The final countdown is on to the opening session of the Global Specialty Lens Symposium (GSLS) this week in Las Vegas. This is the meeting for anything and everything contact lenses! Before jumping ahead too far, we are forever grateful to our meeting sponsors, because GSLS would not be possible without their gracious and generous support.
Although the General and Breakout Sessions are packed with the hottest topics in contact lenses, we are honored and excited to recognize this year’s GSLS Award of Excellence winner, Dr. Joe Barr. Joe has been a close friend, colleague, and mentor to many of us in the field of cornea and contact lenses—including myself—and has tirelessly advanced research and clinical care in this field for his entire career (not to mention having served as editor of Contact Lens Spectrum for 20 years!). Please join us in both congratulating and celebrating the remarkable career of Dr. Barr at the meeting; he exemplifies excellence in all ways, and we could not recognize a more-deserving individual.
Jason J. Nichols, OD, MPH, PhD
CooperVision Announces Brilliant Futures Myopia Management Program
CooperVision announced the Brilliant Futures Myopia Management Program. According to the company, the program features a transparent, defined protocol for care, meaning that patients are aware of everything included in the program (including services and lenses) while promoting confidence and efficiency for eyecare practitioners (ECPs); free product shipping and returns; and an interactive mobile app to keep patients engaged with the practice and their program of care.
ECPs who gain certification to implement the Brilliant Futures Myopia Management Program in their practice will have online access to the latest information about myopia management, insights on parent and patient beliefs and behaviors, and how those apply to prescribing the company’s MiSight 1 day lenses. Every certified provider will also be connected with a specialist in both the clinical and practice integration elements of the comprehensive program. Additionally, practices will receive patient and parent education tools, staff training tools, practice integration support, and community outreach and engagement resources.
Contamac Introduces Nutrifill
Contamac announced the introduction of Nutrifill, a U.S. Food & Drug Administration (FDA)-cleared preservative-free contact lens solution indicated for filling and rinsing specialty GP lenses. Nutrifill’s formula contains calcium, magnesium, potassium, phosphate, and sodium, with an optimal pH (7.4) and osmolality (300) to provide a fill solution that closely mimics the body’s natural tears, according to the company. Ralph Stone, PhD, is the inventor, patent holder, and developer of Nutrifill.
Nutrifill is launching on Jan. 23 at the Global Specialty Lens Symposium and will be available wholesale to eyecare practitioners for retail to their patients. Nutrifill will also be available direct to patients, who can purchase single cartons (35 single-use 10ml ampules) or sign up for subscription packages. Nutrifill is currently only available in the United States.
Mojo Vision Developing Smart Contact Lens
Mojo Vision, the Invisible Computing company, announced a pair of initiatives aimed at assisting people who have low or impaired vision. The U.S. Food & Drug Administration (FDA) has granted Breakthrough Device Designation to Mojo for the development of its smart contact lens and Mojo announced a new partnership with Vista Center for the Blind and Visually Impaired.
The smart contact lens, called the Mojo Lens, has a built-in Mojo Vision 14K PPI Display, which delivers a pixel pitch of more than 14,000ppi and a pixel density of more than 200Mppi. The display provides information to users without forcing them to look down at a screen. Mojo calls this eyes-up experience Invisible Computing. The company is currently demonstrating a working prototype of the device but it is not yet available for sale anywhere in the world.
Mojo Vision also announced a new partnership with Vista Center for the Blind and Visually Impaired, a Palo Alto, CA-based nonprofit that offers rehabilitation services to more than 3,000 children and adults with blindness or impaired vision each year. Through the partnership, Vista Center clients will play a direct role in defining Mojo’s technology and providing input to the company’s team of scientists and engineers. In turn, the Mojo Lens will be designed to increase contrast, highlight edges, magnify objects (like text), and zoom-out to spot check surroundings, helping people with low vision navigate the world and increase their social independence, according to the company.
