Marketing of diagnostics, devices, and therapeutics is a key element to their uptake into clinical practice. In my opinion, marketing materials need to efficiently convey clinical relevance and be backed by sound scientific evidence supporting the product and claims. This will allow you to make quick and informed judgements about the materials being presented.
Jason J. Nichols, OD, MPH, PhD
The Contact Lens Museum Opens
The Contact Lens Museum opened to the public on July 30, 2019. Conceived by Patrick J. Caroline, Jiah Pack, and Craig Norman—longtime collectors of contact lens artifacts, instruments, and publications—they welcomed visitors from near and far with free general admission to the new facility, located in Forest Grove, OR.
Established in 2019 to preserve, protect, and educate eyecare practitioners, researchers, historians, and the public about these optical devices and objects, The Contact Lens Museum has more than 2,000 historical items documenting the history of this field over the past 100+ years. The new museum features a chronological selection of the evolution of contact lenses from early glass and plastic scleral lenses, the discovery of corneal designs, original soft lenses from Czechoslovakia, and GP designs through the recent rebirth of scleral lenses. Mr. Caroline also noted that the museum will travel to at least four major contact lens meetings and education institutions in 2020.
The Contact Lens Museum is located at 2309 Pacific Ave, Forest Grove, OR 97116. It is open from 10:00am – 5:00pm Monday through Thursday by appointment only.
Patient-Focused Executive Summary of TFOS DEWS II Report Announced
In recognition of Dry Eye Awareness Month, the Tear Film & Ocular Surface Society (TFOS) announced the availability of a patient-focused Executive Summary of the TFOS Dry Eye WorkShop (DEWS) II Report. Creation of this document was prompted by the recognition that it is very important for patients to have access to, and to be able to rely on, accurate, relevant, and comprehensive information about dry eye disease. The patient version of the TFOS DEWS II Executive Summary is available at: https://www.tearfilm.org/dettnews-tfos_dews_ii_patient_summary/6814_5519/eng.
Samsung Awarded Patent for Augmented Reality Contact Lenses
The U.S. Patent and Trademark Office has granted a patent to Samsung for augmented reality contact lenses, which are specialized contact lenses with a built-in hidden camera. Samsung notes that an external device such as a smartphone may include a program interacting with the smart contact lens.
Scientists Create Contact Lenses that Zoom In or Out When You Blink Twice
Scientists from the University of California, San Diego and the Harbin Institute of Technology in China have created a new robotic soft contact lens that lets you zoom by blinking twice. The lens can be controlled by your eye movements.
According to the researchers, eye movements such as blinking carry change potential to signal. Therefore, these scientists measured the electrical impulse and found a way to use it to change the focal length of the lens. The study claims that because of the soft materials used in the lens, relative changes in the focal length can be as large as 32%. The focal length is changed by deforming the lens. In the experiment, the team used dielectric elastomer to achieve the required deformation.
The scientists said that this lens could be used for visual prostheses, adjustable glasses, and/or remotely operated robotics in the future.
Visioneering Technologies Expands into Asia
Visioneering Technologies, Inc. (VTI) has received registration from Hong Kong’s Department of Health for its current and anticipated products. The registration covers the use of the company’s NaturalVue Multifocal for myopia progression control. While contact lenses can be sold without registration in Hong Kong, the registration allows for sales through regulated channels, such as hospitals, and for the specific claim of myopia progression control. VTI will now work to establish a distribution partnership in anticipation of commercial launch in Hong Kong in 2019.
Wendy Hauteman Named Chief Marketing Officer at VSP Global
VSP Global has announced the promotion of Wendy Hauteman to chief marketing officer. In the role, she will lead the organization’s global marketing strategy to deliver its products and services to a diverse set of stakeholders. Most recently, she served as senior vice president of marketing for VSP Vision Care (since 2015). She will report to Michael Guyette, president and CEO of VSP Global. Ms. Hauteman succeeds Mark Ginsberg, who served as chief marketing officer since 2016 and who is moving into a new role as VSP Global’s chief giving officer.
