular Surface Disease Index questionnaire, a Schirmer test with anesthesia, tear breakup time (TBUT), corneal fluorescein staining, and conjunctival lissamine green staining.
     The study evaluated 190 consecutive eyes (95 patients). Corneal sensation was reduced at all postoperative visits, with improvement over 12 months (P<.001). There was no difference in corneal sensation between the different hinge positions, angles, or flap thicknesses at any time point. The overall ocular surface disease index score was increased at 1 week, 1 month, and 3 months (P<.0001, P<.0001, and P = .046, respectively). The percentage of patients with a TBUT longer than 10 seconds was significantly lower at 1 week and 1 month (P<.0001).
     The researchers concluded that dry eye syndrome after myopic LASIK with a femtosecond laser was mild and improved after 3 months. Corneal flap hinge position, hinge angle, and thickness had no effect on corneal sensation or dry eye syndrome.
Mian SI, Li AY, Dutta S, Musch DC, Shtein RM. Dry eyes and corneal sensation after laser in situ keratomileusis with femtosecond laser flap creation Effect of hinge position, hinge angle, and flap thickness. J Cataract Refract Surg 2009;35:2092-8.

Last week I asked for comments about how you have incorporated consumer technologies into your practices. Several of you emailed me, but there is one comment that stands out that I want to share with you. 
     "I still like my poor man's retinal analyzer, the Amsler Grid."  Michael Molamphy, OD
The comment made me smile, but reminded me how important it is to keep perspective on our roots in the midst of the evolution of clinical practice.
Jason J. Nichols, OD, MPH, PhD, FAAO 

This month at www.siliconehydrogels.org: adverse events with daily wear of silicone hydrogels, SEALs with extended wear, controlling case contamination, contact lens complications, and part two of our AAO 2008 synopsis.