Although we have come a long way in the field of contact lenses, there are certainly lingering issues or questions that remain important to all of us. While we could enumerate many of them that we feel are important, we would like to hear from you. What do you feel are the most important issues facing the contact lens industry or your contact lens practice? Please email us at firstname.lastname@example.org.
Jason J. Nichols, OD, MPH, PhD
Allergan Announces Availability of Restasis MultiDose
Allergan plc announced the availability of Restasis Multidose, which is the same preservative-free Restasis formulation, but now offered in a multidose bottle. Restasis Multidose is an FDA-approved, preservative-free, prescription eye drop. Since its launch in 2003 until now, Restasis was accessible only in single-use vials.
Restasis helps increase your eyes' natural ability to produce tears, which may be reduced by inflammation due to chronic dry eye. Restasis Multidose is designed with a patented unidirectional valve and air filter technology. The new multidose bottle uses less plastic than a package of single-use vials and will be available for the same price.
Allergan offers eligible Restasis Multidose patients a savings program called My Tears, My Rewards, which helps patients save on each prescription. For more information on the savings program and to determine eligibility, visit www.Restasis.com/savings or call 844-4MY-TEARS.
CooperVision Joins The Vision Council
As part of its broad commitment to engaging and educating eyecare professionals on clinical and marketplace advances, CooperVision, Inc. has joined The Vision Council.
Jerry Warner, president, The Americas, CooperVision stated that the company believes it is essential for contact lenses to be represented in The Vision Council’s research, education, and advocacy efforts. As a contact lens company member, CooperVision looks forward to contributing its perspective and working alongside The Vision Council moving forward, according to the company.
One such opportunity for collaboration is on the issue of digital eye fatigue. For the past five years, The Vision Council has issued annual reports on the use of digital devices and the implications on visual health. CooperVision has actively worked over the last 18 months to raise awareness of digital eye fatigue as well through the launch of FightEyeFatigue.com, the facilitation of an educational radio media tour on World Sight Day, and appearances at the Consumer Electronics Show in 2016 and 2017 to discuss the topic with mainstream technology media. In June 2016, CooperVision launched Biofinity Energys lenses to help with eye tiredness and dryness, two key symptoms commonly associated with digital eye fatigue.
B+L Launches Ultra for Astigmatism, Announces Leadership Changes
Bausch + Lomb (B+L) has launched Bausch + Lomb Ultra for Astigmatism contact lenses, a monthly silicone hydrogel lens that combines MoistureSeal technology and OpticAlign design, engineered for stability to promote a successful first fit.
B+L says that the MoistureSeal technology helps to maintain 95% of lens moisture for a full 16 hours through a two-phase polymerization process. The OpticAlign design was developed after extensively analyzing, testing, and optimizing numerous lens geometries to determine which performed best with the Bausch + Lomb Ultra contact lens material. The design also features spherical aberration control optimized in both axes to help reduce halos and glare, according to B+L.
Bausch + Lomb Ultra for Presbyopia lenses are manufactured in samofilcon A (46% water) materials, which has a Dk/t of 114 at the center of a –3.00D lens. Parameters include 8.6mm base curve, 14.5mm diameter, spherical powers of plano to –6.00D in 0.25D steps, and cylinder powers of –0.75D, –1.25D, –1.75D, and –2.25D in axes of 10º to 180º in 10º steps. Spherical powers up to –12.00D will be available later this year.
In unrelated news, B+L announced several changes to its management team that the company says are designed to improve operational efficiencies and foster potential synergies to drive growth.
Joseph “Joe” Gordon, senior vice president and general manager, U.S. Consumer Healthcare, will expand his role to include the U.S. Vision Care business. Tracy Valorie, senior vice president and general manager, U.S. Pharmaceuticals, will also expand her role to include the U.S. Surgical business. Mr. Gordon and Ms. Valorie will be responsible for ensuring that their respective businesses achieve financial, marketing, and sales goals and objectives while increasing operating performance. They will also oversee business development, R&D, customer education, and training.
John Ferris, most recently the vice president of marketing for B+L’s OTC Vitamin portfolio, will serve as the vice president and general manager for U.S. Vision Care, reporting to Mr. Gordon. Mr. Ferris will be responsible for the day-to-day management of the business, driving all aspects of the U.S. contact lens portfolio. And, Chuck Hess, vice president and general manager for U.S. Surgical, will oversee the daily operations of the business, reporting to Ms. Valorie.
Tangible Science Announces First 16 Licensing Partners and Laboratories to Offer Tangible Hydra-PEG
Tangible Science, LLC announced the first set of licensing partners and authorized laboratory partners offering Tangible Hydra-PEG, its new contact lens coating designed to reduce discomfort. Tangible Hydra-PEG has been shown to improve wettability, increase surface water retention and lubricity, and minimize deposits on lenses, according to the company.
