With the long holiday weekend behind us in the United States, I am reminded of the many great opportunities that contact lenses afford patients of all ages of life. This is something that we as practitioners often forget. However, it is important to remember that even what we may perceive as the smallest conveniences provided to our patients for their visual benefit can make a huge difference in their quality of life.
Jason J. Nichols, OD, MPH, PhD
Blanchard Sponsored Gabby Chaves for Indy 500 Race
Blanchard Contact Lenses supported IndyCar driver Gabby Chaves, in the No. 88 Harding Racing car, for the 101st running of the Indianapolis 500, which took place on May 28, 2017. Chaves has been wearing Onefit Scleral Lenses since February 2017 and reached out to Blanchard to express his gratitude for what the lenses have done to help continue his racing career. The Onefit Scleral Lens logo could be found on Chaves’ helmet during the Indy 500 race.
B+L Launches New Renu Formula
Bausch + Lomb (B+L) has launched Renu Advanced Formula multipurpose solution for soft and silicone hydrogel contact lenses. This formula combines three disinfectants and two surfactants to provide excellent lens cleaning and disinfection in addition to all-day comfort, according to the company.
Renu Advanced Formula is a sterile, isotonic solution that contains poloxamine, poloxamer 181, diglycine, sodium citrate, boric acid, sodium borate, edetate disodium, and sodium chloride, preserved with a triple disinfectant system (polyaminopropyl biguanide 0.00005%, polyquaternium 0.00015%, and alexidine 0.0002%). B+L says the new formula kills 99.9% of germs, helps prevent the formation of deposits on lenses when used daily, and delivers up to 20 hours of moisture to provide all-day comfort.
The new Renu Advanced Formula multipurpose solution will be the only Renu solution on the market, replacing Renu Sensitive and Renu Fresh, beginning in June 2017 in major retailers. For more information, visit http://www.bausch.com/renuadvancedformula.
TearClear Completes $4.5 Million Series A Financing and Introduces Leadership Team
TearClear announced the completion of its Series A financing, with proceeds totaling $4.5 million. The round was co-led by Visionary Venture Fund and Bluestem Capital. The financing will provide sufficient capital to advance development of TearClear’s filter technology.
The company’s chemical filter removes benzalkonium chloride (BAK) at the point of instillation, allowing multi-dose product preservation until the moment of application. BAK is the most common preservative used in multi-dose topical ophthalmic drugs for the treatment of glaucoma, dry eye drugs available over the counter, and allergic conjunctivitis.
In addition, the company has assembled a team of ophthalmology veterans to drive forward the development of its filter technology, including William Link, PhD, who has significant executive and investment expertise in ophthalmology and has been appointed to the board of directors. Other members of the leadership team include Rick Heinick, chairman of the board, who was previously executive vice president at Bausch + Lomb; Kevin Hershfield, CEO, who formerly led chemical manufacturing and distribution businesses supporting medical and industrial markets; Richard D’Souza, PhD, chief science and technology officer, who was formerly Head of Research & Development for Bausch + Lomb; and Howard Golub, MD, PhD, head of clinical development, who was founder and CEO of multiple medical diagnostic companies including Care-Safe LLC.
Nicox Receives FDA Approval for Zerviate
Nicox S.A. announced that the U.S. Food and Drug Administration (FDA) has approved the New Drug Application (NDA) for Zerviate (cetirizine ophthalmic solution 0.24%; formerly AC-170), which the company says is the first topical ocular formulation of this antihistamine, for the treatment of ocular itching associated with allergic conjunctivitis. Cetirizine, the active ingredient in Zyrtec, is a second-generation antihistamine (H1 receptor antagonist) that binds competitively to histamine receptor sites to reduce swelling, itching, and vasodilation. Partnering discussions are currently underway for U.S. commercialization rights.
Nicox says that the efficacy of Zerviate was established in three randomized, double-masked, placebo-controlled, conjunctival antigen challenge (Ora-CAC model of allergic conjunctivitis) clinical trials in patients who have a history of allergic conjunctivitis. Onset and duration were evaluated in two of these trials in which Zerviate demonstrated statistically and clinically significantly less ocular itching compared to vehicle at 15 minutes and eight hours after treatment.
Alcon Announces Launch of New Dailies AquaComfort Plus Patient-Friendly Packaging
Alcon launched new U.S.-specific packaging for Dailies AquaComfort Plus (DACP) spherical contact lenses in 90-, 30-, and five-packs to assist patients with proper lens wear and care. The company says that this new packaging, the first of several planned packaging changes, reflects the commitment of Alcon to support successful lens wear, particularly in new lens wearers, and eyecare professionals and their practices.
