The Global Specialty Lens Symposium (GSLS) Education Committee has begun planning the Jan. 24 to 27, 2019 meeting. The GSLS highlights anything and everything related to specialty contact lenses—and the meeting really covers the contact lens market from A to Z. If you have topics that you would like to see or ideas for the meeting, please email them to email@example.com.
Jason J. Nichols, OD, MPH, PhD
In Memoriam: Morton Greenspoon, OD
Morton “Mort” Kenneth Greenspoon, OD, passed away on April 2, 2018 at the age of 89. After graduating from the Southern California College of Optometry in 1951, Dr. Greenspoon opened his own practice that same year in Sherman Oaks, CA (now known as Professional VisionCare Associates) and saw patients up to a week before his death.
He took over his father’s special cosmetic contact lens practice in the early 1950s and was later the first optometrist to receive a movie credit for his work on “The Lost Boys” in 1987. Notable celebrities for whom he provided lenses include Elvis Presley in “Flaming Star,” Audrey Hepburn in “Wait Until Dark,” Yul Brenner in “Westworld,” Bill Bixby in “The Incredible Hulk,” and Michael Jackson in “Thriller,” among others. He is also known for fitting the first mirrored contact lens for “Camelot.”
He is survived by his wife Sandra and his three daughters Claudia Mosher, Ronda Carnegie, and Andrea Medina as well as six grandchildren and two great-grandchildren.
Consumer Protection in Eye Care Act Signed into Law in Kentucky
Kentucky Gov. Matt Bevin signed into law House Bill 191, the Consumer Protection in Eye Care Act. The bill, which passed both the House and Senate with widespread, bipartisan support, allows consumers to use advancements in eyecare technology while also establishing safety standards to protect consumer health. The law also protects current and future opportunities to utilize telehealth. Optometrists and ophthalmologists supported the legislation in its final version.
Safeguards include a minimum age of 18 to use the technology, a prior in-person eye examination within the previous 24 months, the same standard of care applied as when conducted in an in-person visit, and the technology cannot be utilized for an initial contact lens prescription.
I-MED Pharma’s I-PEN Receives Regulatory Approval from INVIMA and ANMAT
I-MED Pharma Inc. received regulatory approval from INVIMA in Colombia and ANMAT in Argentina for its patented I-PEN Osmolarity System, which is a handheld platform that offers eyecare professionals a tool for screening dry eye patients.
CORE Unveils CORE Knowledge
The Centre for Ocular Research & Education (CORE) is inviting attendees at the ARVO 2018 Annual Meeting to play CORE Knowledge, an eye science digital game that will debut at the show (being held April 29 to May 3 in Honolulu). Participants will match wits and reflexes with colleagues and friends from across the planet, answering a range of rapid-fire questions covering multiple basic and clinical research topics. Daily and run-of-conference winners will not only see their names on the in-booth leaderboards and fly home with bragging rights, but are also eligible to walk away with fun prizes.
In addition, members of the CORE team are sharing aspects of their research during the conference with three posters, and members of the CORE senior staff will be at the CORE booth.
IDOC Launches "Satisfaction Guarantee" On Membership Plans and New Contact Lens Offering
IDOC, a privately held alliance of independent optometrists, is launching a “Satisfaction Guarantee” program that allows independent ODs to take full advantage of an IDOC membership program risk-free. If members are not completely satisfied with their IDOC membership, their dues will be refunded in full if all conditions of the offer are met.
In an unrelated announcement, IDOC is expanding and introducing a new IDOC Select Contact Lens Plan that will offer eyecare practitioners enhanced choice and flexibility, according to the company. IDOC members have access to a new IDOC Select Contact Lens Plan in addition to the current IDOC Select Contact Lens and Lab Plan offering. As with the existing plan, Alcon and CooperVision continue as exclusive manufacturers to IDOC Select.
SynergEyes Appoints Jessica Chi and Mark Hinds to Professional Relations Team
SynergEyes, Inc. announced the appointments of Jessica Chi and Mark Hinds to the Professional Relations team for SynergEyes in Australia/New Zealand.
Dr. Chi is the director of Eyetech Optometrists, an independent specialty contact lens practice in Melbourne. She is the current vice president of the Cornea and Contact Lens Society of Australia (CCLSA) and previously served as national president of the CCLSA. She is a clinical supervisor at the University of Melbourne, a member of the Victoria Optometric Sector Advisory Group, and a columnist for MiVision. Dr. Chi is a fellow of the Australian College of Optometry and the British Contact Lens Association (BCLA). She consults for various contact lens companies and is an invited speaker throughout Australia and beyond.
Dr. Hinds has been involved with Queensland University of Technology School of Optometry post-graduate specialty contact lens clinics since 2004 and lectures to the fourth-year students in their advanced contact lens studies. He has a private practice in Brisbane (Queensland, Australia) with a clinical focus on specialty contact lenses for the complex cornea. He is also a fellow of the BCLA.
