Our sponsors and readers continue to be the reason for our success, and making sure that we continue to cover your preferred topics is of utmost importance to us!
Jason J. Nichols, OD, MPH, PhD
Optimum Extra, Optimum Extreme Materials Receive 510(k) Clearance from the FDA
Contamac has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for the therapeutic use of its Optimum Extra, Optimum Extreme, and Hexa100 lens materials in contact lenses.
Optimum Extra, Optimum Extreme, and Hexa100 lens materials are suitable for therapeutic use in eyes with ocular surface disease (e.g., ocular graft-versus-host disease, Sjögren’s syndrome, dry eye syndrome, and filamentary keratitis), limbal stem cell deficiency (e.g., Stevens-Johnson syndrome, chemical radiation and thermal burns), disorders of the skin (e.g., atopy, ectodermal dysplasia), neurotrophic keratitis (e.g., herpes simplex, herpes zoster, familial dysautonomia), and corneal exposure (e.g., anatomic, paralytic), for which the expanded tear reservoir and protection against an adverse environment afforded by a scleral lens might prove beneficial..
SynergEyes Hosts Webinar Series on Specialty Contact Lenses
SynergEyes, Inc. announced a new webinar series featuring nationally recognized optometrists addressing astigmatism, presbyopia, and irregular cornea conditions. The webinars are designed to provide eyecare professionals with tools for success when prescribing the latest scleral and hybrid contact lenses. The series will be hosted by leading industry experts including Louise Sclafani, OD; Melissa Barnett, OD; Christine Sindt, OD; and Jeffrey Sonsino, OD.
The series includes the following four webinars:
"SynergEyes VS Scleral Lens: Introduction to Prescribing, with Case Studies" on June 11 and July 16
"SynergEyes VS Scleral Lens: Design Overview and Complex Cases for Current Prescribers"; on July 31, Aug. 13, and Aug. 27
"Duette Progressive Hybrid Lenses: Personalized Contact lenses for Presbyopia, with Case Studies"; on June 18 and Aug. 20
“Duette Hybrid Lenses: Playbook for High Performance Vision for Astigmatic Patients, with Case Studies” on July 10.
Primary Eyecare Network (PEN), a division of ABB Optical Group, is offering a workshop on scleral lenses presented by Mile Brujic, OD, on Aug. 11 from 8 a.m. to noon in Concord, CA.
This hands-on workshop is designed to cover all of the bases of scleral lenses from fitting to billing. Participants will experience a virtual lens fitting that will allow them to see the application, fit assessment, and clinical considerations of scleral lenses. Additionally, the workshop will provide a framework for appropriate office procedures, including proper billing and coding. This workshop is worth four hours of Council on Optometric Practitioner Education (COPE) credits, pending approval.
The Association of Optometric Contact Lens Educators (AOCLE) has developed another Healthy Habits tool to educate contact lens patients. This new guide focuses on corneal reshaping lenses and can be utilized by educators, practitioners, residents, and students to educate novice contact lens users on how to properly take care of their contact lenses as well as patients who are noncompliant with instructions. The guides are available in three languages—English, French, and Spanish—and are all downloadable at aocle.org.
FDA Approves First Artificial Iris
The U.S. Food and Drug Administration (FDA) approved the first standalone prosthetic iris, a surgically implanted device to treat adults and children whose iris is completely missing or damaged due to aniridia or other damage to the eye, in the United States.
The CustomFlex Artificial Iris is made of thin, foldable, medical-grade silicone and is custom-sized and colored for each individual patient. A surgeon makes a small incision, inserts the device under the incision, unfolds it, and smooths out the edges using surgical instruments. The prosthetic iris is held in place by the anatomical structures of the eye or, if needed, by sutures.
The CustomFlex Artificial Iris is contraindicated in eyes with any of the following conditions: uncontrolled or severe chronic inflammation (uveitis), abnormally small eye size (microphthalmus), untreated retinal detachment, untreated chronic glaucoma, cataract caused by rubella virus, abnormal blood vessels on the iris (rubeosis), certain kinds of damaged blood vessels in the retina, and intraocular infections. It is also contraindicated for patients who are pregnant.
The CustomFlex Artificial Iris was approved through a premarket approval application (PMA) and was granted Breakthrough Device designation. The FDA granted approval of the CustomFlex Artificial Iris to Clinical Research Consultants, Inc.
First 3D Printed Human Corneas
The first human corneas have been 3D printed by scientists at Newcastle University in the United Kingdom. Currently, there is a significant shortage of corneas available to transplant, with 10 million people worldwide requiring surgery to prevent corneal blindness as a result of diseases such as trachoma, an infectious eye disorder. Therefore, this technique could be used in the future to ensure an unlimited supply of corneas, according to the release.
