I am not sure if you are aware, but there is now at least one online "prescriber" of contact lenses– www.simplecontacts.com. As its website says, for $10 you "take the test" (using your current contact lenses), "select your contacts," and "sit back and relax" while you wait to receive your prescription and contact lens order. There are several caveats including disease-based exclusions, the need to have a full eye examination (including dilation) in the last four years, and the need to have 20/20 vision to use the test, among others.
Although the intervals of receiving regular eyecare may be debatable and are dependent on many factors (age, family history, comorbidities, etc.), most would recognize that more frequent in-office care is associated with better long-term eye health. Benjamin Franklin was right, "An ounce of prevention is worth a pound of cure."
Aside from this, this online prescribing approach raises lots of other interesting questions. For example, how will patients learn about new technologies in contact lenses that provide greater ocular health benefits, and better vision? Likewise, how will more comfortable materials (and care solution combinations) be recommended to these patients to prevent them from dropping out of contact lenses? Lastly, will this approach lead to further commoditization of these medical devices, and perhaps stifle future innovations, leading to better technologies we can offer to patients?
While it is unclear what the ultimate success of this online prescribing approach will be, I believe it is important to consider the many ways this could impact our patients and our practices.
Jason J. Nichols, OD, MPH, PhD
CooperVision Announces Its 2017 Best Practices Honorees
CooperVision, Inc. recognized industry leaders through its 2017 Best Practices. The new class of 10 honorees was chosen after a nationwide search for eye care practices that advance the profession through innovation, industry leadership, and patient experience. This year’s honorees are:
Amarillo Vision Specialists – Amarillo, TX
Established by Shauna Thornhill, OD, within a Wal-Mart located in the heart of her community, and now has a second location.
Blount County Eye Center – Maryville, TN
Founded in 1965, Blount County Eye Center by Will Tantum, OD.
Caruso Eye Care – Lake Worth, FL
Established in 2005 by Britney Caruso, OD, and is now located inside Target Optical.
Castle Pines Eye Care – Castle Pines, CO
Led by owner Jason Ortman, OD.
Complete Eye Care of Medina – Medina, MN
Founded in 2008 by Gina Wesley, OD.
Havasu Eye Center – Lake Havasu, AZ
Opened by Stuart Adams, OD, in 1990, and joined by Stephanie Woo, OD, in 2012.
Lawrenceville Family Eyecare – Lawrenceville, GA
Founded by Mehdi Kazem, OD, in 2012.
Little Eyes – Carmel, IN
Opened by Katherine Schuetz, OD, in 2013 to specializing in primary care pediatric optometry.
Premier Eyecare – Knoxville, TN
Established in 2002 by Brent Fry, OD, who has since grown the practice to include six full-time employees.
Specialty Eyecare Group – Kirkland, WA
Led by David Kading, OD, and Kristi Kading, OD, it now has doctors with a variety of specialties.
All U.S. optometry practices currently fitting contact lenses were eligible for consideration in Fall 2016. A panel of judges including past Best Practices honorees, industry experts, and CooperVision leaders evaluated the nominees. Evaluation was based on insights and experiences shared about the practices’ innovation, patient experience, and business culture.
Think About Your Eyes Launches 2017 Advertising Campaign
Think About Your Eyes, the vision industry’s national public awareness campaign, launched its 2017 national advertising campaign.
Campaign advertisements will run for three quarters in 2017, up from two quarters in previous years. Thanks to increased funding from industry partners, including The Vision Council and the American Optometric Association, as well as the addition of Johnson & Johnson Vision Care as a leadership partner, media spending has increased by 60% in 2017. The ads include 15 million spots on podcasts and online audio (Pandora and Spotify), 14 million online video spots, and 6 million digital banner ads across 2,000 top websites like The New York Times and ESPN.
Broadcast ads will appear in primetime across 27 cable networks, including popular networks like USA, Comedy Central, and FX. For the first time ever, Think About Your Eyes ads will appear on broadcast networks, such as ABC and NBC, during primetime programming and sporting events, including NBA and MLB games.
The campaign has also announced a new milestone, with 3 million visitors to the campaign’s website since its launch. The site features a comprehensive practice locator tool where visitors can easily find local Think About Your Eyes eye care providers from a database that now houses more than 19,000 participating providers.
SSF Calls Upon Eyecare Professionals to Help Educate Public
April 2017 marks the 19th annual Sjögren’s Awareness Month. Once again, The Sjögren’s Syndrome Foundation (SSF), along with members and volunteers across the country, will unite to continue its mission of educating patients and families about Sjögren’s, an autoimmune disorder affecting more than 4 million Americans, with an estimated 2.5 million patients currently undiagnosed.
Each day during Sjögren’s Awareness Month, the SSF will be using one or more of its social media channels (Twitter, @SjogrensOrg; Facebook @SjogrensSyndromFoundation; and LinkedIn, Sjögren’s Syndrome Foundation) to educate consumers, healthcare professionals, and others by providing facts about the disease, offering resources, and sharing stories of those with Sjögren’s to help others visualize and better understand what it is like to suffer from Sjögren’s. SSF will be employing the #ThisisSjogrens hashtag.
