I've been reminded recently that we have many ophthalmic office staff members who read our newsletter and publication. I think it goes without saying, but it must be said, that office staff are the life-blood of any solid contact lens practice. Our office staff obviously help in so many key aspects of regular patient care, but also contribute in beyond measure to the ultimate success of the contact lens patient as well. Thank you all for your contribution to the contact lens field.
Vistakon, Division of Johnson & Johnson Vision Care, Inc., announced the creation of a new Professional Development group, which combines its Professional Affairs, ODLean Consulting Program, and optometry school educational efforts into one department.
Damian May, PharmD, MBA, has been appointed Senior Director, Strategy & Professional Development, responsible for working with the new organization to set the vision, strategy and roadmap for the Group to meet the changing demands of the optometric marketplace. Dick Wallingford, OD, FAAO, has been named Senior Director, Professional Affairs. In this expanded role, Dr. Wallingford will continue to lead the company's professional affairs activities with associations and eyecare practitioners, as well as oversee management of its optometry school programs. W. Lee Ball, OD, FAAO, will continue to work with Dr. Wallingford to support these efforts.
Dr. May has been with Johnson & Johnson for seven years with experience in both the Pharmaceutical and Medical Device and Diagnostics Sectors. Since 2008, he has been responsible for Market Access & Strategy for Vistakon. Prior to joining the company, he held positions focusing on health economics, clinical consulting, third party reimbursement (commercial and governmental), outcomes research and market access within Pfizer Pharmaceuticals, Prudential Healthcare, Alcon Laboratories, and VHA, Inc.
Dr. Wallingford joined Vistakon in 2008. He is a past President of the American Optometric Association. He is also the past President of the Maine Optometric Association and past President of the Maine Board of Optometry, serving eleven years by the Governor's appointment. Dr. Wallingford served on an AOA committee or board continuously for over 28 years.
Dr. Wallingford is a graduate of the New England College of Optometry and has served on their Board of Trustees for over 8 years. He is a member of the Governing Board and the Treasurer of the World Council of Optometry, and the World Foundation for Optometry. He is also the Past President of the Partnership Foundation for Optometric Education.
Vision Source announced that the Vision Source-named surgical center has opened at the University of Houston and it is the first surgery center in the nation to be housed and affiliated with a college of optometry.
Classes have already started in the new Vision Source Ambulatory Surgical Center at the University of Houston. The Center is a fully licensed ambulatory surgery center whose primary activity will be to perform ophthalmic surgery of all types. It is an open facility that is available for any qualified surgeon that meets the VSSC credentialing criteria. The Vision Source Surgery Center is equipped with the latest technology and is one of only 50 centers in the nation, and the only licensed ambulatory surgery center in Houston, to offer bladeless cataract surgery.
Keratoconus Patient Fit with Silicone Hydrogel Lens By Boris Severinsky, MOptom, Jerusalem, Israel
Silicone hydrogel soft lens fitted on keratoconic cornea shows initial good motion. The right image, taken 5 hours after the lens insertion, demonstrates conjunctival imprint and signs of tight lens syndrome.
We thank Boris Severinsky for his image. 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 an explanation of the photo and your full name, degree or title and city/state/country. ^ Back to top
CARE SOLUTION CORNER Susan J. Gromacki, OD, MS, FAAO
A presentation at this year's Global Specialty Lens Symposium helped review some of the FDA's research regarding lens care. Based on a series of 2012 publications in the Eye & Contact Lens journal, Loretta Szczotka-Flynn, OD, PhD, FAAO reported that the FDA has been studying the physiochemical properties of silicone hydrogel (SiHy) contact lenses in order to classify them into their own material categories with regards to solution testing and compatibility. In addition to the four current groupings for soft lenses, the FDA has proposed a group 5 for silicone hydrogel lenses, which would then be subdivided into five subgroups.
Group 5-A: low water content, non-ionic, and surface treated lenses
Group 5-B1: Low water content, non-ionic, non-surface treated, and hydrophilic monomer-containing lenses
Group 5-B2: Low water content, non-ionic, non-surface treated, and semi-interpenetrating network-containing lenses
Group 5-C: High water content, non-ionic lenses
Group 5-D: Ionic materials, both low and high water content lenses
If finalized, there will be a total of five groups, with Group 5 further divided into 5 subgroups. This will certainly be a welcome change, for both classification and solution testing purposes.
1. Eydelman MB, Kiang T, Tarver ME, Alexander KY, Hutter JC. Preclinical Research to Aid in the Development of Test Methods for Contact Lenses and Their Care Products. Eye Contact Lens. 2012 Nov;38(6):385-7. Published ahead of print.
2. Green JA, Phillips KS, Hitchins VM, Lucas AD, Shoff ME, Hutter JC, Rorer EM, Eydelman MB. Material Properties That Predict Preservative Uptake for Silicone Hydrogel Contact Lenses. Eye Contact Lens. 2012 Nov;38(6):350-357.
3. Hutter JC, Green JA, Eydelman MB. Proposed Silicone Hydrogel Contact Lens Grouping System for Lens Care Product Compatibility Testing. Eye Contact Lens. Nov 2012;38(6):358-362. ^ Back to top
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
OSD in Patients with Prosthetic Eyes: Part 2 of 2
Part one of this series discussed a study that concluded that the tear meniscus height of artificial eyes was significantly lower than that of normal eyes.
In this second study, Jang and coworkers showed that eyelids with an ocular prosthesis were associated with a significantly greater degree of meibomian gland dysfunction, particularly obstructive MGD, and meibomian gland loss compared with the normal paired eyelid.
The authors propose two mechanisms for the above finding. First, they postulate that meibomian gland loss in prosthetic eye wearers is similar to that induced by contact lenses, that is, that mechanical rubbing of the prosthesis on the tarsus and posterior surface of the lid margin might induce hyperkeratinization and/or inflammation of the tarsal epithelium, resulting in MGD. Second, that obstructive MGD occurring in eyelids associated with prosthetic eyes is due to decreased and weakened eyelid blinking.1 Decreased blinking might be associated with MGD.2
. Jang SY, Lee SY, Yoon JS. Meibomian gland dysfunction in longstanding prosthetic eye wearers. Br J Ophthalmol. 2013;0:1-5
2. Shah CT, Blount AL, Nguyen EV, Hassan AS. Cranial nerve seven palsy and its influence on meibomian gland function. Ophthal Plast Reconstr Surg. 2012;28:166-8
Dry Eye Symptoms and Chemosis Following Blepharoplasty: A 10-Year Retrospective Review
Researchers wanted to determine the incidence of and risk factors associated with dry eye symptoms (DES) and chemosis following upper or lower blepharoplasty. They also wanted to examine the outcomes among long-term blepharoplasty data to better understand the incidence of and risk factors associated with dry eye symptoms (DES) and chemosis, to evaluate the known risk factors for DES in the general population, and to analyze intraoperative procedures (such as forehead-lift, midface-lift, canthopexy, and canthoplasty) to determine their effects on DES and chemosis.
A retrospective medical record review was performed among all the cases of upper or lower blepharoplasty performed by the senior author during a 10-year period (January 1999 through December 2009). A self-reported dry eye questionnaire was used to collect baseline and follow-up data. Patients with incomplete medical records, multiple (>1) revision procedures, less than 3 weeks of postoperative follow-up data, or a history of Sjogren syndrome, severe thyroid eye disease, histoplasmosis ocular infection, periocular trauma causing eyelid malposition, or radiotherapy for nasopharyngeal cancer were excluded from the study. Binary logistic regression analyses were performed to analyze the relationship between 13 preoperative and anatomical variables and DES or chemosis. Chi2 Tests were performed to analyze the relationship between intraoperative risk factors and DES or chemosis.
In total, 892 cases met the study inclusion criteria. Dry eye symptoms and chemosis following blepharoplasty were reported in 26.5% and 26.3% of patients, respectively. The incidences of DES and chemosis were significantly higher in patients who underwent concurrent upper and lower blepharoplasty (P < .001) and in patients who underwent skin-muscle flap blepharoplasty (P = .001). Hormone therapy use and preoperative scleral show were associated with DES after blepharoplasty (P < .05). Male sex, preoperative eyelid laxity, and preoperative DES were associated with an increased incidence of chemosis following blepharoplasty (P < .05). Intraoperative canthopexy significantly increased the risk for developing chemosis (P = .009), and postoperative lagophthalmos significantly increased the risk for DES following blepharoplasty (P < .001).
The researchers concluded that dry eye symptoms and chemosis are common following blepharoplasty, and the risk for developing these conditions may increase with intraoperative canthopexy, postoperative temporary lagophthalmos, concurrent upper and lower blepharoplasty, and transcutaneous approaches violating the orbicularis oculi muscle. Patients with a preoperative history of DES, eyelid laxity, scleral show, or hormone therapy use may be at greater risk for developing dry eyes or chemosis following surgery.
Prischmann J, Sufyan A, Ting JY, Ruffin C, Perkins SW. Dry eye symptoms and chemosis following blepharoplasty: a 10-year retrospective review of 892 cases in a single-surgeon series. JAMA Facial Plast Surg 2013;15:39-46.