The program committee for the Global Specialty Lens Symposium is already at work in its initial planning phases for the 2020 meeting. If you have topics—specific or general—that you think deserve to be on the meeting program, please let us know. Please email your thoughts and suggestions to firstname.lastname@example.org—they are very much appreciated!
Jason J. Nichols, OD, MPH, PhD
Art Optical Launches Online Initial Rx Lens Calculator
Art Optical has launched a new online calculator to accompany the fitting tools supporting the Ampleye scleral lens. Developed in partnership with the KATT Design Group, the Ampleye Initial Rx Lens Calculator is intended to assist fitters with determining patients’ initial Rx lens parameters based on inputs from the diagnostic assessment process. The required data for input into the calculator should be collected from the on-eye assessment after the diagnostic lens has settled for 20 to 30 minutes. After noting which diagnostic lens was trialed on a patient, fitters will assess the central and peripheral clearance zones as well as the limbal and scleral landing zones, along with noting the over-refraction and cylinder for input into the calculator. The resultant Ampleye lens specifications can then be ordered via Art Optical’s online order form or by calling the company.
The Ampleye Initial Rx Lens Calculator is not intended for use on follow-up visits or in determining lens adjustment requirements after extended settling. According to the company, the Ampleye Initial Rx Lens Calculator can also be used as a tutorial to help fitters learn the types and degrees of adjustment that are typically altered in each individual zone of the Ampleye lens based on the diagnostic results.
Scott Filion Promoted to CEO of Rev360
Scott Filion has been promoted to CEO of Rev360. Formerly the president and COO of Rev360, Mr. Filion will now oversee its three business units: RevolutionEHR, a cloud-based electronic health record (EHR) and practice management software platform for eye care; the Professional Eye Care Associates of America (PECAA), a doctor alliance group; and Visionary Partners, a partnership between Rev360 and eyecare practitioners to sustain and grow independent eyecare practices. Rev360’s founder and former CEO, Scott Jens, will assume a senior advisor position to the Rev360 Board of Directors.
Novartis Shareholders Approve Alcon Spinoff
Novartis shareholders approved the proposed 100% spin-off of the Alcon eyecare division, as previously endorsed by the Novartis Board of Directors. In addition to shareholder approval, completion of the spin-off remains subject to certain conditions precedent. The spin-off is expected to be completed in the second quarter of 2019.
It will be implemented through the distribution of a dividend-in-kind of new Alcon shares to Novartis shareholders and to ADR (American Depositary Receipt) holders. The distribution is expected to be tax neutral on a U.S. and Swiss income tax basis. For every five Novartis shares or every five Novartis ADRs, shareholders will receive one Alcon share.
In the Feb. 24, 2019 issue of Contact Lenses Today, the concentration of Bruder Healthcare’s Bruder Hygienic Eyelid Solution was incorrect. The correct description is that it is a 0.02% pure hypochlorous acid solution.
Call for Articles
Do you have an article that should be in Contact Lens Spectrum? Check out the submission guidelines here and send it our way!
Thomas G. Quinn, OD, MS, Athens, OH
A 45-year-old female who has granular corneal dystrophy in both eyes presented with longstanding discomfort in the right eye and blurry vision in both eyes. Visual acuity improved from 20/50 and 20/70 to 20/30 and 20/20 in the right and left eyes, respectively, with scleral contact lenses in place. Additionally, comfort of the right eye was dramatically improved during lens wear.
We thank Dr. Quinn 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
The Perfect Match?
Prosthetic contact lenses are chiefly indicated for various eye disorders ranging from congenital conditions to injury to an unanticipated surgical complication from disfigurement or disease. Common indications include iris atrophy or coloboma, leukocoria, ocular albinism, or aniridia. Secondary complications of trauma—such as traumatic mydriasis or iris disfigurement due to surgical complications—can also warrant a prosthetic contact lens. Indications typically depend on the origin of the problem. In many cases, photophobia is widely attributed as a primary indication. Prosthetic lenses can also be used to mask a disfigured eye or to help manage diplopia via occlusion.1,2 Thus, functional need will dictate what type of lens is warranted.
The possibilities of prosthetic contact lens combination are practically limitless. The main types include tinted lenses, computer-generated or -printed lenses, and hand-painted lenses. Tinted lenses have color throughout the normal iris area, with a translucent hole for the pupil or black for occlusion. