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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO
I am often surprised how frequently we don’t try new things—in terms of contact lens material and design options. Perhaps we are all stuck in our ways, but I think it is important to step out of the box. I am very proactive in teaching students, interns and residents that they should be constantly trying new contact lens options in their patients. If nothing else, we can often learn how easy or better a new option might be. And, ultimately this would no doubt be of benefit to our patients.

Unilens Introduces C-Vue ADDvantage
Unilens Vision Inc. announced the launch of its new disposable C-Vue ADDvantage Multifocal for Presbyopia contact lens in silicone hydrogel material for monthly replacement. According to the company, the new product incorporates Unilens’ highly advanced next-generation multifocal contact lens design technology, which allows for ease of fit by providing a consistent near ADD power across all power profiles, ultimately resulting in clear vision for presbyopes at all distances. The lens is also thinner and more rounded at the edges for comfort.

The new lens for monthly replacement, which is available in a High and a Low ADD, and power ranges from +6.00 to -10.00, incorporates an aspheric design with a consistent center ADD power across all power ranges. The lenses will be sold exclusively to independent eyecare professionals. Unilens will provide eyecare professionals with an attractive and user-friendly display cabinet and trial program with a 120-Day Performance Guarantee on the lenses.

For more information, visit www.unilens.com.
Sattler Retires from Alcon
Industry veteran Dave Sattler, FAAO will retire from Alcon effective August 2, 2014 after 28 years of service. Dave’s most recent role has been Director Professional Relations, overseeing academic development for U.S. Vision Care. In this role, Dave strengthened Alcon’s ties to optometry schools and colleges. He also worked with the Alcon Foundation, the city of Fort Worth and two optometry schools in Texas to help establish an eye clinic for the underserved in downtown Fort Worth.

Dave’s career with Alcon began in 1986 as a sales representative in San Diego, CA. He held a number of positions of increasing responsibility including National Account Manager, District Sales Manager and Director of National Accounts. In 2008 he assumed the role of Director Professional Relations – Global Optometry and in 2010 peer-to-peer professional marketing was added to his list of responsibilities. In 2011 he took on his current role working with the optometry, ophthalmology and optician academic community. Over the years, Dave has collaborated with key opinion leaders, professional associations, academic institutions and he participated in countless national conventions and education programs in the contact lens, lens care, ocular pharmaceutical and surgical areas.

Dave is a Fellow of the American Academy of Optometry and is currently serving as a volunteer board member for the American Optometric Association’s Foundation and The Pennsylvania College of Optometry Advisory Board.

After Dave’s retirement, Tom Duchardt will step in to lead the academic development initiatives for Alcon U.S. Vision Care.
ONS Educational Symposium Scheduled
The Ocular Nutrition Society (ONS) continues its tradition of assembling the top researchers in nutrition science to present at their 13th educational symposium. This year, speakers from around the Rocky Mountain area will converge in Denver to offer in-depth research into the role of nutrition in treating and preventing ocular disease.

Scientists from several prestigious institutions will present the latest science, ranging from dietary influences on ocular disorders to the role of carotenoids in ocular function to the recent ocular research studies. ONS members and all attendees of the Academy are welcome to participate in this day-long forum. The program this year is free for ONS members, so consider joining up now!

The symposium will be on November 11, 2014 at the Denver Convention Center, in conjunction with the American Academy of Optometry meeting.
More details are available at www.ocularnutritionsociety.org.
NIH Grant for BLINK Study
Investigators at University of Houston (UH) and The Ohio State University (OSU) Colleges of Optometry were awarded grants from the National Institutes of Health (NIH) National Eye Institute, worth approximately $7.5 million over five years. The Bifocal Lenses In Nearsighted Kids (BLINK) Study is a multicenter randomized clinical trial that will follow nearly 300 children over the course of three years.

Children 7 to 11 years old will be enrolled and randomly assigned to wear soft contact lenses with no reading power, soft contact lenses with medium reading power or soft contact lenses with high reading power. The investigators will measure the length of the eye and the amount of nearsightedness to determine whether light focused by the reading power of the soft bifocal contact lenses in front of the retina will result in slower eye growth and, thus, slower progression of nearsightedness.

Members of the study team are BLINK Study chair and OSU associate professor Jeffrey J. Walline, OD, PhD; OSU professor Donald O. Mutti, OD, PhD, the Clinic Principal Investigator at OSU; David A. Berntsen, OD, PhD, the Clinic Principal Investigator at UH; and Lisa A. Jones-Jordan, PhD, the Director of the Data Coordinating Center at OSU.

The investigators plan to begin enrollment this summer and complete recruitment within one year.

CooperVision Sponsors Professional U.S. Triathlete
Following CooperVision’s sponsorship of three Team Great Britain athletes in the U.K., including a half pipe skier, ice hockey player, and mogul skier, CooperVision, Inc. is sponsoring Steven Rosinski, who is not only a nationally ranked professional triathlete, but a practicing Doctor of Optometry.

Steve’s triathlon career began while he was studying for his Doctorate in Optometry at The Ohio State University. He finished eighth in the 2010 Collegiate Triathlon National Championships. Upon graduating in 2011 with his doctorate, Steve made the decision to dedicate himself to his training and racing and in doing so, earned his Elite Triathlete license within a year. In 2013, Steve completed his first full season as a professional. This year, he has high hopes for qualifying for the Ironman 70.3 world championships.

To follow Steve and his race season, visit his website at http://www.steverosinski.com or follow him on Twitter @steverosinski.

