As summer draws to a close (in the northern hemisphere), the emotions associated with “back to school” fill the air for parents, teachers, and students alike—with great variety depending on which of those hats a person wears! It is a significant time in many students’ lives, whether they are young children going to kindergarten for the first time or young adults headed off to their freshman year in college. Along these lines, we like to take this opportunity to remind our readers of the opportunities and responsibilities that we have with regard to caring for our student populations. Do not forget to remind families in your practice of their yearly eyecare needs. Also, remember the importance of contact lenses, myopia management, and dry eye management as you think about the visual demands of students and their families.
Jason J. Nichols, OD, MPH, PhD
Several OTC Eyecare Products Recalled
At the beginning of July, Altaire Pharmaceuticals Inc. voluntarily recalled various over-the-counter (OTC) eyecare products and lots sold at Wal-Mart and Walgreens due to concerns over the sufficiency of Quality Assurance controls in Altaire’s manufacturing facility. The recall was then expanded this past week to include CVS Health-brand OTC eye drops and ointments and 15 Ocusoft eye products. To date, the manufacturer has not received reports of adverse events nor acquired any out-of-specifications results, including sterility testing, for the products.
The recall, carried out at the retail level, includes lots that are sold under each company’s private labels. For additional information and a full list of recalled products, visit the following U.S. Food & Drug Administration bulletin pages:
X-Cel Specialty Contacts Divests Disposable Lens Business
X-Cel Specialty Contacts has divested Hydrogel Vision Corporation (HVC), the manufacturer of the Extreme H2O brand of contact lenses, to Clerio Vision. According to X-Cel, the move allows it to focus on the expansion of specialty lens designs, including the development of new designs and refinements to its industry leading portfolio.
Clerio’s technology enables the laser writing of unique patterns into contact lenses to help optimize visual acuity, including at both far and near distances for those who have presbyopia. Clerio’s multifocal contact lens product is currently in clinical development and is expected to be on the market in the next 18 months.
HVC products are sold in 25 countries, either under the Extreme H2O brand or under one of several private label arrangements. All HVC employees will be retained, and its manufacturing and fulfillment activities will continue to be carried out in its locations in Sarasota, FL.
CooperVision’s Joel Kamp Promoted to Executive Role at Paragon Vision Sciences
Paragon Vision Sciences has appointed Joel Kamp as U.S. commercial director. This promotion comes following his success as a director of Corporate Accounts at CooperVision, where he focused on customer partnerships, satisfaction, and growth. Paragon is part of the CooperVision Specialty Eye Care division. In the new role, Mr. Kamp is responsible for sales and marketing strategy and execution, including enhanced support for eyecare professional-centered initiatives.
In Memoriam: Judy Perrigin, OD
Judy Perrigin, OD, professor at the University of Houston College of Optometry (UHCO), passed away suddenly on July 1, 2019. Typical of her incredible work ethic, she was at work when she collapsed, and best medical efforts were unable to help her. She is survived by her husband Dave Perrigin, OD.
Her students describe her as the “kindest professor” and “a profound influence.” Judy believed in excellence in every area in which she was involved, including clinical education and patient care. Her areas of teaching and research included contact lenses, medical laboratory testing, ocular microbiology, and management of myopia. Additionally, she was in private practice and was an investigator with the Texas Eye Research and Technology Center at UHCO. She also touched the lives of many residents as the program director for UHCO’s Cornea and Contact Lens Residency. She was instrumental in helping to place many of her students in residency programs as well as mentoring future clinical educators. Judy was active in the Association of Optometric Contact Lens Educators (AOCLE) for many years and had served as secretary, vice chair, and chair.
She was a voice of wisdom and brought out the best in those around her. For many of us fortunate to call her friend, she was loyal, caring, and full of fun. Judy had a love of the outdoors and enjoyed scuba diving and hiking.
