With school out and extracurricular activities usually lessened, summer is a great time to get families in the office. This provides a great opportunity to promote contact lenses, especially to children and teens (if appropriate).
While always an issue, summer is the time when most people are more conscious of potential issues stemming from too much exposure to ultraviolet (UV) light. I am reminded that many contact lens materials have UV-blocking technology. Theoretically, contact lenses provide more protection to the eye from UV rays than spectacles do. Keep this tip in mind when promoting all of the benefits of contact lenses to your patients.
Jason J. Nichols, OD, MPH, PhD
In Memoriam: Timothy O. Koch, COT
Industry veteran Timothy O. Koch, COT, recently passed away after a brief illness. Beginning his career as an optician and contact lens fitter, he also developed into an administrator in major ophthalmology centers in Minnesota and California.
Over the past 25 years, he held numerous positions in the contact lens field working with companies as they developed and brought to market GP materials, corneal refractive therapy (CRT) and orthokeratology designs, and custom soft and hybrid lenses. From the podium, he was noted as a well-sought-after humorous and entertaining speaker.
While small in stature, Tim had the biggest of personalities and touched all whom he encountered. He will be missed.
Contributed by Craig Norman.
VTI Unveils NaturalVue Sphere, NaturalVue Multifocal Contact Lenses in Plus Powers
Visioneering Technologies, Inc. (VTI) introduced its new enhanced NaturalVue (etafilcon A) Sphere 1 Day Contact Lenses with CleanComfort technology.
According to VTI, to ensure better comfort, three ingredients have been added to the packaged saline solution, giving the lens a “TripleTear Lubrication System.” The new ingredients include hyaluronic acid (HA) as well as elements known to lock-in moisture and stabilize tears. Additionally, the new edge on the NaturalVue Sphere is designed to balance movement for a more optimal fit while still allowing adequate tear exchange to wash away debris. It also features a Class 2 UV blocker.
VTI also announced the availability of NaturalVue (etafilcon A) Multifocal (NVMF) 1 Day Contact Lenses in plus powers. The expansion of plus powers will take the full power range of the lens from +4.00D to –12.25D (in 0.25D steps). NVMF plus powers will be available in 30- and 90-revenue packs as well as in 10-pack trials. A further parameter expansion to up to +6.00D is planned for the future.
Bausch + Lomb Announces Licensing Agreement With Tangible Science
Bausch + Lomb (B+L) has entered into a worldwide licensing agreement with Tangible Science, LLC. As part of the agreement, B+L’s Specialty Vision Products business will offer the Tangible Science Hydra-PEG contact lens coating technology for use with several of its Boston GP materials, including Boston XO, Boston XO2, Boston EO, and Boston ES, along with the Zenlens and Zen RC scleral lenses by the end of 2018.
Myopia Awareness Coalition Holds Inaugural Event
On June 19, a group of 33 eyecare industry leaders met in Denver to discuss how to raise public awareness of the eye health risks associated with childhood myopia. Named the “Myopia Awareness Coalition,” attendees represented manufacturers, retailers, insurers, equipment manufacturers, eyecare practitioners, researchers, and a consumer advocate. Coalition members universally agreed on the importance of partnering with existing organizations to coordinate efforts to educate the public on myopia and to secure resources for further research into this critical area. A key insight from the group was that the industry currently has no singular, easy-to-understand message from these various organizations about the importance of identifying and treating myopia. Groups worked through the top ideas to think through how they could be executed, what resources would be required, and specific next steps needed to move toward successful implementation.
Oyster Point Pharma Announces FDA Clearance of IND Application
Oyster Point Pharma, Inc. announced that the U.S. Food and Drug Administration (FDA) has cleared the company’s Investigational New Drug (IND) application to proceed with clinical development of OC-01, an investigational compound intended to stimulate natural tear film production in people who have dry eye disease that is administered with a nasal spray.
According to the company, this regulatory milestone will support its ongoing Phase 2 clinical trials evaluating the safety and efficacy of two different nicotine acetylcholine receptor (nAChR) agonists—OC-01 and OC-02—as potential treatments for the signs and symptoms of dry eye disease.
OC-01 and OC-02 come from a class of drugs called nAChR agonists that are known to affect the parasympathetic nervous system. The trigeminal nerve provides parasympathetic control of the glands that produce the eye’s natural tear film. These compounds are being developed in a nasal spray to deliver them directly to the trigeminal nerve, which is accessible within the nose.
"Myopia Awareness Week" Going Global in 2019
Brien Holden Vision Institute and the World Council of Optometry (WCO) announced a partnership to promote “Myopia Awareness Week” globally in 2019.
The campaign will target the general public and eyecare sector. Both organizations decided on the partnership because they believe the growing prevalence of myopia required a comprehensive response from the optometric community.
RightEye Unveils EyeQ Trainer
RightEye LLC unveiled its new EyeQ Trainer computer-based vision rehabilitation program, which gives eyecare practitioners (ECPs) a tool that their patients can use at home to rehabilitate eye-movement issues.
