We continue to hear positive feedback regarding our 11th annual Global Specialty Lens Symposium, which was held in Las Vegas on January 26-29, 2017. Almost everyone I spoke with commented on several new things they were able to take away from the meeting and immediately incorporate into their practices. It also goes without saying that we wish to sincerely thank not only our attendees and speakers, but also our sponsors and exhibitors without whom this meeting simply would not be possible. Look forward to a brief recap in the News Spectrum section of the March issue of Contact Lens Spectrum, as well as a feature article about the meeting that will be published in the April issue.
Jason J. Nichols, OD, MPH, PhD
On Feb. 2, 2017, Harue Marsden, OD, MS, passed away after a long battle with breast cancer.
Dr. Marsden was a professor and the associate dean for clinical education at Southern California College of Optometry (SCCO). She was a fellow of the American Academy of Optometry and diplomate in the Cornea and Contact Lens Section. She was also an owner of two private practice offices with Vicki Leung, OD, and Eric Leser, OD.
Dr. Marsden’s primary clinical responsibilities included the cornea and contact lens service, where she also served as chief for many years. She lectured internationally and previously served as president of the California Optometric Association (COA) from 2010-2011. She was currently serving on COA’s Legislation and Regulation Committee.
She was an inspiration for many upcoming students and mentored many is her role as assistant dean of SCCO. She also was an advocate for optometrists both locally and nationally. She volunteered with the American Optometric Association, American Academy of Optometry, COA, Orange County Optometric Society, Great Western Council of Optometry, and Association of Optometric Contact Lens Educators.
Dr. Marsden is survived by her twin sister Midori, sisters Yuki and Fumi, and brother, Akira. A memorial service was held at SCCO’s Marshall B. Ketchum University campus on Feb. 10.
Editor’s Note: I was fortunate to get to know Harue early on in my career, when I was considering Cornea and Contact Lens Residency training options. Her knowledge and passion for cornea and contact lenses was incredibly deep and inspirational; her advocacy for the profession was unwavering; and her sense of humor was indeed remarkable. She was an inspiration and mentor to so many of us and she will be deeply missed. Our most sincere regrets go out to her family, in addition to the many others of us whose lives she touched.
B+L Discontinues Its UPP
The recent decision from the U.S. Court of Appeals for the Tenth Circuit upheld Utah’s Contact Lens Consumer Protection Act, which prohibits unilateral pricing policies (UPP) on contact lenses. According to Bausch + Lomb (B+L), this law has created a competitive imbalance by permitting Utah-based customers to sell contact lenses at rates below those who sell its contact lenses in other states.
Therefore, B+L has re-evaluated its UPP and decided to discontinue it, effective immediately. The company plans to continue to provide programs and tools that help make its products more affordable and accessible, such as its rebate program. For patients to receive the maximum rebate value, they must get their contact lens exam and purchase their contact lenses from their prescribing doctor. Complete information about the rebate program is available through your B+L sales representative or the company’s customer service team at (800) 828-9030.
TearLab Osmolarity System Receives Mexican Regulatory Approval
TearLab Corporation has received approval for the TearLab Osmolarity System from the Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS) in Mexico. This approval allows TearLab to begin selling the product in Mexico.
The TearLab Osmolarity System provides an objective assessment to diagnose and manage patients with DED by measuring the osmolarity of human tears, according to the company. It is expected to launch in the Mexican market in the first half of 2017. TearLab has signed an exclusive distribution agreement with Cyan Medica, a sales, marketing, and distribution organization offering extensive knowledge, experience, relationships and proven success across the ophthalmic market in Mexico.
ABB Optical Group and Paragon Vision Sciences Announce Optometry Student Challenge Winners
ABB Optical Group, in partnership with Paragon Vision Sciences, announced the winners of the Optometry Student Challenge, a program designed to support optometry students and foster the study of contact lenses. Through the Optometry Student Challenge, third- and fourth-year optometry students who registered were asked to create an abstract focusing on study projects or student-based case histories related to contact lenses. From more than 40 submissions, five finalists were chosen. The five students were required to convert their abstracts into scientific posters and from there the judges selected the top three posters. These top three students were awarded travel grants of $1,500 to attend and present their posters at the recent 2017 Global Specialty Lens Symposium.
