It is absolutely amazing how fast technology develops. I purchased my first health-tracking band just over two years ago in September of 2013. I’ve worn it off and on for these two years, and with a recent New Year’s resolution to improve my health, I began wearing it again recently. Along the way, I also ventured to look what is out and available today and boy was I amazed. Not only do contemporary bands measure traditional outcomes like steps and calories burned, they now also appear to measure body mass, body fat, muscle mass, in addition to notifying you of incoming calls and text messages! The reason why I bring this up is that it is critical that we stay on top of technologies that may benefit our patients. Before you know it, we may have a contact lens that not only measures but perhaps even displays these health status monitoring activities in real time for our patients!
Jason J. Nichols, OD, MPH, PhD
Valeant Names Schiller Interim CEO
Valeant Pharmaceuticals International, Inc. announced that Howard B. Schiller has been appointed interim chief executive officer of Valeant, effective immediately. Schiller has served as Valeant's chief financial officer from December 2011 through June 2015 and currently serves on Valeant's Board of Directors. Valeant also announced that Robert Ingram, Lead Independent Director, will serve as interim chairman of the Board of Directors.
J. Michael Pearson remains in the hospital where he is being treated for severe pneumonia, and as the timing of his expected return is uncertain, he will be on a medical leave of absence until further notice.
Schiller joined Valeant following a 24-year career at Goldman Sachs, a global investment banking firm. From 2009 to 2010, he was the chief operating officer for the Investment Banking Division of Goldman Sachs. From 2003 to 2009, he was responsible for the global healthcare, consumer products, retail, industrial and natural resource businesses in the Investment Banking Division of Goldman Sachs. He is also on the business advisory council of the University of Chicago Law School. Schiller received his BS in economics from the Wharton School at the University of Pennsylvania and his JD from the University of Chicago Law School.
Ingram has served on Valeant's Board since September 2010, and was the Chairman of the Board from December 2010 to March 2011. Since January 2007, Ingram has been a general partner at Hatteras Venture Partners, a venture capital firm focused on biopharmaceuticals, medical devices, diagnostics and related opportunities in human medicine. Since January 2010, he has served as a special advisor to the Chief Executive Officer of GlaxoSmithKline. He served as Vice Chairman Pharmaceuticals of GSK from 2002 through 2009 and Chief Operating Officer and President of Pharmaceutical Operations, CEO of Glaxo Wellcome plc from October 1997 to December 2000 and chairman of the board of Glaxo Wellcome Inc., Glaxo Wellcome plc's U.S. subsidiary, from January 1999 to December 2000. Mr. Ingram was President and CEO of Glaxo Wellcome Inc. from October 1997 to January 1999.
Contact Lens Spectrum Wants to Hear from You!
Is there a topic you would like to see addressed in the pages of Contact Lens Spectrum? Have you thought about submitting an article? The editors and staff of CLS are looking for ideas for articles and authors to present them.
When you read an issue of Contact Lens Spectrum or review Contact Lenses Today, if you think of something you would like to know more about in the constantly evolving contact lens arena or like to address in the management of ocular surface conditions, please contact us. Ideas may be submitted by contacting our Managing Editor, Lisa Starcher at firstname.lastname@example.org.
Time Is Running Out! Register Now for the 10th Global Specialty Lens Symposium
The 10th Global Specialty Lens Symposium will be held January 21 – 24, 2016 at Caesars Palace Las Vegas, Nevada. The GSLS is a must-attend meeting, brought to you by Contact Lens Spectrum, focusing on the successful management of ocular conditions using today's specialty contact lenses. This meeting will include insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.
The 2015 event was attended by almost 600 registrants from 36 countries, 42 states, Puerto Rico and Guam. It continues to be the largest conference of its kind in the U.S.
Join your peers in 2016 for the 10th anniversary in Las Vegas! Visit www.GSLSymposium.com for more information and to register.
WCO Names Bullimore Executive Director
The World Council of Optometry (WCO) is announced the appointment of Mark A. Bullimore MCOptom, PhD, FAAO as its new Executive Director.
