This is the time of year that our editorial team at Contact Lens Spectrum begins planning its 2020 editorial calendar. As always, we solicit editorial ideas from both our team of contributing editors and editorial staff in addition to our readership. Please let us know if you have ideas for articles, content, or authors for next year. We look forward to hearing from you in this regard. Email us at firstname.lastname@example.org.
Jason J. Nichols, OD, MPH, PhD
International Forum for Scleral Lens Research
Occurring just prior to the annual Global Specialty Lens Symposium in Las Vegas in January 2020, the International Forum for Scleral Lens Research (IFSLR) will be held on the afternoon of Jan. 22, 2020. The program is supported by Bausch + Lomb and CooperVision Specialty Eye Care. IFSLR’s mission statement is "To advance the discipline of scleral contact lens prescribing through the coordinated efforts of evidenced-based research and clinical practice."
According to IFSLR, world-leading practitioners, clinician scientists, and scientists will discuss a number of topics such as whether scleral lenses provide sufficient oxygen, the latest findings and recommendations about the post-lens tear reservoir, and an update on scleral shape and how it affects scleral lens fitting and performance. At the event, presenters will include Langis Michaud, Stephen Vincent, Jason Nichols, Lynette Johns, Greg DeNaeyer, Gonzalo Carracedo, Daddi Fadel, and more.
Alcon Introduces Air Optix plus HydraGlyde for Astigmatism
Alcon launched Air Optix plus HydraGlyde for Astigmatism contact lenses in the United States. According to the company, the lenses include the proprietary HydraGlyde Moisture Matrix for long-lasting lens surface moisture, a Precision Balance 8|4 lens design to hold the lens in place with every blink, and SmartShield Technology that helps guard against irritating deposit buildup.
Air Optix plus HydraGlyde for Astigmatism contact lenses will immediately be available in the following parameters: sphere powers of +6.00D to -6.00D (0.25D steps) and –6.50D to –10.00D (0.50D steps); cylinder powers of –0.75D, –1.25D, –1.75D, and –2.25D; and around-the-clock axes in 10° steps.
AAOF Announces 2019 Joe and Janet Barr Early Career Cornea and Contact Lens Research Award Recipients
The American Academy of Optometry Foundation (AAOF) announced the recipients of the Joe and Janet Barr Early Career Cornea and Contact Lens Research Award. The award is intended to provide a masters, doctorate, vision science, or physiological optics student attending a school or college of optometry seed funding for a research project in cornea/ocular surface or contact lenses.
In conjunction with the joint meeting of the American Academy of Optometry and the World Council of Optometry, two awards will be given this year to include students abroad. This year’s awardees are Pabita Dhungel and Rabia Mobeen.
Ms. Dhungel is an MS/PhD Candidate at Pacific University College of Optometry. Her project is on the "Impact of Scleral Lens Wear on Intraocular Pressure and Posterior Ocular Perfusion." Ms. Mobeen is a PhD Scholar at the University of New South Wales School of Optometry and Vision Science. Her project is on the "Corneal Immune Response in Children, Adolescents, and Adult Contact Lens Wearers."
Both recipients will receive a $2,000 award and a $750 travel fellowship to attend Academy 2019 Orlando and 3rd World Congress of Optometry.
Blanchard Offers Tangible Hydra-PEG with Boston XO and Boston XO2 Materials
Blanchard Contact Lenses announced that Tangible Hydra-PEG (Tangible Science) is now available with Boston XO and Boston XO2 from Boston Materials (Bausch + Lomb). Boston XO and Boston XO2 are also U.S. Food and Drug Administration cleared for the treatment of multiple ocular diseases, including dry eye.
Eyeganics Launches Organic Tears
Eyeganics launched Organic Tears (0.2% organic glycerin), a U.S. Department of Agriculture-certified organic eye drop for the treatment of eye dryness. Organic Tears lubricates the eye with natural organic ingredients; it is made of oil from organic vegetables, salt, and water.
Organic Tears is exclusively available for purchase from eyecare professionals. The 10mL bottle, with a preservative-free multidose ophthalmic squeeze dispenser, has a suggested patient price of $28.
BCLA Announces New Myopia Management Certificate
The British Contact Lens Association (BCLA) is offering a new certificate in myopia management that is due to launch later this year. The online course will feature six narrated lectures and will include the latest evidence-based research presented in an easily accessible format to allow the learning to be shared and adopted by practice staff, according to BCLA. The CET-accredited program is free for BCLA members.
B+L Announces U.S. Launch of Ocuvite Eye Performance Vitamins
Bausch + Lomb (B+L) announced the U.S. launch of Ocuvite Eye Performance vitamins. Ocuvite Eye Performance eye vitamins were formulated with seven vital nutrients that help strengthen the macula, which protects the eye from stressors such as sun light and blue light emitted from digital devices, according to B+L. Nutrients include lutein and zeaxanthin (the two carotenoid pigments naturally found in the eye), omega-3s, zinc, vitamins C and E (two antioxidants), and vitamin D.
