This week, we are reporting the abstract from the Scleral Lenses in Current Ophthalmic Practice (SCOPE) Study—one of the first studies to comprehensively examine scleral lens usage on a wide-scale basis. One interesting finding was the diversity of lenses that were used, with the majority (65%) that were fitted being in the 15mm to 17mm range. There are many other interesting findings and trends that are reported, and we encourage you to check out the full report.
Jason J. Nichols, OD, MPH, PhD
B+L Recycling Program Continues Momentum with Consumer Event
Bausch + Lomb (B+L) announced that more than 180,000 units of used contact lenses and blister packs have been recycled through the B+L One by One Recycling Program. To date, more than 1,800 optometry offices have signed up to recycle used contact lenses and blister packs through this free program, developed by B+L, in collaboration with TerraCycle.
B+L recently educated consumers about the recycling program during an Earth Day celebration that was held on April 18 in New York City. Earth Day Initiative, a not-for-profit organization that promotes environmental awareness through year-round programs and partnerships with schools, businesses and governments, hosted the event.
This program is the first sponsored contact lens recycling program from B+L and TerraCycle, and for each pound of waste that is recycled through the program, B+L will make a $1 donation to Optometry Giving Sight. Visit www.BauschRecycles.com to learn more.
2017 ARVO Student Travel Fellowship Recipients Announced
The American Academy of Optometry announced the recipients of the 2017 Student Travel Fellowship Awards. The travel fellowships will allow six students to present their research at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting in May 2017. The 2017 recipients and their respective schools follow.
Supported by Johnson and Johnson Vision:
• Bright Ashimatey, OD, Indiana University
• Billie Beckwith-Cohen, DVM, MBA, University of California Berkeley
• Gareth Hastings, MPhil, BOptom, University of Houston
• Jakaria Mostafo, University of Houston
• Cornelia Peterson, DVM, The Ohio State University
Supported by the American Academy of Optometry:
• Yifei Wu, BScOptom, Indiana University
The American Academy of Optometry administers travel fellowships to encourage optometry students, optometric residents, and students in eye- and vision-related graduate programs to attend key national meetings and exchange scientific ideas on research. Fellowships are awarded primarily for accomplishment and potential in optometric research and education, and are evaluated by the American Academy of Optometry’s Research Committee.
Applications for student travel fellowships for the Academy’s annual meeting, Academy 2017 Chicago, will be available in July 2017. For more information visit http://www.aaopt.org/students/stf.
SynergEyes Launches Cornea and Contact Lens Resident Job Finder Program
SynergEyes has announced a Job Finder program for Contact Lens and Cornea Residents. The company says that this new program recognizes the importance of specialty contact lens training and education and helps these talented post-graduate residents find jobs by connecting them with eyecare professionals who prescribe specialty contact lenses.
Contact Lens and Cornea Residents may access a portal on synergeyes.com, where they can register for the Job Finder program. The residents provide information on what parts of the country they are seeking employment and when they are available. Eyecare professionals receive a list of residents along with their preferred state for employment. SynergEyes will connect the eyecare professionals in those states with the job-seeking resident.
Simple Contacts Raises $8 Million Series A Led by Goodwater Capital
Simple Contacts has raised an $8 million Series A financing round led by Goodwater Capital, which specializes in early-stage consumer technology companies. Previous investors Justin Kan, Notation Capital, and Autonomous Ventures also participated in the round.
The $8 million financing will help Simple Contacts grow its product and marketing teams, expand marketing efforts to new channels and bring the product to more platforms, including web and Android. The latest round brings the total investment in the company to $10 million.
Simple Contacts is a telemedicine platform designed to allow patients to renew their contact lens prescriptions from home. At a cost of $10, the Simple Contacts vision test is designed to save time and money, according to the company. With comparably priced contact lenses, patients can renew their prescription and have contacts shipped to their door.
Kyriakos Telamitsi, Limassol, Cyprus
A 65-year-old female wore scleral lenses OD and OS due to keratoconus. This is the left eye with the scleral lens on. I could easily recognize that she needed more elevation (vault) and maybe more of a seal in the haptic zone. I fit her with a new scleral with a 20mm diameter and a vault of 450 microns. With this lens, her best-corrected visual acuity was pure 2/10. Despite normal optical coherence tomography imagery, she eventually did need a corneal transplant. I waited another six months to fit her with a new scleral lens.
We thank Kyriakos Telamitsi 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.