Sergina M. Flaherty, COMT, OSC, San Antonio, TX
This image shows epithelium ingrowth after laser-assisted in situ keratomileusis (LASIK) surgery.
We thank Sergina M. Flaherty 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
Can We Quantify the Fogging of Scleral Lens Wear?
Those of us who fit patients in scleral contact lenses realize that over time, debris often accumulates in the retro-lens fluid reservoir. This accumulation of material often varies from individual to individual based on numerous factors. In addition, the impact that this has on vision quality and function also can vary from almost no impact up to significant visual distress.
A study was recently published by researchers from the Mayo Clinic in Minnesota that examined debris accumulation in the post-lens fluid reservoir during scleral lens wear.1 The researchers evaluated a method to quantify increases in turbidity of the post-lens fluid reservoir by assessing changes in optical density of the fluid over time; they compared these changes during two hours of scleral lens wear using three different lens designs.
Thirty-five patients who had no history of eye disease were enrolled in the study. Participants were fit with a 15.0mm, 18.0mm, and 18.2mm scleral lens on one randomly selected eye during the enrollment examination. During each of three subsequent visits, one of three lenses selected during enrollment was placed on the eye. Scheimpflug images were acquired within five minutes of lens placement and at 20-minute intervals for the ensuing two hours. Fluid reservoir optical density was assessed using Pentacam (Oculus Inc.) analysis software.
Results showed that increases in fluid reservoir optical density were significant between each time interval with all lenses until 100 minutes. No significant increases in fluid reservoir optical density were noted with the 15.0mm and 18.0mm lenses between 100 and 120 minutes; fluid reservoir optical density increased with the 18.2mm lens between 100 and 120 min. Optical density increased by 105% (15.0mm lens) and 117% (18.0mm and 18.2mm lenses) at two hours.
The researchers concluded that optical density of the post-lens fluid reservoir can be quantified during scleral lens wear and that during two hours of wear, fluid reservoir optical density doubled with all lens designs evaluated.
Having an objective method to quantify this phenomenon is an important step in our ability to understand it better. This is true in terms of both patient characteristics and lens fit characteristics that may predispose patients to increased turbidity. Additionally, it would provide practitioners with the ability to measure changes in response to potential remediation methods. Consider adding this measurement to your diagnostic procedure protocol for your scleral lens patients.
1. Schornack MM, Nau CB. Changes in Optical Density of Postlens Fluid Reservoir During 2 Hours of Scleral Lens Wear. Eye Contact Lens. 2018 Mar 16. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Pre-Surgical Cataract Patients and Dry Eye
In 2017, the Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO) study demonstrated that the frequency of dry eye in patients scheduled to undergo cataract surgery in a real-world setting is higher than anticipated.1 In this prospective, multi-center, observational study, the primary outcome measure was the frequency of dry eye as evaluated by grade on the International Task Force scale and secondary outcome measures that included tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, corneal staining with fluorescein, conjunctival staining with lissamine green, and a patient questionnaire to evaluate symptoms of dry eye.
This year, a separate study aimed to determine the frequency of meibomian gland dysfunction and to quantify subjective dry eye symptoms in cataract surgery candidates.2 These patients completed the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Lipid layer thickness and partial blink rate measurements, as well as gland structure assessment, were performed. TBUT and the quantity and quality of the meibomian gland secretion were determined. In this pre-surgical cohort, 52% had meibomian gland dysfunction, and 56% had meibomian gland atrophy equal to or more than the Arita scale, grade 1. Interestingly, 50% of the patients who had meibomian gland dysfunction were asymptomatic.
Taken together, these studies remind us to carefully evaluate the ocular surface and meibomian gland function of those patients preparing for cataract surgery.
1. Trattler WB, Majmudar PA, Donnenfeld ED, McDonald MB, Stonecipher KG, Goldberg DF. The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO) study: the effect of dry eye. Clin Ophthalmol. 2017 Aug 7;11:1423-1430.
2. Cochener B, Cassan A, Omiel L. Prevalence of meibomian gland dysfunction at the time of cataract surgery. J Cataract Refract Surg. 2018 Feb;44:144-148.
Application of 3D Printing Technology in RGPCL Simulation Fitting The rigid GP contact lens (RGPCL) is an ideal choice to improve the corrective vision of patients who have a high degree of refractive error, keratoconus, and corneal transplantation. However, RGPCL fitting is not easy for those patients who have an extremely irregular corneal surface. Technicians or doctors often need to try many times to determine satisfactory lens parameters. This repeated try-on process not only increases patient discomfort, it also will increase the risks of corneal epithelial shedding or corneal infection.
To conduct GP fitting in a faster and safer manner, the authors of this study assumed a new method of simulating RGPCL fitting in 3D printing technology. The preliminary experimental results indicated that this method could effectively reduce the number of diagnostic lenses and increase patient satisfaction, while decreasing the risk of epithelial shedding or infection.
Zhao F, Zhao G, Weijie F, Chen L. Application of 3D printing technology in RGPCL simulation fitting. Med Hypotheses. 2018 Apr;113:74-76.