What is happening in the world of contact lens distribution? Are subscription-based contact lens distributors becoming the new normal? To address some of these types of issues, we have asked our expert columnist Dr. David L. Kading to address trends in contact lens distribution in the September issue of Contact Lens Spectrum. Stay tuned to see what our expert thinks.
Jason J. Nichols, OD, MPH, PhD
Bausch + Lomb To Host Multi-City Lecture Series on Scleral Lenses
Bausch + Lomb announced that its Specialty Vision Products business will be hosting a multi-city lecture series, with hands-on training sessions, on the Zenlens family of scleral lenses throughout September and October 2018. The workshops will educate attendees on how to fit Zenlens scleral lenses, review patient cases, and provide hands-on training on fitting and handling the Zenlens and Zen RC scleral lenses.
The series will feature lectures from experienced eyecare professionals, including Jason Jedlicka, OD; Michael Ward, MMSc; and Tom Arnold, OD.
Sessions will be held in major regional cities nationwide, including Los Angeles, Dallas, and Chicago. To see the full list of cities and to register for a session near you, visit www.bausch.com/svpedu.
OcuBlink, Inc. Wins Seed Funding from Two Business Accelerators
OcuBlink, Inc. has received funding from two prominent business accelerators. The company will use the funds and associated entrepreneurial coaching to scale its business.
AC JumpStart, funded by FedDev Ontario, awarded OcuBlink $30,000 Canadian in seed capital and $10,000 Canadian of in-kind mentorship. The accelerator helps technology start-ups establish and grow their business in Southern Ontario. OcuBlink was also named one of four winners in the annual Velocity Fund $5K competition, an entrepreneurship program at the University of Waterloo.
OcuBlink began as an initiative of the Centre for Ocular Research & Education (CORE) and now operates as an affiliate, utilizing CORE’s staffing, counsel, and laboratories. OcuBlink develops in vitro eye models for ophthalmic companies to accelerate research and development of products for the eye, including devices for studying anterior and posterior eye disease and contact lens offerings.
OGS Launches 2018 World Sight Day Challenge
Coordinated by Optometry Giving Sight and the International Agency for the Prevention of Blindness (IAPB), The World Sight Day Challenge fundraising campaign (which launched on Aug. 1) brings the global optometry community together to raise money and awareness to help provide eye care to those in need. The challenge is focused on World Sight Day, Oct. 11, and continues through to the end of November.
World Sight Day Challenge will help fund projects that will help an additional 1 million people receive eye care in 2018. For the past 12 years, thousands of eyecare practitioners, their staff, patients, students, and families have taken the World Sight Day Challenge and made a difference by making a tax-deductible donation and/or by raising funds in their practice, school, or company.
Vision Expo West to Introduce Expanded Education Programming
Vision Expo West, taking place Sept. 26 to 29 in Las Vegas, will introduce an expansive scope of education, products, trends, and solutions that keep the industry updated on best practices in patient care, practice management, retail strategies, and more. Some of this year’s new sessions include Attract and Retain Customers, Ocular Aesthetics, Supporting the Practice Experience, Clinical Concepts for Opticians and Technicians, Private Equity and Eye Care: Should I Stay or Should I Go?, Private Equity Takes Root – What Does It Mean for Optometry?, and ODs on Facebook After Dark.
The 30th Anniversary of Vision Expo West features sessions that provide insight on the future while using history as a guiding force, including The State of the CL Industry: Future Trends in Contact Lenses and Ocular Surface, Where Have We Been and Where Are We Going; OptiCon @ Vision Expo’s General Session - Back to the Future: Why Our Past Matters; and The Future of Optometry: Telehealth & Eyecare - Challenge & Opportunity. As in past years, conference goers can attend the free Global Contact Lens Forum, Ocular Surface Disease and Wellness Symposium, and Vision Series events as well as workshops for optical coherence tomography, scleral lenses, and specialty lenses.
GSLS Accepting Free Paper and Poster Submissions
Free paper and poster abstract submissions may include new and innovative concepts on 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.
Abstract submissions for free papers and posters will be accepted until Aug. 31, 2018 at 11:59 pm Eastern Standard Time (EST) and must be submitted online.
Sabrina Cordell, and Lance McNaughton, OD, PhD, Pomona, CA
This image depicts a moderately advanced pterygium of the right eye in a 39-year-old male. Despite the degree of corneal involvement, vision was 20/20. Lissamine green and fluorescein were instilled to visualize the impact of the lesion on local tissue.
We thank Ms. Cordell and Dr. McNaughton and 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
Placido Topography and Scleral Lens Fitting: Are We Barking up the Wrong Tree?
With the ever-increasing interest and utilization of GP scleral lenses, we are looking for ways to make our fitting procedure more reliable and more efficient. The utilization of advanced diagnostic technologies has the potential to do just that.
A recent article was published that explored the role of Placido-based corneal topography in the fitting of scleral contact lenses.1 The purpose of the study was to analyze the relationship between corneal sagittal height and asymmetry parameters derived from Placido-videokeratoscopy with the parameters of fitted scleral lenses (ScCLs).
Corneal topographies were measured with the Medmont E300 in a total of 126 eyes that had irregular and regular corneas before ScCL fitting was analyzed. Measurements of sagittal height (OC-SAG) at steep and flat corneal meridians were obtained for 10mm and 12mm chords. Estimated Height (EH Chord) parameters were taken for a chord equal to the diameter of the lens that each subject was wearing at different semi-meridians. Corneal asymmetry (difference in OC-SAG between steep and flat corneal meridians) was also assessed. These outcomes were correlated to ScCL parameters that subjects were wearing after one month.
