Hopefully, you have noted that we have just published our Annual Report for 2016 in Contact Lens Spectrum covering the latest trends and developments in the contact lens field (http://www.clspectrum.com/issues/2017/january/contact-lenses-2016). Over the last year, we have seen a good deal of discussion about contact lens markets, distribution channels, and pricing. One new statistic found in the Annual Report that you may find of interest addresses the purchase location of contact lenses—notably, practitioners estimate that 67% of contact lens purchases occur within the practice setting, whereas 18% occur online, 13% occur at a third-party retailer, and 2% occur at another practice setting. It will be interesting to examine changes in these trends as we proceed through the new year—stay tuned for updated information as we move forward through 2017.
Jason J. Nichols, OD, MPH, PhD
SynergEyes to Offer GP and Scleral Lenses
SynergEyes announced a new partnership with NKL Contact Lens, Europe's largest specialty contact lens manufacturer and wholly owned subsidiary of Menicon Co., Ltd. Starting in 2017, SynergEyes will expand its specialty contact lens portfolio beyond hybrid lenses to include GP and scleral lenses. By combining the SynergEyes branding, technical support, and sales team with the proven lens designs of NKL, independent ECPs will now have access to a complete line of specialty contact lens products from SynergEyes.
The new line of SynergEyes GP and scleral contact lenses will be introduced at the Global Specialty Lens Symposium in Las Vegas.
Two Weeks Until GSLS 2017
The 2017 Global Specialty Lens Symposium (GSLS) will be held January 26-29, 2017 at the Rio Hotel in Las Vegas. 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. The meeting includes insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.
The Registration Desk will open Wednesday, January 25 from 3:00 p.m. - 6:00 p.m., and will reopen on Thursday, January 26 at 7:30 a.m.
The GP Lens Institute plans to continue its webinar series in 2017. Monthly events will take place as follows.
January 17 – Scleral lens fitting to optimize corneal physiology: Langis Michaud, OD, and John Gelles, OD
February 15 – Incorporating technology into specialty contact lens practice: Barry Eiden, OD
March 21 – The lost art of corneal GP fitting: Buddy Russell
April 18 – Specialty GP case grand rounds: Matt Kauffman, OD
May 16 – GP correction of presbyopia: Jason Jedlicka, OD
June 20 – Corneal and scleral contact lens care update: Susan Gromacki, OD
July 18 – Amniotic membrane and specialty soft lens update: Stephanie Woo, OD
August 15 – How to optimize contact lens comfort: Mile Brujic, OD, and Dave Kading, OD
September 19 – Clinical controversies with scleral lenses and their management: Patrick Caroline
October 17 – Myopia control update: Jeff Walline, OD, PhD
November 21 – Scleral lens update: Muriel Schornack, OD
December 19 – Getting started with orthokeratology in your practice: Melanie Frogozo, OD
This image shows hydrops in advanced keratoconus. Treatment was penetrating keratoplasty.
We thank Thomas Arnold 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
Contact Lenses and Pregnancy
Anticipating a new child can be an exciting time for an expectant mother and her family. Pregnancy can also bring with it challenges for the mother, family members, and healthcare providers who administer care to the expectant mother. As providers, we may need to perform alternative testing during our exams, or we may need to consider different medications when treating expecting or new mothers for an aliment. Pregnancy may also have implications for refractive corrections.
Pregnancy has been associated with myopic shifts, corneal thickness changes, corneal curvature changes, and altered tear films/decreased tear production.1,2 These ocular changes can subsequently result in decreased spectacle satisfaction.1 It can also result in contact lens intolerance.1,2 In fact, it has been estimated that 25% to 30% of women who are pregnant develop contact lens intolerance, an intolerance that is more likely related to tear film alterations than corneal sensitivity because corneal sensitivity is likely reduced during pregnancy.1
This information indicates that you should educate all contact-lens-wearing expectant mothers that they may experience contact lens discomfort but that it will likely return back to baseline after their child is born.1 You should also educate them that they may experience mild refractive error changes that will abate at about the same time.1,2 With this in mind, the best course of action may be to have expectant mothers either treat their contact lens discomfort with artificial tears or to have them temporally stop contact lens use. Updates in prescriptions should also wait until after the pregnancy, unless a substantial refractive error shift is noticed by the patient.1
1. Sharma S, Rekha W, Sharma T, Downey G. Refractive issues in pregnancy. Aust N Z J Obstet Gynaecol. 2006 Jun;46:186-188.