In her honor, the Foundation for Education and Research in Vision (FERV), the fundraising arm of UHCO, will be dedicating all proceeds from its upcoming 2019 FERV Anderson Fair for UHCO Scholarships concert to a newly established Judy Perrigin Endowment for UHCO Scholarships. —Contributed by Vinita Henry, OD
American Academy of Optometry Announces 2019 Award Recipients
The American Academy of Optometry has announced the following 2019 award recipients.
Raymond A. Applegate, OD, PhD, Charles F. Prentice Medal and Lecture Award Uduak C. Udom, OD, MPH, (posthumously), AAO-Essilor Award for Outstanding International Contributions to Optometry Thomas R. Stelmack, OD, William Feinbloom Award J. Daniel Twelker, OD, PhD, Brien Holden Humanitarian Award Andrew D. Pucker, OD, PhD, Irvin M. and Beatrice Borish Award Rami Aboumourad, OD, Julius F. Neumueller Award in Optics (American Academy of Optometry Foundation Award) Thomas G. Quinn, OD, MS, Vincent Ellerbrock Clinician Educator Award Thomas A. Aller, OD; Maria Liu, OD, PhD; and Christine F. Wildsoet, DipAppSci(Optom), PhD, Garland W. Clay Award Heather A. Anderson, OD, PhD, and Donald O. Mutti, OD, PhD, Michael G. Harris Family Award for Excellence in Optometric Education (American Academy of Optometry Foundation Award)
Awards of the Section on Cornea, Contact Lenses and Refractive Technologies Philip B. Morgan, PhD, MCOptom, Max Schapero Memorial Lecture Award S. Barry Eiden, OD, Founders’ Award
Awards of the Public Health and Environmental Vision Section Robert N. Kleinstein, OD, PhD, Henry B. Peters Award for Public Health and Environmental Vision (American Academy of Optometry Foundation Award)
Award winners will be recognized at the Joint American Academy of Optometry and World Council of Optometry Recognition Gala and Awards Program on Oct. 26. The Fry and Prentice Lectures will be held on Oct. 25 and will feature lectures from both the Charles F. Prentice Award recipient and the Glenn A. Fry Award recipients. Section on Cornea, Contact Lenses and Refractive Technologies award recipients will be honored on Oct. 23. The Public Health and Environmental Vision Section Henry B. Peters awardee will be honored on Oct. 24.
VTI Promotes Cynthia Flynn to Senior Territory Manager for the Austin/San Antonio Area
Visioneering Technologies Inc. (VTI) promoted Cynthia Flynn to senior territory manager in the Austin and San Antonio markets. In this role, Ms. Flynn will continue to coordinate sales outreach for NaturalVue (etafilcon A) Multifocal 1 Day Contact Lenses and for other NaturalVue Brand products to eyecare practitioners and practices across the region.
She started her optical career with a division of Essilor called Silor Optical. In 2000, she moved from the lens division to the lab division of Essilor. She later worked for US Safety before a brief stint with two start-up companies, QSpex Technologies and eSight Digital Eyewear. Most recently, she was with Nikon Lenswear.
BHVI Launches Third Myopia Education Program
Brien Holden Vision Institute (BHVI) has launched the third course in its Myopia Education Program: The Business of Myopia. The course will deliver the business knowledge and expertise to successfully integrate myopia management into a practice. Building upon the foundation of practical skills offered in the first two courses, The Business of Myopia provides guidance in areas such as marketing, communications, and education to drive awareness and reverse the trend in the global rise of myopia. For more information or to register, visit https://www.brienholdenvision.org/academy.html. Early bird registration ends July 30.
Eyepoint Pharmaceuticals Adds Wendy DiCicco to Its Board of Directors
Eyepoint Pharmaceuticals Inc. has appointed Wendy DiCicco, CPA, to the company’s board of directors and Audit Committee, where she will serve as chair of the committee. Most recently, Ms. DiCicco was chief operating and financial officer of Centinel Spine. She currently serves on the board of directors of Carmell Therapeutics and is a financial, executive, and board advisory consultant for several emerging growth companies.