The lead authors of the top three posters were:
- Sara Siebert, a third-year student and secretary of the Contact Lens Club at Indiana University. She presented on utilizing corneal and scleral topography to aid in predicting scleral toricity for the purpose of fitting scleral lenses.
- Kimberly-Anne Llamzon, a fourth-year student and former member of Student Volunteer Optometric Services to Humanity at New England College of Optometry. She covered the topic of keratoconus and scleral lenses.
- Michael Kreuzer, a fourth-year student and former Interprofessional Liaison of the Canadian Association of Optometry Students at University of Waterloo. He presented on reducing scleral lens fogging with an impression-based design versus a conventional lens.
Ryan Chia, a student at Salus University, and Olivia Cheng, a student at UC Berkeley, received honorable mentions and $250 each.
Concert at SECO to Benefit Optometry Giving Sight
The “Bad Habits - Eye Docs of Rock” band will be hosting a special benefit concert for Optometry Giving Sight in Atlanta during SECO on March 3. The concert will mark the band’s 30-Year Anniversary and will feature special appearances of key personalities from the optometric community including Drs. Ted McElroy, Tom Griffith, Paul Ajamian, and Alan Glazier. Complimentary wristbands for the concert are available at the following sponsors’ booth: OptoVue, Vision Source, SECO, CooperVision, PentaVision, and Marco.
Bad Habits will also be hosting a raffle to benefit Optometry Giving Sight, offering an opportunity to win an iFusion system from OptoVue (retail value $54,450). Raffle tickets are available at Optometry Giving Sight’s booth #1627.
EyeGate Pharmaceuticals, Inc., a specialty pharmaceutical company that focuses on developing and commercializing products for treating diseases and disorders of the eye, announced the promotion of three executives.
Sarah Romano, corporate controller, was named interim CFO. She joined EyeGate Pharmaceuticals in 2016, and has been responsible for the company’s accounting, tax, financial reporting, and internal controls. Previously, Ms. Romano served as assistant controller at TechTarget and corporate controller at Bowdoin Group, a healthcare-focused executive recruiting firm.
Lisa Brandano was promoted from director, clinical operations to vice president, clinical operations. She joined EyeGate in 2011, and has served as associate director and director of clinical operations. Prior to joining EyeGate, she served as assistant managing director of the Boston Office and director of clinical trial operations at CATO Research, an international contract research organization.
Carol Assang, associate director, clinical operations was named director, clinical operations. She joined EyeGate in 2010, and has been responsible for all aspects of clinical study planning and the execution of multiple clinical development programs. Prior to joining EyeGate, Ms. Assang served as an associate project director/senior clinical associate at New England Research Institutes, where she was responsible for clinical development and operations of several programs.
BCLA Initiates Inaugural Awards
The first-ever BCLA Awards will be handed out at the British Contact Lens Association’s forthcoming Clinical Conference and Exhibition as part of its 40th anniversary celebrations, which are being held on June 9-11 in Liverpool, United Kingdom.
Categories will include Dry Eye Practitioner of the Year, Young Contact Lens Practitioner of the Year, and the BCLA Presidents Award, which will be awarded to an individual for his or her contribution to contact lens and anterior eye profession.
Applications are due by April 7. To view more information about the awards and/or the conference, visit www.bcla.org.uk.
Allergan Launches See America
Allergan plc announced a bold commitment to fight preventable blindness in the United States with a new initiative—See America. The launch follows the release of a major report published in September 2016 by the National Academies of Sciences, Engineering, and Medicine (NASEM), declaring eye health a public health imperative.
