This past Thursday, we kicked off the 2020 Global Specialty Lens Symposium with an opening session that focused on myopia and its controversies. During the session, we were tremendously excited to announce a new standalone meeting that will solely be focused on myopia and myopia management—the Global Myopia Symposium—which will be held in 2021 in Las Vegas. I am excited to serve on the inaugural education committee with several top myopia experts including Kate Gifford, PhD, BAppSc(Optom)Hons; Lyndon Jones, PhD, DSc, FCOptom; Shalu Pal, OD; and Jeff Walline, OD, PhD.
We look forward to hearing your input about which important myopia initiatives we should cover as we plan the 2021 meeting.
Jason J. Nichols, OD, MPH, PhD
CooperVision Appoints Jane Agbontaen as Senior Brand Marketing Director for Myopia Management in North America
CooperVision has named Jane Agbontaen as senior brand director for Myopia Management – Americas. In this newly created role, Ms. Agbontaen will be responsible for the strategic planning and execution of all activities that support the U.S. growth of CooperVision’s myopia management portfolio—specifically the Brilliant Futures Myopia Management Program and its MiSight 1 day contact lenses.
Ms. Agbontaen has more than 20 years of professional experience in the healthcare space and with large medical device players such as Hologic, Abbott Medical Optics, and Johnson & Johnson DePuy Synthes. While at Abbott Medical Optics, which was acquired by Johnson & Johnson Vision Care during her tenure, she managed a broad brand portfolio in the cataracts segment, including intraocular lenses and instruments.
Researchers at Tohoku University have developed a new type of smart contact lenses that may prevent dry eyes. The self-moisturizing system, which is described in the journal Advanced Materials Technologies, maintains a layer of fluid between the contact lens and the eye using a novel mechanism.
According to the researchers, one of the biggest problems with contact lenses is that they can cause "dry eye syndrome" due to reduced blinking and increased moisture evaporation. To tackle this problem, the researchers developed a new mechanism that keeps the lens moist. The system uses electroosmotic flow (EOF), which causes liquid to flow when a voltage is applied across a charged surface. In this case, a current applied to a hydrogel causes fluid to flow upward from the patient's temporary tear reservoir behind the lower eyelid to the surface of the eye.
The researchers also explored the possibility of using a wireless power supply for the contact lenses. They tested two types of batteries—a magnesium-oxygen battery and an enzymatic fructose-oxygen fuel cell—both of which are known to be safe and non-toxic for living cells. They showed that the system can be successfully powered by these biobatteries, which can be mounted directly on the charged contact lens.
Further research is needed to develop improved self-moisturizing contact lenses that are tougher and capable of operating at smaller currents.
Tangible Science Announces Tangible Boost Launch
Tangible Science announced that Tangible Boost, an at-home conditioning treatment designed to repair wear on Tangible Hydra-PEG coated lenses, is expected to be available in the third quarter of 2020 through eyecare practitioners as a prescription-only product. Tangible Boost is designed to maintain the coating’s wettability and benefits for the prescribed life of the lenses when used regularly. During a half-hour soak of coated lenses in the Tangible Boost solution, the polymers in the formula build upon polymers on the coated lens at a microscopic level, filling in gaps from wear and restoring the thickness of the coating, according to the company. Restoring the coating’s thickness restores the full benefits of the coating delivered upon original dispensing.
Eaglet Eye Announces Two New Features
Eaglet Eye announced two new major features for its Eye Surface Profiler (ESP). First, the Scleral Profiler allows practitioners to quickly and easily determine if they should pursue a spherical, toric, quad, or fully custom scleral periphery. According to Eaglet, this feature will make the fitting process with an ESP even faster. The second new feature is the ability to enter the over-refraction to allow for more seamless interaction with the lab of choice. This is one more step to help reduce the complications when ordering scleral lenses, according to the company.
CooperVision Sponsors 2020 Annual Educator’s Meeting at GSLS
To educate contact lens faculty—and to collaborate on how to best support them, their students, residents, and schools—CooperVision sponsored the annual Educator’s Meeting for the fourth consecutive year, on January 23, immediately prior to the Global Specialty Lens Symposium (GSLS).
The half-day meeting featured several sessions related to MiSight 1 day, including an overview of the clinical study results, lens design, and clinical protocol from Debbie Jones, FCOptom, as well as a panel discussion featuring eyecare professionals who have experience fitting patients in the lens in Canada. Panelists included Tina Goodhew, OD, and Jeff Goodhew, OD, as well as Sheila Morrison, OD, MS. Experts from two CooperVision Specialty EyeCare businesses—Paragon Vision Sciences and Blanchard Contact Lenses—also provided updates to attendees.
Which of the following topics do you think is the most important for us to cover in 2020?
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.
S. Barry Eiden, OD
There Is No Room for “Fake News” Here!
Over the last few decades, darts have been thrown from both sides of the contact lens versus refractive surgery (primarily laser-assisted in situ keratomileusis [LASIK]) camps. Each side would highlight the “risks” of each modality of vision correction. The truth is that both are excellent methods for vision correction when applied to the appropriate candidates. Regardless of the side, their single most important concern is the risk for vision loss.
A recent paper attempted to compare the risk of vision loss following contemporary LASIK with different types and modality of use of contact lenses.1 Data from a previously published study were used to derive the incidence of vision loss (≥ 2 line loss of best-corrected spectacle acuity) following microbial keratitis for different contact lens types and wearing modalities, stratified by duration of lens wear. A literature search on articles from between 2003 and 2019 and on vision loss following LASIK was performed. The prevalence of vision loss at six months post-surgery was captured from clinical trials published after 2003. A proportion meta-analysis was applied to derive the prevalence of vision loss following LASIK. A least-squares fitting of cumulative vision loss (P, per 10,000 wearers) over time (t, years) using an exponential model estimated the years of contact lens wear to which the risk of vision loss with LASIK was equivalent.
