I recently attended the Sjögren’s Syndrome Foundation board of director’s annual meeting and was reminded once again how important this organization is relative to the significant impact that this disease has on our patients (www.sjogrens.org). Sjögren’s is an autoimmune disease that impacts the entire body, with a significant impact on the ocular surface.
The organization as a whole is one that engages all involved, from healthcare providers to those involved in policy and law and, in particular, those patients affected by the disease. I encourage you to engage the foundation for resources as you care for this very affected cohort of patients.
Jason J. Nichols, OD, MPH, PhD
B+L Receives 510(K) Clearance from FDA for Ultra Multifocal for Astigmatism Lenses
Bausch + Lomb (B+L) has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for B+L Ultra Multifocal for Astigmatism contact lenses, a multifocal toric lens that is available as a standard offering in the eyecare professionals’ fit set. These contact lenses are expected to be available by mid-2019.
In unrelated news, B+L and Modulight, Inc. have entered into an exclusive agreement to collaborate and develop a new laser specifically designed for use with B+L’s Visudyne (verteporfin for injection) photodynamic therapy (PDT). Visudyne is an injectable photosensitizer drug that is indicated for the treatment of patients who have predominantly classic subfoveal choroidal neovascularization due to age-related macular degeneration (AMD), pathologic myopia, or presumed ocular histoplasmosis. It is activated through use of a photodynamic laser via direct laser excitation.
BCLA Appoints Alcon’s Jonathon Bench as President Elect
Alcon’s head of professional affairs, Jonathon Bench, has been nominated as president elect of the British Contact Lens Association (BCLA). He has been a BCLA member for 12 years, serving on its committee for five years and joining its executive council last year. After graduating from Cardiff University, Mr. Bench worked at a multiple and owned a franchise practice before joining Alcon in 2013.
AccuLens Announces New Training Center
In response to growing demand for scleral lens training and education, AccuLens announced the opening of a brand new, in-house training facility in its manufacturing location in Denver. The new 1,200-square-foot addition and state-of-the art facility will host mini Scleral Lens Academies in a 12-person, classroom-style conference room as well as offer hands-on instruction in a newly appointed exam lane for reviewing actual cornea-challenged patients. The training format will be modeled after the Scleral Lens Academies hosted nationwide, which include formal lectures and patient-driven, hands-on experience. A 2019 training schedule in the new facility will be available in January. For more information or to register, visit http://www.acculens.com/education.html.
Kemberly Grizzaffi Joins Eaglet Eye
Eaglet Eye announced that Kemberly Grizzaffi, NCLE, has joined the team. Ms. Grizzaffi’s primary responsibility will be to coordinate and execute installation, training and support for eyecare practitioners who have acquired an Eye Surface Profiler. She brings significant specialty lens experience to Eaglet Eye with more than 25 years in practice with 10 years fitting and managing specialty contact lenses. Ms. Grizzaffi has spent the last three years at SynergEyes concentrating on sales and account management.
Your Interesting Case Photo Here in the Next Issue
Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in Contact Lenses Today in the coming weeks!
We welcome photo submissions from our 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
Don’t Forget About the Little Guy!
GP lenses have been the gold standard for visual rehabilitation for years—before scleral, hybrid, and soft contact lenses. With the profound increase in awareness of clinical indications of specialty contact lenses in the medical field, it’s important to keep up on your GP lens fitting principles for many reasons. Mainly, GP lenses provide superb vision quality. These lenses are often more affordable than other lens options, and the cleaning regimen is simple and relatively easy. The main issues are patient comfort and practitioner ease in clinical fitting.
Several resources are available to aid in fitting beyond the didactic clinical model. Several systems are available for simulation of GP contact lens fitting based on anterior corneal elevation topography.1 In a study conducted by Jani and Szczotka, they reported a greater than 80% success rate in fitting GP lenses on normal corneas utilizing this method.2 Recently, a paper published in China demonstrated a promising approach utilizing virtual simulation and 3D printing technology for GP fitting. The results demonstrated greater prediction of lens centration on the eye.3 While the study is primitive and the results are limited, perhaps this could be the wave of the future.