The new DACP box design, which replaces the current packaging, features new patient-friendly educational elements, including detailed application and removal illustrations; a toll-free patient helpline and email address; and the Dailies website address for more at-home and online support.
Additionally, the U.S. flag symbol will appear on the new packaging to identify the boxes as specific only to U.S. patients. U.S.-specific lot numbers will also enhance supply chain tracking capabilities. By the end of 2017, Alcon also plans to launch U.S.-specific packaging for Air Optix plus HydraGlyde contact lenses.
The new packaging will be the only DACP sphere packaging that Alcon sells into the U.S. market. The previous, global packaging design will no longer be sold in the United States after June 15, 2017. Eyecare professionals or others who are concerned about sales of DACP lenses with global packaging, or have any other concerns about Alcon packaging, are asked to report the issues via the “Contact Us” page on MyAlcon.com. Alcon states that it’s important to note that while the DACP packaging will look different, nothing is changing with the lenses themselves.
Primary Eyecare Network, Diversified Buying Group, and ECP Network to Merge Under PEN Name
ABB Optical Group announced that it is merging Diversified Buying Group and the ECP Network, both part of Diversified Ophthalmics, with Primary Eyecare Network (PEN). ABB Optical Group acquired Diversified Ophthalmics in October 2016.
A division of ABB OPTICAL since 2007, PEN is focused on supporting independent optometrists by providing favorable purchasing arrangements, business management and marketing support, educational programs for practitioners and staff, medical billing services, and other support services. Diversified Ophthalmics’ ECP Network is a practice development organization that offers independent eyecare providers tools and guidance to manage a successful practice. The Diversified Buying Group offers customers discounts and special pricing on products from more than 100 vendors with the convenience of one monthly statement.
With the merger of the three entities into one practice development organization under the PEN brand, members will have access to a broad range of practice development resources, a comprehensive roster of educational events for practitioners and staff, a wide variety of valuable vendor discounts and rebates, and “white glove” account management services, according to the company.
Members of Diversified Buying Group and the ECP Network will have immediate access to PEN’s new online educational portal, which provides eyecare practitioners and paraoptometric staff with on-demand webinars and continuing education classes. Billing statements will transition to ABB Optical Group/PEN during the next several months.
ABB Optical Group has also named Angela Moore as director of marketing for insights and communications. She brings more than 15 years of marketing and analytics experience to her position at ABB. Most recently, Moore was director of professional promotion and neuroscience marketing at Novartis Pharmaceuticals. In addition, Lisa Patterson was named manager of content and digital marketing. She brings more than 13 years of marketing experience to her new position. She was most recently corporate communications manager at Campus Management.
CLX, a contact lens management and marketing system, has launched a system upgrade designed to enhance its current integration with practice management system Compulink.
According to the company, Compulink users with CLX integration can place contact lens orders directly with a distributor of choice in their Compulink system; no double entry of orders is required. This system also automatically identifies patients who are due to reorder and will email and/or text messages to those patients with reorder instructions.
Beaver-Visitec International (BVI) announced the U.S. launch of Extend 180 Absorbable Synthetic Implants, a new long-term punctal implant for patients experiencing dry eye symptoms.
Extend 180 is designed to provide six months of effective dry eye relief, according to BVI. These long-term dissolvable implants are indicated for post-ocular surgery, seasonal dry eye, contact lens intolerance, and/or dry eye associated with digital eye strain.
Extend 180 implants are made of dissolvable polydioxanone material and are available in 0.3mm, 0.4mm, and 0.5mm sizes, packaged in a single pair or 10-pair box. BVI is now accepting orders for June shipment.
Do you think that if your patients don’t see well in their contact lenses, they can still be comfortable in their lenses?
A 44-year-old male patient had intracorneal ring segments implanted to stabilize irregular corneal astigmatism caused by an injury to his left eye. The patient had an unusual sleeping posture in which he would sleep with his fist against his left eye, which resulted in the intracorneal ring segments becoming displaced and overlapped. He could not imagine changing his sleeping position, so the implants were eventually removed.