IACLE Calls for 2020 Award Nominations
The International Association of Contact Lens Educators (IACLE) is offering educators worldwide the chance to become IACLE Contact Lens Educator of the Year and to travel to the annual meeting of the American Academy of Optometry’s (AAO) Academy 2020 in Nashville, TN in October. IACLE Contact Lens Educator of the Year will be awarded to three individuals, one from each of IACLE’s three global regions (Americas, Asia Pacific, and Europe / Africa – Middle East). These awards recognize and reward achievements in contact lens education and are sponsored by CooperVision, with support from the AAO. The winners will each receive a bursary of up to $3,000 toward the cost of attending Academy 2020 Nashville and permission to use the title 2020 IACLE Contact Lens Educator of the Year for their region.
The awards are open to all IACLE members who have been paid-up for at least three years. Members can either nominate themselves or be nominated by another member, their IACLE regional/country coordinator, or IACLE staff. Applicants must demonstrate use of IACLE resources, engagement with IACLE, impact on their institution, and the ways that they inspire their students to become future contact lens practitioners.
The IACLE Travel Awards are bursaries of up to $3,000, allowing IACLE Educator Members to attend international meetings. The IACLE Travel Awards are sponsored by IACLE through the generous support of all of IACLE’s sponsors (Alcon, CooperVision, Johnson & Johnson Vision, Bausch + Lomb, and Euclid). This year, there will be three IACLE Travel Awards. Recipients will attend either Academy 2020 Nashville (one award), the Association of Optometric Contact Lens Educators (AOCLE) Annual Workshop (one award) in Fort Lauderdale, FL, or another major meeting to be agreed upon by the IACLE Executive Board (one award). Academy attendance is supported by AAO, and AOCLE attendance is supported by AOCLE.
The deadline for entries for the 2020 awards is midnight (EST) on Feb. 28, 2020. Entries must be submitted using the application forms at www.iacle.org.
Vyzulta Receives Additional Approvals
Nicox SA announced that its partner, Bausch + Lomb, has received approval for Vyzulta (latanoprostene bunod ophthalmic solution), 0.024% in Mexico, Hong Kong, and Argentina. Vyzulta is indicated for the reduction of intraocular pressure (IOP) in patients who have open-angle glaucoma or ocular hypertension.
Smart Lens for Diabetes Diagnosis and Retinopathy Treatment Invented
Diabetic patients need to measure their blood-sugar level by drawing blood before and after a meal, and it is easy to develop complications due to diabetes. Recently, a research team from Pohang University of Science & Technology (POSTECH) developed technology that allows diagnosis of diabetes and treatment of diabetic retinopathy just by wearing a smart light-emitting diode (LED) contact lens. The research group is anticipating that this technology will be used for the development of wearable diagnostic and therapeutic devices for diabetes.
Professor Sei Kwang Hahn, Geon-Hui Lee (his PhD student), and the rest of his research team invented a smart photonic contact lens and a wearable medical device that can diagnose diabetes and treat diabetic retinopathy. In collaboration with the research group led by Zhenan Bao from the Department of Chemical Engineering at Stanford University and David Myung from Stanford Medicine Ophthalmology, the group’s research results were published online in Nature Reviews Materials.
The research team successfully developed a smart contact lens that had integrated micro LEDs and a photodetector that can measure glucose concentration in the conjunctival blood vessels by analyzing the near-infrared light. According to the researchers, this newly developed device will not only let diabetic patients monitor their blood-sugar level in real-time, it will also enable medical treatment for retinopathy, which is caused by diabetic complications.
Meanwhile, Professor Hahn and his research team have developed a smart contact lens that can diagnose diabetes by analyzing the glucose concentration in tears and deliver drugs to treat diabetic retinopathy. Recently, they also developed a smart wearable medical device that can do highly sensitive analysis on the glucose concentration in sweat, and they verified that it could be clinically feasible for diabetes diagnosis. Also, with PHI Biomed, they developed a Bluetooth system that can send data wirelessly, allowing patients to check their diabetes diagnosis results on their mobile phones.
