This week’s abstract shows an increasing concern about myopia among eyecare practitioners but similar levels of intervention compared to a survey taken four years prior. I think we need to continue to be vigilant in getting out the message about the importance of myopia control. There is no doubt that several strategies for myopia control exist and have an impact outside of controlling myopia itself. With the recent U.S. Food and Drug Administration approval of a contact lens labeled for myopia control, I hope that this further motivates practitioners who are not active in this space to take action.
Jason J. Nichols, OD, MPH, PhD
Simple Contacts Offers New Trial Lens Service
Simple Contacts has launched a new service for users who want to try out a new contact lens prescription. Those users will take an online test and provide certain information about the contact lenses that they currently wear. Once the test is complete and the company is assured that a user’s prescription hasn’t changed, Simple Contacts will recommend a daily disposable lens that would be the right fit for a user. The company says that users can contact their own eyecare practitioner if they have any issues or questions regarding the trial lens.
In other news, the company has also begun offering a broader array of prescription services under its Simple Health brand by expanding into other aspects of the healthcare market.
Vivior and SwissLens to Collaborate on Personalized Contact Lenses
Vivior and SwissLens, which are both Swiss companies, have agreed to collaborate in the field of personalized multifocal soft contact lenses for presbyopia correction. The objective is to optimize the design in soft multifocal contact lenses by using the data generated by Vivior’s visual behavior monitor, the Vivior Monitor.
Survey Reveals Vision Is Deprioritized by Parents in Children’s Overall Health
In a new survey from The Global Myopia Awareness Coalition (GMAC), parents ranked annual visits to an eyecare practitioner as less important compared to visits to the dentist or pediatrician. In fact, only 27% of parents reported taking their children to an optometrist in the past year.
This may be due to the misperceptions that the survey also revealed about what comprehensive eye exams entail. According to the survey, parents reported waiting until something was “wrong,” such as their children telling them that they can’t see the whiteboard (66%), seeing their children squint more than normal (62%), or seeing their children hold materials far away (52%), before taking them in for a comprehensive eye exam.
This survey, conducted online by Dynata on behalf of GMAC among parents in the United States, included 4,004 responses.
Santen Receives CADTH CDEC Reimbursement Recommendation for Verkazia
Santen Canada Inc., a subsidiary of Santen Pharmaceutical Co., Ltd. announced that the Canadian Agency for Drugs and Technologies in Health (CADTH) Canadian Drug Expert Committee (CDEC) released a reimbursement recommendation for Verkazia (cyclosporine 0.1%) eye drops. Verkazia cyclosporine 0.1% topical ophthalmic emulsion is indicated for treatment of severe vernal keratoconjunctivitis in children from years of age through adolescence. The recommended treatment regimen by Health Canada is four-times-daily administration. For more information, visit the CADTH website at https://www.cadth.ca/cyclosporine-8.
BCLA Launches Global Consensus Report on Contact Lenses
The British Contact Lens Association (BCLA) announced a new BCLA global consensus report that will deliver evidence-based guidance on contact lenses and the anterior eye to ensure the best possible care for patients around the world. The Contact Lens Evidence-based Academic Reports (CLEAR) will include a series of nine global consensus reports, which will be compiled during 2020 and published in Contact Lens and Anterior Eye in March 2021.
Papers will be chaired by internationally renowned experts and will focus on the following subjects: anatomy and physiology of the anterior eye - Dr. Laura Downie; biochemistry of lens materials, coating, comfort drops, and solutions - Professor Mark Willcox; effect of lens materials/design on the anatomy and physiology of the eye - Professor Philip Morgan; specialty lenses - Professor Pauline Cho and Dr. Melissa Barnett; contact lens complications - Professor Fiona Stapleton; medical use of contact lenses - Associate Professor Debbie Jacobs; contact lens optics - Dr. Kathryn Richdale; future applications of contact lenses - Professor Lyndon Jones; and evidence-based contact lens practice - Professor James Wolffsohn. Those interested in being considered as a co-authors should contact the BCLA by Dec. 20.