Foundation Fighting Blindness Appoints Judy Taylor as Vice President, Development
The Foundation Fighting Blindness has appointed Judy Taylor as vice president, development. In her new role, she will be responsible and accountable for the strategic direction, planning, and oversight of major gifts and planned giving function for the Foundation. Prior to joining the Foundation, she served as the chief advancement officer for the National Breast Cancer Coalition.
Reminder: We Need Your Contact Lens Prescribing Data
In May, we mailed and emailed our annual International Survey on Contact Lens Prescribing to 1,000 Contact Lens Spectrum readers. Were you one of these lucky few? We thank our readers who have already submitted their completed survey forms. If you haven’t yet, you still have time! Please enter the data on up to 10 of your most recent contact lens fits and refits on the survey form and either mail, email, or fax the form to Contact Lens Spectrum to arrive by Aug. 15. Thank you in advance for your participation in this important research.
Which therapy for myopia management do you believe is most efficacious?
This shows a placido disc image of a patient who has advanced keratoconus before and then with scleral lenses. Notice the difference of the rings formed over the cornea and the regularization after the scleral lenses have been applied.
We thank Professor Cusato 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.
S. Barry Eiden, OD
Childhood Myopia: It Starts with Awareness but Needs to Result in Action
Although significant understanding of childhood progressive myopia, its implications, and methods to manage it have been around for decades, it has only been relatively recently that evidence-based research has solidified this area of eye care as a critically important part of clinical practice. Awareness and acceptance is growing worldwide in leaps and bounds. However, it is the impression of many of us who have embraced myopia management for some time that we remain the exception to the rule and that the vast majority of eyecare professionals still do not actively manage progressive childhood myopia.
A recent article was published that investigated the understanding of Australian optometrists in relation to myopia, its natural history, and associations with vision-threatening ocular disease; self-reported clinical diagnosis and management approaches for childhood myopia; engagement with adult caregivers; and utilization of information to guide practice.1 An online survey was distributed to Australian optometrists (n = 4,124). Respondents provided information about their demographics, myopia knowledge, self-reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Completed surveys were returned by 239 optometrists (6% completion response rate). Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment, and primary open-angle glaucoma. Practitioners used a range of techniques to diagnose childhood myopia, with a preference for non-cycloplegic refractive measures. The most common approaches to management were single-vision distance and progressive addition spectacle lenses, despite most of them identifying orthokeratology, low-dose (0.01%) topical atropine, and soft peripheral defocus contact lenses as three potentially more effective therapeutic interventions for modifying childhood myopia progression. Almost 90% of respondents considered increasing time spent outdoors to be beneficial for reducing the rate of myopia. The main sources of information used to guide clinical practice were continuing education conferences and events, systematic reviews, and personal experience. Respondents perceived adult caregivers to generally be involved in myopia management decisions and considered all aspects of myopia education as important.
The authors concluded from the survey results that Australian optometrists appear aware of emerging evidence but are not routinely adopting measures that have not yet received regulatory approval for modulating childhood myopia progression. Clinical guidelines may be of value for assisting practitioners in making clinical decisions based upon the current, best-available research evidence.
This publication, although from a population of Australian optometrists, likely reflects the situation in most eyecare practices; it may actually be more advanced than the average in terms of the understanding of progressive myopia, its implications, and available evidence-based effective management strategies. We need to continue to do the research and educate our peers as well as the public.
That being said, it is now time for all practitioners to step into action and actively manage progressive childhood myopia based on the ever-increasing evidence being presented. Methods such as environmental control to influence myopia onset, corneal reshaping/orthokeratology along with multifocal daytime-wear contact lenses and pharmacological treatments to reduce myopia progression rates are well within the realm of what we can do today. Let’s get up and get going people!
1. Douglass A, Keller PR, He M, Downie LE. Knowledge, perspectives and clinical practices of Australian optometrists in relation to childhood myopia. Clin Exp Optom. 2019 Jun 30. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Wear It Is
Wearable technology in healthcare is an exciting and rapidly advancing area. Wearable technology can instantly transmit a variety of metrics to healthcare professionals and/or patients, and it allows patients to be proactive about their health. Although currently not at the level of wearable technology, strip meniscometry (SM) may be able to support dry eye patients by allowing them to self-monitor the volume of their tear film and take therapeutic measures to make adjustments in advance of tear film volume-related ocular surface stress.