In last week’s Ocular Surface Update column, Katherine Mastrota, MS, OD, incorrectly provided an example of abnormalities in lid or punctal position or intermittent occlusion of the puncta by loose conjunctiva. The correct example is conjunctivochalasis.
Louis T, Chateau-Thierry, France
This funny fluorescein pattern occurred when a practitioner put a scleral lens on a patient with idiopathic megalocornea. The horizontal visible iris diameter was 14mm.
We thank Louis T for these images 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
Passive Contact Lens Prescription Verification
The 2004 Contact Lens Rule (CLR), which was written by the Federal Trade Commission, was designed to protect contact lens consumers’ rights.1 The CLR indicates that prescribers are required to provide patients with a copy of their contact lens prescription after the completion of the contact lens fitting process.1 A patient is then allowed to take their prescription to the seller of their choice, though the seller is required to verify the patient’s prescription (e.g., patient’s name, contact lens power, base curve, manufacturer, quantity).1 Prescription verification needs to come from the prescriber’s office within eight regular business hours.1 If the prescriber does not respond in time, a seller can automatically consider the patient’s prescription verified and sell the patient contact lenses.1
While the CLR was designed to protect consumers, some sellers have gone beyond what is granted them by the automatic verification clause to sell our patients contact lenses that have not been prescribed, an act that goes directly against the CLR.1,2 That is, emboldened by the lack of response from the prescriber, some retailers take it upon themselves to employ alternatives that benefit the retailer rather than the patient. This issue is highlighted by a phone survey of adult contact lens wearers that was conducted by APCO Insight.2 This survey found that about 25% of consumers who purchased contact lenses online were given a different brand of contact lenses than they had been prescribed without being consulted. And, about 33% of patients reported that their online retailer actually advised them to purchase a non-prescribed contact lens.2 This same survey also found that about 33% of patients were able to purchase contact lenses with an expired prescription.2
More than 90% of patients believe that it is important to receive the correct prescription.2 As a prescriber, I think that 100% of patients deserve the correct prescription. While patients do have the right to purchase their contact lenses from the seller of their choice, it is our job to inform our patients about the importance of wearing the correct contact lenses and about the importance of obtaining regular eye exams, habits that will help your patients maintain healthy eyes for a lifetime.
I see them everyday. Honestly, I wish I didn’t. I think to myself, if only I had seen you a year ago or two ago, we could have made a difference. But now, is it worth it? I guess so, a little is better than nothing. You are probably wondering what I’m talking about—moderate to advanced myopic kids who present with their parents for a myopia consult.
I know that you and I would much rather fit ortho-k lenses on a –2.00D myope than a –4.50D myope. Once a child gets into the –5.00D correction range, my experience is that our chances for success go down. There are some amazing designs out there that still make us look like heroes, but let’s face it, –5.00D is much harder than a –2.00D. So in the famous words by Tom Cruise in “Jerry Maguire” I offer the following advice to eyecare providers and patients out there: “Help me…help you!” Keep in mind that contact lenses used for myopia control are still an off-label use, but it is certainly a growing practice.
When a child advances in their myopia by 0.50D over the course of 12 months, they are clinically progressing. We have evidence in the literature that we can slow it down. Let's do it. Get that patient into a myopia control treatment protocol, or refer them to someone who does it. Years from now, the child will be much better off.
The reality of the situation is that the parent and the child don’t know what they don’t know. They trust us to give them the appropriate options and solutions. If we present a myopia control treatment, who knows, maybe someday we won’t have 5.00D patients in our office requesting myopia control treatment.
A Randomized Clinical Trial to Evaluate the Usefulness of Amniotic Membrane Transplantation in Bacterial Keratitis Healing
This study was conducted to determine whether early amniotic membrane transplantation improves the outcomes among patients with bacterial keratitis. In this prospective randomized clinical trial, 49 eyes from 49 patients with bacterial keratitis received routine antibiotic therapy followed by double-layer amniotic membrane transplantation during two to five days after start of the medications; a second group of 50 eyes from 50 patients only received routine antibacterial therapy. The main outcomes—including visual acuity, corneal healing time, scar size, hypopyon size, and duration, as well as the depth of corneal opacity and neovascularization—were followed for a six-month period. In addition, Langerhans cells density and tectonic procedures were documented during the healing period.
The study results indicated statistically significant better best corrected visual acuity (p < 0.001), uncorrected visual acuity (p < 0.001), as well as contact lens corrected visual acuity (p < 0.001) at six months in the case group compared to control group. Corneal healing time, the depth of corneal opacity, hypopyon size, and duration were not significantly different in the case group while the scar size (p < 0.001) was significantly smaller. Also significantly less corneal vascularization at six months (p < 0.001) and Langerhans cells density (p < 0.001) at one month were observed in the case group.
The study concluded that the early use of amniotic membrane transplantation in treatment of patients with bacterial keratitis was associated with better outcomes compared to antibiotic therapy alone. More comparative studies to investigate the probable side effects as well as the cost benefit of this method are necessary.
Tabatabaei SA, Soleimani M, Behrouz MJ, Torkashvand A, Anvari P, Yaseri M. A randomized clinical trial to evaluate the usefulness of amniotic membrane transplantation in bacterial keratitis healing. Ocul Surf. 2017 Jan 25. [Epub ahead of print]