Specialty contact lenses are very much of interest today, as they can provide tremendous benefit to patients who otherwise could not wear non-specialty lenses. With this growing enthusiasm and usage also come many clinical questions that translate into clinical research projects. It is important for the community to ask these questions and, along those lines, we would love for you to share your clinical research questions relating to specialty contact lenses. Please email them to firstname.lastname@example.org.
Jason J. Nichols, OD, MPH, PhD
B+L Announces FDA Filing Acceptance for Loteprednol Etabonate Ophthalmic Gel, 0.38%
Bausch + Lomb (B+L) announced that the U.S. Food and Drug Administration (FDA) has accepted the New Drug Application (NDA) for its sub-micron loteprednol etabonate ophthalmic gel, 0.38% with a Prescription Drug User Fee Act (PDUFA) action date of Feb. 25, 2019. If approved, the product would be the lowest concentrated loteprednol ophthalmic corticosteroid indicated for the treatment of postoperative inflammation and pain following ocular surgery. B+L says that this investigative product utilizes a novel submicron particle to help increase ocular penetration and residence time in anterior segment tissues.
Optometry Students Honored with 2018 GP Clinical Excellence Awards
The Contact Lens Manufacturers Association (CLMA) and the GP Lens Institute (GPLI) bestowed the 2018 GP Clinical Excellence awards on fourth-year optometry students who showed exemplary performance in GP contact lens fitting during the course of their education.
Sponsored by ABB Optical Group: Michelle Chan, OD, Southern College of Optometry; Sarah Whiteside, OD, University of California, Berkeley College of Optometry; Vicky Yiannoulis, OD, New England College of Optometry; Katherine Zhang, OD, Southern California College of Optometry, Ketchum University
Sponsored by Art Optical Contact Lens Company: Michael Gorz, OD, Illinois College of Optometry; Alexandria Lui, OD, Indiana University; Avi David Yehudai, OD, State University of New York College of Optometry; Evelyn Yue Tong Zhang, OD, University of Waterloo; Tina Zhu, OD, Pacific University
Sponsored by Essilor USA Contact Lenses Inc.: Shannon Deitch, OD, University of Houston; Allie McKelvey, OD, University of Alabama at Birmingham School of Optometry
Sponsored by Blanchard Contact Lenses, Inc.: Viviana Baron, OD, University of Montreal
Sponsored by Lancaster Contact Lens, Inc.: Samantha Elizabeth Myers, OD, Salus University, Pennsylvania College of Optometry
Sponsored by TruForm Optics Inc.: Taylor Dahms, OD, University of Missouri-St. Louis College of Optometry; Alia Khalaf, OD, Massachusetts College of Pharmacy and Health Sciences University School of Optometry; Stephanie Uchida, OD, Northeastern State University Oklahoma College of Optometry
Sponsored by Visionary Optics LLC: Brett Christensen, OD, Midwestern University – Arizona; Ashley Noble, OD, Nova Southeastern University; Kimberly Weisenberger, OD, The Ohio State University
Blanchard Contact Lenses Announces Fall Scleral Lens Workshops
Blanchard Contact Lenses announced that its Beyond the Limbus Scleral Lens Workshops will be coming to Philadelphia on Sept. 23 and to Manchester, NH on Oct. 7. Beyond the Limbus workshops are a training program within Blanchard’s educational division, Blanchard University. These intensive, one-day workshops provide comprehensive hands-on training to eyecare professionals interested in learning how to fit Blanchard’s Onefit family of scleral lenses.
Workshop attendees will receive in-depth training on how and when to fit each lens design, will participate in a hands-on wet lab, and will take part in live demonstrations of the many innovative and time-saving online tools available to practitioners. Attendees will be provided with a deeper appreciation of the minimalist approach to scleral lens design and fitting that Blanchard says it has pioneered with its Onefit family of scleral lenses.
First recipients of BCLA Dry Eye & Contact Lens Retention Certificate
The first 12 candidates to complete a new dry eye and contact lens retention course have received their certificates following an Objective Structured Clinical Examination (OSCE) at Aston University. The June 26 test was the first practical examinations since the British Contact Lens Association (BCLA) course officially opened online in March.
The OSCE could only be taken once the five online modules had been completed, plus one relevant, General Optical Council (GOC)-approved Dry Eye or Ocular Surface Health (OSH) workshop, peer review, or lecture. The exam involved five OSCE work stations in which participants had to demonstrate their practical knowledge related to dry eye diagnosis.
The new CET-accredited program, supported by Associate Partners Thea Pharmaceuticals, focuses on clinical skills for OSH and dry eye, allowing BCLA members to gain CET points while working toward a Dry Eye certificate or a higher level to lead to a BCLA Fellowship.
Academy of Optometry Announces 2018 Award Recipients
Each year, the American Academy of Optometry recognizes distinguished individuals who have made countless important contributions to advancing the profession of optometry.