Through See America, Allergan will partner with Prevent Blindness, the nation’s leading volunteer eye health and safety organization, to champion better access to vision care. Through a series of vision-screening events in various cities, sponsored by Allergan, attendees will receive free one-on-one professional eye exams, follow-up treatment plans, and education about the most common diseases affecting people’s vision. In addition to sponsoring Prevent Blindness, Allergan will look to partner on programs from like-minded organizations that support the goals of See America.
Comfort Vision Partners with Wisconsin Vision Associates
Comfort Vision announced a new distribution agreement with Wisconsin Vision Associates (WVA). This new partnership enables Comfort Vision to offer ProOcular daily dual aspheric lenses to eyecare practitioners across the United States. WVA will provide 90-pack ProOcular daily disposable lenses.
GlassesUSA.com Adds Contact Lenses to Its Offerings
GlassesUSA.com, an online retailer for prescription eyewear, has added contact lenses to its list of eyewear products. GlassesUSA.com already provides designer and in-house brands in prescription eyewear and sunglasses for the whole family, and will now round out its product line with the addition of leading contact lens brands in a total of 79 different varieties including: Acuvue; CooperVision’s Biofinity and BioMedics; and Alcon’s Dailies and FreshLook.
As with all of the brand’s eyewear offerings, GlassesUSA.com will offer free shipping and returns for contact lenses, five- to seven-day shipping, and 24-hour customer service, seven days a week.
Millette Romualdez, Manila, Phillipines
This patient is a 20-year-old college student who was referred for contact lens fitting. She was caught in the middle of a fight and part of a beer bottle cut her cornea and sclera, causing both areas to be lacerated. She underwent repair of the cornea and sclera, as well as repositioning of iris prolapse, ciliary body repair, and anterior segment reconstruction for the left eye. This image shows a horizontal full-thickness limbus-to-limbus corneal scar. Her uncorrected visual acuity (VA) was 20/20 OD and 20/100 OS. She was lucky that the laceration was below the pupillary area sparing her vision. Although she has high astigmatism, her astigmatism was considerably regular within the 4mm to 5mm central zone. Spectacle refraction was +1.00 -6.00 x 175 OD with VA of 20/20. Contact lens options considered inlcuded corneal GPs, sclerals, and customized soft contact lenses. Ultimately, she was fitted with a customized soft toric lens that yielded a VA of 20/20, as well as a stable and comfortable fit.
We thank Millette Romualdez 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
SiHy Versus Hydrogel Materials in Daily Disposable Contact Lenses
Over the past few years, a number of silicone hydrogel (SiHy) daily disposable (DD) lens designs have entered the market. Touted as healthier and more comfortable options for our patients, these lenses have been prescribed at ever-increasing frequencies. The question that often comes up from eye care practitioners is “Do we need SiHy for daily wear and daily disposable modalities of lens use?”
A recent study was conducted that compared subjective, objective, and safety performance of SiHy DD with hydrogel DD contact lenses.1 A retrospective analysis on approximately 40 participants (Px) each in five trials was conducted. Lenses were grouped into SiHy (delefilcon A, somofilcon A, and narafilcon A) and hydrogel (omafilcon A and nelfilcon A). Participants attended follow-up visits at baseline, two weeks, and one and three months. Subjective ratings (1 to 10 scale), adverse events (percentage of Px), physiological variables (0 to 4 scale), and wearing time were collected at each visit and compared between groups.
Results showed no differences in age, sex, and lens wear experience between SiHy and hydrogel groups (P ≥ 0.09). There was greater increase in limbal redness from baseline in the hydrogel group (0.18 ± 0.38 versus 0.02 ± 0.47, P < 0.001), whereas conjunctival staining and indentation were less in the hydrogel group (P < 0.001). No differences in comfortable wearing time were found between groups (P = 0.41), and comfort at lens application, during the day, and end of day were also not different (P ≥ 0.71). The frequency of corneal infiltrative events (SiHy vs. hydrogel: 6.7% versus 2.5%; P = 0.32) and mechanical adverse events (SiHy versus hydrogel: 0.0% versus 0.0%; P = 0.99) were not different.