2. Gotovac M, Kastelan S, Lukenda A. Eye and pregnancy. Coll Antropol. 2013 Apr;37 Suppl 1:189-193.
MATERIALS & DESIGNS
David Kading, OD
Start the Year in High Gear
Being a futurist, I am always excited for tomorrow. I love what it brings. And, few things excite me more than drawing a line and starting new with something. That is why I get so jazzed up about January. As the operator of my business, I love to see my scorecard.
One of my top strengths (according to Gallop’s StrengthsFinder) is that I am competitive. Not so much in the Monopoly game playing during a holiday with my family, but more so against myself. I’m always looking at myself and seeing if there is a way that I can be better and improve on a prior score.
January is this time for me, folks, and I would encourage you to join me. Here are steps on how to come out with a bang this year.
1. Set Goals. In November 2016, I sat down and thought about the things in our business that are awesome and the things that I want to do in the coming year. Here are a couple of mine:
– Focus on having a certain percentage of my exams be contact lens patients
– Focus on having a certain number of overnight corneal reshaping patients
– Focus on having a certain number of specialty contact lens patients
– Focus on growing my dry eye services to a broader patient base
– Improve upon my daily disposable offerings
2. Go Back. Without knowing what last year’s numbers were for these, I wouldn’t know whether I am doing better than I normally do or the same. So, after discovering the things that you want to do this year, look at what you did last year for these items.
3. Set Targets and Break Them Up. It’s great to have goals, but if they are not specific, realistic, and timely, they won’t happen. For the offerings above, I have broken out exactly which targets I want to meet on a monthly or quarterly basis for each goal. If I note during or after a specific month that I am falling short, I may need to adjust my goals.
4. Use a System to Track Your Progress. I have a spreadsheet that has hundreds of lines in it with all the numbers that I track from my electronic health record (EHR). Honestly, I don’t need all these numbers. But, I like having them in case I need to look back at them at some later date. Instead, on a weekly or monthly basis, I use a program (Glimpse, Edge, some EHRs have this too) that pulls my info from my EHR and reports back to me about how I am doing in regards to reaching my goals. This makes it way easier.
5. Come up with Marketing and Strategy Ideas of How to Reach These Goals. Consider having team meetings and trainings on how to move together as an office to reach these goals.
Whatever you do, just set some goals. Even if you miss the goal, you will be thinking about the process and you will certainly do better than the prior year. To have an amazing year, it’s time to kick it into high gear.
Impact of Chronic Smoking on Meibomian Gland Dysfunction
The aim of this study was to explore the relationship between chronic cigarette smoking and meibomian gland dysfunction (MGD). The study enrolled 322 smokers with MGD and 2,067 non-smokers with MGD. All enrolled subjects were tested in the following sequence: Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), corneal fluorescein staining (CFS), Schirmer I test (SIT), and slit-lamp microscope examination of lid margin abnormalities, meibomian gland expression, as well as meibum.
Compared with the MGD patients who smoked, the non-smoker MGD patients had significantly increased scores of lid margin abnormality and meibum (P < 0.01 for each comparison). No significant difference was noted in OSDI, TBUT, CFS, SIT, or the score of meibomian gland expressibility between the smokers and non-smokers (P>0.05 for each comparison). In the smokers, the smoking index was significantly correlated with the scores of lid margin abnormality (both sexes, R = 0.19, P < 0.01; Male, R = 0.18, P<0.01) and meibum (both sexes, R = 0.29, P<0.01; Male, R = 0.20, P < 0.01), but was not significantly correlated with OSDI, TBUT, CFS, SIT, or the score of meibomian gland expressibility (P>0.05 for each comparison).
The findings of this study suggest chronic smoking might be associated with MGD.
Wang S, Zhao H, Huang C, Li Z, Li W, Zhang X, Liu Z. Impact of Chronic Smoking on Meibomian Gland Dysfunction. PLoS One. 2016 Dec 28;11:e0168763.