ABB Optical Group Reintroduces Its Practice Performance Software
ABB Optical Group announced that its practice performance and dashboard analytics software has been updated with new features and has been rebranded as ABB Analyze, powered by Glimpse. Acquired by ABB Optical Group in 2018, the software was previously known as Glimpse Live.
According to the company, ABB Analyze securely integrates with electronic health records and practice management systems to provide in-depth analytics, live benchmarking, staff metric engagement tools, practitioner and staff performance measures, goal setting and tracking, multi-location comparisons, missed revenue identifiers, and daily metrics in a snapshot format, among other features. Data and reports can be accessed securely from anywhere on any mobile platform via a mobile app.
New features include Total Capture Refraction, which shows the total number of purchases associated with a refraction and highlights how well a practice can convert a refraction into a sale; and Overall Capture Rate, which is a key performance indicator that measures how well a practice captures outside purchases and those tied to a refraction. ABB Analyze also has expanded electronic health record integrations, with more under development, and has been building new administration tools and an onboarding portal. Mobile app enhancements as well as market share and brand reporting also will soon be introduced.
BCLA Webinar to Discuss Soft Lens Fitting
The latest British Contact Lens Association (BCLA) webinar will discuss soft lenses. It will examine dropout rates and offer suggestions regarding how eyecare practitioners can “get control” over their fittings. The online session, to be held on Feb. 26 from 6.30 p.m. to 7.30 p.m. (GMT), will be presented by Eef van der Worp, BSc, PhD. He will help viewers gain an understanding of the limitations of the current methods of soft lens fitting and will discuss new potential methods of soft lens fitting, while looking at a new mathematical model to possibly predict soft lens fit success. The session will evaluate when to use standard soft designs for the normal eye and will also discuss the use of custom-made lens designs for irregular eyes. To register, visit www.bcla.org.uk.
AOA to Make 2020 the Year of the Eye Exam
The American Optometric Association (AOA) announced the official launch of the #2020EyeExam campaign to make eye health and vision care a national priority in 2020. The public awareness campaign underscores the importance of receiving an in-person comprehensive eye examination with an AOA doctor of optometry as part of an annual healthcare routine.
Through the #2020EyeExam Employer Pledge program, AOA is spreading the message even further by enlisting visionary employers nationwide to pledge their support for raising employee awareness about the importance of a comprehensive eye exam. For more information on the #2020EyeExam initiative, please visit AOA.org/2020.
Don’t Forget to “Say Cheese” at GSLS 2020
Attending GSLS? Don’t forget to enter the social media contest for a chance to win a $50 American Express gift card. Follow these three steps to enter: 1) Follow @GSLSconference on Twitter and/or "Like" us on Facebook. 2) Post a photo from the event. 3) Mention us in the post and use hashtag #GSLS2020. Three winners will be randomly selected and announced Saturday, Jan. 25 during the Awards general session.
Which of the following topics do you think is the most important for us to cover in 2020?
This patient has severe dry eye, limbal stem cell deficiency, and glaucoma and has undergone multiple surgeries of the left eye. These images illustrate corneal edema while wearing a scleral lens; the condition was confirmed with optical coherence tomography (OCT).
We thank Dr. Barnett 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
What Is Ocular Surface Disease?
Ocular surface disease has become a “buzz” word and can tend to be substituted for dry eye. However, what is ocular surface disease? How do we define it, and how can it truly be distinguished from dry eye—or can it?
The term ocular surface disease has been traditionally reserved for more severe types of dry eye in which one or more ocular structures is moderately or severely impaired. It can be limited to one ocular structure such as the eyelid; commonly, however, the disease process invades and destroys several structures of the eye. While there is no question that dry eye disease may eventually lead to ocular surface disease, it can be helpful to distinguish the two.
