Survey results are in, and as you can see (no pun intended) from the quick poll results below, about half of the participants believe that patients who don’t see well in their contact lenses can still be comfortable during the wear of those lenses. As noted by a recent study by Rao and Simpson,1 blurred vision was associated with ocular discomfort responses, but the issue is a complex one. I also think the relationship between blur and discomfort is extremely complicated because multiple neurological and psychophysical mechanisms (that may compete with one another) are likely involved. Thank you to those who participated in the poll—please look for our next one to appear soon.
1. Basuthkar Sundar Rao S, Simpson TL. Impact of Blur on Suprathreshold Scaling of Ocular Discomfort. Invest Ophthalmol Vis Sci. 2015 April;56:2304-2311.
Jason J. Nichols, OD, MPH, PhD
Louise Sclafani Joins SynergEyes
SynergEyes has announced that Louise Sclafani, OD, is joining SynergEyes as vice president of Professional Affairs. In this position, Dr. Sclafani will be responsible for working with thought leaders and professionals in the global eyecare professional community to develop strategies and programs that will increase the company’s value within the profession.
Dr. Sclafani is an alumnus of Illinois College of Optometry and has spent the last 24 years at the University of Chicago where she was an associate professor of ophthalmology and director of Optometric Services. She will be working from Chicago and will continue to be active in private practice and training future eyecare professionals.
Menicon America Introduces Additional Base Curve for Miru 1day Flat Pack Contact Lenses
Menicon America recently introduced a second base curve for its Miru 1day Menicon Flat Pack daily disposable contact lenses. Miru 1day Flat Pack is now offered in an 8.4mm base curve in addition to the existing 8.6mm base curve. Menicon says that the 1day Miru 8.4mm base curve was designed based on direct feedback from optometrists (ODs) who expressed an interest in additional base curve options for their patients. In conjunction with its OD partners, Menicon says that it wanted its daily disposable patients to benefit from a customized fit that could only be achieved by offering a second base curve. Miru 1day Menicon Flat Pack 8.4mm base curve lenses are available in trial six packs, 30 packs, and 90 packs.
Shire Appoints New Group VP & Head of Ophthalmics US Franchise
Shire has announced the appointment of John Snisarenko as group vice president & head of Ophthalmics US Franchise. He replaces Robert Dempsey, who has taken on a leadership role in Shire’s Global business as vice president & head of Global Ophthalmics.
Mr. Snisarenko brings 30 years of experience in the pharmaceutical, biotech, and medical device industries, many in ophthalmics leadership positions. He has a proven track record in taking programs from development to successful commercialization and in helping businesses achieve high growth, according to Shire.
Most recently, Mr. Snisarenko was vice president of Sales & Marketing for the Rheumatology franchise at Genentech USA. Prior to that, he led sales and marketing for Genentech’s USA Ophthalmology franchise.
During his time at Novartis Pharma Canada, Mr. Snisarenko led the integration of the Ophthalmology business from Ciba Vision to Novartis Pharma. He also helped shape Novartis’ long-term strategy and vision in ophthalmics. At Ciba Vision, Mr. Snisarenko built an ophthalmology business unit and led the commercial activities for the medical device, consumer health and ophthalmic pharmaceutical sectors. He also worked and held leadership positions at Novadaq Technologies, Alcon Canada, and Allergan Canada.
Avedro Names Thomas E. Griffin Chief Financial Officer
Avedro, Inc. announced that Thomas E. Griffin has joined the company as chief financial officer (CFO). He has more than 25 years of executive management experience at emerging growth medical technology companies. He brings a track record of success, leading both early-stage and commercial companies throughout his career. For 10 years and during the company’s initial public offering, Mr. Griffin served as CFO of Entellus Medical, Inc., before transitioning to vice president of finance in May 2016. Prior to this, he served in a variety of executive level financial positions at several organizations, including Digital Gene Technologies, Inc., Centerpulse Spine-Tech, Inc. (now Zimmer Spine, Inc.), and Cima Labs Inc. (now owned by Teva Pharmaceutical Industries Ltd.).
Johnson & Johnson Vision Launches Advocacy Academy
Johnson & Johnson Vision Care, Inc. launched Advocacy Academy, an on-demand virtual learning tool to educate, empower, and mobilize a new community of eye health advocates to engage with lawmakers, agencies, and patient associations on key issues impacting eye health. The self-paced modules are designed with generational learning styles in mind and provide guidance to eye health professionals who have an interest in sharing their expertise and insights with lawmakers, agencies, and associations to effectively advocate for policies that put patients first.