Dr. Bullimore is a British-trained optometrist and accomplished scientist who has taught optometry students in the UK, USA and Trinidad and Tobago and has lectured to professional groups on four continents. He is the former President and Development Director of the American Optometric Foundation and the former Editor of Optometry and Vision Science, the Journal of the American Academy of Optometry.
He will assist the Officers, Executive Committee and Governing Board of the WCO in fulfilling the organization’s mission to facilitate the development of optometry around the world and support optometrists in promoting eye health and vision care as a human right through advocacy, education, policy development and humanitarian outreach.
Dr. Bullimore will ensure that the WCO meets its current and future objectives in line with the requirements of its members through the development, implementation and review of appropriate strategies. He will also direct all aspects of the WCO's relationship with its membership, including recruitment and retention, strong fiscal management, communication and the development, promotion and delivery of services.
Academy 2016 Course Submission Window Open
The Lectures and Workshops Committee of the American Academy of Optometry invites you to submit courses in consideration for Academy 2016 Anaheim.
The submission window will remain open until 5:00 PM ET on February 1, 2016 (Monday). Please note that due to the large number of submissions, the Academy cannot consider any courses submitted after the deadline.
In particular the Academy encourages the submission of new and innovative courses as well as novel course topics so that they may continue to offer a cutting-edge and original educational program. Please also keep in mind the Grand Rounds sessions, in which unusual or enlightening case reports are discussed in a 17-minute format.
As a new feature for Anaheim, the Lectures and Workshops Committee would like to include a limited number of “Rapid-Fire” format offerings. These would likely involve four presenters for a 1 hour submission, with each given a 12 minute slot, all covering the same general topic area.
See 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.
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
I heard it for the first time at a lid hygiene lecture: "Homoserine lactones."
I am the first to admit that although I know about biofilms (biofilms are bacterial communities held together by a self-produced extracellular matrix), I did not know what homoserine lactones were or their relationship to biofilms. .
Homoserine lactones are a class of signaling molecules produced within the bacterial cell involved in quorum sensing. Quorum sensing is a method of communication between bacteria that enables the coordination of group-based behavior based on population density. This allows bacteria to coordinate group-based behavior (you can imagine it akin to a gang mentality). Once the bacterial population density has reached a particular threshold, such as in large bacterial aggregates nestled in their biofilm, there are a signal changes in gene expression secondary to quorum sensing. Quorum sensing plays a central role in regulating many community derived symbiotic and pathogenic relationships of bacteria, for example changes in virulence of common bacterial commensals. Bacterial community production of homoserine lactone escalates in biofilm, potentiating quorum sensing. More on biofilms in upcoming ocular surface Contact Lenses Today segments.
Corneal Reshaping Is Effective and Safe in the Management of Myopia – Ophthalmology Comes on Board!
At least one design of an overnight corneal reshaping contact lens (A.K.A. orthokeratology) has been FDA cleared in the United States since 2002 and many have been used worldwide for large numbers of patients. A multitude of clinical studies have been conducted and published that support the ability of this modality to provide clear daytime vision and (although not specifically FDA indicated or cleared for this purpose) its value in controlling myopic progression in young individuals. However, I believe that there still exists a relative division in its clinical implementation and attitudes about its utility between the professions of optometry and ophthalmology, where I think optometry has embraced corneal reshaping treatment to a greater degree than ophthalmology. However, we are now starting to see more and more ophthalmologists begin to accept and even use this modality as noted in two recent peer reviewed papers.
The first study published shared the outcomes of corneal reshaping treatment in a group of ophthalmology practices.1 The study took place over three ophthalmology practices, which were trained in fitting corneal reshaping therapy lenses. The patients' age ranged from 9 to 59 years. There were a total of 260 eyes being tested and the manifest refraction ranged from -0.25 diopters (D) to -7.75 D with astigmatism up to 1.50 D. Results showed that patients’ uncorrected visual acuity (UCVA) were improved with 99% achieving visual acuities better than 20/40 and 85% achieved 20/20. There were no significant differences between UCVA of left and right eyes in patients who received bilateral correction (P>0.05). The study showed that women respond to the therapy better than men. The average difference from the target UCVA for women was 0.24, whereas men were off by an average of 0.34 (P<0.05). Only two patients (one in the 9 to 13 year age group and one in the 37 to 43 year age group) did not respond to the therapy. The authors concluded that corneal reshaping or orthokeratology is an effective method to correct myopia and that only 1.4% of patients were unresponsive to the correction.