Clearwave Introduces Mike Lamb as New CEO
Clearwave, a provider of automated patient check-in solutions, introduced Mike Lamb as its new CEO. Mr. Lamb brings a strong background of executive leadership in technology and digital healthcare solutions to the company. He spent more than 20 years at ADP in senior sales and operations leadership across major and global client segments, followed by seven years as COO and then CEO of Viverae/SimplyWell, an employer wellness company.
Prevent Blindness to Hold 12th Annual Swing Fore Sight Golf Tournament
Prevent Blindness will be holding its 12th Annual Swing Fore Sight Golf Tournament at Vision Expo West. The event will be held on Sept. 18 at the Bali Hai Golf Club in Las Vegas. Tickets and sponsorships are still available. Current sponsors include Transitions, gold sponsor; Zyloware, award sponsor; and Essilor, lunch sponsor. Additional sponsors include Acuity, CooperVision, GPN-EDGEPro, HEA, Hilco, Hoya/Vision Ease, Jobson, Jobson Medical, Lovejoy Consulting, Ocuco, Reed Exhibitions, Satisloh, The Vision Council, and West Group. For more information, visit preventblindness.org/swingforesight.
Do you believe that standard soft contact lenses used to correct myopia are associated with actual increases in myopic refractive error?
This image shows a successful scleral lens on a 23-year-old male with history of keratoconus. The patient decided to have an intrastromal corneal ring segment implanted first and then to continue with a scleral lens fitting. Visual acuity of 20/20-2 was obtained for this eye. You can see a part of the ring under the tear film. The scleral lens had the following parameters: a vault of 350μm, a base curve radius of 7.80mm, a landing zone diameter of 16.5mm, a scleral curve of 13.5mm, and sphere power of –1.00D.
We thank Dimitrios Spourdalakis 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
Visual Performance with Developing Contact Lenses for Myopia Management
As we learn more about myopia progression management, we will continue to see the development of new and often novel approaches used to treat progressive myopia. Much attention is being given to contact lens options in this area. Recently, a study was published that evaluated the retinal image quality and visual performance of three prototypes of contact lenses intended to control axial elongation of the eye before they are considered for clinical trials.1
In this non-dispensing, cross-over, double-blind study, 30 right eyes of myopic subjects wore three multifocal test lenses and one monofocal control lens in random order. Lens 1 was a radial refractive gradient (RRG) center-distance design, and Lens 2 and Lens 3 were center-near with an additional annular ring for near. Nominal add power was 2.00D, 1.50D, and 2.00D, respectively. Subjects were aged 21.96 years ± 2.23 years [range 18 to 30 years] and had mean spherical equivalent refraction M = –2.23D ± 1.50D [range –0.75D to –5.50D], with refractive astigmatism below –0.75D. Higher-order aberrations (HOAs), glare formation (halo), high- and low-contrast LogMAR visual acuity, and contrast sensitivity function (CSF) were measured under monocular conditions.
Results indicated that all individual terms of HOAs and total RMS (root-mean-square) from 3rd to 8th order increased significantly with the three test lenses compared to the control. Among the test lenses, Lens 1 significantly increased the higher HOAs compared with Lens 2 and Lens 3. Halo size was significantly larger with the test lenses compared with the control, with Lens 1 showing the largest. Visual acuity under high-contrast conditions was similar for all lenses. Under low contrast, Lens 1 and Lens 2 performed significantly worse compared to the control (Bonferroni post-hoc correction, p < 0.001). CSF was below normal limits with Lens 1 for three and six cycles per degree (cpd) spatial frequency but was not significantly different between the test lenses and the control.
The researchers concluded that lenses with larger stabilized areas for distance vision interfere less with visual acuity and induce lower values of HOAs and image degradation.
When utilizing multifocal daytime wear contact lenses for myopia progression management, one of the challenges is to maintain acceptable levels of visual performance while simultaneously impacting myopia progression. Practitioners find that often these lenses fail to provide excellent acuity and often induce significant HOAs. We also find that older patients tend to complain of associated compromise in visual performance more than younger patients who are being treated for progressive myopia do. This often leads to compliance challenges with these patients. Special attention continues to be needed when considering these types of lenses for myopia progression control.