Coinciding with the launch of Advocacy Academy, Johnson & Johnson Vision has also revamped its online home for eye health advocacy information, Vision to Action—formatting the site for easier search and quicker access to the most relevant resources. Vision to Action is a one-stop shop for resources that eyecare professionals, policymakers, and the public can use to stay updated on policy initiatives and proposals at the state and federal levels impacting eye health. Visit www.jnjvisioncareinfo.com for more information.
ABB Optical Group Launches Fourth Annual ABB Cares Program
ABB Optical Group will begin accepting applications for its fourth annual ABB Cares program on Monday, Aug. 1, 2017. ABB Cares highlights and celebrates organizations throughout the country that have improved the quality of life in local communities.
The program is open to all eyecare professionals who want to nominate an outstanding nonprofit organization in their community. ABB Optical Group will award an ABB Cares Platinum grant of $5,000, two Gold grants of $2,500 each, and four Silver grants of $1,000 each. Since the inception of the program three years ago, ABB Optical Group has awarded grants totaling $38,000 to 24 organizations throughout the country that improved the quality of life in their communities.
Organizations do not need to focus on eye health to qualify for the program. To be considered as a grant recipient, all candidates must comply with the following:
- The organization must be a 501(c)(3) organization and must be able to provide a valid tax ID number.
- The organization’s local office must be within 30 miles of the nominating practice’s primary location.
- Applications must be completed and submitted online.
- Applications open Aug 1. The deadline to submit an application is 11:59 p.m. EDT on Aug. 31, 2017.
Donald Egan Named Director of Contact Lenses at KYCO
Donald J. Egan, OD, professor at the University of Pikeville-Kentucky College of Optometry (KYCO), has been appointed the director of contact lenses. The curriculum has been developed to include a full cornea contact lens, specialty contact lens didactic and clinical program.
Dr. Egan joined KYCO as a founding member of the administration and as part of the executive council for the optometry school. His career includes more than 100 professional publications, posters and speaking engagements.
Egan received his doctorate of optometry degree from the Pennsylvania College of Optometry and then went on to complete a post-doctoral residency program in clinical optometry at the University of Waterloo School of Optometry after which he continued as a member of their faculty. Subsequently, he became a founding faculty member and administrator at two other new optometry programs—the University of Missouri-St. Louis (UMSL) and Western University of Health Sciences. While at UMSL he also developed the resident and ophthalmic technician programs at St. Louis University School of Medicine Department of Ophthalmology.
Do you think that if your patients don’t see well in their contact lenses, they can still be comfortable in their lenses?*
*Note: Results are rounded.
Tom Arnold, OD, Sugar Land, TX
This image depicts a huge air bubble under an 18.0mm scleral lens. The lens’ edge was landing too flat, which allowed air to enter the post-lens tear layer after a short period of time. Modifying the landing resolved the issue. It was a real head-scratcher upon first glance.
We thank Dr. Arnold 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
Addressing HOA in Keratoconus with Specialty Designed Soft Contact Lenses
We all are aware that in cases of keratoconus, there are typically increases in both low-order aberrations (sphere and cylinder) and in higher-order aberrations (HOAs)—most notably in vertical coma in many cases. Our attempts at fitting contact lenses to “mask” the irregularity of the anterior corneal surface have been quite successful in addressing both low- and high-order aberrations; however, not all anterior corneal surface aberrations can be eliminated with contact lenses. Additionally, the irregular posterior corneal surface results in residual HOAs even in a very well-constructed contact lens for keratoconus.
A recent study was published that evaluated the visual performance and optical quality of a standardized asymmetric soft contact lens (SCL) used for correction of HOAs in eyes with keratoconus.1 The researchers included 30 eyes (26 patients) with keratoconus (average K: 45.7D ± 2.3D). The patients were subjected to corneal tomography, aberrometry, measurements of manifest refraction, visual acuity (VA), and visual analog scale (VAS) assessments. The study lenses were made using a molding method and consisted of six standardized types in which an asymmetric power distribution of approximately 2.0D to 12.0D (in 2.0D step) was used to correct HOAs. The lens type suitable for each eye was selected based on the corneal tomography and aberrometry data. The on-eye performance of the lens was evaluated using aberrometry (4mm pupil), over-refraction, VA, and VAS. The results indicated that the standardized asymmetric SCL improved the best spectacle-corrected VA from –0.07 ± 0.09 logMAR to –0.11 ± 0.08 logMAR (P < 0.05) and the mean VAS score from 66.2 ± 21.8 to 75.4 ± 20.5 (P < 0.05). Vertical coma decreased significantly (–0.50μm ± 0.36μm without SCL; –0.36μm ± 0.34μm with SCL; P < 0.01).
In subgroup analysis, subjects in the high VAS group (score ≥ 75) accounted for 70% of all subjects, and this was the group in which the vertical coma decreased significantly from the level without the lens. They concluded that a standardized asymmetric SCL can reduce HOAs and improve vision quality when compared with spectacles in patients.