ProtoKinetix AAGP Dry Eye Therapy Program Launched
ProtoKinetix, Incorporated announced the initiation of a program testing AAGP to develop a potential therapy to treat dry eye disease (DED). AAGP has repeatedly demonstrated anti-inflammatory and cytoprotective properties, and it also exhibits pharmaceutical properties beneficial for topical formulations, according to the company.
Before efficacy testing can commence, an eye irritation study will be conducted in accordance with both industry and regulatory requirements. This testing has been contracted to ITR Laboratories of Montreal. This testing is scheduled to commence in early December, with results before January 2020.
J&J Vision Announces Availability of Acuvue Oasys with Transitions in the United Kingdom
Johnson & Johnson (J&J) Vision announced the national availability of Acuvue Oasys with Transitions Light Intelligent Technology in the United Kingdom. Acuvue Oasys with Transitions is a two-week reusable contact lens. It is now commercially available at select retailers in the United Kingdom and is being rolled-out to other markets in Europe, the Middle East, and Africa (EMEA).
NovaBay Pharmaceuticals Launches NovaWipes Eyelid Wipes on Amazon.com
NovaBay Pharmaceuticals, Inc. launched NovaWipes, a dry, soft, hypoallergenic and absorbable wipe for use in applying Avenova, on Amazon.com. Avenova Direct, NovaBay’s prescription-strength lid and lash spray, is also available on Amazon.com without a prescription. NovaWipes are available in a 30-count package for $5.99.
EyePoint Pharmaceuticals Announces New Agreement for Expanded Access of Dexycu
EyePoint Pharmaceuticals, Inc. has entered into a formal two-year contract with one of the largest integrated delivery systems in the United States to offer Dexycu within its network. This agreement opens up new distribution channels for Dexycu that were previously unavailable in key U.S. regions, including California, Washington, Georgia, Colorado, and mid-Atlantic states. EyePoint has also received Preferred Vendor status from the system.
Stephen Paul Burke
Stephen Paul Burke, formally with City Crown, Polymer Technology, and Bausch + Lomb, passed away Nov. 5, 2019 in Port St. Lucie, FL from multiple health issues at the age of 63. He is survived by his wife Sondra of Port St. Lucie, his mother Audrey Burke, and sister Linda Cobb, both in the United Kingdom.
Steve’s career within the contact lens industry spanned multiple decades working with independent contact lens laboratories as an active member of the Contact Lens Manufacturers Association. Possessing tremendous engineering skills, Steve’s ability to help contact lens laboratories become more efficient, solve critical manufacturing challenges, and improve product quality were second to none. What made Steve such a perfect fit for his role was his determination to solve problems and his love of being challenged.
Steve’s many contributions to our companies and our industry are greatly appreciated. His kindness, friendship, humor, and his can-do attitude will be missed by his family, friends, and colleagues. –Contributed by David Bland and Jim Lunkley.
Pierre Pitance died suddenly on Sunday Dec. 1 at 54 years old. Pierre had led Precilens as CEO since 2004. He was a well-respected optical pioneer and business leader. Pierre leaves behind his wife Christel, four children, and the memory of a warm man with an entrepreneurial soul. Those who worked with him praise his friendliness.
Leonard Osias, OD
Leonard Osias, OD, passed away on Nov. 15 at the age of 95. In addition to private practice in San Lorenzo, CA, Dr. Osias was a clinic professor at the UC Berkeley School of Optometry for 20 years as well as an active leader in his profession. Dr. Osias, along with several colleagues, was also a founding member of the Primary Eyecare Network, which began in 1984.
He was predeceased by his wife of 70 years, Irene. He is survived by his three sons: Gary (Lydia), David (Jeanette), and Joel (Fatmata) and seven grandchildren: Aaron, Rachel (Renee), Sara (Andrew), Josh, Benjamin (Tess), Gabriella, and Malaka.
AAOF Announces the 2019 VSP Global Scholarship Recipients
The American Academy of Optometry Foundation (AAOF), the philanthropic arm of the American Academy of Optometry (AAO), and VSP Global announced the recipients of this year’s Practice Excellence Scholarships. Nearly $200,000 was awarded to several top-performing fourth-year optometry students in the United States, Puerto Rico, and Canada as well as to four additional international students from Australia.