Award winners will be recognized at the American Academy of Optometry’s annual meeting, Academy 2018 San Antonio, which will take place Nov. 7 to 10, 2018, at the Henry B. González Convention Center in San Antonio, TX. The awards ceremony will take place on Nov. 9. Section on Cornea, Contact Lenses and Refractive Technologies award recipients will be honored on Nov. 7. And, the Public Health and Environmental Vision Section Henry B. Peters Awardee will be honored on Nov. 8.
Professor Kovin Naidoo has resigned as CEO of both the Brien Holden Vision Institute (BHVI) and the Brien Holden Vision Institute Foundation. The board of BHVI announced that Yvette Waddell will be the new CEO of the Institute, and she will focus on a translational research response. In addition, it announced that Amanda Davis will take on a dedicated position of CEO of the BHVI Foundation to drive the public health agenda.
Ms. Waddell has been the COO of BHVI since 2003. She replaced Professor Brien Holden on the board in July 2015. In the last 20 years, she has spearheaded licensing of intellectual property and building new business relationships with leaders of industry, among other accomplishments. She will head a team that includes Dr. Ravi C. Bakaraju, head of Research and Development; Professor Arthur Ho, chief scientist and Innovation Officer; Professor Padmaja Sankaridurg, head of Myopia Program and Intellectual Property; Associate Professor Klaus Ehrmann, director of Technology; and others.
Ms. Davis is a leader in the public health sector and has been the COO for the Foundation since 2006. She also currently holds the position of chair of the International Agency for the Prevention of Blindness in the Western Pacific Region. She leads a strong team of more than 100 educators, optometrists, public health researchers, project managers, and support staff.
X-Cel Specialty Contacts Announces New Atlantis Scleral Patient Care Kits
X-Cel Specialty Contacts is now offering an Atlantis Scleral patient kit, which was designed to assist scleral lens patients in keeping their supplies easily accessible and organized in a travel-sized compact kit. Each mirrored kit contains application and removal tools, unpreserved saline solution, and a contact lens case.
Takeda Receives Clearance from FTC for the Proposed Acquisition of Shire plc
Takeda Pharmaceutical Company Limited has received unconditional clearance from the U.S. Federal Trade Commission (FTC) for the proposed acquisition of Shire plc announced on May 8, 2018. The FTC’s unconditional clearance of the acquisition is another significant milestone in the transaction process. The acquisition remains subject to a number of conditions, including receipt of other regulatory clearances and approval by the shareholders of both companies.
Visioneering Technologies Promotes Gary Sacks to National Field Trainer
Visioneering Technologies Inc. (VTI) has announced the promotion of Gary Sacks to National Field Trainer. He assumed his new position as of July 1, 2018. In this role, he will support the VTI sales force by providing training as new territory managers are hired as well as by providing in-territory coaching.
Opternative Announces International Expansion
Opternative Inc. announced its first international partnership with Ben & Frank, giving patients in Mexico access to its online vision test. Opternative also announced that it has begun implementing its technology internationally with partners in Australia, Canada, Finland, Germany, Iceland, the Netherlands, New Zealand, Norway, South Africa, Sweden, and the United Kingdom.
Are you measuring tear osmolarity in clinical practice?
This patient was a 27-year-old male who had a herpes scar on his left eye. He had a visual acuity of 6/18 (20/60). By wearing a mini-scleral lens, he was able to achieve a visual acuity of 6/7.5 (20/25). This optical coherence tomography image shows the extent of the corneal scar and the mini-scleral contact lens clearance.
We thank Mr. Ezekiel 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
Red Eye Risk by the Numbers
Children historically get a bad rap when it comes to wearing contact lenses (CLs).1 Parents often fear that their child will not be able to safely wear CLs, and practitioners may fear to fit young patients or may want to avoid potential extra time associated with fitting children in CLs.1 Nevertheless, with the recent success of myopia control, practitioners may not be meeting their ethical obligations to the community if they fail to at least offer and educate their patients about myopia control CLs.2 Therefore, this article should put a child’s risk of developing a CL-related complication in perspective with the overall population, with college-age patients, and with slightly older adults.
