There is no question that optical intervention for myopia control is one of the hotter topics in the contact lens field. Although off-label, contact lenses used in this regard allow practitioners to really impact patient lives. That said, it is important to ensure that you are following appropriate outcomes and follow-up schedules to ensure efficacy and safety. Look for an editorial supplement to Contact Lens Spectrum on the topic of myopia control with our August issue.
Jason J. Nichols, OD, MPH, PhD
TFOS DEWS II Report Is Now Available
After almost two and a half years of effort, the Tear Film and Ocular Society (TFOS) Dry Eye Workshop (DEWS) II report has just been published in The Ocular Surface and will be available to all for free at www.TearFilm.org. This massive undertaking involved 150 clinical and basic research experts from around the world, who utilized an evidence-based approach and a process of open communication, dialogue, and transparency to achieve a global consensus concerning multiple aspects of dry eye disease. This TFOS DEWS II report is the sequel to the original TFOS DEWS publication of 2007.
Translations of the TFOS DEWS II report will be offered in numerous languages, including but not limited to French, Italian, German, Spanish (sponsored by Allergan), Chinese, Korean, Portuguese, Vietnamese (sponsored by Novartis), Romanian, and Turkish (sponsored by SIFI).
TFOS also reports that Elsevier posted most of the report on The Ocular Surface website as restricted access. This will be corrected and made free and Open Access early next week. If you paid for access, please send your receipt to TFOS, and the organization will seek a refund.
Bausch + Lomb Launches Horizon Rewards Program
Bausch + Lomb (B+L) launched a new patient savings and rewards program, Bausch + Lomb Horizon Rewards. To enroll in the program, patients can visit www.BauschRewards.com. Patients can earn points by purchasing eligible B+L contact lenses, including B+L Ultra and Biotrue Oneday contact lenses, as well as B+L lens care products. Tokens also can be earned by participating in engagement activities within the website, such as reading educational content, taking surveys, or watching videos.
Accumulated tokens can be redeemed to play instant win games or to enter a sweepstakes, providing patients the chance to win a gift card, or to receive a coupon for B+L products. Additionally, points can be redeemed for gift cards or the option to donate to Optometry Giving Sight.
In addition, the online portal provides patients the ability to communicate with B+L customer service representatives. Bausch + Lomb Horizon Reward members can also choose to receive emails about new program elements, eyecare health information, and the latest updates on products.
Memorandum of Agreement signed for Haiti School of Optometry
A Memorandum of Agreement was signed to establish the first ever School of Optometry in Haiti. The School is a collaboration between l’Universite d’Etat d’Haiti (UEH), Brien Holden Vision Institute, Optometry Giving Sight, VOSH International, and Charity Vision, with support from University of Montreal. The signatories hope that the first students will commence their studies in October. Other organizations supporting the project include the National Council for the Prevention of Blindness (CNPC), the Port au Prince Chapter of Lions, and Digicel.
There are currently only three optometrists and 58 ophthalmologists (six in the public sector) to serve Haiti's population of 10 million people. These are predominantly located in the capital, making it difficult for the majority (70%) of people to access primary eye care services.
The partners note that funding is still needed for the school. For further information, contact Optometry Giving Sight at firstname.lastname@example.org or (303) 526-0430.
Prevent Blindness Declares August as Children’s Eye Health and Safety Awareness Month
As children in most parts of the country head back to school, Prevent Blindness, a non-profit eye health and safety group, asks all parents and caregivers to set their child on a path to success in the classroom with a certified vision screening or eye exam.
More than one in 20 preschool-age children and one in four school-age children have a vision disorder. The National Center for Children’s Vision and Eye Health at Prevent Blindness (NCCVEH) issued a comprehensive report, “Children’s Vision and Eye Health: A Snapshot of Current National Issues,” detailing the link between healthy vision and the impact it may have on learning.
Prevent Blindness has declared August as Children’s Eye Health and Safety Awareness month to inspire parents to make their child’s vision health a priority. Prevent Blindness recommends a continuum of eye care for children to include both vision screening and comprehensive eye examinations. All children, even those with no signs of trouble, should have their eyes checked at regular intervals. Any child who experiences vision problems or shows symptoms of eye trouble should receive a comprehensive eye examination by an eyecare practitioner.
To support children’s vision programs, OcuSoft Inc., a privately held eye and skin care company, has agreed to donate 10% of all online sales to Prevent Blindness during August’s Children’s Eye Health and Safety Awareness Month.
Call for Papers and Posters – GSLS 2018
The Educational Program Committee of the Global Specialty Lens Symposium invites the submission of abstracts for the Free Paper Section and the Scientific Poster Competition. Papers and posters related to presbyopia, keratoconus, corneal topography, post-penetrating keratoplasty or related irregular corneal surface, myopia control, orthokeratology, and lens care topics are welcome.
This image shows a 67-year-old Caucasian male who has a nasal pterygium fit with a notched scleral contact lens.
