We asked about this topic in this month’s Quick Poll. About 60% of respondents believe that measures of axial length are required (and about 40% of respondents feel that they are not necessary). We will be discussing this, among other hot topics, in the pages of Contact Lens Spectrum and in the opening general session of the Global Specialty Lens Symposium, which is being held on Jan. 22 to 25, 2020 in Las Vegas.
Jason J. Nichols, OD, MPH, PhD
OcuSoft Inc. Acquires Digital Heat’s Eyelid Warming Device
OcuSoft Inc, in a joint venture with Essentia Pharma, a marketing and investment subsidiary of OcuSoft, has acquired the intellectual property portfolio of Digital Heat Corporation. The price was not disclosed.
The portfolio includes an eyelid warming device that will be marketed as the OcuSoft Thermal 1-Touch. It offers preset modes and temperature settings that can treat four eyelids simultaneously, which provides improved patient convenience for in-office procedures, according to the company. In addition, the company says that the device eliminates disposables cost by leveraging the Digi Lens technology, making Thermal 1-Touch cost-effective for physicians.
X-Cel Is Manufacturing Lenses in 200Dk Material
X-Cel Specialty Contacts is now manufacturing scleral contact lenses and corneal GP lenses in the new Optimum Infinite hyper-Dk GP lens material.
This material, launched early this year from Contamac, is stable, wettable, scratch-resistant and easy to handle by both practitioners and patients, according to the company.
Optimum Infinite has received 510(k) clearance from the U.S. Food and Drug Administration for a full range of indications, including myopia, hyperopia, astigmatism, and aphakia. The material includes a UV blocker, is compatible with Tangible Hydra-PEG (Tangible Science), and is available in customizable larger diameter sizes.
ABB Optical Group Announces New Director of Strategic Partnerships
ABB Optical Group welcomed Mike Austin as the company’s new director of Strategic Partnerships. In his new position, he will be instrumental in identifying, developing, and maximizing the relationships between ABB Optical and leading organizations in the optical industry.
An optical industry veteran of 20 years, Mr. Austin has held leadership roles with Luxottica, EyeMed, and Total Eye Care Partners in the areas of operations, strategy, finance, managed care, and product development.
CooperVision Names FORCE Student of the Year
CooperVision has announced that Juliette Papin, a third-year student at the Institut Supérieur d’Optique in Nantes, France, is its 2019 Future Ocular Research Creativity Event (FORCE) Student of the Year. Her project evaluated how phoria measurements were affected in patients wearing CooperVision’s Biofinity Energys compared to Biofinity multifocal contact lenses. Ms. Papin wins a full delegate package, including travel and accommodation, to attend an international contact lens meeting and the opportunity to have her project presented or published.
A shortlist of students from 11 different countries came together at the FORCE final, which took place at CooperVision’s Centre of Innovation in Budapest, Hungary on May 10 and 11.
Second place was awarded to Marianne Lindenberg and Cor Oosting-Klock from Hogeschool van Utrecht in the Netherlands for their research into the content and frequency of contact lens hygiene instruction given by eyecare professionals. In addition, Aniket Saha, from Bharati Vidyapeeth School of Optometry in Pune, India, was awarded third place. His project considered whether current contact lenses meet the corneal physiological needs of both men and women equally.
FORCE is an annual competition that aims to encourage students to develop their professional knowledge of contact lenses by competing against students from Europe, the Middle East, and Africa. Entrants are invited to present a project on a contact lens-related subject and are judged on the evidence for, and the importance of, the project. Winners from each country then go on to the FORCE final.
Rev360 Appoints John Fowle as CFO
John Fowle has been named CFO for Rev360. He will be responsible for the company’s financial and accounting functions as well as for supporting Rev360’s business expansion. Mr. Fowle has held senior positions with Panasonic and GE Healthcare; most recently, he served as vice-president, corporate controller, and officer of Welltok, a provider of technology solutions that connect consumers with personalized health improvement resources.
NuSight Medical Announces Issuance of U.S. Patent Covering the NuLids System
NuSight Medical announced that the U.S. Patent Office has issued Patent No. 10,314,763, which is directed to methods related to the treatment of dry eye disease. The patent covers the use of the NuLids System for the treatment of dry eye/ocular surface disease, blepharitis, and related conditions. All 29 claims were approved, providing key declarations that involve stimulating the meibomian glands to effectively treat dry eye, according to the company.
University of Tusculum’s College of Optometry to Offer OD Degrees
The Southern Association of Colleges and Schools Commission on Colleges has authorized Greenville, TN-based Tusculum University to add doctorates to its menu of available degrees. This clears the way for Tusculum to grant a Doctor of Optometry to those who will graduate from the Niswonger College of Optometry once that college receives required approvals.
As Tusculum pursued the level change, it also worked on securing the necessary approvals from the Accreditation Council of Optometric Education. The Niswonger College of Optometry is seeking accreditation from that organization and has completed the first step in that process. Tusculum projects that it will enroll the first class of 70 students in the four-year program in fall 2020, pending the receipt of preliminary approval for accreditation.
In Memoriam: George Meszaros
Beloved contact lens pioneer, leader, and advocate George Meszaros passed away on June 8. Born in Hungary, he arrived in the United States in 1949. He started as an optician and practiced for 10 years. For many years, he owned a contact lens laboratory. In 1982, he founded Polychem, Inc. and made the first ready-to-use contact lens polish for both polymethylmethacrylate (PMMA) and GP lenses. He also introduced—through Polychem—the first automated radiuscope to the United States and overseas.
Mr. Meszaros is best known for his work on behalf of the Contact Lens Manufacturers Association (CLMA). He became the youngest president in CLMA history in 1980. But his legacy is—and always will be—what transpired between 1978 and 1990. Contact lenses were all considered Class III medical devices by the U.S. Food and Drug Administration (FDA). For small independent GP laboratories, the expense to have a contact lens approved by the FDA was prohibitive. He took the lead, and through his persistence, GP lenses were ultimately reclassified as Type II medical devices.
For his efforts, no one has received more honors from the CLMA than George Meszaros has. In 1984, he received the CLMA’s highest honor, the Joseph Dallos Award, for outstanding contributions to the development and advancement of the contact lens industry and for services to humanity. Previous recipients had included Joseph Dallos, William Feinbloom, Newton Wesley, Otto Wichterle, Robert Mandell, and Irvin Borish. He also received the CLMA’s Leonardo da Vinci Award in 1998 and its Honorary Recognition Award in 2008.
His contributions can be best summarized by his friend and fellow past CLMA President and Joseph Dallos Award recipient, Carl Moore. “George was the most positive and enthusiastic contact lens advocate in the manufacturing industry. He was a great friend and my mentor for the CLMA.”
--contributed by Edward S. Bennett, OD, MSEd, clinical features editor for Contact Lens Spectrum
In the June 23, 2019 issue of Contact Lenses Today, the parameters for Bausch + Lomb Ultra Multifocal for Astigmatism contact lenses were listed incorrectly. The correct parameters are as follows. The lenses are available with a base curve of 8.6mm and a 14.5mm diameter. Spherical powers are available from +4.00D to –6.00D in 0.25D steps (in 0.50D steps above –6.00D), in axes of 10° to 180° (in 10° steps), add powers of +0.75D to +1.50D (Low) and +1.75D to +2.50D (High), and in cylinders of –0.75D, –1.25D, –1.75D, –2.25D, and –2.75D.
Are measures of axial length required for practicing myopia control in your practice?
This image shows the frothy saponification of meibum that has been altered by lid bacteria and blepharitis and that will eventually end up in the tear film and on a contact lens. Contact lens discomfort and deposition for both rigid and soft modalities can be frustrating to manage clinically. However, a detailed evaluation of the ocular surface and eyelids with targeted treatment to resolve these findings prior to a fitting can save a lot of headaches for practitioners and their patients.
We thank Dr. Lundquist 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
It’s Important to Ask the Question
Classically quoted prevalence rates of keratoconus are now known to be significant underestimates of the true prevalence of the disease. Modern diagnostic technologies that evaluate both anterior and posterior corneal shape as well as global corneal thickness and corneal thickness changes from the thin point to the periphery are able to detect keratoconus earlier in the course of the disease and with greater degrees of sensitivity.
With the ability of corneal cross-linking to halt the progression of keratoconus, a practitioner’s responsibility is to identify keratoconus as early as possible and to treat those individuals who have demonstrated definitive progression or those who are at high risk for progression. As such, identifying individuals who may be at risk for keratoconus becomes of paramount importance.
Today, there seems to be consensus regarding the genetic nature of keratoconus. A study was recently published that evaluated the tomographic and refractive characteristics of pediatric first-degree relatives of patients who have keratoconus.1 Both eyes of all participants aged between 6 and 18 years were included and studied. Subjects were tested with Scheimpflug tomography, manifest refraction, and slit lamp examination. Two masked cornea and refractive surgeons of different training backgrounds independently evaluated the participants’ tomographic outputs. Anterior curvature indices, posterior elevation values, thinnest pachymetry, and subjective and objective tomographic interpretation were used in the decision-making process for the presence of keratoconus in the subject population.
