The results of our July Quick Poll are in and are very interesting. As noted below, a little more than one-third of respondents believe that a combination of a pharmaceutical (atropine) and a contact lens offers the greatest efficacy in managing myopia. Perhaps this is not surprising to some, but it lends further insight into the direction we are headed in managing myopia in our practices.
Jason J. Nichols, OD, MPH, PhD
BCLA to Host Webinar on Myopia Management
The British Contact Lens Association (BCLA) will be hosting a webinar that will look at factors preventing eyecare practitioners from fully engaging with myopia management while examining real-world experiences to look at ways that myopia management can be integrated into everyday clinical practice. The webinar, titled “Myopia Management: Incentives and Impediments,” will be presented by Dr. Manbir Nagra and Gillian Bruce at 6.30 p.m. (BST) on Oct. 7.
Dr. Nagra works as a Reader in Optometry at the University of Portsmouth and continues to provide consultancy within the optical sector. She is also current chair of British and Irish University and College Contact Lens Educators (BUCCLE). Ms. Bruce is the clinical lead optometrist at Cameron Optometry in Edinburgh, providing the hospital contact lens service for the Lothian region. She developed the myopia management service for the practice in 2015 and continues to oversee its growth.
Art Optical Expands Tangible Hydra-PEG to Boston and Paragon Lens Materials
Art Optical Contact Lens Inc. has added the Tangible Hydra-PEG (Tangible Science) surface treatment as an available option on its specialty contact lenses made in Boston ES, Boston EO, Boston XO, Boston XO2, Paragon HDS, Paragon HDS 100, Paragon Thin, FluoroPerm 30, FluoroPerm 60, FluoroPerm 92, and FluoroPerm 151 GP lens materials. Tangible Hydra-PEG has been available from Art Optical on both corneal and scleral lenses made in Optimum Comfort, Optimum Extra, Optimum Extreme, and Hexa 100 materials from Contamac since January 2017.
Glaukos Announces Global Licensing Agreement with Intratus Inc.
Glaukos Corporation has entered into a licensing agreement with Intratus Inc. under which Intratus has granted Glaukos a global exclusive license to research, develop, manufacture, and commercialize Intratus’ patented, non-invasive drug delivery platform designed for use in the treatment of dry eye disease, glaucoma, and other corneal disorders, such as allergy, blepharitis, conjunctivitis, and related conditions. Financial terms of the agreement were not disclosed.
Intratus’ cream-based drug formulations are applied to the outer surface of the eyelid for transdermal delivery of pharmaceutically active compounds for the treatment of eye disorders.
Prevent Blindness, NOA Declare August as Children’s Eye Health and Safety Month
Prevent Blindness has teamed up with the National Optometric Association (NOA) to promote August as Children’s Eye Health and Safety Month. The shared goal is to educate the public on the importance of healthy vision for kids and its impact in the classroom. In addition, Ocusoft Inc., a Prevent Blindness partner, will make a donation to Prevent Blindness in support of Children’s Eye Health and Safety Awareness Month.
Which therapy for myopia management do you believe is most efficacious?
This 20-year-old keratoconus patient was referred to us for contact lens fitting. He had intrastromal corneal ring segments implanted in both eyes. However, one year after the procedure, deep corneal vascularization developed in the left eye. The corneal specialist decided to remove the intrastromal ring on the left. The new Ks were measured to be 62.5D/78.54D with a Medmont topographer. With a scleral lens, this eye yielded a best-corrected visual acuity of 20/40.
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SPECIALTY LENS SPACE
Karen DeLoss, OD
When it comes to specialty contact lenses, GP lenses have been the gold standard for decades. More recently, scleral contact lenses have gained popularity due to advances in lab technology, scleral mapping technology, and boundless lectures and articles that have helped practitioners overcome fitting obstacles. However, hybrid contact lenses can also benefit patients. These lenses may serve to improve visual acuity through the benefits of GP lens optics, reduce the handling obstacles of a piggyback system, and aid in comfort or with fitting obstacles of scleral lenses such as haptic-to-scleral alignment mismatch or debris entrapment, which is a common problem for scleral lens patients.