Results of the analysis indicated that vision loss following LASIK occurred in 66 (95% confidence interval [CI] 34 to 108) per 10,000 wearers. As a conservative estimate based on the lower confidence interval of the estimated equivalent years of contact lens wear, daily wear and extended wear overnight silicone hydrogel contact lenses need to be worn for 103 years (95% [CI] 103 to 391) and 25 years (95% [CI] 25 to 79), respectively, to equal the rate of vision loss equivalent to a one-off LASIK procedure.
The authors concluded that the risk of vision loss to individuals is low with either contact lens wear or refractive surgery. Contact lens wear does not pose a higher risk of vision loss compared to LASIK surgery for the most common wear modalities.
Moments before writing this column, I was in an exam room with a current contact lens wearer (daily wear, monthly replacement, compliant) who asked me whether he should consider LASIK. I replied with a thorough review of his candidacy (refraction, corneal tomography, corneal thickness, anterior segment health and systemic health status, and age review). I told him that he was an excellent candidate and reviewed the benefits of LASIK. However, I then reviewed the relative risks involved and told him that the decision for this elective surgery was his. Having information as described in the study referenced in this column helps practitioners provide appropriate patient counseling with minimal bias.
1. Wu YT, Ho A, Naduvilath T, et al. The risk of vision loss in contact lens wear and following LASIK. Ophthalmic Physiol Opt. 2020 Jan 9. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
Laundry detergent pods (or packs) are water-soluble pouches containing highly concentrated laundry detergent, softener, and other laundry products. The chemistry of laundry detergent packs is the same as in liquid detergents. The dissolvable packet is typically made of polyvinyl alcohol (PVA) or a derivative of PVA. A detergent pack’s liquids may contain 10% water compared to 50% typically found in liquid detergents.
Some have raised concern over children accidentally being exposed to or ingesting laundry packs, because their appearance and packaging design are colorful and may appeal to children; they may believe that the packs are hard candy or a toy. The pods are jelly-like, smooth, and cool; they also feel good to manipulate and squeeze. In fact, a study published in Pediatrics reported that from 2012 to 2013, more than 17,000 calls were made to poison control centers about children who had been exposed to the packs.1
Despite the industry’s move toward safer packaging, a 2017 study published in JAMA Ophthalmology reported that between 2012 and 2015, the number of chemical eye burns associated with laundry detergent pods among 3- to 4-year-old children skyrocketed from fewer than 20 to almost 500 per year; in 2015, these injuries were responsible for 26% of all chemical eye burns among this population.2 And, a recent study reported that a growing number of children are getting chemicals from laundry detergent pods in their eyes, even as ocular injuries from other types of household cleaners steadily decline.3 The highest exposure was among 2-year-olds, with 62.8 cases for every 100,000 residents.
Contrary to the overall trend, ocular exposures to laundry detergent packets have increased significantly and merit special preventive action. Counsel the parents of toddlers regarding the safe storage and use of “laundry pods”—consider posting an infographic—and help prevent laundry pod eye-related and other serious injuries/death.
1. Valdez AL, Casavant MJ, Spiller HA, Chounthirath T, Xiang H, Smith GA. Pediatric exposure to laundry detergent pods. Pediatrics. 2014 Dec;134: 1127-1135.
2. Haring RS, Sheffield ID, Frattaroli S. Detergent Pod–Related Eye Injuries Among Preschool-Aged Children. JAMA Ophthalmology. 2017 Mar 1;135:283-284.
3. Kamboj A, Spiller HA, Casavant MJ, Kistamgari S, Chounthirath T, Smith GA. Household cleaning product-related ocular exposures reported to the United States poison control centres. Eye (Lond). 2019 Dec 9. [Epub ahead of print]
Tear Film Dynamics of Soft Contact Lens-Induced Dry Eye
The purpose of this study was to prospectively assess tear dynamics in soft contact lens-induced dry eye while wearing and after removing soft contact lenses.
The researchers analyzed 17 right eyes of soft contact lens users at Wada Eye Clinic (11 men, 6 women; mean age: 36.8 ± 8.3 years; range: 24 to 57 years). Participants were divided into two groups depending on presence of dry eye symptoms. Video interferometry was used to observe tear dynamics while the subjects wore and after they removed their soft contact lenses. Interference images focusing on tear spread and interference fringe were compared between groups.
This study included 10 symptomatic and seven asymptomatic eyes. Considering the symptomatic eyes—while the subjects wore soft contact lenses—eight eyes showed poor tear spread and multicolor interference fringe (i.e., swift flow of multicolor interference waves after a grayish monochromatic band-color after a blink), but eight and 10 eyes showed good tear spread and a grayish monochromatic interference fringe when soft contact lenses were removed, respectively. As for asymptomatic eyes, six eyes exhibited good tear spread and a grayish monochromatic interference fringe while wearing soft contact lenses and after removing soft contact lenses.
The researchers concluded that soft contact lens-induced dry eye was associated with tear dynamics only while wearing soft contact lenses. Observation of tear film dynamics in eyes with soft contact lenses could facilitate the understanding of dry eye-related symptoms.
Kaido M, Kawashima M, Ishida R, Tsubota K. Tear Film Dynamics of Soft Contact Lens-Induced Dry Eye. Curr Eye Res. 2020 Jan 3:1-7. [Epub ahead of print]