Controversy is ubiquitous and seems inescapable in this age of 24-7 connectivity. And, as much as clinical science has advanced our evidence-based knowledge that guides clinical care, there are still holes in this knowledge that remain unanswered. This certainly is true as it relates to the care of contact lens patients. What controversies do you find most relevant as they relate to the practice of contact lenses today? We would love to hear your thoughts—please email me directly at (firstname.lastname@example.org.).
Jason J. Nichols, OD, MPH, PhD
Call for CE Courses for GSLS 2020
The Global Specialty Lens Symposium (GSLS) Program Committee invites you to submit one-hour continuing education courses for consideration for the GSLS 2020, which will take place in Las Vegas from January 22 to 25, 2020. Course submissions can cover all aspects of contact lenses (such as materials, designs, lens care) in addition to related topics such as corneal and ocular surface disease, diagnosis and treatment approaches, and practice management. Submissions must be received by 5:00pm ET on May 10, 2019.
Visioneering Technologies, Inc. Creates Educational Series for Eyecare Practitioners
Visioneering Technologies, Inc. has created a new educational series for eyecare practitioners featuring some of the world’s leading researchers and clinicians.
The first installment of the video series highlights the following speakers and topics: Prof. Earl Smith – Impact of Eye Growth, Disease States; Dr. Nicola Anstice – Contact Lenses and Safety with Children; Prof. Padmaja Sankaridurg – Future Prevalence and Implications of Myopia; Dr. Kate Gifford – Helping Parents Manage Childhood Myopia; and Dr. Sally Dillehay – Disease States and Impact of Genetics. The educational series is free and can be accessed at https://vtivision.uk/practitioners/educational-video-series/.
Future video installments will include more on managing children and presbyopic adults in practice and will feature Prof. Lyndon Jones, Dr. Tom Arnold, Dr. Jeff Cooper, Dr. Brett O’Connor, and Dr. Tom Aller, among others.
GMAC Provides Progress Update
The Global Myopia Awareness Coalition (GMAC), which was formed in January 2019 and operates as an advisory board under the World Council of Optometry, already has 11 corporations committed to its efforts. These include Alcon, CooperVision, Essilor, Euclid Systems Corporation, Hoya, Johnson & Johnson, Menicon, Nevakar, Oculus, SightGlass Vision, and Visioneering Technologies.
Message development is underway, including preliminary conversations with communications and creative partners to help shape the narrative. GMAC has also initiated dialog with other prominent industry organizations such as the American Optometric Association, the International Agency for the Prevention of Blindness, and the Vision Council, to better align, complement, and coordinate ongoing efforts.
Novabay Pharmaceuticals Announces New Partner Pharmacy Program
NovaBay Pharmaceuticals, Inc. announced a new pharmacy partnering program and has added six new pharmacies as Avenova channel partners. The company’s pharmacy partners serve patients across the United States and together ensure that patients in all 50 states have convenient access to Avenova.
New England College of Optometry Inaugurates New President
The New England College of Optometry (NECO) inaugurated Dr. Howard B. Purcell as president. Dr. Purcell is the 13th president in the college’s 125-year history. He is a graduate of the program, continuing the legacy of his father, Saul Purcell, OD ’54.
In outlining his strategic priorities for the college, Dr. Purcell said he plans to diversify revenue; nurture diversity, equity, and inclusion; expand continuing education and specialized degree programs; collaborate with industry; and find ways to best support and prepare NECO’s students for whatever changes may arise.
Alcon Launches Project Presbyopia
Alcon is launching Project Presbyopia, an ongoing effort to educate consumers about how to recognize signs and symptoms of vision changes that occur after age 40, uncover more intuitive language for the condition, and motivate existing and emerging presbyopes to visit an eyecare professional (ECP) to explore options including multifocal contact lenses.
Alcon will reach consumers and ECPs with content designed to help close the awareness gap, including video content testing everyday people’s knowledge of presbyopia, its pronunciation, meaning, and management options as well as suggestions for renaming the condition to make it easier to understand. The company will also offer a 40th birthday e-card to help ECPs creatively engage their patients at the outset of symptoms in a conversation around the condition. In addition, Alcon has formed a partnership with Dr. Susan Resnick, who will make media appearances to encourage people who are aged 40+ to speak with their ECPs about multifocal contact lens options.
Do you feel that it is necessary to have an optical coherence tomography (OCT) image to fit scleral contact lenses?
Your Interesting Case Photo Here in the Next Issue
Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in Contact Lenses Today in the coming weeks!
We welcome photo submissions from our readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit . 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
Bandage Contact Lenses for Therapeutic Use
Contact lenses for dry eyes can be confusing to today’s practitioners. For many practitioners, the primary goal is to prevent contact lens dropout, and a large part of our day may be consumed with educating patients on new technologies that can help with contact lens discomfort. On the flip side, for severe ocular surface disease, practitioners tend to default to scleral contact lenses for this demographic. The dilemma is what to do for those patients who do not note relief from scleral lens use. In many of these cases, don’t discount the idea of a bandage contact lens (BCL) for “therapeutic” relief.
