As the holiday season is upon us, we at Contact Lenses Today and Contact Lens Spectrum wish you and your practices a very happy holiday season and a very happy new year! There is a tremendous amount of excitement as we ring in 2020, and we have our event of the year and annual report both printing in January 2020—stay tuned for this exciting information. Season’s greetings!
Jason J. Nichols, OD, MPH, PhD
1-800 Contacts Enters Agreement to Acquire 6over6 Vision
1-800 Contacts announced that it entered into a definitive written agreement to acquire 6over6 Vision Ltd., which is expected to close before the end of December 2019.
6over6 currently offers a variety of vision test technologies. Specifically, its GlassesOn is a suite of optometry tools within a mobile application that can retrieve optical parameters from existing lenses and measure pupillary distance, enabling consumers to renew their prescriptions from anywhere, according to the company. Their technology is currently in use by numerous vision companies worldwide, with more licensing deals expected in the coming months. GlassesOn is registered as a Class 1 Exempt Medical Device on the FDA Medical Device Listings.
1-800 Contacts expects to utilize the technology across a variety of its existing businesses and products, including Express Exam, which currently enables consumers to confirm their prescriptions for contact lenses with a computer or smartphone.
In the future, 1-800 Contacts and 6over6 expect to work together on telemedicine offerings, such as enabling consumers to obtain a new prescription for eyeglasses and contact lenses from anywhere without an office visit.
CooperVision Receives Puerto Rico Environmental Award for Fifth Consecutive Year
The Puerto Rico Aqueduct and Sewer Authority (PRASA) has honored CooperVision for the fifth consecutive year with its Pre-Treatment Excellence Compliance Award. Given to the company’s Juana Diaz, Puerto Rico contact lens production and packaging facility, the recognition is based on adherence to operating permit conditions, made possible by ongoing investment in the site’s sustainable infrastructure and employee training. Juana Diaz manufactures a range of CooperVision brands shipped worldwide, including Biofinity silicone hydrogel contact lenses.
Improvements at the plant have included an overall decreased reliance on manufacturing-related water, additional production monitoring, and reuse of water used in some processes.
NewGradOptometry Moves to CovalentCareers
NewGradOptometry.com, an online publication for new optometrists, has migrated its content and media to CovalentCareers.com. Founded in 2013, NewGradOptometry published articles, interviews, clinical resources, and guides for an audience of new optometrists. CovalentCareers, founded in 2015 as a career development company for new healthcare professionals and a provider of eyecare career resources, acquired NewGradOptometry in May 2018 but ran the site as a separate brand and publication until this month. As of December 16, 2019, all NewGradOptometry resources will be available at covalentcareers.com/eyecare.
According to the company, CovalentCareers features 850-plus articles, videos, guides, industry reports, and ebooks published on NewGradOptometry, and CovalentCareers Resources will be easily discoverable within the eyecare section of its site.
Seed Acquires Majority Stake in Sensimed
Sensimed announced the closure of a transaction whereby the Japanese public company Seed has acquired more than 90% of outstanding shares in Sensimed. The transaction closed on Nov. 29. Financial terms of the deal were not disclosed.
Previously, in August 2013, Seed invested in Sensimed by way of a loan. They worked closely together to obtain PMDA (Pharmaceuticals and Medical Devices Agency, Japan) approval for Sensimed Triggerfish in September 2018. Also in 2013, the two companies signed a memorandum of understanding concerning further collaboration. In August 2019, Seed’s loan was converted to preferred shares, and Seed became a 12.55% shareholder in Sensimed.
Eyenovia Expands Scientific Advisory Board
Eyenovia, Inc. a clinical stage ophthalmic biopharmaceutical company that is currently focused on the late-stage development of micro-dosed medications for presbyopia, myopia progression, and mydriasis, announced that Professor Mark Bullimore, PhD, and April Jasper, OD, have joined Eyenovia’s Scientific Advisory Board.
Professor Bullimore is currently an adjunct professor at the University of Houston College of Optometry and is also the associate editor of Ophthalmic and Physiological Optics. Dr. Jasper currently owns and operates Advanced Eyecare Specialists, a group optometry practice in West Palm Beach, FL and is also a Benedict Professor in practice management at Houston College of Optometry. Dr. Jasper is chief optometric editor of Optometric Management magazine.
Bausch Health Licenses Novaliq's NOV03
Bausch Health Companies Inc., Bausch + Lomb, and Novaliq GmbH announced that Bausch Health has acquired an exclusive license for the commercialization and development in the United States and Canada of the investigational treatment NOV03 (perfluorohexyloctane), a first-in-class investigational drug with a novel mechanism of action to treat dry eye disease (DED) associated with meibomian gland dysfunction (MGD). NOV03 is a proprietary water-free, preservative-free solution based on Novaliq's patented EyeSol technology.
Under the terms of the licensing agreement, Novaliq is eligible to receive upfront and milestone payments based on regulatory and commercialization milestones, and sales royalties based on annual net sales of NOV03 in the United States and Canada. In addition, Bausch Health has the right to pursue development and commercialization of NOV03 for DED and combination products based on NOV03 in additional ophthalmic indications in the United States and Canada.
How often do you observe contact lens-related corneal infiltrates in your practice?
This image shows severe corneal edema due to chronic high intraocular pressure (IOP).