Numerous publications have discussed the utility of hybrid contact lenses and their benefits for both comfort and quality of life. Hashemi and co-authors concluded that patient satisfaction was higher with hybrid lenses.1 And, in a 2017 publication, Hassani et al hypothesized that hybrid contact lenses may yield better visual outcomes compared to scleral lenses due to a tear film height of 50 microns.2 Similarly, Lipson and Musch concluded that patients’ overall quality of life was improved with hybrid contact lenses.3 Thus, in a world with many, many options for specialty contact lenses, there is always another option to consider.
1. Hashemi H, Shaygan N, Asgari S, Rezvan F, Asgari S. ClearKone-Synergeyes or rigid gas gas-permeable contact lens in keratoconic patients: a clinical decision. Eye Contact Lens. 2014 Mar;40:95-98.
2. Hassani M, Jafarzadehpur E, Mirzajani A, Yekta A, Khabazhoob M. A comparison of the visual acuity outcome between Clearkone and RGP lenses. J Curr Ophthalmol. 2017 Aug 16;30:85-86.
3. Lipson MJ, Musch DC. Synergeyes versus soft toric lenses: vision-related quality of life. Optom Vis Sci. 2007 Jul;84:593-597.
MATERIALS & DESIGNS
David L. Kading, OD
We are in the middle of 2019, and it’s time to consider what we have we accomplished thus far. I always like to set goals for the year that detail how I can improve my patient experience and work to make their eye health better. And, regardless of practice type, whether we are an owner, employee, or professor, it is always good to look at where we are partway through the year to decide whether we are meeting our objectives.
This year, I am trying to see myopia as a disease, improve the experience of my presbyopic patients, and grow my non-wearing contact lens population into part-time wearers. So far this year, we have made progress, but we can do better.
What are the areas that you want to see improved? How have you been accomplishing those goals? What are the things that have improved, and what did you do to get there? What have you tried that has not worked?
Realize that improvement in patient care rarely just happens. It takes purpose to really make leaps in patient care. Implementation, more often than not, does not really happen because of a lack of follow-through as well as a lack of process review. Stay strong on your patient care objectives, look at what is working, and review how you can do better. The year is still young, but December will be here before we know it.
International Survey of Contact Lens Fitting for Myopia Control in Children
The purpose of this study was to determine the extent of contact lens fitting for myopia control (MC) in children (defined as ≤ 17 years of age) worldwide and to characterize the associated demographics and fitting patterns.
Survey forms were sent to contact lens fitters in 66 countries between January and March every year for eight consecutive years (2011 to 2018, inclusive). Practitioners were asked to record data relating to the first 10 contact lens fits performed after receiving the survey form. Data were analyzed for those countries reporting ≥ 100 contact lens fits to children.
Data were analyzed for 535 MC fits and 23,830 other (non-MC) lens fits undertaken in 31 countries reporting ≥ 100 contact lens fits to children, with 52.1% of MC fits and 12.0% of non-MC fits being with rigid lenses (p < 0.0001). Overall, MC lenses represented 2.3% of all contact lens fits to children, with significant differences among nations (p < 0.0001), ranging from no MC fits recorded in the Czech Republic, Greece, Japan, South Korea, and Puerto Rico to 24.9% in Austria. There has been an increase in contact lens fitting for MC over the survey period (p < 0.0001). MC contact lenses were fitted to younger children compared to non-MC lenses (MC, median 13 years versus non-MC, median 15 years) (p < 0.0001). There was no sex bias in the fitting of MC lenses (p = 0.89).
The researchers determined that MC lenses are currently being prescribed for younger children in equal measure in terms of soft versus rigid lenses and males versus females. The extent of MC fitting is low and varies among nations. The gradual increase in MC fitting throughout the survey period perhaps reflects growing concerns among practitioners over the myopia epidemic.
Efron N, Morgan PB, Woods CA, Santodomingo-Rubido J, Nichols JJ; International Contact Lens Prescribing Survey Consortium. International survey of contact lens fitting for myopia control in children. Cont Lens Anterior Eye. 2019 Jul 3. [Epub ahead of print]