This year, in honor of the 3rd World Congress of Optometry held in conjunction with the Academy meeting in Orlando, FL, VSP Global added an Australian Practice Excellence Scholarship, open to students from four institutions: Deakin University, Flinders University, Queensland University of Technology School of Vision Science, and the University of New South Wales.
Two students from each school or college of optometry as well as one student from each Australian institution were selected by nomination from their individual institutions to receive the scholarship. The scholarships are funded through VSP’s Global Charitable Fund and are administered through the AAOF. Each scholarship included a travel grant to participate in the AAO’s 98th annual meeting, Academy 2019 Orlando.
AOA Accepting Nominations for the 2020 Hall of Fame
Nominations for the 2020 National Optometry Hall of Fame are now being accepted online, with inductees to be honored at Optometry’s Meeting 2020, which will be held June 24 to 28, 2020 in National Harbor, Maryland/Washington, D.C. The deadline for online submissions is Jan. 31, 2020.
Administered by Optometry Cares—The AOA Foundation, the National Optometry Hall of Fame has recognized since 1998 outstanding eyecare practitioners of optometry who have made long-lasting contributions to the profession.
Practitioners may be nominated for one of two categories: academia or private practice/federal service. Nominees must meet specific criteria for either category, but general eligibility requirements state that nominees must have more than 30 years’ service in the profession; be involved in optometric clinical care, private practice, federal service, academia, research, or industry; have records of dedicated service and lifetime achievements or contributions; and must be a resident of the United States.
This image shows the eye of a 26-year-old woman who was referred to my service for a contact lens fitting. During the ocular examination, I discovered this interesting finding—post-flap laser-assisted in situ keratomileusis (LASIK) folds.
We thank Dr. Correa 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
Early Identification of Keratoconus by Combining Corneal Tomography and Corneal Biomechanical Measurements
With the advent of treatment modalities that can halt the progressive nature of keratoconus, practitioners now have the potential to prevent vision loss and to preserve vision for patients who previously were destined to suffer the impact of this disease. As such, earlier diagnosis becomes that much more important.
A recent study was published that attempted to develop a combined biomechanical and tomographic model for identifying eyes that have subclinical keratoconus (SKC) and are categorized as normal or borderline in the Pentacam (Oculus) Belin/Ambrósio Enhanced Ectasia Display.1 This case-control study was comprised of 62 eyes that had SKC and of randomly selected eyes of 186 age-matched healthy controls. SKC was defined as the presence of the following: 1) normal topography, topometric indices, and slit lamp; 2) normal or borderline Belin/Ambrósio Enhanced Ectasia Display “D” index, back and front elevation difference; and 3) keratoconus in the fellow eye. Stepwise logistic regression analysis was performed to identify the best variable combination for detecting SKC cases from Ocular Response Analyzer (ORA; Reichert Technologies) and Pentacam parameters. Receiver operating characteristic curve analysis was used to determine the predictive accuracy [area under the curve (AUC)] of the model. Based on the predictors in the final logistic regression model, a linear equation was derived using the discriminant function analysis.
Results indicated that the final model (AUC: 0.948, sensitivity: 87.1% and specificity: 91.4%) chose corneal hysteresis (CH) and D index from a total of 63 candidate variables. The final model had a higher AUC compared with D (0.933, P = 0.05) and CH (0.80, P < 0.001) alone. According to the discriminant function analysis, a higher CH was required with increasing D index to classify an eye as normal.
The authors concluded that the proposed combined model provided varying cutoffs for CH and D as a function of the other. Therefore, the probability plot as a function of CH and D index may be used for identifying eyes that have SKC.
New technologies are allowing practitioners to identify keratoconus at earlier stages. In fact, today they have the ability to make a diagnosis prior to any negative impact on visual function. Corneal tomography allows them to do this because it can detect abnormalities on the posterior cornea and abnormalities of overall corneal thickness distribution. Now, eyecare practitioners are discovering that the biomechanical properties of the keratoconic cornea are quite different from the normal cornea.
