CONTACT LENSES TODAY

December 21, 2003

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches nearly 10,000 readers in 74 countries.

Cummings to Replace Yamane
Vistakon recently announced that it has appointed J. Patrick Cummings, OD, FAAO, as the company's new vice president of Professional Affairs. He will replace Stan Yamane, OD, FAAO, who is set to retire on April 30, 2004 after spending 12 years at Vistakon. Dr. Yamane has been the leader in many professional organizations including the American Academy of Optometry Section on Cornea & Contact Lenses. Dr. Cummings has been an active member and leader of many professional organizations, and was twice named the Wyoming Optometrist of the Year.

Americans Concerned About CVS
A recent telephone survey of 1,020 adults conducted by Opinion Research Corporation in partnership with the Computer Vision Syndrome (CVS) Information Center for the American Optometric Association has found that a majority (61%) of Americans are concerned about vision problems caused by prolonged computer use. According to the survey, people feel that CVS is a major vision problem and 64% believe that it will worsen in the future. The survey was designed to examine current consumer opinions on vision, computers and the workplace. More than two-thirds (67%) of respondents also thought that CVS could affect routine activities such as driving home from work. Also, 54% of respondents believe that employers aren't aware of CVS and the risks that employees face of developing the symptoms based on how much time they spend working on computers each day.

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Menicon Widens Availability
Menicon America, Inc. is strategically expanding its distributor network to make its Menicon Z GP lens and other products more widely available to U.S. practitioners. The company's U.S. manufacturer and distributor, Con-Cise Contact Lens Co., has appointed six strategically located labs (ABB Optical in Massachusetts and Florida, Diversified Ophthalmics in Ohio, Firestone Optics in Missouri, Mid-South Premier Ophthalmics in Tennessee, TruForm Optics in Texas and Westlens in Utah) to distribute the Menicon Z line of Hyper Dk/t GP lenses. Menicon's new intensive protein remover/disinfection solution (Progent) for professional in-office use is now available through Con-Cise and these distributors.

CooperVision Wants You to Talk to Patients
CooperVision, Inc. recently conducted patient studies and found that one out of two contact lens patients can't make it through a normal work day without experiencing lens discomfort. The studies also revealed that 71% of patients believe that all contact lenses are alike and that there's not much their doctor can do to improve their comfort. Also that patients are worried that their doctor will tell them to stop wearing their lenses if they complain about discomfort. Because of these and other findings, CooperVision will launch a new marketing campaign for their Proclear brand of contact lenses next month. The campaign will carry the theme "Get the Conversation Going" to encourage eyecare practitioners to talk to their patients about contact lens comfort. It will consist of a new trade advertising theme centered on "Get the Conversation Going," a new patient demonstration tool and new in-office promotional materials.

Survey Results on Soft Toric CL Fitting
In a recent (November 2003) CIBA Vision study of 159 practitioners, 82% of respondents said that they charge a premium fitting fee for soft toric contact lenses. Fifty-six percent of respondents said that at least 51% of their astigmatic patients wear monthly lenses. Forty-two percent of practitioners said that they begin actively recommending toric lenses to patients at around 0.75D of refractive astigmatism, 46% say they do so at around 1.00D and 6% say they wait until around 1.25D. Four percent say they start recommending torics when a patient tells them that he doesn't see as well with contact lenses as he does with eyeglasses.

New Gloves Enter the Market
The FDA has granted clearance to Cardinal Health for its new line of medical gloves made with an emollient (Neu-Thera) that's proven to clinically improve skin health and protect hands from irritation. According to the company, the gloves are the first to be manufactured with a proprietary formula that protects, restores, moisturizes and soothes hands. Esteem synthetic exam gloves are made from nitrile, which is known for its chemical resistance, barrier integrity, elasticity and strength.

Abstract: Comparing Endothelial Bleb Formation in Different Lens Types
In comparing corneal endothelial bleb formation and disappearance processes between GP and soft contact lenses in the same class of oxygen transmissibility, researchers found no difference in influence on the corneal endothelium between the two types of lenses with similar Dk/L in the high and hyper classes. Ten nonwearers of contact lenses kept their eyes closed for 20 minutes after putting on one of six kinds of GP lenses or soft lenses (hyper Dk/L, high Dk/L and medium Dk/L) in each eye. The researchers examined each of the subjects' eyes for blebs every five minutes starting just after eye opening using specular microscopy. They also calculated the percentage area of the blebs. For control, the researchers examined the same eyes without contact lenses. They also found that in the medium Dk/L class, GP lenses may have less of an impact on the corneal endothelium than do soft lenses.

Inagaki, Y; Akahori, A; Sugimoto, K; Kozai, A; Mitsunaga, S; Hamano, H. Comparison of Corneal Endothelial Bleb Formation and Disappearance Processes Between Rigid Gas Permeable and Soft Contact Lenses in Three Classes of Dk/L. Eye & Contact Lens 2003. Oct;29(4):234-237.

Editor's Commentary: CVS and CL Wear
In our area, CVS is a pharmacy chain, but in the larger context, CVS refers to computer vision syndrome, the cluster of responses to too much improper body and eye stress from computer use. For me, it ranges from dry eye to tension headaches and inducing my intermittent exotropia. My colleague at Ohio State, Jim Sheedy, OD, PhD, is an expert on the subject and has taught me a lot about it. My experience is that although many concentric soft and GP and alternating vision GP contact lens designs can be helpful, the best solution for the contact lens wearer for cmoputer use is aspheric soft or GP multifocals.

Fitting Tip: Corneal Distortion Adds Up to Poor Refraction
In cases where I obtain a poor subjective refraction with a contact lens wearer, I suspect possible corneal distortion, which you can easily miss with biomicroscopy and fluoroscein evaluation. Even though I suspect that corneal distortion secondary to oxygen deprivation may be involved, it's nice to have an objective measure of this. In these cases, I've found corneal topography extremely helpful. The corneal irregularity measure will often be higher than one standard deviation from normal while other indices are normal.
This not only substantiates my suspicions for the need for corneal rehabilitation, it also allows me to demonstrate directly to the patient the issue at hand. It allows me to explain the need for a change to a higher-Dk material and or to re-address any compliance concerns that I may have.
--Dean T. Bryan, OD
Lakewood, Colo.

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