The average non-CL-wearing person has an estimated risk of developing a microbial keratitis of 1 per 10,000 patient years.3 A daily disposable CL-wearing patient has a risk of developing a microbial keratitis of 2 to 4 per 10,000 patient years, and a patient who sleeps in CLs has a risk of 20 per 10,000 patient years.4 While these risks do vary by age, they may not follow your preconceived pattern of risk.5
The Contact Lens Assessment in Youth (CLAY) Study found that children who were between the ages of 8 and 14 years old were significantly less likely to develop a soft CL-related complication compared to patients who were between the ages of 15 to 25 years old. In fact, they found that risk likely peaks in the 15- to 25-year-old age group, with lower risks in the under-14-years-old and over-26-years-old age groups.6
The CLAY study group interestingly found that the spike in risk in the approximate college age group is unlikely to be associated with many of the commonly noted risk factors such as topping off solutions, overnight wear, and rinsing and storing CLs in water because these factors did not vary with age.6 Instead, the authors found that the increased risk likely stemmed from the fast-paced lifestyle of this group, which may make them more prone to napping or unplanned sleeping in their CLs when away from home or after drinking alcohol and to wearing their CLs in the shower.4 These data overall suggest that children may actually be at a lower risk of developing a CL-related red eye compared to other age groups possibly because they are still under parental supervision and that college-age students may benefit from targeted education to help them avoid the risky CL behaviors of their peers.5, 6
1. Walline JJ, Gaume A, Jones LA, et al. Benefits of contact lens wear for children and teens. Eye Contact Lens. 2007 Nov;33:317-321.
2. Walline JJ. Myopia Control: A Review. Eye Contact Lens. 2016 Jan;42:3-8.
3. Pepose JS, Wilhelmus KR. Divergent approaches to the management of corneal ulcers. Am J Ophthalmol. 1992 Nov;114:630-632.
4. Stapleton F, Keay L, Edwards K, Holden B. The epidemiology of microbial keratitis with silicone hydrogel contact lenses. Eye Contact Lens. 2013 Jan;39:79-85.
5. Bullimore MA. The Safety of Soft Contact Lenses in Children. Optom Vis Sci. 2017 Jun;94:638-646.
6. Wagner H, Richdale K, Mitchell GL, et al; CLAY Study Group. Age, behavior, environment, and health factors in the soft contact lens risk survey. Optom Vis Sci. 2014 Mar;91:252-261.
MATERIALS & DESIGNS
David L. Kading, OD
A Toric Scleral Wearer – "Soft Lenses Don’t Work for Me"
Stacy was a new mom when I first met her. She had worn contact lenses in college but had switched over to glasses when she became frustrated with the rotation that her toric lenses were giving her. A busy professional woman, she did great in her glasses that corrected her 2.75D of astigmatism. At 34 years old, when her 1-year-old was constantly grabbing at her glasses, Stacy knew it was time for a change. She saw me for contact lenses and asked whether there had been any improvements since she had dropped out of lens wear six years earlier.
Upon evaluation, she had 12.2mm corneal horizontal visible iris diameters (HVIDs). I asked whether anyone had ever mentioned anything about her corneal size before. She said that they hadn’t; instead, they had just ordered lenses that had XR in their name. We then spoke about her vision and how we could improve it with soft lenses or with scleral lenses. She elected to move forward with scleral lenses because she had been fed up with rotation in her soft lenses. With a scleral lens, Stacy was happy with her lens wear time and visual improvement. She was elated that there was no variability in her vision and that her one-year-old was not constantly pulling off her glasses.
Stacy had large corneas, and her prior fitters had not taken them into account when ordering her soft lenses. Had they, her soft lens experience would have been different. The conversation about preferred lenses was important for Stacy. Although she would have done fantastically in custom soft lenses that accounted for her HVID, she was eager for something different. Scleral lenses provided exactly what she wanted.
Additive Effects of Orthokeratology and Atropine 0.01% Ophthalmic Solution in Slowing Axial Elongation in Children with Myopia: First Year Result
The purpose of this prospective, randomized clinical trial was to investigate the additive effects of orthokeratology (OK) and atropine 0.01% ophthalmic solution, both of which are effective procedures to slow axial elongation in children who have myopia.
Japanese children aged 8 to 12 years who had a spherical equivalent refractive error of –1.00D to –6.00D were included. A total of 41 participants who had been wearing the OK lenses successfully for three months were randomly allocated into two groups to receive either the combination of OK and atropine 0.01% ophthalmic solution (combination group) or monotherapy with OK (monotherapy group). Subjects in the combination group started to use atropine 0.01% ophthalmic solution once nightly from three months after the start of OK. Axial length was measured every three months using non-contact laser interferometry, and the axial length measurement at month three of OK therapy was used as the baseline value in both groups. The increase in axial length over one year was compared between the two groups.
A total of 40 consecutive subjects (20 subjects in the combination group and 20 in the monotherapy group) were followed for one year. The increase in axial length over one year was 0.09mm ± 0.12mm in the combination group and 0.19mm ± 0.15mm in the monotherapy group (P = 0.0356, unpaired t test).
The authors found that during the one-year follow up, the combination of OK and atropine 0.01% ophthalmic solution was more effective in slowing axial elongation compared to OK monotherapy in children who have myopia.
Kinoshita N, Konno Y, Hamada N, Kanda Y, Shimmura-Tomita M, Kakehashi A. Additive effects of orthokeratology and atropine 0.01% ophthalmic solution in slowing axial elongation in children with myopia: first year results. Jpn J Ophthalmol. 2018 Jul 4. [Epub ahead of print]