Visionary Optics Extends Consultation Hours
Visionary Optics, the manufacturer of the Jupiter and Europa brand of Scleral contact lenses, has extended their consultation hours. In an effort to better assist our accounts in all time zones, our consultants will be available until 7pm Eastern on Tuesday, Wednesday and Thursday. Accounts may continue to utilize the order forms on their website and email after business hours. For additional information on Jupiter or Europa Scleral lens designs, contact Visionary Optics at 1-877-533-1509 or www.visionary-optics.com.

Contact Lens After Two Years Continuous Wear
Krishnendu Mandal, MOptom, Hydrabad, India
This is a case of a 29 year-old male patient who was wearing the same prosthetic soft contact lens for two years without removing and cleaning of lens. The images show protein and lipid deposition on contact lens surface.

We thank Krishnendu Mandal 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 http://www.cltoday.com/upload/upload.aspx 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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CARE SOLUTION CORNER
Susan J. Gromacki, OD, MS, FAAO

Report from the Ophthalmic Devices Panel of the Medical Devices Advisory Committee
Despite new lens materials and solutions, the FDA has not updated its guidance since 1997 – seventeen years ago. On May 13, 2014, I had the privilege of representing the American Academy of Optometry at the FDA-convened Ophthalmic Devices Panel of the Medical Devices Advisory Committee. The purpose of the meeting was for the FDA to present its proposed changes to the Contact Lens and Care Product Guidance Documents and to ascertain input from the panel, which included optometrists, ophthalmologists, scientists, and consumer and industry representatives.

Members of the FDA spoke on their organization’s proposed changes in the following topical areas:

1. Grouping scheme for silicone hydrogel lenses
2. Clinical test matrix for contact lens care products with silicone hydrogel lenses
3. Screening solutions for lens preservative uptake and listing incompatible lenses in solution labeling.
4. Testing under “real world” conditions, including adding soil; extending the soaking time; and measuring lens uptake.
5. The use of water with gas permeable (GP) lenses.

I will discuss these topics in greater detail in my next column.

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OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD, FAAO
Meibomian Gland Loss Secondary to Trabeculectomies
In my practice, we have a very large number of patients referred for glaucoma: many cases are recalcitrant to treatment. Our glaucoma surgeon has performed thousands of successful trabeculectomies. In all likelihood, many of these patients spent years using multiple glaucoma medications, known to compromise the environment of the ocular surface.

Mitomycin C, a chemotherapeutic used at the time of trabeculectomy surgery, helps prevent scarring that causes bleb failure by inhibiting fibroblast proliferation. A recent study from Japan investigated meibomian gland loss secondary to trabeculectomies with mitomycin C.

This cross-sectional observational case study used a mobile pen-shaped noncontact meibography system to access the morphology and determine loss of the meibomian glands. Meibomian gland loss was scored in the bleb-contacting and bleb-noncontacting upper eyelid areas in the primary position and in the lower eyelid. The median duration from trabeculectomy to examination was 7.4 years. The results of this study demonstrated that blebs after trabeculectomy with MMC may be the cause of meibomian gland loss, particularly when the bleb is avascular. The authors suggest that the presence of an avascular bleb warrants extra vigilance for decreased meibomian gland secretions because this decrease can lead to tear dysfunction and ocular surface damage, including bleb-wall damage.

Sagara H, Sekiryu T, Noji H, Ogasawara M, Sugano Y, Horikiri H. Meibomian gland loss due to trabeculectomy. Jpn J Ophthalmol. 2014 May 24. [Epub ahead of print]

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A Randomized Controlled Trial Comparing SCL and RGP Lens Wearing in Infantile Nystagmus

The objective of this study was to perform the first randomized controlled trial comparing soft contact lens (SCL) with rigid gas-permeable lens (RGPL) wearing in infantile nystagmus (IN), using spectacle wear as a baseline.

This was a randomized, controlled cross-over trial with an intention-to-treat design. The study included a total of 24 participants with IN (12 idiopathic, 12 with albinism). Participants were randomized into one of two treatment arms receiving the following sequence of treatments (2-3 weeks for each treatment): (A) spectacles, SCL, RGPL, and spectacle wear; or (B) spectacles, RGPL, SCL, and spectacle wear.

The main outcome measure was mean intensity of nystagmus at the null region viewing at 1.2 m. Secondary outcome measures included the same measure at 0.4 m viewing and across the horizontal meridian (measured over a ±30° range at 3° intervals) for distance and near. The nystagmus foveation characteristics were similarly assessed over ±30° and at the null region at 1.2 m and 0.4 m viewing. Visual outcome measures included best-corrected visual acuity (BCVA) at 4 m and 0.4 m, gaze-dependent visual acuity (GDVA) (i.e., visual acuity when maintaining gaze angles over a ±30° range at 10° intervals) at 4 m, and reading performance at 0.4 m derived from the Radner reading chart.

There were no significant differences between SCL and RGPL wearing for any nystagmus characteristics or compared with spectacle wearing. The BCVA, reading acuity, and critical print size were significantly worse for SCL wearing compared with RGPL and baseline spectacle wear (P<0.05), although mean differences were less than 1 logarithm of the minimum angle of resolution (logMAR) line.

The researchers concluded that nystagmus was not significantly different during SCL and RGPL wearing in IN, and contact lens wearing does not significantly reduce nystagmus compared with baseline spectacle wearing. The wearing of SCL leads to a small but statistically significant deterioration in visual function compared with both RGPL and spectacle wearing at baseline, although mean effect sizes were not clinically relevant.

Jayaramachandran P, Proudlock FA, Odedra N, Gottlob I, McLean RJ. A Randomized Controlled Trial Comparing Soft contact lens and Rigid Gas-Permeable Lens Wearing in Infantile Nystagmus. Ophthalmology. 2014 May 6. [Epub ahead of print]


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