ABB Optical Group is an independent optical industry platform that serves among other functions as a wholesale contact lens distributor. For many years, Contact Lens Spectrum has partnered with ABB Optical on our Annual Report by relaying the insights afforded to them in terms of contact lens prescribing patterns in the United States.
This issue will kick-off a new partnership between Contact Lens Spectrum and ABB Optical that will look deeper into trends in the contact lens market. On a periodic basis, we will provide a snapshot of an interesting industry segment, contact lens modality, or practice statistics.
By the Numbers
This analysis looked at 11,000 practices, all of which have been regular customers of ABB Optical for the last two years. As seen in the figure below, higher proportions of daily disposable use in a practice are directly related to increased overall dollar growth in the contact lens aspect of a practice. Daily disposable prescribing has increased in North America over the last several years due to the many benefits that they afford to patients; these data also confirm the financial benefit that practices can realize by increasing daily disposable use.
Figure 1: Percent Contact Lens Dollar Growth of Practice
I hope you enjoyed this first installment of “By the Numbers.”
Jason J. Nichols, OD, MPH, PhD
Neurostimulation Device for Dry Eye Comes to Market
Allergan plc announced the official launch of TrueTear, an FDA-cleared device developed to temporarily increase tear production in adult patients. TrueTear is a handheld neurostimulation device with disposable tips that is inserted into the nasal cavity to temporarily induce the production of natural tears. TrueTear provides tiny pulses of energy within the nasal cavity to create tears and may be appropriate for most patients who have inadequate tear production, according to Allergan. TrueTear is a prescription only device.
Alcon Adds New Gemstone Collection to Air Optix Colors Lens Portfolio
Alcon introduced its new Air Optix Colors Gemstone Collection of colored contact lenses, with three new colors—Amethyst, True Sapphire, and Turquoise; the lenses are now available in 12 colors: the three new colors plus Gray, Blue, Green, Pure Hazel, Brown, Sterling Gray, Brilliant Blue, Gemstone Green, and Honey.
At the same time, Alcon is launching a two-count pack for all Air Optix Colors, allowing eyecare professionals (ECPs) to introduce more patients to colored contact lenses, with or without vision correction. This smaller size pack gives patients a more flexible option to play with eye color for part-time wear and to try multiple colors.
To support practices in rolling out the new Gemstone Collection to their patients, Alcon will provide updated social and online media assets on the Alcon Vision Care Marketing Portal. The new materials can be shared on practice websites and social media channels to drive patient awareness of and interest in Air Optix Colors lenses to help bring them into the office. ECPs can also speak to their Alcon sales representative for in-office Air Optix Colors materials to help spark patient interest. Patients can also virtually try on the colors before coming to the office through the Air Optix Colors Color Studio.
B+L Receives 510(k) Clearance from FDA for Boston Scleral Lens Case
Bausch + Lomb’s Specialty Vision Products business has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for the Boston scleral lens case, a storage case developed specifically for scleral lenses. The case is designed to hold lenses up to 23.5mm in diameter and up to 10.0mm in sagittal depth. The Boston scleral lens case is indicated for use with Boston original conditioning solution, Boston Advance formula conditioning solution, and Boston Simplus multi-action solution. Patients can purchase the lens case from the Specialty Vision Products Web Store.
NECO Selects Dr. Howard Purcell as Next President
The New England College of Optometry (NECO) Board of Trustees has named Howard Purcell, OD, as the 13th president and CEO of the college. Dr. Purcell, who will take office on July 2, 2018, was selected following a national search to succeed Clifford Scott, OD, MPH, who will be stepping down after serving for nine years.
Dr. Purcell is a graduate of NECO’s Class of 1984 and brings a wealth of experience and success in many aspects of optometry. His optometric career began with 11 years of private practice in Florida with his father, NECO alumnus Saul Purcell, OD, '54. He then joined the faculty at Nova Southeastern University College of Optometry, rising to the position of Deputy Dean prior to being recruited by Johnson & Johnson as senior Director of Professional Affairs. Most recently, Dr. Purcell was the senior vice president of Customer Development for Essilor of America.
Haiti’s First School of Optometry Has Opened
Haiti has the highest level of blindness and vision impairment in the region, and most of this is avoidable. It is three times higher than that of other countries in the region. An important reason for this is the critical shortage of qualified eyecare personnel. In a country of more than 10 million people, there are only three local optometrists.
This changed on Apr. 12th, 2018, with the official opening of Haiti’s first ever School of Optometry & Vision Sciences at the Faculty of Medicine and Pharmacy of I’Université d’État d’Haïti. The school’s five-year degree program will seek to graduate 16 optometrists per year.
Additionally, Drs. Susan and Tom Quinn, Vision Source optometrists from Ohio and Optometry Giving Sight supporters for more than 10 years, travelled to Haiti to take part in the school’s first community outreach programs.
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 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.
S. Barry Eiden, OD
Hybrid Contact Lenses and Keratoplasty—Do They Go Together?
Contact lens utilization following keratoplasty is a common requirement to achieve optimal vision correction. Concerns are abundant regarding possible complications induced by contact lens wear on a post-penetrating keratoplasty (PK) cornea. A study was recently published that evaluated the outcomes of new-generation hybrid contact lenses for visual rehabilitation of post-keratoplasty patients.1
From 20 post-keratoplasty patients, 20 eyes were fit with hybrid lenses. Each patient’s keratometric values, ocular surface irregularity indices, central corneal thickness (CCT), uncorrected visual acuity (UCVA), spectacle-corrected visual acuity, contact lens-corrected visual acuity, contact lens fitting data, and contact lens daily wearing time were recorded. Follow-up examinations were performed at the one-week, one-month, and three-month visits after successful fitting of the lenses.