SM is a low-cost, rapid, non-invasive test to measure the tear volume that can be performed by professionals or patients. SM data correlates strongly with those of the Schirmer's test, tests of tear breakup time, and tear meniscus height measurement by anterior optical coherence tomography.1
Avaki et al2 concluded that SM has the potential to be used to identify diurnal variation of tear meniscus volume in the general population. Intuitively, patients would positively intervene (e.g., environmental change, drops, warm compresses, neurostimulation, hydrated eye mask, etc.) should their self-measured tear volume be low. The results of the small study cohort of 36 (mean age, 35.7) demonstrated that the measured SM value was the highest upon awakening and gradually decreased in the evening.
It is intriguing that we may have the ability to collect data across age and dry eye disease subtypes to build a tear profile for our patients. Likewise, engaging patients in self-care and awareness may enhance disease outcomes and quality of life.
1. Ibrahim OM, Dogru M, Ward SK, et al. The Efficacy, Sensitivity, and Specificity of Strip Meniscometry in Conjunction with Tear Function Tests in the Assessment of Tear Meniscus. Invest Ophthalmol Vis Sci. 2011 Apr;52:194-198.
2. Ayaki M, Tachi N, Hashimoto Y, Kawashima M, Tsubota K, Negishi K. Diurnal variation of human tear meniscus volume measured with tear strip meniscometry self-examination. PLoS One. 2019 Apr 23;14:e0215922
The Influence of Orthokeratology Compression Factor on Ocular Higher-Order Aberrations
The purpose of this study was to investigate the influence of compression factor upon changes in ocular higher-order aberrations (HOAs) in young myopic children undergoing orthokeratology treatment.
Subjects aged between 6 and < 11 years, who have low myopia (–0.50D to –4.00D, inclusive), low astigmatism (≤ 1.25D), and anisometropia (≤ 1.00D), were randomly assigned to wear orthokeratology lenses of different compression factors in each eye (one eye with a compression factor of 0.75D and the fellow eye with 1.75D). HOAs were measured weekly over one month of lens wear. Wavefront analysis was conducted over a 5mm pupil using a sixth-order Zernike polynomial expansion. Linear mixed models were used to examine the individual Zernike co-efficients and specific root-mean-square (RMS) error (i.e., spherical, comatic, total HOAs) metrics and their changes between the two eyes during the study period.
Twenty-eight myopic (mean manifest spherical equivalent refraction: –2.10D ± 0.58D) children (median [range] age: 9.3 [7.8-11.0] years) were analyzed. Significant interocular differences in HOAs at baseline were observed for Z6−6 | and Z6−4 | only (both p < 0.05). During the lens wear period, eyes fitted with the increased compression factor showed greater changes in primary spherical aberration ( Z40 |, p = 0.04) and RMS values for spherical and total HOAs (both p < 0.01). Considering data from both eyes together, after adjusting for the paired nature of the data, some other Zernike terms ( Z31 | and Z60 |, both p < 0.01) and the RMS value of comatic aberrations (p < 0.001) significantly increased after one month of orthokeratology treatment. The increase in primary spherical aberration ( Z40 |) was positively correlated with the reduction in spherical equivalent refractive error, but only in eyes fitted with the increased compression factor (r = 0.69, p < 0.001).
The authors concluded that increasing the orthokeratology compression factor by 1.00D significantly altered some HOAs, particularly spherical aberration. Given the association between positive spherical aberration and eye growth in children, further research investigating the influence of orthokeratology compression factor on axial eye growth is warranted.
Lau JK, Vincent SJ, Cheung SW, Cho P. The influence of orthokeratology compression factor on ocular higher-order aberrations. Clin Exp Optom. 2019 Jul 1. [Epub ahead of print]