The proof-of-concept research, conducted by Abigail Issacson, Stephen Swioklo, and Che J. Connon and published in Experimental Eye Research, reports how stem cells (human corneal stromal cells) from a healthy donor cornea were mixed together with alginate and collagen to create a solution that could be printed, a “bio-ink.” Using a simple, low-cost, 3D bio-printer, the bio-ink was successfully extruded in concentric circles to form the shape of a human cornea. It took less than 10 minutes to print. The stem cells were then shown to culture – or grow. The gel—a combination of alginate and collagen—keeps the stem cells alive while producing a material that is stiff enough to hold its shape but soft enough to be squeezed out of the nozzle of a 3D printer. The dimensions of the printed tissue were originally taken from an actual cornea. By scanning a patient’s eye, data could be used to rapidly print a cornea that matches the size and shape.
ABB Optical Group Acquires Glimpse Live
ABB Optical Group, a national supplier of optical products and services for the eyecare industry, has agreed to acquire Glimpse Live, a data and analytics provider for eyecare professionals and other healthcare practitioners. Terms of the acquisition were not disclosed.
Casey Hedberg, who founded Glimpse in 2013, will become managing director of Glimpse following the acquisition by ABB Optical Group.
Orasis Pharmaceuticals Closes $13 Million Series B Financing
Orasis Pharmaceuticals Ltd., a privately held, clinical-stage pharmaceutical company focused on developing CSF-1 (an eye drop for the treatment of presbyopia symptoms), announced the closing of a $13 million Series B financing. The financing was led by the ophthalmology-focused venture capital fund Visionary Ventures, with participation from Sequoia Capital, SBI (Japan) Innovation Ventures, LifeSci Venture Partners, and other private investors. Jeffry Weinhuff, managing partner of Visionary Ventures, and Masafuyu Tanaka, president of SBI (Japan) Innovation Ventures, will join the Orasis Board of Directors in conjunction with the financing.
AllAboutVision.com Provides Spanish Translations of Eyecare Articles
AllAboutVision.com now has a library of 100 patient education articles about eye health and vision correction for its Spanish-speaking visitors. The translated articles have generated more than 2.6 million page views so far in 2018.
A list of the articles can be found at https://www.allaboutvision.com/es/, although visitors most commonly arrive directly to their topic of choice via a Google search. Each translated article is also linked from its English counterpart. The translated articles cover eye conditions and diseases, contact lenses, eyeglasses, eye exams, children’s vision, digital eye strain, and LASIK and vision surgery.
Opternative Partners with LD Vision Group
Opternative, Inc. has partnered with LD Vision Group to provide access to online prescription renewal technology on the company’s websites OnlineVisionTest.com and LensDiscounters.com. Customers of the aforementioned websites will be able to get an ophthalmologist-issued contact lens and glasses prescription.
CooperVision Reveals EYEdea Lab at Optometry’s Meeting 2018
CooperVision, Inc. has unveiled the Best Practices EYEdea Lab, a "think tank" that will take place on June 21 in the exhibit hall at Optometry's Meeting 2018 in Denver. In the EYEdea Lab, Best Practices honorees will leverage their collective experiences and expertise to advance the profession. The 2018 Best Practices honorees will be joined in the EYEdea Lab by several past award recipients. In addition, all Optometry's Meeting attendees are invited to stop by and provide their own insights about the future of the profession.
The collaboration is being facilitated by Dr. David Ricketts, Innovation Fellow at Harvard University. He kicked off the initiative as 2018 honorees met for the first time this Spring at the CooperVision Best Practices Summit in Austin, Texas.
Shire Launches Screen Responsibly, an Eyelove Initiative
Shire plc launched Screen Responsibly, its new educational initiative about the intersection between screen use and eye health. This initiative is underscored by new national Shire-sponsored survey data and, as part of it, a partnership with Thrive Global, a behavior-change media and technology company, to increase dialogue about how to love our screens and our eyes. Screen Responsibly is an extension of Shire's Eyelove campaign, which launched in 2016 to elevate the importance of eye health and raise awareness of the signs and symptoms of chronic dry eye.
New resources and custom content are available on screenresponsibly.com that show how people can live a screen-healthy lifestyle. A screen personality quiz is also available on the site that will guide users to content tailored to their unique screening style along with information on dry eye and tips on how to best chat with their eyecare practitioner.
Alcon Launches New Multifocal Advertising Campaign
Alcon has launched its “See Near and Far” direct-to-consumer (DTC) campaign to increase consumer awareness of multifocal contact lens options and encourage them to visit an eyecare professional (ECP). The campaign will include a television spot that will run on ABC, NBC, CBS, and ESPN, among others, throughout 2018 and will also feature national print and digital media. According to the company, the new campaign aims to reach presbyopes who may already wear reading glasses or who are just starting to experience difficulties with their near vision.
Kristyn Reed, OD, Sugar Land, TX
This image shows a scleral lens over a very “proud” graft”—a penetrating keratoplasty, usually older, which is very elevated. In this case, it is elevated superiorly, which makes for a challenging fit. This lens is 19.0mm in diameter, which helps create the necessary vault.
We thank Dr. Reed 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
Influence of Contact Lens Continuous Wear on Pro-Inflammatory Mediators and Other Elements in the Tear Film
The implications of continuous wearing of contact lenses (CL CW) are expanding as we continue to investigate this complex arena. Recently, a group of researchers examined the impact of CL CW with low-oxygen-transmissible lenses on the presence of pro-inflammatory mediators and other elements in the tear film.1 The effect of wearing soft contact lenses with a low oxygen permeability on the tear fluid composition was evaluated after one day, one week, and one month of continual wear.