S. Barry Eiden, OD
Electrophysiological Testing Using VEP as a Predictor of Success with Multifocal CLs Versus Monovision
Efforts have been made to predict success of either multifocal contact lenses or monovision contact lenses in various ways, with limited positive predictive value. A recent small scale study was conducted to determine whether elements of visual evoked potential (VEP) outcomes could serve as a method to predict success with either multifocal contact lenses or monovision.1 The purpose of this study was to compare monovision and multifocality and to identify clinical and electrophysiological predictive markers of visual comfort for each correction available in clinical practice.
Ten presbyopic patients participated in this study. Patients received monovision and multifocal correction using contact lenses for three weeks each in a random order. A clinical evaluation (visual acuity, TNO test, binocular contrast sensitivity, and quality of vision questionnaires) and an electrophysiological evaluation (monocular and binocular pattern VEP with multiple spatial frequencies at 60 feet, 30 feet, and 15 feet) were performed before and after each correction modality.
The VEP P100 was significantly wider and slightly earlier after binocular compared to monocular stimulation at T0. The TNO stereopsis score decreased significantly after correction. No other significant differences, either on clinical or electrophysiological criteria, were found between the two modes of correction. Several significant correlations were found between the stereoacuity difference, depending upon correction and evoked potentials by binocular pattern at T0. The larger the stereoacuity difference (better stereoacuity with multifocal compensation), the longer the latency of the P100 using 60-foot checks (R = 0.82; P = 0.004) and the greater the amplitude of the N75 using 30-foot checks (R = 0.652; P = 0.04).
The results of this study highlights a benefit of VEP used in current practice and measurement of the P100 wave, the best indicator of stereopsis and the most consistent, to predict visual comfort after compensation presbyopia.
1. El Ameen A, Majzoub S, Pisella PJ. The search for electrophysiological predictors of visual comfort after presbyopia correction with contact lenses. J Fr Ophtalmol. 2017 Apr;40:257-263.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Scleral Show and Tell
I find that “dry eye” patients who have scleral show are some of the more difficult to manage. Scleral show is an anatomical condition in which the sclera is visible beyond the lower border of the iris and can arise for a variety of reasons. It can also occur because of iatrogenies, and it is considered one of the most complex blepharoplasty complications.1 The defect is not always linked to an ectropion. Any condition that creates laxity or limits motion of the lower eyelids can contribute to scleral show.
The cheekbone position is quite important when considering scleral show. Patients who have strong cheekbone support have excellent positional support for the lower eyelids. Conversely, those with relatively flat cheekbones or heavy cheek pads are at risk for scleral show. Age-related mid-facial descent, as well as facial fat loss and loss of muscle tone in the skin, can also contribute to loss of support for the lower eyelid, resulting in inferior scleral show. Trauma, large eyes, or orbital changes related to thyroid disease can also create scleral show.
In your dry eye evaluation, remember to sit back and evaluate the position and tone of the eyelids…much information can be gained from a thorough eyelid evaluation.
1. Loeb, R. Scleral Show. Aesthetic Plast Surg. 1988 Aug;12:165-170.
Scleral Lens Prescription and Management Practices: The SCOPE Study
The object of the SCOPE (Scleral Lenses in Current Ophthalmic Practice: an Evaluation) study was to assess current scleral lens prescription and management practices by conducting an international online survey of eyecare providers.
The SCOPE study group designed and administered an online survey regarding current scleral lens prescription and management practices. The survey was open from January 15 to March 31, 2015 and generated 723 responses from individuals who had fit at least five patients with scleral lenses.
A majority of respondents (n=663) prescribed scleral lenses that ranged from 15mm to 17mm in diameter (65%). However, they also prescribed lenses that were smaller than 15mm (18%), and larger than 18mm (17%). In addition, more than 50 lens designs were identified.
Average daily wearing time of 11.8 hours was consistent across 651 respondents, and 475 of the 651 (73%) recommended midday removal on some, most, or all days. Most respondents recommended nonpreserved saline to fill the bowl of the lens before application (single-use vials, 392 [60%] and bottled products, 372 [57%], both out of 653 respondents). A hydrogen peroxide-based disinfection system was the most commonly recommended care product (397 out of 651 [61%]).
The authors reported that a reasonable degree of consensus exists regarding some aspects of scleral lens prescription and management (average lens diameter, daily wearing time, and use of nonpreserved products for lens application). However, they also feel that further study is needed to develop evidence-based guidelines for scleral lens prescription and management.
Harthan J, Nau CB, Barr J, Nau A, Shorter E, Chimato NT, Hodge DO, Schornack MM. Scleral Lens Prescription and Management Practices: The SCOPE Study. Eye Contact Lens. 2017 Apr 6. [Epub ahead of print]