This study points to the fact that by combining these two diagnostic modalities, physicians may be even more sensitive in diagnosing keratoconus. This study utilized Pentacam corneal tomography along with biomechanical measurements from the ORA. Additionally, a tonometer can be used to take biomechanical corneal measurements. Software has been developed that combines the analysis of results from both of those instruments into what is termed a “TBI” analysis, which stands for tomographic–biomechanical index analysis. Ongoing evaluation of such diagnostic systems will continue to allow practitioners to move forward in earlier diagnosis and management of keratoconus and will allow them to preserve vision for their patients who have keratoconus.
1. Atalay E, Özalp O, Erol MA, Bilgin M, Yıldırım N. A Combined Biomechanical and Tomographic Model for Identifying Cases of Subclinical Keratoconus. Cornea. 2019 Nov 13. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
When Wet = Dry
Benign prostatic hyperplasia (BPH)—also called prostate gland enlargement—is a common condition as men get older. The prostate gland is located beneath the bladder and, if enlarged, begins to block urine flow. An enlarged prostate gland can cause uncomfortable urinary symptoms such as a weak, slow urinary stream, a hesitancy and straining to urinate, prolonged voiding, dribbling at the end of urination, an inability to empty the bladder completely, the frequent passage of small amounts of urine, or nighttime urination (nocturia). Another symptom of BPH may be the uncontrollable need to void and other symptoms of an overactive bladder. Although an overactive bladder is much more common in women than in men, some gents are plagued by the problem that also precipitates urinary urgency, frequency, and incontinence.
Anticholinergic drugs that slows the bladder’s contractions, such as oxybutynin, are the mainstays of therapy for OAB in men and may be used in combination with BPH medication. One notorious side effect of anticholinergic drugs is that they provoke eye dryness.
Lifestyle changes can reduce the need to therapeutically manage OAB. These changes include reducing fluid intake, especially alcohol and caffeine; avoiding medications that stimulate muscles in the bladder neck and prostate such as pseudoephedrine and other decongestants; and reducing or changing diuretic medication use for high blood pressure.
Make sure to explore the therapeutics that your male dry eye patients who have BPH are using; you just may identify the underlying culprit for this anterior segment pathology.
Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice – 2019 Update
A survey in 2015 identified a high level of eyecare practitioner concern about myopia with a reported moderately high level of activity, but the vast majority still prescribed single-vision interventions to young myopes. This research aimed to update these findings four years later.
A self-administrated, internet-based questionnaire was distributed in eight languages through professional bodies to eyecare practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy of available strategies and adoption levels of such strategies, and reasons for not adopting specific strategies.
Of the 1,336 respondents, concern was highest (9.0 ± 1.6; p < 0.001) in Asia and lowest (7.6 ± 2.2; p < 0.001) in Australasia. Practitioners from Asia also considered their clinical practice of myopia control to be the most active (7.7 ± 2.3; p < 0.001), the North American practitioners being the least active (6.3 ± 2.9; p < 0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by pharmaceutical approaches and approved myopia control soft contact lenses (p < 0.001). Although significant intra-regional differences existed, overall, most practitioners did not consider single-vision distance under-correction to be an effective strategy for attenuating myopia progression (79.6%) but prescribed single-vision spectacles or contact lenses as the primary mode of correction for myopic patients (63.6% ± 21.8%). The main justifications for their reluctance to prescribe alternatives to single-vision refractive corrections were increased cost (20.6%) and inadequate information (17.6%).
The researchers conclude that while practitioner concern about myopia and the reported level of activity have increased over the last four years, the vast majority of eyecare clinicians still prescribe single-vision interventions to young myopes. With recent global consensus evidence-based guidelines having been published, it is hoped that this will inform the practice of myopia management in the future.
Wolffsohn JS, Calossi A, Cho P, et al. Global trends in myopia management attitudes and strategies in clinical practice - 2019 Update. Cont Lens Anterior Eye. 2019 Nov 21. [Epub ahead of print]