Tangible Hydra-PEG authorized laboratory partners in the United States include: AccuLens, Advanced Vision Technologies, Art Optical, Boston Foundation for Sight, GP Specialists, Metro-Optics, TruForm Optics, and X-Cel Specialty Contacts. International laboratory partners include: Blanchard Contact Lenses, Corneal Lens Corp NZ Ltd., Falco Lisen AG, Hetych, Northern Lenses, and Oftalmica Iovino Snc. Contamac is a global licensing partner and offers Tangible Hydra-PEG on its Optimum GP lenses. SynergEyes is also a global licensing partner and offers the coating on its Duette hybrid lens materials.
IKA to Partner with SLS
The International Keratoconus Academy of Eye Care Professionals (IKA), a collaborative optometric and ophthalmologic organization established to promote ongoing professional education and scientific development in the area of keratoconus and other forms of corneal ectasia, has announced its partnership and collaboration with the Scleral Lens Education Society (SLS), which was founded to educate contact lens practitioners on the science and art of prescribing all forms of scleral contact lenses.
Both organizations heavily support public education and professional development of corneal disease detection, advancing technology and surgical and non-surgical management. IKA and SLS consist of international experts, educators, and lecturers from private practice, academia, government, and research. They will cohesively work to further develop global best practices and clinical recommendations to provide eyecare providers the necessary tools and the most up-to-date resources to maximize patient success.
New Name for the American Academy Of Optometry’s Foundation
The American Optometric Foundation has officially changed its name to the American Academy of Optometry Foundation (AAOF). The foundation’s board of directors voted to change the name for the purpose of better aligning and branding the Academy’s foundation.
This year, the foundation celebrates 70 years. According to the foundation, its mission is to continue to develop and provide financial support for optometric research and education in vision and eye health to improve clinical patient care. To learn more about the organization and to stay apprised of the awards it administers, visit its website at www.aaopt.org/aof.
Prevent Blindness Declares April as Women’s Eye Health and Safety Awareness Month
According to the Prevent Blindness study, The Future of Vision: Forecasting the Prevalence and Costs of Vision Problems, more women than men have eye disease, including age-related macular degeneration, cataracts, and glaucoma, and it predicts that these numbers will only continue to increase in the years to come.
Prevent Blindness has designated April as Women’s Eye Health and Safety Month in an effort to educate women about the steps they can take today to help preserve vision in the future. For the second straight year, OcuSoft Inc., a privately held eye and skin care company dedicated to innovation in eyelid hygiene and ocular health, has partnered with Prevent Blindness to help spread this message. OcuSoft will again donate 10% of all online sales during April’s Women’s Eye Health and Safety Awareness Month to promote the education of eye safety and wellness among women.
Additionally, Prevent Blindness has created See Jane See: Women’s Healthy Eyes Now to provide free education and resources on everything from eye disease to cosmetic safety to vision changes during pregnancy. Valuable information and new data on a range of topics related to women’s vision health at every life stage can be found at SeeJaneSee.org. In addition, the site also features a section written by leading experts on a range of topics from the importance of eye exams to the effects of smoking on vision.
What percentage of your contact lens dropouts do so because of contact lens discomfort?
Celia de Lourdes Feliciano, OD, Santa Isabel, Puerto Rico
A patient came into my office because she had been suffering from blurred vision, tearing, photophobia, and ocular pain for several days. After examination, she was diagnosed with herpes simplex keratitis. The patient was referred to a cornea specialist, and I did the follow up. Because she had a big dendrite, I titled the picture “Medusa in the cornea.”
We thank Celia de Lourdes Feliciano for this image and 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 a detailed explanation of the photo and your full name, degree or title, and city/state/country.
CARE SOLUTION CORNER
Ralph Stone, PhD – Guest Columnist
The March 17 Combined Meeting of the Ophthalmic Device Panel and the Risk Communication Advisory Committee
On March 17, the U.S. Food & Drug Administration held a joint meeting between the Ophthalmic Device Panel of the Medical Devices Advisory Committee and the Risk Communication Advisory Committee to discuss the apparent increases in misuse-related adverse events reported with hydrogen peroxide care systems, according to a review over 2015 and 2016. The data presented to the panels indicated a total of 370 reports of misuse since 2007, with about half occurring in 2015 and 2016.