Ocuvite Eye Performance eye vitamins are available for purchase at major retailers nationwide, including Walgreens, CVS, Walmart, Target, and Amazon, and have a manufacturer suggested retail price of $19.99 for a 50-count bottle.
Physician Partnered Products LLC Founded
Dr. David Hansen announced the founding and launch of Physician Partnered Products LLC. (PPP), with owner, founder and vision-medical director, Dr. Steve Ferguson. Dr. Hansen serves as the company’s CEO.
PPP creates strategic partnerships with eyecare practitioners and vision clinics across the United States. These partnerships allow doctors to acquire research-based diagnostic and treatment technology for advanced vision-medical services, with the initial launch focused on ocular surface disease, specifically meibomian gland dysfunction. PPP also provides clinics with mentoring programs and collateral support for optimizing treatment outcomes with reduced expenses.
Currently, PPP is working with Johnson & Johnson Vision. PPP purchases the LipiFlow system from Johnson & Johnson Vision, which installs the system and technically trains the practice doctors and staff. PPP provides supplementary training and comprehensive guidance for dry eye treatment as well as ongoing education and support for billing, coding, record keeping, and even marketing support.
New Practice Performance Trend Report Available
CareCredit has partnered with Glimpse, a division of ABB Optical Group, to produce a new Independent Optometry Key Performance Metrics Trend Report available for free for eyecare professionals.
Based on data derived from more than 500 independent optometric practices across the United States, the report details industry benchmarks including gross revenue, revenue per patient, total eyewear revenue, and other important information that providers can use to better evaluate their practice performance.
Dr. Paul Sieving to Retire from NEI
Paul A. Sieving, MD, PhD, director of National Eye Institute (NEI), will retire from the National Institutes of Health (NIH) on July 29, 2019. He will be launching and directing a new Center for Ocular Regenerative Therapy at the University of California, Davis.
Following Dr. Sieving’s departure, and while the NEI conducts a national search for a new director, Santa Tumminia, PhD, will serve as the acting director. Currently, Dr. Tumminia serves as the NEI Deputy Director.
ABB Optical to Collaborate with RevolutionEHR
ABB Optical Group and RevolutionEHR announced the integration of ABB Optical products with RevolutionEHR’s SmartFlow for Sight ordering technology, which automates the entire product ordering process for eyecare practitioners (ECPs) from order submission to delivery to their office or directly to their patients.
According to the company, placing orders through RevolutionEHR removes the need for users to access multiple disparate ordering portals, thus eliminating double entry. Using RevolutionEHR’s orders dashboard, customers receive automatic and real-time order status updates directly from their SmartFlow suppliers. Additionally, RevolutionEHR users can leverage the integrated contact lens catalog, provided by ABB Optical, for automatic parameter verification.
Nicox Receives $3 Million Milestone Payment from Eyevance for Zerviate
Nicox SA has received a $3 million milestone payment from partner Eyevance Pharmaceuticals. Nicox and Eyevance entered into a licensing agreement for Zerviate in the United States in Sept. 2017 in which Nicox agreed to provide pre-launch manufacturing support to Eyevance and was responsible for completing the requisite scale-up activities for the manufacturing of the commercial product and the professional samples necessary for the launch.
Zerviate is also licensed to Ocumension Therapeutics for the Chinese market, and Nicox currently retains rights for all other territories outside of the United States and China.
Zeriviate (cetirizine ophthalmic solution), 0.24% is a topical ocular formulation of the antihistamine cetirizine for the treatment of ocular itching associated with allergic conjunctivitis
Which therapy for myopia management do you believe is most efficacious?
This image is from a female patient who uses InSight Scleral lenses (Metro Optics). It shows how a lower blanching was improved with toric haptics.
We thank Juan Camilo Cuesta Redondo 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
A Keratoconus Progression Definition
Corneal cross-linking (CXL) is widely used to interrupt or halt keratoconus corneal progression. Many practitioners routinely see keratoconus patients and talk about CXL with potential candidates. Recently, I had some questions regarding the specific indicators of true progression, which led to this article.
From sifting through the literature, it is evident that there is no specific standard definition of what constitutes progression. According to Gomes et al,1 there is no formal or clear delineation of ectatic progression. A collective group of specialists concluded that progression of ectasia can be defined by at least two of the following: a steepening of the anterior corneal surface, a steepening of the posterior corneal surface, or thinning and/or an increase in the rate of corneal thickness change from the periphery to the thinnest point.1 However, these findings must be outside of the normal variance or "noise" of the testing system and consistent over time. Of note, uncorrected visual acuity changes and/or best-corrected spectacle visual acuity change does not factor into the definition of progression.