Results of the study indicate that the mean ScCL-SAG was 4,696μm ± 240μm and that the mean OC-SAG ranged from 1,891μm (10mm), 2,914μm (12 mm), and between 4,162μm and 4,251μm for EH 0° to 180° and EH 30° to 210°. Stronger correlations (p < 0.001) between OC-SAG and ScCL-SAG were determined for EH 0° to 180° (r = 0.595) and EH 30° to 210° (r = 0.618). The mean differences between OC-SAG and ScCL-SAG were between 447μm ± 290μm (EH 0° to 180°) and 389μm ± 360μm (EH 30° to 210°). There was no relationship between corneal asymmetry and the need to fit a ScCL with toric haptic design in irregular corneas. Orientation of flat corneal and scleral meridians was similar only in corneas that have high regular astigmatism.
From these results, the authors concluded that EH Chord attributes were the parameters that best correlated with the ScCL-SAG. The corneal asymmetry was a poor predictor for the need to fit a ScCL with toricity at the landing zone in irregular corneas, but it could have some predictive power in regular corneas.
The utilization of anterior segment optical coherence tomography (OCT) has had dramatic positive influence on our ability to assess the fitting characteristics of scleral lenses. We can observe peripheral landing as well as full corneal vaulting characteristics. Anterior segment (AS)-OCT is not as useful for the designing of scleral lenses. New corneo-scleral profile devices, however, are showing great promise in their ability to “virtually” fit scleral lenses. The use of Placido-based corneal topography provides only corneal curvature data. The limitation of measurements taken exclusively from the cornea makes corneal topography limited in its application for scleral lens fitting. In addition, interpolation of curvature data to come up with elevation data has its own limitations. So, it seems to me that, although Placido corneal topography may have some use in scleral lens fitting, we may be barking up the wrong tree. We likely should be concentrating on technologies that allow us to both measure elevation directly and to measure the corneo-scleral shape.
1. Macedo-de-Araújo RJ, Amorim-de-Sousa A, Queirós A, van der Worp E, González-Méijome JM. Relationship of placido corneal topography data with scleral lens fitting parameters. Cont Lens Anterior Eye. 2018 Jul 25 [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
HA! HA! HA! Hyaluronic Acid
Dry eye always has me wondering…
Hyaluronic acid (HA) is a carbohydrate, specifically a mucopolysaccharide, occurring naturally in all living organisms. It can be several thousands of sugars long. When not bound to other molecules, it binds to water, giving it a stiff, viscous quality similar to gelatin.1 HA is present in large amounts in the spaces between skin cells, where it provides moisture, firmness, and suppleness to the skin. Topical forms of HA that are applied to the skin act as a moisturizer that hydrates the skin and plumps it by attracting water from the air. Hence, HA is an ingredient in many commercially available skin care products. It is also used in lubricating eye drops.
I wonder whether topically applied HA in creams applied to the high cheek and eyelid areas act as a water depot that slowly allow water to evaporate in more arid environments? Is applying facial and eyelid HA-containing products advantageous to our dry eye patients? How could we test this? I wonder…
1. Necas J, Bartosikova L, Brauner P, Kolar J. Hyaluronic acid (hyaluronan): a review. Veterinarni Medicina. 2008;53(8):397-411.
Multicenter Study of Intense Pulsed Light Therapy for Patients With Refractory Meibomian Gland Dysfunction
The purpose of this study was to evaluate the efficacy of intense pulsed light (IPL) therapy combined with meibomian gland expression (MGX) for refractory meibomian gland dysfunction (MGD) in a prospective study conducted at three sites in Japan.
Patients who have refractory obstructive MGD were enrolled and underwent four to eight IPL-MGX treatment sessions at three-week intervals. Clinical assessment included the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire; noninvasive breakup time of the tear film and interferometric fringe pattern as determined by tear interferometry; lid margin abnormalities, fluorescein breakup time of the tear film, corneal and conjunctival fluorescein staining (CFS), and meibum grade as evaluated with a slit-lamp microscope; meibomian gland morphology (meiboscore); and tear production as measured by the Schirmer’s test without anesthesia.
Sixty-two eyes of 31 patients (17 women, 14 men; mean age ± SD, 47.6 ± 16.8 years) were enrolled. The SPEED score (P < 0.001), noninvasive breakup time (P < 0.001), and interferometric fringe pattern (P < 0.001) were significantly improved after therapy, with 74% of eyes showing a change in the interferometric fringe pattern from one characteristic of lipid deficiency to the normal condition. Meibum grade, lid margin abnormality scores, fluorescein breakup time, and CFS were also significantly improved (P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively) after treatment, whereas the meiboscore and Schirmer’s test values remained unchanged.
The authors concluded that IPL-MGX ameliorated symptoms and improved the condition of the tear film in patients who have refractory MGD and is therefore a promising treatment option for this disorder.
Arita R, Mizoguchi T, Fukuoka S, Morishige N. Multicenter Study of Intense Pulsed Light Therapy for Patients With Refractory Meibomian Gland Dysfunction. Cornea. 2018 Jul 10. [Epub ahead of print]