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CARE SOLUTION CORNER
Andrew D. Pucker, OD, PhD
Choose Your Words Wisely
Conveying an accurate and understandable message to patients is a learned art. I am reminded of this every time I work with my students in the classroom and the clinic. As clinicians, we develop canned explanations for myriad topics—everything from contact lens care habits to explaining the potential visual consequences of uncontrolled Type II diabetes. While most of us leave optometry school with a comprehensive skill set for delivering complex patient messages, we need to continuously work to improve our communications skills. We also need to continue to adapt our messages as we move into the information age.1
Practitioner-patient communications via email and similar platforms are becoming more common.1 I predict that, in the coming years, electronic patient messaging is going to become a standard of care because it will allow patients to ask medical questions from the safety and convenience of their own homes, which may make them more comfortable with divulging sensitive information while at the same time allowing medical professionals more time to thoughtfully respond to sensitive and complex patient questions.1
This emergent means for patient communication also has some inherent risks that go beyond breaching confidentiality. Electronic communications do not convey body language.1 It may also be more difficult for medical professionals to judge their patients’ understanding of the material.1 This issue is especially problematic when two medical terms have similar but slightly different meanings;1 for example, Jucks and Bromme offer up a situation in which a clinician typically understands that migraines and headaches are similar yet different conditions, while patients may consider them to be synonymous diseases.1
Internet communication can be a valuable and effective means for conveying information, though you should perform these communications as thoughtfully or even more thoughtfully than you do your in-person patient education sessions.1 Do not assume that patients have a full understanding of medical terminology.1 Define complex medical terms even if you think your patients already understand them, give your patients examples, and personalize your messages whenever possible to ensure that your patient have the best chance to understand your message.1
1. Jucks R, Bromme R. Choice of words in doctor-patient communication: an analysis of health-related internet sites. Health Commun. 2007;21(3):267-277.
MATERIALS & DESIGNS
David L. Kading, OD
Wobbly Lenses Won’t Work
When I was doing my training in contact lenses, I was taught that cylindrical corneas need toric GPs to stabilize them. As I have traveled the world discussing contact lenses, I have asked practitioners far and wide whether they agree with this statement. I have also asked “At what cylinder power do patients need toric GPs?” But, it really is a trick question. Here is why.
Patients who have cylinder that lies only within their central cornea have very different shaped eyes compared to patients who have limbus-to-limbus astigmatism. When the cylinder reaches to the limbus, an obvious fit difference exists. As such, the question we really need to be asking isn’t “Does the patient have cylinder?” but rather “What does the cylinder look like?”
Some patients may have 3.00D of corneal cylinder that all lies in the central area of the cornea. When we design a GP lens for this eye, it may have a diameter of 10.0mm. With that size diameter, the edge of the lens may come down upon the cornea in a fashion that it doesn’t encounter 3.00D of cylinder, but rather 0.75D or 1.00D. As such, this patient may be well suited for a spherical GP lens.
Other patients have limbus-to-limbus astigmatism. Even patients who have 1.50D of cylinder, who normally would not appear to need toric curves, may benefit from a toric GP if they exhibit the cylinder limbus-to-limbus. For these patients, as the 10.0mm lens lands on the cornea, its edges may be encountering > 1.00D of cylinder, in which case the cornea may be better suited for a toric GP.
The question isn’t how much cylinder, but rather what does the astigmatism look like. For patients who have limbus-to-limbus cylinder, consider a toric GP lens to bring about better vision, comfort, and fit.
Identification of Microorganisms Isolated from Counterfeit and Unapproved Decorative Contact Lenses
All contact lenses (corrective/noncorrective) are considered Class II or Class III medical devices under the Federal Food, Drug, and Cosmetic Act, which also states that contact lenses can only be obtained with a prescription. The Forensic Chemistry Center of the U.S. Food & Drug Administration has examined more than 300 decorative, noncorrective contact lenses obtained without a prescription.
Twenty-nine different brands of noncorrective contact lenses were examined, and 48% of them had at least one sample positive for microbial contamination. The authors’ observations also indicate that 60% of the counterfeit lenses and 27% of the unapproved lenses examined were positive for microbial contamination. Each microorganism was further identified using DNA sequencing.
Contaminated contact lenses are associated with numerous health risks, including ocular infections and conjunctivitis leading to permanent visual impairment or blindness. These results support the contention that acquiring contact lenses without a prescription is a considerable threat to consumer health and safety.
Land AD, Penno KL, Brzezinski JL. Identification of Microorganisms Isolated From Counterfeit and Unapproved Decorative Contact Lenses. J Forensic Sci. 2017 May 24. [Epub ahead of print]