In general, candidates for CXL must demonstrate clinical signs of progression. The widely accepted protocol published in 2017 recommends evidence of the following as clinical data for candidacy for CXL: at least 1.0D of change in keratometry in 12 months; an increase of 1.0D or more of corneal astigmatism (cycloplegic) in 12 months; a loss of at least two lines of best-corrected vision in 12 months; and/or thinning of the cornea of more than 20 microns at the thinnest point in 12 months. There is no protocol or agreed consensus for treatment of patients who have subclinical keratoconus. It is helpful to know that CXL is generally not recommended for those over the age of 40.2,3
1. Gomes JA, Tan D, Rapuana CJ et al; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectactic Diseases. Global Consensus on Keratoconus and Ectatic Diseases. Cornea. 2015 Apr;34:359-369.
2. Santiago MR. Corneal Crosslinking: The Standard Protocol. Rev. bras.oftalmol. 2017 Jan/Feb;76 (1).
3. Michaud L, Chang C. Care of Keratoconus Patients: An International Perspective. Presented at the Global Specialty Lens Symposium. Jan. 2019, Las Vegas.
MATERIALS & DESIGNS
David L. Kading, OD
By now you are probably wondering why it has taken me so long to realize that myopia is a disease, not just a nuisance that my patients have. I know, me too. The more that practitioners learn about myopia, the more they realize how devastating it can be for patients.
Myopia isn’t just a refractive error; it is a ticking time bomb. The risks have been widely published regarding the correlation between increased myopia and increased risk for glaucoma as well as macular and retinal pathology. This is apparent for every level of myopia; for higher levels, however, it is a near certainty. It is fortuitous that you all subscribe to Contact Lenses Today and Contact Lens Spectrum, where we can learn about some fantastic treatment methods to help save our patients’ vision.
I want to highlight orthokeratology (ortho-k). For some reason, ortho-k still has not caught on. According to lens manufacturers, only a fraction of practitioners fit this incredible modality. Ortho-k has proven for decades to be an effective method of slowing the progression of myopia, so why not start now? (Note: ortho-K is currently not cleared for myopia control by the U.S. Food and Drug Administration. My claims are based on clinical experience and published research.)
There are several ways to get started; I would suggest doing so on five low myopes. Pick five patients who have refractive errors under –2.00D. As far as I understand, all of the manufacturers have an empirical fitting system. I suggest calling one of the manufacturers and discussing the first five cases. Generally, practitioners will need Ks, Rx, and horizontal visible iris diameter (HVID). If you have the topography, send that over as well. In turn, the manufacturer will send a lens to try on the patient at a dispensing visit. Make sure to provide training on wearing the lens and to schedule a follow-up appointment.
If my predictions are right (based on my highly sophisticated clinical experience), practitioners will be successful in getting at least 4/5 (but probably 5/5) of the patients to 20/25 with no additional correction on the first night. Not only will the patients be amazed, the practitioners will be making an incredible leap toward slowing the progression of myopia in their patients.
Efficacy of Atropine 0.01% for the Treatment of Childhood Myopia in European Patients
The purpose of this study was to evaluate the efficacy and safety of atropine 0.01% in slowing myopia progression in European pediatric patients. Medical charts of pediatric patients who have myopia progression > 0.5D/year and who were treated with atropine 0.01% for at least one year were included in this retrospective, medical records review study. Patients receive a complete ophthalmic examination before and 12 months after initiation of atropine treatment. A group of myopic untreated children served as a control group. The rate of myopia progression at baseline and 12 months after treatment with atropine was evaluated. The rate of myopia progression in treated and untreated patients was also compared. Adverse events were recorded.
Medical records of 52 treated and 50 control subjects were analyzed. In the atropine group, the mean rate of myopia progression after 12 months of treatment (–0.54D ± 0.61D) was significantly slower compared with the baseline progression (–1.20D ± 0.64D; p < 0.0001) and with the progression in the control group (–1.09D ± 0.64D; p < 0.0001). Approximately 79% of patients responded to the treatment (41/52), whereas 21% (11/52) of patients showed a progression of > 0.50D despite treatment. The only adverse event was temporary photophobia in five patients (9.6%). Severe adverse events were not reported, and none of the patients discontinued the treatment.
The researchers concluded that low-dose atropine significantly slowed the rate of myopia progression in European pediatric patients who have a favorable safety profile.
Sacchi M, Serafino M, Villani E, Tagliabue E, Luccarelli S, Bonsignore F, Nucci P. Efficacy of atropine 0.01% for the treatment of childhood myopia in European patients. Acta Ophthalmol. 2019 Jun 13. [Epub ahead of print]