The second paper published performed a literature search to investigate the safety of corneal reshaping or orthokeratology (OrthoK) treatment for myopia correction and retardation.2 Clinical studies reviewed were identified from MEDLINE, EMBASE CNKI, CQVIP, and WANFANG DATA (all from 1980 to April 2015). The reference lists of the studies and the Science Citation Index were also searched. The review incorporated a total of 170 publications. Results found that the risk of microbial keratitis in overnight OrthoK was similar to that of other overnight contact lens modalities. The most common complication was corneal staining but also included epithelial iron deposit, prominent fibrillary lines, and transient changes of corneal biomechanical properties. There was no long-term effects of OrthoK on corneal endothelium identified in the review. The authors concluded that there is sufficient evidence to suggest that OrthoK is a safe option for myopia correction and retardation. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications.
It now seems that eye care professions are moving to agree that corneal reshaping is a safe and effective treatment modality. This happens when we let evidence based data speak for itself so we can move forward to promote the elements of patient care to maximize safe outcomes that benefit our patients.
1. Koffler B, Sears J, Wohl L, Forstot L. Success Rate of Incorporating Corneal Refractive Therapy into 3 Different Ophthalmology Practices. Eye Contact Lens. 2016 Jan;42(1): 74-9.
1. Liu YM, Xie P. The Safety of Orthokeratology-A Systematic Review. Eye Contact Lens. 2016 Jan;42(1):35-42.
Miniscleral Lens Wear Influences Corneal Curvature and Optics
Transient changes in corneal topography associated with soft and conventional or reverse geometry rigid contact lens wear have been well documented; however, only a few studies have examined the influence of scleral contact lens wear upon the cornea. Therefore, in this study, the researchers examined the influence of modern miniscleral contact lenses, which land entirely on the sclera and overlying tissues, upon anterior corneal curvature and optics.
Anterior corneal topography and elevation data were acquired using Scheimpflug imaging (www.pentacam.com) immediately prior to and following 8 hours of miniscleral contact lens wear in 15 young healthy adults (mean age 22 ± 3 years, eight East Asian, seven Caucasian) with normal corneas. Corneal diurnal variations were accounted for using data collected on a dedicated measurement day without contact lens wear. Corneal clearance was quantified using an optical coherence tomographer (RS-3000, www.nidek.com) following lens insertion and after 8 hours of lens wear.
Although corneal clearance was maintained throughout the 8-hour lens wear period, significant corneal flattening (up to 0.08 ± 0.04 mm) was observed, primarily in the superior mid-peripheral cornea, which resulted in a slight increase in against-the-rule corneal astigmatism (mean +0.02/-0.15 × 94 for an 8 mm diameter). Higher order aberration terms of horizontal coma, vertical coma and spherical aberration all underwent significant changes for an 8 mm corneal diameter (p ≤ 0.01), which typically resulted in a decrease in RMS error values (mean change in total higher order RMS -0.035 ± 0.046 μm for an 8 mm diameter). There was no association between the magnitude of change in central or mid-peripheral corneal clearance during lens wear and the observed changes in corneal curvature (p > 0.05). However, East Asian participants displayed a significantly greater reduction in corneal clearance (p = 0.04) and greater superior-nasal corneal flattening compared to Caucasians (p = 0.048).
The researchers concluded that miniscleral contact lenses that vault the cornea induce significant changes in anterior corneal surface topography and higher order aberrations following 8 hours of lens wear. The region of greatest corneal flattening was observed in the superior-nasal mid-periphery, more so in East Asian participants. Practitioners should be aware that corneal measurements obtained following miniscleral lens removal may mask underlying corneal steepening.
Vincent SJ, Alonso-Caneiro D, Collins MJ. Miniscleral lens wear influences corneal curvature and optics. Ophthalmic Physiol Opt. 2015 Dec 21. doi: 10.1111/opo.12270. [Epub ahead of print]