Practitioners have historically used GP contact lenses to address keratoconus. However, more recently, various designs of scleral GP, hybrids, and customized soft lenses have gained popularity and success in keratoconus vision management. However, I feel that we have been relatively satisfied with the visual outcomes when we may have the ability to further improve them.
One of the most commonly overlooked elements is residual regular astigmatism. A sphero-cylinder over-refraction will disclose this when present, and most current CL designs will allow for the incorporation of anterior toric correction that will have a positive impact on vision quality. However, there have been numerous previous attempts at correcting HOAs that have failed due to the meridional sensitivity of exact HOA correction.
This study has demonstrated that by slightly lowering the bar and not trying to specifically address all HOAs directly, we can achieve notable improvement in visual performance. Our hope is that we will continue to advance in this area and provide better vision for our patients suffering from keratoconus.
1. Suzaki A, Maeda N, Fuchihata M, Koh S, Nishida K, Fujikado T. Visual Performance and Optical Quality of Standardized Asymmetric Soft Contact Lenses in Patients With Keratoconus. Invest Ophthalmol Vis Sci. 2017 Jun 1;58:2899-2905.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
The Effect of Diabetes on MGD
It is generally accepted that diabetes is a risk factor for meibomian gland dysfunction (MGD)/ocular surface disease. In a collaborative study with investigators from China and the Ocular Surface Center of the Department of Ophthalmology at the Baylor College of Medicine, a new study, published in the Journal of Ophthalmology, explores MGD in Type 2 diabetic patients.1
This prospective study compared changes in meibomian gland and tear film function in type 2 diabetic patients with those in non-diabetic patients. Meibomian gland function was evaluated by measuring lipid layer thickness (LLT), grading of meibomian gland loss, lid margin abnormalities, and expression of meibum. Tear film function was assessed by measuring tear breakup time (TBUT), the Schirmer I test, noninvasive breakup time (NIBUT), tear meniscus height (TMH), and corneal fluorescein staining.
Results of this study demonstrated that meibography scores (MG loss) were significantly higher in the diabetic group compared with the non-diabetic group. The number of expressible glands was significantly lower in the diabetic group in the temporal, central, and nasal third of the lower eyelid. The lid margin abnormality score was significantly higher in the diabetic group than in the non-diabetic group. Interestingly, there was no statistically significant difference in the tear film function parameters between the two groups.
The authors conclude that MGD in type 2 diabetic patients is more severe compared with non-diabetic patients. Overall, they state, most of the diabetic patients manifest as having asymptomatic MGD. With this is mind, consider MGD yet another consequence of diabetes and avenue for patient education.
1. Lin X, Xu B, Zheng Y, Coursey TG, Zhao Y, Li J, Fu Y, Chen X, Zhao YE. Meibomian Gland Dysfunction in Type 2 Diabetic Patients. J Ophthalmol. 2017;2017:3047867.
The Effect of Previous Soft Contact Lens Wear on Corneal Refractive Surgery Outcomes
The purpose of this study was to examine the influence of previous soft contact lens (SCL) wear on corneal refractive surgery (CRS) outcomes when SCL wear is ceased for two weeks versus 24 hours, and also when compared to no wear, prior to CRS.
A retrospective examination of CRS patient records was carried out for two groups of patients: those who ceased SCL wear for two weeks (n = 45) and for 24 hours (n = 49) prior to CRS and a non-contact lens (NCL) control group (n = 45 and n = 49, respectively). CRS outcomes (efficacy, predictability, visual acuity, and refractive error) were compared pre-operatively and at one and six months postoperatively.
One-month postoperative results indicated that unaided distance visual acuity (UDVA) was significantly better for laser epithelial keratomileusis (LASEK)/photorefractive keratectomy (PRK) patients who had ceased SCL wear for two weeks prior to CRS (–0.05 ± 0.09), compared with the NCL group (0.02 ± 0.09; p = 0.04). Furthermore, six-month postoperative results indicated that UDVA was significantly better for both laser-assisted in situ keratomileusis (LASIK) and LASEK/PRK patients who had ceased SCL wear for two weeks prior to CRS and for LASEK/PRK patients who had ceased SCL wear for 24 hours prior to CRS compared with the NCL group.
Given the current setup and methods followed, the authors concluded that previous SCL wear had no negative impact on visual outcomes following CRS compared with a NCL control group, regardless of previous SCL cessation time prior to CRS.
Lloyd-McKernan A, Simo Mannion L, O’Dwyer V. The effect of previous soft contact lens wear on corneal refractive surgery outcomes. Cont Lens Anterior Eye. 2017 Jun 10. [Epub ahead of print]