Forty-five percent of patients reported accidental exposure to hydrogen peroxide solution, and another nearly 29% admitted to failing to follow the neutralization step. Ten percent admitted purchasing the wrong product. They also determined that while exposure of hydrogen peroxide in the eye was painful, the long-term clinical outcomes were relatively minor, with the FDA reporting that 57% reported burning sensation and 50% reported chemical eye burns. Another 21% reported hyperemia, superficial punctate keratitis, injection, or epithelial erosion. Nearly 90% either didn’t report on the recovery or recovered from the insult. Even panel members who use peroxide systems for lens care reported that they had had misuse experiences that were unreported. They agreed that most exposure resolves without sequelae.
It raises the question of what can be done to address the events caused by misuse. The general discussion from members of the panel indicated that they felt that the reports of misuse of peroxide systems, although under-reported, were relatively rare. However, it does raise cause for concern. The objective was to discuss additional measures to mitigate the potential risk of these exposures. To that end, the panel discussed various questions regarding current labeling, strategies to reduce risk during purchase, strategies to reduce risk once purchased, and ways to promote improved compliance.
The main takeaway from the meeting was that eyecare practitioners can do a better job in their communication to patients. However, given the paucity of data indicating that these misuse events cause a significant health risk, the panel agreed that more extensive measures are not needed. Several panel members noted that providing a substantial educational campaign on an issue that does not result in adverse sequelae detracts from the attention of patients and practitioners regarding compliance issues that do have potential for lasting ocular effects.
MATERIALS & DESIGNS
David L. Kading, OD
No One Have Ever…
We all know those patients who just aren’t happy. The “my vision is so crisp in my glasses but no one can get my contact lens vision as good as it is with glasses” patients. The “needy patients” who should stop complaining; they see 20/20 with their contact lenses, and you just want to ask “What’s your problem?”
When we refract these patients, they might have a half a diopter or maybe even three-quarters of a diopter of cylinder. However, they have never tried wearing toric contact lenses because prior practitioners never thought those lenses were ideal for them.
I believe that we all run the gamut from sane to crazy, and we are all a little weird. From the acceptance of “good vision” to the need for “crisp vision,” we all find ourselves somewhere along this spectrum. Frankly, a patient who wants clear vision may just be on the spectrum of desiring crisp vision, and it is probably not that much to ask.
If our patient in question really has some low amount of astigmatism, finding the solution may be easier than we think. In addition to our readily available soft toric lenses on the market that correct for –0.75D of cylinder, we also have lenses that go down to –0.50D of cylinder available to us. Although we may not elect to use them on hundreds of patients each year, those lenses may be just what the practitioner (and patient) ordered for a patient who has –0.50D or –0.75D of cylinder.
Now, I know what we are all thinking: “Really? Correct someone who has low cylinder like that? What a hassle. They can suck it up. That much cylinder isn’t that much of a big deal.” You may be right, but you may “not a big deal” yourself out of contact lens wearers as they seek a good provider who can fix their problem.
When a patient tells us “no one has ever…,” it’s best to make sure they don’t continue saying that when they leave your office.
A Link Between Tear Breakup and Symptoms of Ocular Irritation
In this study, the authors used the presence or absence of a soft contact lens (CL) as a barrier to test the hypothesis that tear breakup (TBU) presents a direct noxious stimulus to the ocular surface.
Ten subjects kept one eye open as long as possible–termed sustained tear exposure (STARE)–for 10 consecutive trials while discomfort was monitored with and without a CL in place. The area of TBU was quantified in each frame. Discomfort was measured during and after each STARE trial, and symptoms of ocular irritation were assessed before and after all testing.
The study found that TBU increased at the end of trials to an average of 19.89% ± 17.91% and 20.58% ± 15.33%, and discomfort increased to 9.09 ± 1.44 and 1.97 ± 2.19 in trials without and with a CL, respectively. Discomfort was significantly higher during trials without CLs (Friedman test, p < 0.005), but there was no significant difference in the area of TBU between trials (Friedman test, p = 0.296) with and without a CL (Friedman test, p = 0.527). Discomfort after each STARE trial increased significantly across trials (Friedman, p < 0.005). Symptoms of ocular irritation increased significantly from pre- to post-testing (Wilcoxon signed rank test, p < 0.005).
The authors concluded that TBU during STARE trials was associated with increasing ocular discomfort, which was partially blocked by wearing a CL, supporting the hypothesis that TBU directly stimulates the corneal surface. Repeated STARE trials led to increasing discomfort and dry eye–like symptoms of ocular irritation, suggesting that repeated bouts of TBU can lead to alterations in ocular surface sensory processing.
Zhang J, Begley CG, Situ P, Simpson T, Liu H. A link between tear breakup and symptoms of ocular irritation. Ocul Surf. 2017 Mar 6. [Epub ahead of print]