We thank Dr. Miao 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
Uninterrupted Initial Talking Times
I, like many of my students, struggled early in my optometric training to complete eye exams in an efficient manner. Selecting the minimal-needed testing and asking only the most pertinent questions is certainly a learned skill. In many respects, mastering these skills is just as important as being able to fit soft contact lenses or being able to correctly identify a corneal ulcer. I generally address student efficiency issues by going through each step of the eye exam with them. More often than not, my students indicate that their patients are being too talkative, which they feel has consistently increased their exam durations. I actually used to feel the same way when I was in their position, but should we really be blaming our patients?
Pointer’s 2014 study sheds some light on this subject matter.1 In his study, Pointer tested uninterrupted initial talking times (UITT) after asking his patients “Do you have any problems with your eyes or your sight?”1 Pointer found that while his 822 subjects had a wide range of UITT (9.19 seconds to 125.44 seconds), the median talking time was only 28.87 seconds.1 Times were slightly longer for subjects who were older (≥ 86 years = 37.28 seconds) compared to subjects who were younger (18 to 25 years = 18.39 seconds). UITTs were also slightly longer for patients who reported with a vision problem (35.81 seconds) compared to those who had no complaints (28.05 seconds).1 With that said, neither of these time differences were clinically meaningful.
Our patients’ time and our time is precious, and the vast majority of patients respect this fact.1 Similarly, we can make the best of everyone’s time if we simply allow our patients to fully convey their chief complaints and lifestyle concerns. A comprehensive conversation with our patients about their problem(s) can also lead to the prescribing of contact lenses and care solutions that better suit their lifestyle. A quality conversation could also facilitate a better patient-practitioner relationships, and together this could equate to improved contact lens compliance and healthier contact lens use.2
And my students’ extended exam times? Those are most likely a natural result of their being students. After all, allowing our patients to speak is unlikely to increase our exam times dramatically. In addition, having a full understanding of patients’ history could lead to quicker, more accurate diagnoses.1
1. Pointer JS. The primary eye care examination: opening the case history and the patient's uninterrupted initial talking time. J Optom. 2014 Apr-Jun;7:79-85.
2. Collins MJ, Carney LG. Patient compliance and its influence on contact lens wearing problems. Am J Optom Physiol Opt. 1986 Dec;63:952-956.
MATERIALS & DESIGNS
David L. Kading, OD
With a Million Choices, How Are We to Choose?
When a patient has less than three-quarters of a diopter of cylinder and a myopic correction, how do you go about choosing an appropriate lens? Some have said that it depends on what that patient has worn in the past, while others have a go-to lens that they choose regardless of what the patient wore previously.
I think it is a great idea to have a minimum standard for things to consider. If you are choosing soft lenses, work to stay with your modality of choice as long as the lens parameters support it. For me, this is a daily disposable lens. I have found that those lenses result in far fewer issues for my patients; I see far fewer infections or eye-related problems from my daily disposable patients.
Next, have a preference for materials or what the materials provide. For me, it means silicone hydrogel. Even if the cornea doesn’t need the high amount of oxygen in a single-use daily lens, I want my patients to have every opportunity for ocular health that I can give them. Like a seat belt, most of the time we don’t need it; however, when we do need it, we are sure glad we had it. The reality is that patients sleep in their lenses from time to time and may present in other situations in which that little extra oxygen is needed.
With a million to choose from, select your standards and stick to them.
Myopia Correction in Children: A Meta-Analysis
The purpose of this study was to conduct a meta-analysis comparing rigid GP lenses with soft contact lenses (SCLs), spectacles, and orthokeratology (OK) lenses for myopia control with respect to axial length elongation, spherical equivalent, and measures of corneal curvature.
Medline, Cochrane, EMBASE, and Google Scholar databases were searched to Sept. 29, 2015 using the following keywords: “rigid gas permeable contact lens”; “refractive error”; and “refractive abnormalities.” Randomized controlled trials, two-arm prospective studies, and retrospective studies of children who have myopia treated with GP lenses compared with spectacles, SCL, and OK lenses were included. Outcome measures were changes in axial length, spherical equivalent, flatter meridian, steeper meridian, and corneal apical radius.
Five studies were included in the analysis. Three studies reported axial length change after two to three years of treatment with GP lenses and SCL/spectacles, and no difference between the groups was noted (pooled mean difference = –0.077, 95% confidence interval [CI]: –0.120 to 0.097, p = 0.840). Two studies reported a change of spherical equivalent after two to three years of treatment with GP lenses and SCL/spectacles, and no difference between the groups was noted (pooled mean difference = 0.275, 95% CI: –0.390 to 0.941, p = 0.417). Two studies compared corneal curvature measures between GP and OK lenses after three to six months of treatment, and no differences in any measures of corneal curvature were seen.
The authors concluded that the effect of GP lenses and SCL/spectacles on axial length elongation and spherical equivalent, and of GP and OK lenses on corneal curvature, in children who have myopia was similar.
Cui Y, Li L, Wu Q, Zhao J, Chu H, Yu G, Wei W. Myopia correction in children: a meta-analysis. Clin Invest Med. 2017 June 26;40:E117-E126.