One thing that has always been challenging has been the development of contact lens care systems that are efficacious against all forms of Acanthamoeba. Acanthamoeba keratitis is a devastating condition, so thankfully it is relatively rare. As noted by the abstract this week, the U.S. Food and Drug Administration has developed an optimized protocol for evaluating multipurpose care solutions for their efficacy against Acanthamoeba, which will certainly be of benefit to the long-term safety of contact lens wearers.
Jason J. Nichols, OD, MPH, PhD
CLMA Announces 2018 Award Winners
The Contact Lens Manufacturers Association (CLMA) bestowed the following awards on Jan. 24, 2018 at its Awards Banquet held at The Tropicana – Las Vegas:
CLMA Medal of Honor – Quido A. Cappelli. This award is given to the person who embodies the Ideals of the CLMA at the highest levels, through service and achievements within the contact lens industry.
The Leonardo da Vinci Award – Edward S. Bennett, OD, MSEd; and Jan B. Svochak. This award is for vision in establishing the focus of the CLMA and dedication to the achievement of its goals.
The Dr. Josef Dallos Award – Jan PG Bergmanson, OD, PhD, DSc. This award is for an outstanding contribution to the development and advancement of the contact lens industry and for service to humanity.
Creative Design & Process Award – John McGregor. This award is for innovation in lens design and manufacturing process to the enhancement of the contact lens industry.
Industry Enhancement Award – John D. Hibbs. This award is for unselfish dedication to the CLMA and the contact lens industry.
Trailblazers Award – Vic McCray, MD, and Team Tangible Science. This award is for outstanding achievement in product development to the enhancement of the contact lens industry.
In addition, the following award was presented on Jan. 27, 2018 during the Rising Stars Reception held during the 2018 Global Specialty Lens Symposium in Las Vegas:
2018 GPLI Practitioner of the Year – Renée E. Reeder, OD. This award is for outstanding professional expertise in fitting customized contact lenses to benefit patients who have improved vision and corneal health, and to advance the contact lens field.
Matthew M. Walsh Appointed Executive Vice President and CFO of Allergan plc
Allergan plc announced that Matthew M. Walsh has been appointed executive vice president and CFO. He will formally join Allergan later this month following a transition period from his current role as executive vice president, CFO at Catalent, Inc.
Prior to joining Catalent, Mr. Walsh was president, CFO and acting CEO at Escala Group, Inc. Prior to joining Escala, he held a variety of finance leadership roles at industrial manufacturer GenTek, Inc., including vice president-Finance & CFO, vice president & treasurer, and group controller.
ABB Optical Group Releases Practice Efficiency Survey Results
ABB Optical Group, a resource for identifying optical industry trends, has released results from its fall 2017 practice efficiency survey.
The company found that “access and choice” and “one- to two-day shipping” are the two most important considerations for practices when ordering soft contact lenses (SCLs). Other important considerations include online ordering, direct to patient shipping, and providing one bill.
In addition, practices spend an average of 70 minutes (during a typical day) managing SCLs, which includes ordering, inventory management and administrative time. Interestingly, ODs underestimate the effort by 20 percent.
The research points to the opportunity to free up staff time and refocus on growth opportunities for the practice.
ASCO Announces Special Recognition Award Recipients
The Association of Schools and Colleges of Optometry (ASCO) announced the recipients of the 2018 Special Recognition Awards.
ASCO Lifetime Achievement Award
Dr. William E. Cochran, president emeritus of Southern College of Optometry, is given this year’s Lifetime Achievement Award. This award recognizes an outstanding individual who, over an extended period of time, provided exceptional leadership to ASCO and to optometric education; made outstanding contributions to the optometric community; and displayed exemplary commitment and dedication to the association.
ASCO Rising Star Award
Sponsored by Oculus, the ASCO Rising Star Award is given to an outstanding faculty member or administrator with less than seven years of service. Dr. Andrew D. Pucker is recognized for his outstanding contributions to the University of Alabama at Birmingham, School of Optometry, through teaching, scholarship, administration and professional service and most notably in contributions to ASCO’s Biomedical Educators Special Interest Group.
ASCO Ophthalmic Industry Leadership Award
The ASCO Ophthalmic Industry Leadership Award recognizes an individual from a current or past Corporate Contributor partner company who demonstrates exemplary support of ASCO and its member institutions. The individual serves as an example for his or her colleagues in industry and has made exceptional and meaningful contributions to the advancement of ASCO and optometric education. ASCO’s 2018 Industry Leadership Awardee is Dr. Rodney L. Tahran. Dr. Tahran recently retired from Essilor after 36 years and is an adjunct professor at Southern California College of Optometry at Marshall B. Ketchum University and the Pacific University, College of Optometry.
What is your preferred terminology for discussing myopia with your patients, particularly in the context of myopia control therapies?
This image shows severe vascularization in patient who is suffering from Urrets-Zavalia syndrome. This patient was fitted with a prosthetic soft lens to relieve the disability glare.
We thank Vittorio Zannoni 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.