In this prospective clinical trial, several tear fluid biomarkers were measured in 84 non-adapted contact lens wearers (NACLWs), including the pH, electrolytes, osmolarity, pro-inflammatory molecules [interleukin (IL)-8, IL-1β and interferon (IFN)-γ], total protein (TP) levels and enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and alkaline phosphatase (AP)].
Results showed that the tear pH was significantly decreased after one day and one week; however, after one month of use, the tear pH level returned to the baseline. Tear electrolyte analysis demonstrated a significant decrease in Na+ at one day, one week, and one month and in Cl- levels at one week and one month as well as a significant increase in Ca2+ at one week and one month; in K+ at one day, one week, and one month; in IL-8 at one week and one month; in IL-1β only at one week; and in IFN-γ at one week and one month.
Furthermore, the study observed an elevation of TP, AST, LDH, and AP levels; however, there were no significant changes in ALT. The researchers concluded that continuous wearing of soft contact lenses with low oxygen permeability increase tear fluid pro-inflammatory cytokine levels and enzymes, reflecting tissue damage.
Ongoing research into the physiological implications of CW CL is critical. We have much yet to learn. Somehow, the keys in this area will allow us to better understand why some individuals do so well with continuous wear while others are fraught with complications, some of which are vision threatening.
1. Barba Gallardo LF, Muñoz Ortega MH, Ventura Juarez J, et al. Extended low oxygen transmissibility contact lens use induces alterations in the concentration of proinflammatory cytokines, enzymes and electrolytes in tear fluid. Exp Ther Med. 2018 May;15:4291-4297.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
A Look at Trichomegaly
A good part of my clinical career has been focused (no pun intended) on changes of the lid margin and eyelashes (poliosis, madarosis, trichiasis, etc.) related to disease and disease-provoking settings. Exploring another interesting association of disease-related cilia manifestations is a study described in the June 2018 issue of the European Journal of Pediatrics.1
Eyelash trichomegaly is increased length (≥ 12mm), curling, pigmentation, or thickness of eyelashes. Among acquired causes, allergic diseases and atopic dermatitis (AD) have been found to be associated with eyelash trichomegaly, especially in children. This study compared the eyelash lengths of AD and ichthyosis vulgaris (IV) (a rare inherited skin condition that is characterized by extremely dry skin) patients with those of age- and sex-matched patients who have unrelated skin disorders. The authors report that eyelashes of the AD and male IV patients were significantly longer than those of the controls. The severity of atopic dermatitis and high IgE levels significantly correlated with the long eyelashes.
It was concluded that long eyelashes may act as a surrogate marker of severe AD and serve as a cutaneous marker of IV patients.
Take a closer look at your patients’ eyelashes. Create a mental image of “normal” lashes, and let subtle changes in cilia prompt a guided differential diagnosis of medical history and review of systems.
1. Singh M, Pawar M. Eyelash length for the diagnosis of atopic dermatitis and ichthyosis vulgaris in children-a case control study. Eur J Pediatr. 2018 Jun;177:955-960.
Assessment of Tear Film and Bulbar Redness by Keratograph 5M in Pediatric Patients After Orthokeratology
The objective of this study was to assess the tear meniscus height (TMH), noninvasive tear breakup time (NITBUT), and bulbar redness in pediatric patients after orthokeratology (OK).
Pediatric patients who underwent overnight OK between Dec. 2014 and Nov. 2017 were retrospectively investigated. According to the time of wearing, subjects were divided into three groups: one-week, one-month, and more-than-one-year. Age-matched subjects were recruited as a control group. Keratograph 5M was used to assess TMH, NITBUT-first, NITBUT-average, and bulbar redness score.
A total of 106 subjects aged from 7 to 15 years were included. Compared with the control group, NITBUT-first was significantly lower in the one-week group (P = 0.036), and NITBUT-average was significantly lower in the one-month group (P = 0.019). Compared with the greater-than-one-year group, NITBUT-first was significantly lower in the one-week and one-month groups (P = 0.014 and P = 0.035, respectively), and NITBUT-average was significantly lower in the one-month group (P = 0.022). Bulbar redness score was significantly lower in the one-month group than in the one-week group (P = 0.004). No significant difference in TMH was found among all groups. Significant correlation was found between NITBUT-first and NITBUT-average in all subjects (R = 0.812, P < 0.001). No other significant correlations were found between variables including TMH, NITBUT, bulbar redness score, or target correction.
The authors concluded that as a noninvasive method, Keratograph 5M was easily to be used on pediatric patients. The OK lens did not induce significant tear deficiency or bulbar redness but might affect tear film stability in a short term after wearing.
Xie W, Zhang X, Xu Y, Yao YF. Assessment of Tear Film and Bulbar Redness by Keratograph 5M in Pediatric Patients After Orthokeratology. Eye Contact Lens. 2018 Mar 16.