1. Bhatoa NS, Hau S, Ehrlich DP. A comparison of a topography-based rigid gas permeable contact lens design with a conventionally fitted lens in patients with keratoconus. Cont Lens Anterior Eye. 2010;33:128–35.
2. Jani BR, Szczotka LB. Efficiency and accuracy of computerised corneal topography software systems for fitting rigid gas permeable contact lenses. CLAO. 2000 Apr;26:222-228.
3. Zhao F, Wang J, Wang L, Chen L. An approach for simulating the fitting of rigid gas-permeable contact lenses using 3D printing technology. Cont Lens Anterior Eye. 2018 Oct 15. [Epub ahead of print]
MATERIALS & DESIGNS
David L. Kading, OD
A Final Push
The end of the year is always an exciting time. But, it flew past without us even knowing what happened. Like most practices, we are trying to help as many patients as possible in December in the hopes of helping them use up their insurance benefit—whether it be for an eye examination with their vision benefit or for their materials benefit (glasses or contact lenses). December is our busiest glasses sale month as patients are trying to purchase either prescription eyewear or sunwear before they "lose" their benefits.
December can also be an excellent time to help contact lens patients as well. Run a report in the electronic health record for all of the patients who received a contact lens service from the practice and then add in the dollar value that they brought in. Select the lowest patients (in terms of income to the practice), and you will discover that many of them may have elected to get a minimal supply of lenses or perhaps they did not buy lenses at all.
With a dedicated team member, practitioners can reach out to those patients and see whether any of them want to use their materials benefit before the year runs out. This is an excellent way to improve compliance while at the same time reconnecting with those patients and seeing how they are doing with their lenses. Perhaps they forgot to come in for a contact lens follow-up visit and therefore never finalized their prescription. Perhaps they were not satisfied with the multifocal or toric lenses that had been prescribed and were lost to follow up.
Obviously, this is an ideal habit to do year-round, but it can also be done at year end for one more push and connection. Additionally, practitioners can have their team members wish their patients a "Happy Holidays." This kind gesture will remind patients of how nice the practice is and why they come to see you every year for their eyecare.
International Survey of Orthokeratology Contact Lens Fitting
The purpose of this study was to determine the extent of orthokeratology (OK) contact lens fitting worldwide and to characterize associated demographics and fitting patterns.
Survey forms were sent to contact lens fitters in 45 countries between Jan. and Mar. every year for 14 consecutive years (2004 to 2017, inclusive). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form.
Data were obtained for 295,044 contact lens fits, of which 2,702 were with OK lenses and 292,342 were with other lens types (non-OK). Overall, OK lenses represented 1.2% of all contact lens fits, with significant differences among nations (p < 0.0001), ranging from no fits recorded in Brazil, Egypt, Indonesia, Iran, Lithuania, Nepal, and the United Arab Emirates to 6.0% in The Netherlands. There has been a slight overall increase in OK lens fitting over the survey period (p < 0.0001). OK lenses were fitted to younger persons (OK, 25.0 years ± 12.8 years versus non-OK, 39.8 years ± 14.9 years, p < 0.0001). A higher proportion of males (55%) were fitted with OK lenses versus non-OK lenses (30%, p < 0.0009). There was a skewed distribution toward OK lenses being fit with higher-oxygen-permeable materials (p < 0.0001) and on a planned replacement basis (p < 0.0001).
The researchers noted that OK contact lens prescribing is a niche activity, with this lens type typically being fitted in high-oxygen-permeable materials on a planned replacement basis to younger males. They also determined that the slightly increasing rate of OK fitting, albeit at a very low level, may be attributed to practitioner interest in the reported myopia control properties of this lens type.
Morgan PB, Efron N, Woods CA, Santodomingo-Rubido J; International Contact Lens Prescribing Survey Consortium. International survey of orthokeratology contact lens fitting. Cont Lens Anterior Eye. 2018 Nov 15. [Epub ahead of print]