We thank Dr. Deligio 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
Scleral Lens Decentration…Parameters that Influence Lateral and Vertical Positioning
As more and more of practitioners embrace scleral contact lens fitting, they quickly realize the dramatic positive influences that these devices have on their patients’ vision, contact lens wearing comfort, and overall quality of life. That being said, nuances of scleral lens management become equally evident. One of the challenges regularly faced is scleral lens decentration that can result in discomfort, physiological impact, and negative optical influences.
A recent study was published that looked at a number of parameters that influenced scleral lens decentration.1 Researchers investigated the effect of lens center thickness (and mass) upon short-term horizontal and vertical scleral lens decentration as well as the association between both scleral topography and apical clearance with lens decentration.
Lens decentration was measured using over-topography data from nine healthy young participants (25 ± 4 years) who had normal corneas fit with the ICD 16.5 scleral lens design (hexafocon B material) with center thicknesses of 150μm, 250μm, and 350μm, while controlling for other lens parameters. Scleral toricity and elevation were determined from sagittal height data over a 15mm chord obtained from a corneo-scleral topographer, and central apical clearance was quantified using anterior segment optical coherence tomography.
Analysis results indicated that the mean lens decentration was 0.55mm ± 0.19mm temporally and 0.84mm ± 0.35mm inferiorly, which did not vary significantly with center thickness (p > 0.05). The mean nasal-temporal asymmetry in scleral elevation data was substantially greater (619μm ± 67μm) compared to the vertical meridian (369μm ± 57μm) (p < 0.01), and this variation in scleral topography along the horizontal meridian was associated with the magnitude of horizontal lens decentration (r = 0.68, p = 0.04). Greater initial central apical clearance was associated with more inferior lens decentration (r = –0.78, p = 0.01).
The researchers concluded that lens center thickness and mass did not significantly influence centration. Horizontal lens decentration was associated with the nasal-temporal asymmetry in scleral elevation, while vertical lens decentration correlated with initial central apical clearance. Factors affecting scleral lens centration may vary between the horizontal and vertical meridians.
As practitioners continue to investigate various elements that influence scleral lens performance, they are able to use this information to continually modify their approach to lens fitting, which will result in higher rates of success. This study confirms that scleral topography can significantly impact scleral lens positioning, especially along the horizontal meridian. In addition, apical lens clearance can significantly impact vertical scleral lens positioning.
1. Kowalski LP, Collins MJ, Vincent SJ. Scleral lens centration: The influence of centre thickness, scleral topography, and apical clearance. Cont Lens Anterior Eye. 2019 Dec 10. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
Gaining Traction on Demodex Diagnosis
As eyecare practitioners learn more about the health of the lid margin/eyelashes and their effect on ocular surface disease (whether causative, fallout, or both), they are refining and developing techniques to cull the best information. Identifying the presence of Demodex organisms within the eyelash follicle is an example of a technique refined for clinical study.
Demodex mites present in the lash follicle appear to be ubiquitous across age groups. An overabundance of mites is believed to damage the lash follicle and contribute to ocular surface inflammation. Therefore, identifying mites and managing overpopulation are recommended for care of the lid margin.
Epilation of the eyelash with light microscope inspection of the eyelash for mites can be considered “version 1” for Demodex identification. Eyelash rotation within the follicle would be version 2. And now, version 3 is lateral eyelash traction. Lateral eyelash traction involves simple pulling of the eyelash laterally, with gentle tension, after removing any eyelash collarette debris. It is a simple, low-cost, quick, and efficient way to identify Demodex. While in vivo confocal microscopy is another option if it is available to your practice, simple, lateral eyelash traction (via forceps) is a quick skill to develop and can easily be integrated into standard clinical practice.
Outcomes of Scleral Contact Lens Use in Veteran Population
The purpose of this study was to document outcomes associated with use of scleral contact lenses (SLs) in the veteran population and to analyze the medical and demographic factors that affect these outcomes, specifically those involved in contact lens discontinuation.
A retrospective study was conducted that included consecutive patients first fitted with Jupiter Scleral lenses (Visionary Optics) at the Michael E. DeBakey Veterans Affairs Medical Center between 2010 and 2018. The primary outcome was continuation of SL use at one year. Demographic factors and variables such as presence of comorbid diseases, improvement in visual acuity, and daily lens wear time were compared. Logistic regression analysis was used to determine which factors were associated with SL discontinuation.
One hundred twenty patients with a mean age of 56.7 ± 15.1 years were fitted with SLs during the study period. The most common diagnosis was corneal ectasia (55.8%). Sixty-six patients (55.0%) had difficulty with wear; the most common complaint was ocular irritation (20.0%) and midday fogging or bubbles (15.8%). Forty-one patients (34.2%) discontinued SL use with a median time from fitting to discontinuation of 5.2 months. The most common reason for SL discontinuation was difficulty with application and removal (53.7%). Comorbid neurologic disease had a statistically significant association with discontinuation (odds ratio 4.6, 95% confidence interval 1.3 to 17, P = 0.02). There were statistically significant differences in mean visual acuity improvement (P = 0.003) and daily wear time (P < 0.001) but not age (P = 0.70) between patients who continued and discontinued lens use.
The researchers determined that scleral contact lenses are effective for treating a wide variety of ocular diseases and have positive outcomes in veterans. This study aids in understanding patient factors that affect outcomes of SL use in veterans. Further prospective studies are needed to make formal recommendations regarding candidate selection.
Kanakamedala A, Salazar H, Campagna G, et al. Outcomes of Scleral Contact Lens Use in Veteran Population. Eye Contact Lens. 2019 Nov 29. [Epub ahead of print]