The authors concluded that though some statistical significance was found between the groups, these differences were within measurement error. Neither of the material types showed superiority in comfort, and adverse event rates were low with both material types. These findings suggest that choice of material is a patient and practitioner preference; however, for patients at risk for hypoxia-related complications, SiHy materials should be considered.
This study also suggests that no significant performance differences exist between the tested SiHy and hydrogel DD lens designs. However, one should keep in mind a key limitation of this investigation, which is the relatively short duration of the study (only out to three months). Long-term performance, especially in terms of physiological response, may be different. As with all modalities of contact lens wear, consideration of hypoxic sequelae for those patients at risk should always be considered.
Today, we have a vast array of design and material options for DD contact lenses. Each has a variety of attributes that should be considered when prescribing for an individual patient.
1. Diec J, Tilia D, Thomas V. Comparison of Silicone Hydrogel and Hydrogel Daily Disposable Contact Lenses. Eye Contact Lens. 2017 Jan 17 [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
A One-Sided Debate
It is generally accepted that symptoms of tearing may be indicative of a dry eye or an ocular surface problem. Of course, there are multiple differentials to this diagnosis, especially when tearing is monocular.
As part of the clinical examination, remember to evaluate all four of your patients’ puncta. Changes with age, allergy, surgery or radiation, and topical ocular medication use, among other things, can precipitate changes in the puncta impacting proper tear drainage. Also remember to check for abnormalities in lid or punctal position or intermittent occlusion of the puncta by loose conjunctiva (e.g., as in dermatochalasis).
Today, I had a special surprise. A young woman presented with a six-month history of intermittent tearing of the left eye only. Her ocular and medical histories were unremarkable. She was not a contact lens wearer, and had no indications of allergy. Her lower puncta were large with no suggestion of reflux from the lacrimal sac. On the right, her upper punctum looked fine. As I glided over to the left upper canthus–surprise–there were two upper lacrimal puncta in this patient’s left eye. This lacrimal system dysgenesis is known as congenital supernumerary lacrimal puncta.
Supernumerary punctum is an under-reported congenital anomaly, in which there is more than one lacrimal punctum. Although usually asymptomatic, supernumerary puncta have been reported to cause epiphora and should be included in a patient’s differential diagnosis.1
1. Lacroix Z, Bitton E. Supernumerary punctum: an unusual case of seeing double. Clin Exp. Optom. 2015 Jul;98:375-378.
Relation between Ocular Comfort, Arachidonic Acid Mediators, and Histamine
This study examined changes in the concentration in tears of arachidonic acid metabolites (AAM) prostaglandins, cysteinyl leukotrienes, and resolvin-D1, as well as histamine in a general contact lens population in the morning and evening.
Tears were collected twice a day (morning and evening) for up to 10 days on two different occasions (with and without contact lens wear) from 30 experienced contact lens wearers for analysis of AAM and a separate group (N = 33) for analysis of histamine. Ocular comfort was rated subjectively on an ordinal scale at each time of tear collection. Tears were analyzed using commercial immunoassay-based kits. Statistical analysis was performed using linear mixed models.
Ocular comfort decreased from morning to evening with and without contact lenses (p = 0.001), and the difference in comfort in the evening was greater with contact lens wear (80.9 ± 16.2 versus 75.5 ± 16.8; p = 0.008). The total concentration of PGs (10.7 ± 10.8 ng/ml), cysteinyl leukotrienes (8.7 ± 0.38 ng/ml), resolvin-D1 (1.6 ± 0.5 ng/ml), or histamine 13.8 ± 10.4 ng/ml) did not change during the day or during contact lens wear (p > 0.05).
Prostaglandins, cysteinyl leukotrienes, resolvin-D1, or histamine concentrations did not alter in relation to changes in comfort of the eye during the day or during contact lens wear. These results suggest that release of these mediators may not be associated with contact lens discomfort.
Masoudi S, Zhao Z, Willcox M. Relation between Ocular Comfort, Arachidonic Acid Mediators, and Histamine. Curr Eye Res. 2017 Jan 31:1-5. [Epub ahead of print]