With inflammation as the main culprit for both, impact on the function and actions of the structures of the eye are what lead to distinction. For example, inflammation can ultimately lead to cicatrizing trichiasis and a myriad of other symptoms. Alternatively, patients who are severely impacted by Stevens-Johnson syndrome, graft-versus-host disease, and Sjögren’s syndrome (among many others) will commonly have many structures of the eye affected. In these cases, those structures that are left partially or totally non-functional may have complete destruction of the primary and secondary aqueous production glands, limited or impaired corneal wound healing due to destruction of the limbal stem cells, and chronic inflammation in which patients are in an endless cycle of ocular complications.1,2
Thus, the term dry eye can be easily associated with ocular surface disease. But, for specialty lens fitters, where does “dry eye” fit?
1. Schwartz G, Holland E. Classification and Staging of Ocular Surface Disease. In Krachmer JH, Mannis MJ, Holland EJ. Cornea, Third Edition. Mosby Elsevier. 2010 Oct. 27:1713-1724.
2. Lee WB, Mannis M. Historical Concepts of Ocular Surface Disease. In Holland EJ, Mannis MJ, Lee WB. Ocular Surface Disease: Cornea, Conjunctiva and Tear Film. Elsevier. 2013 Mar 28:3-10.
MATERIALS & DESIGNS
David L. Kading, OD
Everything Is New
Can you believe it? You made it! The year of eyecare. Never in history have we celebrated being an eyecare provider as much as we will this year. After this year, it just gets worse: 20/25, 20/30, 20/40. Will you capitalize? Will you use this celebration of another year to help your practice and to become a better provider? Or, will you let it slip by as just another calendar flip?
I am doing what I can to capitalize on 2020. I have some lofty goals, but most importantly, I want my patients to have a fresh perspective on eye health. Others may want to market this year as the year to “clear your vision,” “keep 2020 in sight,” or countless other turns of phrase.
When it comes to contact lens practice, I encourage you to look for what is new and to talk with your patients about them. Multifocal toric lenses have become hot again…maybe it’s time to give your patients a free trial period. Many patients have dropped out of lens wear because of comfort…maybe it’s time to try to make them a part-time lens wearer.
Everything is new, and it’s time to make some new plans for 2020.
Scleral Lens Centration: The Influence of Centre Thickness, Scleral Topography, and Apical Clearance
The purpose of this study was to investigate the effect of lens center thickness (and mass) upon short-term horizontal and vertical scleral lens decentration and the association between both scleral topography and apical clearance, with lens decentration.
Lens decentration was measured using over-topography data from nine healthy young participants (25 ± 4 years) who had normal corneas fitted with ICD 16.5 scleral lenses (hexafocon B material) with center thicknesses of 150μm, 250μm, and 350μm, while controlling for other lens parameters. Scleral toricity and elevation were determined from sagittal height data over a 15mm chord obtained from a corneo-scleral topographer, and central apical clearance was quantified using anterior segment optical coherence tomography (AS-OCT).
The mean lens decentration was 0.55mm ± 0.19mm temporally and 0.84mm ± 0.35mm inferiorly, which did not vary significantly with center thickness (p > 0.05). The mean nasal-temporal asymmetry in scleral elevation data was substantially greater (619μm ± 67μm) compared to the vertical meridian (369μm ± 57μm) (p < 0.01), and this variation in scleral topography along the horizontal meridian was associated with the magnitude of horizontal lens decentration (r = 0.68, p = 0.04). Greater initial central apical clearance was associated with more inferior lens decentration (r = –0.78, p = 0.01).
Lens center thickness and mass did not significantly influence centration. Horizontal lens decentration was associated with the nasal-temporal asymmetry in scleral elevation, while vertical lens decentration correlated with initial central apical clearance. Factors affecting scleral lens centration may vary between the horizontal and vertical meridians.
Kowalski LP, Collins MJ, Vincent SJ. Scleral lens centration: The influence of centre thickness, scleral topography, and apical clearance. Cont Lens Anterior Eye. 2019 Dec 10. [Epub ahead of print]