CARE SOLUTION CORNER
Andrew D. Pucker, OD, PhD
Discussing Bad News with Patients
Most practitioners at least occasionally deliver bad news, yet few actually receive formal training in delivering it.1 Bad news in the contact lens clinic ranges from educating patients that they are overwearing their contact lenses and that doing so could lead to an eye infection, to telling patients that they have a vision-threatening Acanthamoeba keratitis that may have been caused by poor contact lens handling. Discussing bad news is difficult for most people, though delivering it well can make a big difference in a patient’s outcome and respect for his or her provider. Thus, I would like to take a moment to summarize Harvey et al’s advice for discussing bad news with patients.1
Harvey et al suggests that practitioners should deliver bad news by first ensuring that patients are in a safe, quiet environment and with a family member if patients are amenable.1 Harvey and colleagues then suggest that practitioners deliver a "warning shot" to ease into the topic. For example, practitioners could say that one of the patients’ test results is concerning.1 If they appear uncomfortable, give them some time to process the information.1 If they seem calm, practitioners should proceed by disclosing the bad news in simple terms so that patients can easily understand the tentative diagnosis/concern.1 After they have absorbed the news, it is then acceptable to provide them with some perspective on the severity of the issue and the potential treatment options so that they can develop hope and start working toward healing or developing new habits.1 All of this is to say that the amount of information given should be measured in accordance with patients reaction to the news.1
While patients may experience a range of emotions during the session, it is important for practitioners to always appear warm and empathetic while at the same time not offering "false reassurance" to patients.1 Practitioners should also ask whether patients have any additional questions and should offer contact information to patients in case they think of additional questions after they leave the office.1
Overall, discussing bad news is unpleasant, though it must be done, because patients are often comforted by knowing and understanding their diagnosis.1 Understanding is also the first step toward starting treatment and changing unwanted behaviors.1
1. Harvey JA, Cohen MA, Brenin DR, Nicholson BT, Adams RB. Breaking bad news: a primer for radiologists in breast imaging. J Am Coll Radiol. 2007 Nov;4:800-808.
MATERIALS & DESIGNS
David L. Kading, OD
It Finally Sank In
Don is a 49-year-old executive who has been my patient over the last 10 years. When Don turned 42, he finally started listening when we discussed presbyopia. However, Don had/has a problem. He has 2.50D of cylinder. Don has always been a soft toric contact lens wearer and has always been happy with the lenses. He had tried GP lenses twice in his life and adamantly proclaims that, despite his affection for me, he will not try GP lenses again.
When Don turned 45, I shared with him the info we had about soft toric multifocal lenses. The classic reality-check discussion then ensued about going into multifocal lenses and what he might expect. It was like I was talking to a child; Don didn’t hear a word. When he tried the lenses, he was livid that his vision was not as crisp and clear as his toric soft lenses for distance and over-the-counter reading glasses for near. I shared with him the give-and-take conversation that we all share. Don’s response: "Forget this."
Over the next four years (which gets us to where Don is today), I spoke to Don about new contact lens innovations and about scleral lens multifocal options. Finally, after four years of talking about them, he decided to take the leap this year (although he did ask me why I hadn’t ever told him about them in the past).
I fit Don into scleral lenses that have near-center multifocal optics. He couldn’t be happier. He reports that his near and distance vision are as good, if not better, than his current vision. If you have not tried multifocal scleral lenses, you are missing out on the opportunity. Check with your local laboratory for strategies on helping you to be a hero to your patients.
Optimized Protocol for Testing Multipurpose Contact Lens Solution Efficacy Against Acanthamoeba
The purpose of this study was to evaluate the interlaboratory and intralaboratory reproducibility of a proposed protocol for multipurpose contact lens solution (MPS) disinfection efficacy against Acanthamoeba.
Acanthamoeba castellanii and Acanthamoeba polyphaga and four MPSs that have different biocidal agents were used to evaluate the protocol in two different laboratories. In addition to the negative control, a positive control and neutralization control were used. One experiment was performed in triplicate, and all other experiments were performed in duplicate in each laboratory. Acanthamoeba trophozoites were grown axenically, and cysts were generated using the starvation method. Trophozoites and cysts at a concentration of 2.0 × 103 to 2.0 × 104 organisms per milliliter were exposed to the test MPS for zero, four, six (manufacturer’s recommended soak time [MRST]), eight, and 24 hours. Survivors were determined by a limiting dilution method that used a most probable number evaluation.
The positive and negative controls displayed consistent results and trends both within and between each laboratory for trophozoites and cysts of both A. castellanii and A. polyphaga. The neutralization control consistently demonstrated the ability of the neutralizing agents to neutralize the MPS and the positive control and demonstrated no inhibition of Acanthamoeba by the negative control. Testing in triplicate and duplicate demonstrated the reproducibility of the protocol both within and between the laboratories.
The study results demonstrated that the MPS at the MRST and at eight hours (likely overnight soak time) are generally more effective against trophozoites than they are against cysts. Only the MPS that has hydrogen peroxide as the biocidal agent was able to provide a greater than three-log kill of cysts at the MRST and longer. Among the MPSs that were tested, trophozoites of A. castellanii and A. polyphaga showed similar responses. Some variability was observed when testing cysts of both species. In both laboratories, one non-hydrogen-peroxide-containing MPS had some effect (> 1 log kill) on A. polyphaga cysts. This solution had no effect (< 1 log kill) on A. castellanii cysts, A. castellanii trophozoites, and A. polyphaga trophozoites.
The authors determined that the protocol that they had revised and evaluated is a well-controlled and reproducible procedure that can effectively evaluate the efficacy of MPS against Acanthamoeba trophozoites. Some variability was observed when testing the cyst stage.
Fedorko DP, Brocious JM, Adams KD, Hitchins VM, Hampton DL, Eydelman MB. Optimized Protocol for Testing Multipurpose Contact Lens Solution Efficacy Against Acanthamoeba. Eye Contact Lens. 2018 Jan 24. [Epub ahead of print]