The Vision Care Institute, LLC, an affiliate of Johnson & Johnson Vision Care, Inc. has achieved a major milestone with 100,000 eyecare professionals attending courses throughout its network of 14 sites worldwide.

Launched in 2004, The Vision Care Institute was a first-of-its-kind learning destination and has remained the only institution of such magnitude sponsored by a vision care company. It has evolved from one institute in the U.S. to sites across four continents. To date, there have been over 4,000 courses taught by 257 faculty members in 30 languages to accommodate attendees from 56 countries.

The Vision Care Institute in Jacksonville, Fla. opened in 2004 and has offered about 280 classes to date.

Through both lectures and hands-on training, attendees improve technical skills, expand clinical knowledge, and gain new patient communication skills and management techniques, all of which can have a measurable effect on their practice and patient outcomes. Today, a wide range of pioneering techniques are employed at The Vision Care Institute from electronic headgear that demonstrates eye movement and contact lens stability, to the use of mannequins to show UV exposure to the eyes. In other classes, simulation software provides coaching on patient communications.

For more information, please visit www.thevisioncareinstitute.com.

The MSD Corporation, the owners of msd scleral contact lens design, announced two new global partnerships: Ortolens in Serbia/Croatia and Happy Vision in Korea. These new partners join the company’s existing network which includes Blanchard Contact Lens in the USA, and Les Laboratories Blanchard and Cardinal Contact Lens in Canada.

Receiving KFDA approval in the Korean market is a milestone for the company. These partner companies will strengthen the brand in all international markets and continue to establish MSD as a leader in scleral lens technology.

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TFOS and CLD

The Tear Film and Ocular Surface Society (TFOS) recently reported on their International Workshop on Contact Lens Discomfort (CLD), chaired by our editor Dr. Jason Nichols, in multiple publications in Investigative Ophthalmology and Visual Science. This effort took 18 months and 79 experts to complete, and resulted in an excellent evidence-based report on various aspects of CLD. One subcommittee focused on contact lens materials, design and care.¹ This paper is an amazingly comprehensive literature review of how contact lens materials and designs impact CLD. Though there is a wealth of information on these various aspects, the paper summarizes how difficult it is to pinpoint the actual causes of CLD because there are so many possible reasons why contact lenses are not comfortable. For example, some obvious factors include lens modulus, surface dehydration, friction and lubricity, lens movement, and edge design, but their effects are difficult to isolate in well-controlled studies. This paper raises some good research ideas that will hopefully help us better manage patient complaints of discomfort. It is a great read for any contact lens fitter who thinks about how to best provide the most comfortable lenses for their patients.

Jones L, et al. The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Materials, Design, and Care Subcommittee. Invest Ophthalmol Vis Sci. 2013 Oct; 54(11): TFOS 37-70.

Microbial Analyses of CL-Associated Microbial Keratitis

Fortunately, most cases of contact lens microbial keratitis that are caught early respond well to monotherapy with modern fluoroquinolones and don't require culture. However, when the infection does not respond to therapy or when the infiltrate is large and/or central, corneal cultures are often required. Negative cultures in cases of presumed microbial keratitis are not uncommon and complicate the treatment plan. A recent study from patients at the L.V. Prasad Eye Institute in India sheds some new light on this topic.

The authors performed a retrospective study of 125 eyes presenting with presumed infectious keratitis associated with contact lens wear over a 10 year period. Among the samples tested, positive cultures were obtained 40% of the time from the cornea, in 92% of the cultures from the worn contact lenses, and in 80% of the lens case cultures. Whenever corneal cultures were positive and data existed for cultures of the lenses and storage cases, contact lenses yielded the same microbes as the cornea in 94% of eyes, and storage cases yielded the same microbes as the cornea in 77% of eyes. Importantly, these were monocultures of the same microbe isolated from the cornea in the contact lens and lens case cultures. The odds of having a positive corneal culture were 37 times higher when patients presented to the clinic two weeks after the onset of symptoms.

This data is striking and speaks to routine contact lens cultures as being perhaps more valuable than corneal cultures in cases of suspected microbial keratitis. Routinely gathering and culturing the lens worn at the time of the event may be more cost effective than waiting for potentially inconclusive corneal cultures.

Konda N, Motukupally SR, Garg P, Sharma S, Ali MH, Willcox MD. Microbial Analyses of Contact Lens-Associated Microbial Keratitis. Optom Vis Sci. 2013 Nov 7. [Epub ahead of print]