Results of the tomographic evaluation from the 183 subjects indicated that 32 patients had keratoconus (17.5%), while 35 patients (19.1%) were labelled as having keratoconus by objective analysis. In addition, 37.5% of the keratoconus patients were unilateral as evaluated by tomography alone.
The researchers concluded that the prevalence of keratoconus in pediatric first-degree relatives of diagnosed keratoconus patients is high. Therefore, they believe that screening in this high-risk group is warranted.
Without a doubt, it is important for us to always ask our keratoconus patients whether they have siblings and/or children. Additionally, we should ask about the age of these individuals. If a first-degree relative of a keratoconus patient is young and is at relative risk of progression if keratoconus is diagnosed (conservatively below the age of 30), then we should stress the importance of keratoconus screening. The lay person would think that a routine eye exam would be sufficient. Practitioners now know that this is not the case. Appropriate keratoconus screening must include the evaluation of both the anterior and posterior cornea as well as analysis of corneal thickness distribution (i.e., change in corneal thickness from the thin point out to the periphery). This is currently possible with the use of corneal tomographic analysis. Because most eyecare practices do not have corneal tomography technology in their offices, they should encourage instrument manufacturers to develop instruments that would have appropriate keratoconus screening abilities within affordable and multifunctional technologies.
1. Awwad ST, Yehia M, Mehanna CJ, et al. Tomographic and Refractive Characteristics of Pediatric First-Degree Relatives of Keratoconus Patients. Am J Ophthalmol. 2019 Jun 10. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
OAB + OSA + (FES) = DED
Did you know that overactive bladder (OAB) and obstructive sleep apnea (OSA) are related? This relationship holds for both women and men.1,2
Not discounting the relationship between OSA (± Floppy Eyelid Syndrome [FES]) and dry eye, oral therapeutic treatments for OAB often contribute to or precipitate dry eye. In the United States, the prevalence of OAB is estimated to be 16.5%.3 Medications that relax the bladder can be helpful for relieving symptoms of OAB and reducing episodes of urge incontinence. These drugs include tolterodine, oxybutynin, trospium, solifenacin, darifenacin, mirabegron, and fesoterodine. Common side effects of most of these drugs include dry eyes and dry mouth.4
Do your patients have OAB? Are any of the above-noted medications that precipitate dry eye on their active medication list? Are these medications the key to unlocking the cause/contributor to your patients’ dry eye? Case history, case history, case history. Find the clue.
1. Lowenstein L, Kenton K, Brubaker L, et al. The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women. Am J Obstet Gynecol. 2008 May;198:598.e1-e5.
2. Kemmer H, Mathes AM, Dilk O, Gröschel A, Grass C, Stöckle M. Obstructive sleep apnea syndrome is associated with overactive bladder and urgency incontinence in men. Sleep. 2009 Feb;32:271-275.
3. Reynolds WS, Fowke J, Dmochowski R. The Burden of Overactive Bladder on US Public Health. Curr Bladder Dysfunct Rep. 2016 Mar;11:8-13.
4. Mayo Clinic. Overactive bladder. Available at https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721. Accessed June 20, 2019.
A Pilot Study on the Efficacy and Safety of 0.01% Atropine in German Schoolchildren with Progressive Myopia
Although the interest is growing in topical low-dose atropine to control myopia in schoolchildren worldwide, its use in children of European ancestry remains controversial, and solid evidence is sparse. The Oxford Centre for Evidence Based Medicine (OCEBM) classifies the evidence for this therapy as level I for East Asian populations but only as level IV in non-Asian populations.
In this study, 56 children, who had a median age of 11 years (range 6 to 17 years), were analyzed after 12 months of topical treatment with 0.01% preservative-free atropine in both eyes at bedtime every day. Efficacy was assessed during treatment every six months. In a subset of 20 patients, treatment of the second eye was delayed by one day to enable a controlled safety assessment of side effects such as pupil dilation, hypo-accommodation, and near vision reduction.
Prior to treatment, the mean myopia progression was estimated at 1.05D/year; after 12 months of treatment with 0.01% atropine, it was 0.40D/year (p < 0.0001). The only consistently measurable side effect was the induction of 1mm pupil dilatation, which was noticeable only in comparison to the non-treated eye during the safety investigation.
The researchers concluded that topical low-dose atropine appears to be safe and efficacious in a cohort of European schoolchildren. These data should motivate researchers to conduct more randomized clinical trials.
Joachimsen L, Böhringer D, Gross NJ, et al. A Pilot Study on the Efficacy and Safety of 0.01% Atropine in German Schoolchildren with Progressive Myopia. Ophthalmol Ther. 2019 Jun 12. [Epub ahead of print]