1. Martins C, Amorim-de-Sousa A, Faria-Ribeiro M, Pauné J, González-Méijome JM, Queirós A. Visual performance and high order aberrations with different contact lens prototypes with potential for myopia control. Curr Eye Res. 2019 Jul 17. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
From Eye to Toe
Diabetes mellitus (DM) has been demonstrated to impact corneal nerve morphology and ocular surface integrity. Specifically, the disease is associated with progressive damage to corneal nerves and epithelial cells. Corneal nerve length and corneal nerve thickness changes are evident even in the early stages of DM.1 Corneal neuropathy can lead to loss of cornea sensation and can ultimately result in neurotrophic ulcers and significant visual morbidity. The epithelial fragility and poor wound healing that result from reduced epithelial adhesion to the underlying basement membrane in diabetes, together with corneal neuropathy, are thought to increase the susceptibility to dry eye disease, persistent corneal erosions, and infection as well as to increase the risk of post-surgical complications.2
Loss of corneal sensation (corneal hypoesthesia) can be quantified by the use of the handheld Luneau Cochet-Bonnet Aesthesiometer. The device contains a thin, retractable, nylon monofilament that extends up to 6cm in length. By adjusting the length of the device, variable pressure can be applied to the cornea. The monofilament ranges from 60mm to 5mm. And, as the length is decreased, the pressure increases from 11mm/gm to 200mm/gm.
Podiatrists practice in our multidisciplinary health care centers, and I recently learned about a new test from them—the Semmes–Weinstein 5.07 (10 gram) Monofilament Testing for Loss of Protective Sensation of Diabetic/Neuropathic Feet. Akin to the concept of the Clochet-Bonnet, the Semmes–Weinstein 5.07 monofilament is calibrated such that it takes 10 grams of force to bend it when touched on the skin of the foot (see image below). An inability to detect this degree of force indicates that the client has a loss of protective sensation in the foot.
Should we have our diabetic dry eye patients remove their shoes and socks for this test?
1. dell’Omo R , Cifariello F, De Turris S, et al. Confocal microscopy of corneal nerve plexus as an early marker of eye involvement in patients with type 2 diabetes. Diabetes Res Clin Pract. 2018 Aug;142:393-400.
2. Markoulli M, Flanagan J, Tummanapalli SS, Wu J, Willcox M. The impact of diabetes on corneal nerve morphology and ocular surface integrity. Ocul Surf. 2018 Jan;16(1):45-57.
Assessing a Modified Fitting Approach for Improved Multifocal Contact Lens Fitting
The purpose of this study was to compare the effectiveness of a modified and a previous fitting guide for multifocal (MF) contact lenses that share a common optical design, lotrafilcon B, nelfilcon A, and delefilcon A, in current soft contact lens (CL) wearers needing presbyopia correction.
This international, multicenter, prospective, randomized, subject-masked study assessed the superiority of the modified guide relative to the previous guide as determined by the number of MF CLs needed to successfully fit each eye at the screening/fitting visit.
A total of 183 presbyopic subjects were randomized to being fit using the modified (n = 99) and the previous (n = 84) MF CL fitting guides. The mean ± SD numbers of lenses required to fit each eye at the screening/fitting visit using the modified and the previous fitting guides were 1.2 ± 0.5 and 1.4 ± 0.5, respectively. The least-squares mean difference (0.2) met predetermined criteria for superiority of the modified fitting guide. At the screening/fitting visit, 82.8% (164/108) and 65.1% (105/166) of presbyopic eyes were fit with one pair of MF lenses using the modified and the previous guides, respectively, and 98.0% (194/198) of eyes were fit with one to two pairs of MF lenses using the modified guide. A higher percentage of eyecare practitioners gave the highest ratings for ease of fit to the modified compared to the previous fitting guide (63.6% [7/11] versus 33.3% [3/9]).
The researchers concluded that the modified fitting guide was superior at reducing the number of MF lenses required to successfully fit each presbyopic patient.
Merchea M, Evans D, Kannarr S, Miller J, Kaplan M, Nixon L. Assessing a modified fitting approach for improved multifocal contact lens fitting. Cont Lens Anterior Eye. 2019 Jun 25. [Epub ahead of print]