Bandage contact lenses have been widely applied in ocular surface diseases. These lenses are used for corneal diseases and following ocular surgery. Specific indications such as non-healing epithelial defects, post-refractive surgery, and to protect the ocular surface following corneal transplantation are the most common indications.1-3 The primary goal in these cases is to promote corneal wound healing and to mitigate photophobia.4 However, this type of lens may be used as therapy in some unusual cases in which a patient has been diagnosed with dry eye but the symptoms exceed the signs or the patient has failed with common palliative treatments. While it may not be the first line of choice, I have found soft lenses to be useful when a scleral lens does not help.
1. Choi JA, Chung SH. Combined application of autologous serum eye drops and silicone hydrogel lenses for the treatment of persistent epithelial defects. Eye Contact Lens. 2011 Nov;37:370-373.
2. Lee YK, Lin YC, Tsai SH, Chen WL, Chen YM. Therapeutic outcomes of combined topical autologous serum eye drops with silicone-hydrogel soft contact lenses in the treatment of corneal persistent epithelial defects: A preliminary study. Cont Lens Anterior Eye. 2016 Dec;39:425-430.
3. Lloyd-McKernan A, Simo ML, O’Dwyer V. The effect of previous soft contact lens wear on corneal refractive surgery outcomes. Cont Lens Anterior Eye. 2017 Oct;40:301-310.
4. Arora R, Jain S, Monga S, Narayanan R, Raina UK, Mehta DK. Efficacy of continuous wear PureVision contact lenses for therapeutic use. Cont Lens Anterior Eye. 2004 Mar;27:39-43.
MATERIALS & DESIGNS
David L. Kading, OD
Astigmatism? No Problem
As a reminder, patients who have astigmatism can wear contact lenses too. I know, it is hard to believe, but they can. I still have patients showing up who tell me that they have been told that they cannot wear contact lenses because they have astigmatism. When I share that there are great options, they seem to argue with me in an effort to convince me that they have resigned themselves to the idea. Well, they might have, but I haven’t.
Every major contact lens manufacturer has a toric lens in its flagship frequent replacement lenses as well as in its daily disposable lenses. Patients who have astigmatism greater than 3.0D are still in luck as well. There exist monthly replacement lenses that come in high cylinders and around-the-clock axes. There also are custom-made lenses that can be manufactured and delivered in a few days; I often observe that my custom lenses arrive faster than my high-cylinder monthly replacement lenses do.
Too much instability? Well, there are options for that. Lenses can be custom made in a variety of base curves and diameters to bring about stability.
Still not happy? Let’s go GP. Scleral and corneal lenses alike bring about a crispness of vision to even the most complex astigmats.
In case you forgot or recently refused lenses to an astigmatic patient, your reasons have shrunk to nearly nothing. Fit the astigmats, they will thank you.
Efficacy and Safety of Wet Wipes Containing Hy-Ter Solution Compared with Standard Care for Bilateral Posterior Blepharitis: A Preliminary Randomized Controlled Study
Researchers have proposed a novel treatment for posterior blepharitis that involves the use of disposable wet wipes infused with a solution of terpinen-4-ol and hyaluronic acid (Hy-Ter) as well as aloe, natural anti-inflammatories, and antiseptics (Blephapad Combo, Novelty Technology Care). The aim of this study was to compare the efficacy and safety of treatment with Blephapad Combo to standard treatment.
The researchers conducted a four-week, open-label, randomized controlled study with a closed sequential design at the Magna Graecia University of Catanzaro, Italy in which patients aged > 40 years who have symmetrical bilateral posterior blepharitis were enrolled. Each eye represented a single experimental unit. Patients were randomly assigned using a computer-generated randomization list to apply a reusable heated compress to the eyelid of one eye before cleansing the eyelid with the Blephapad Combo wet wipe (Blephapad Combo treatment arm) or to use the standard treatment of applying a wet and warm gauze to the other eye (standard treatment arm), twice daily for four weeks. The primary endpoint was the percentage change from baseline to week four in meibomian gland dysfunction (MGD) grading scale scores.
Eighteen patients (nine men and nine women) who have a mean (± standard deviation) age of 66.9 years ± 9.03 years were included in the study. Compared to the eye receiving the standard treatment, treatment with Blephapad Combo appeared to improve the MGD total score after four weeks of treatment (mean change from baseline: –29.9% versus –38.5%). The assessment of the investigators was that in 11 patients, the eye treated with Blephapad Combo showed greater benefit; in two patients, the eye treated with the standard treatment showed greater benefit; and in four patients, there was no difference between treatments. Blephapad Combo was well tolerated, with no serious adverse events (AEs) reported. Minor ocular AEs were reported in 44.4% and 38.9% of patients in the Blephapad Combo and standard treatment arms, respectively.
The researchers concluded that treatment with Blephapad Combo was more effective than the standard treatment was in ameliorating MGD in patients who have posterior blepharitis. Minor ocular AEs were equally distributed between the two treatments arms.
De Luca V, Carnevali A, Carnovale Scalzo G, Piccoli G, Bruzzichessi D, Scorcia V. Efficacy and Safety of Wet Wipes Containing Hy-Ter Solution Compared with Standard Care for Bilateral Posterior Blepharitis: A Preliminary Randomized Controlled Study. Ophthalmol Ther. 2019 Mar 30. [Epub ahead of print]