Outcome analysis indicated that the mean spherical component of refractive error was –4.46D ± 2.10D, and the mean astigmatism was –5.31D ± 1.55D. The median UCVA was 1.00 logarithm of the minimum angle of resolution (logMAR), which improved to 0.40 logMAR after spectacle correction. The median visual acuity with hybrid contact lenses was 0.05 logMAR. The median CCT was 544.4μm and increased to 549.2μm at three months after contact lens wear. The difference was not statistically significant (P = 0.38). The mean follow-up of patients was 4.32 ± 0.45 months. Eighteen of 20 patients reported a mean of 8.37 ± 1.95 hours of comfortable wearing time per day during this period. Two patients discontinued contact lens wearing due to conjunctival hyperemia. No graft-related complications—such as decompensation, rejection, and infection—were documented during the follow-up period.
The authors concluded that the new-generation of hybrid contact lenses can be considered helpful in the visual management of post-corneal graft patients, particularly those who are unable to achieve an adequate visual outcome with spectacles.
Today, we have numerous options for the contact lens management of post-PK patients. With all modalities, we need to carefully monitor physiological responses to lens wear. Careful slit lamp observation, visual performance, topographic measures, corneal thickness measures, and endothelial cell counts are some of the important elements to monitor.
1. Altay Y, Balta O, Burcu A, Ornek F. Hybrid contact lenses for visual management of patients after keratoplasty. Niger J Clin Pract. 2018 Apr;21:451-455.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Another Thing to Wonder About
Most conventional carpets are made from synthetic fibers treated with artificial dyes, stain repellents, adhesives, and other chemicals. Carpets, carpet padding, and the adhesives used for product installation may contain chemicals made with volatile organic compounds (VOCs) that have been demonstrated to emit a potentially toxic breathable gas into the air.
In addition, stain repellents applied to carpeting can help make the carpet stain, grease, and water resistant. And, many stain-resisting compounds are comprised of perfluorinated chemicals (PFCs), which have been associated with cancer, reproductive problems, birth and developmental defects, and immune system suppression.1
Of note, older carpets and padding can potentially contain concerning chemicals. Older carpets and recycled padding could contain chemicals that are now banned, but they continue to off-gas toxic fumes into the air. The off-gassing from VOCs, PFCs, and other toxic chemicals from carpeting can then cling to house dust, which we inhale. Therefore, indoor air quality can be impacted by these emissions from carpet and carpet padding.
But, do these chemicals impact the ocular surface? Should we consider recommending that our patients switch to “greener” carpets and flooring? One option would be to suggest use of alternatives to chemically treated carpeting products that are constructed using only wool and that use only naturally-colored fleeces or dye made with organic pigments with no added chemicals; an example of this is found in some moth-proofing carpeting.2
Attention to our home and office surrounds may be a strategy in ocular surface protection. We already discuss other environmental modifications with our allergy patients; this may be a conversation in which we engage with our ocular surface disease patients.
n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease
Dry eye disease is a common chronic condition that is characterized by ocular discomfort and visual disturbances that decrease quality of life. Many clinicians recommend the use of supplements containing n-3 fatty acids (often called omega-3 fatty acids) to relieve symptoms.
In this multicenter, double-blind clinical trial, researchers randomly assigned patients who had moderate-to-severe dry eye disease to receive a daily oral dose of 3000mg of fish-derived n-3 eicosapentaenoic and docosahexaenoic acids (active supplement group) or an olive oil placebo (placebo group). The primary outcome was the mean change from baseline in the score on the Ocular Surface Disease Index (OSDI; scores range from 0 to 100, with higher scores indicating greater symptom severity), which was based on the mean of scores obtained at six and 12 months. Secondary outcomes included mean changes per eye in the conjunctival staining score (ranging from 0 to 6) and the corneal staining score (ranging from 0 to 15), with higher staining scores indicating more severe damage to the ocular surface, as well as mean changes in the tear break-up time (seconds between a blink and gaps in the tear film) and the result of Schirmer’s test (length of wetting of paper strips placed on the lower eyelid), with lower values indicating more severe signs.
A total of 349 patients were assigned to the active supplement group and 186 to the placebo group; the primary analysis included 329 and 170 patients, respectively. The mean change in the OSDI score was not significantly different between the active supplement group and the placebo group (–13.9 points and –12.5 points, respectively; mean difference in change after imputation of missing data, –1.9 points; 95% confidence interval [CI], –5.0 to 1.1; P=0.21). This result was consistent across prespecified subgroups. There were no significant differences between the active supplement group and the placebo group in mean changes from baseline in the conjunctival staining score (mean difference in change, 0.0 points; 95% CI, –0.2 to 0.1), corneal staining score (0.1 point; 95% CI, –0.2 to 0.4), tear breakup time (0.2 seconds; 95% CI, –0.1 to 0.5), and result on Schirmer’s test (0.0mm; 95% CI, –0.8 to 0.9). At 12 months, the rate of adherence to treatment in the active supplement group was 85.2%, according to the level of n-3 fatty acids in red cells. Rates of adverse events were similar in the two trial groups.
The researchers determined that among patients who have dry eye disease, those who were randomly assigned to receive supplements containing 3000mg of n-3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo.
Dry Eye Assessment and Management Study Research Group. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018 Apr 13. [Epub ahead of print]