According to the company, RightEye EyeQ tests (quick, gamified tests that provide information on how a patient’s eyes and brain are working together) have been available to identify a host of issues related to eye movement control, sustaining focus and alignment, dynamic visual acuity, peripheral vision, and depth awareness as well as a range of conditions, including asthenopia, visual fatigue, dry eye, binocular vision, concussion, and reading issues. With the introduction of EyeQ Trainer, the company says that ECPs can now prescribe targeted, at-home vision exercises to improve and strengthen areas of weakness. RightEye EyeQ Trainer integrates with EyeQ reports—offering personalized recommendations for improvement for each patient.
Exercises take about five minutes per sitting, which the patient does once or twice per day for several weeks. Once patients have completed their prescribed training program, they return to their practitioner’s office to be retested with the corresponding RightEye EyeQ test.
Are you measuring tear osmolarity in clinical practice?
A big part of an educator’s job is teaching the next generation of eyecare practitioners, and a big part of this opportunity is helping students decipher a patient’s history, which often involves determining whether the patient is accurately portraying his or her clinical situation. While students get better at this with time, here’s a common clinical situation that students often encounter.
A new patient presents to the clinic and reports that she has a long history of wearing soft contact lenses. The patient (or via student in my case) confidently reports that she would like to keep wearing a specific brand of contact lenses and that she replaces them at the recommended interval. This patient does not have her old prescription, she does not have her contact lens boxes, and she may or may not remember the name of the most recent eyecare professional whom she has seen. Often, students take such a patient’s history at face value, but should they?
All-too-frequently when verifying a patient’s contact lens prescription, one will quickly note that the patient has reported the wrong brand. A study by Zimmerman et al also found that patients who wear daily disposable contact lens can accurately remember their replacement schedule, though wearers of monthly and two-week replacement lenses were able to correctly report their replacement schedule only 92% and 59% of the time, respectively.1
Overall, the above situation highlights the importance of taking a good history while at the same time questioning the patient’s recall ability because he or she could easily lead the practitioner astray. After all, everyone makes mistakes. It is the physicians’ job to educate their patients about the differences among contact lenses and the correct way to wear them so that they stay happy and safe.
1. Zimmerman AB, Emch AJ, Geldis J, Nixon GJ, Mitchell GL. Contact Lens Corneal Inflammatory Events in a University Population. Optom Vis Sci. 2016 Jan;93:42-49.
MATERIALS & DESIGNS
David L. Kading, OD
Multifocal Sclerals—Decenter Your Approach to Things
One of the worst things about multifocal contact lenses is that they increase the amount of aberrations that patients experience. The many reasons for this include pupil size problems, decentration of the lens, and altered tear film in a population more prone toward dry eye. Although practitioners certainly have not solved all of the problems, they are getting closer and closer.
One reason why they are getting closer is because we are realizing the issues. One major issue that practitioners have with several off-the-rack products relates to line of sight. Most people do not look through the center of their cornea, and their visual axis may not align with their central cornea. This misalignment is oftentimes referred to as angle kappa or angle lambda.
When a well-centered multifocal lens is placed on the eye but the visual axis doesn't align, a patient will be looking through optics that do not match up with the optics that the lens was designed to provide. This problem is made worse when a patient is in a dark environment.
Fear not, the contact lens industry’s manufacturing partners are on it. They are looking for ways to decenter lens optics for us. This may be available by the time that this column comes out, but to date, there are no laboratories that are marketing this service—yet. However, stay tuned and ask the laboratory about it. Soon practitioners will be ordering custom soft and scleral lenses with optics that work to maximize their patients’ angle kappas. Sometimes, practitioners just need to decenter their approach to things.
Contact Lens Solutions and Contact Lens Discomfort: Examining the Correlations Between Solution Components, Keratitis, and Contact Lens Discomfort
The objective of this study was to examine the current literature as it relates to contact lens discomfort (CLD) secondary to contact lens solutions. The goal is to provide a better understanding of the characteristics of contact lenses as they uniquely interact with each type of contact lens solution and also to gain a better comprehension of the components of contact lens solutions, such as preservatives, surfactants, and chelating agents, which may contribute to discomfort.
By investigating corneal staining theory and the mechanisms that contribute to its presence, the authors provided insight into this clinical finding, which relates to selection of contact lens solutions. The U.S. Food and Drug Administration (FDA) standards for testing solutions and how this relates to contact lens keratitis were also appraised with regard to current International Organization for Standardization (ISO) recommendations.
Finally, the authors noted that better selection of multipurpose contact lens solutions and hydrogen peroxide-based solutions for patients should be accessible to clinicians based on this review and preexisting clinical findings or diagnoses.
The authors noted that many studies have been conducted comparing comfort between various types of contact lens solutions. It is challenging to decipher this information and apply it clinically when selecting solutions for patients. By comparing solution components, how contact lens solutions interact with different types of lenses, keratitis related to contact lenses, and preexisting ocular conditions, the authors hoped that this review will help improve a clinician's ability to eliminate CLD.
Kuc CJ, Lebow KA. Contact Lens Solutions and Contact Lens Discomfort: Examining the Correlations Between Solution Components, Keratitis, and Contact Lens Discomfort. Eye Contact Lens. 2018 Jun 13. [Epub ahead of print]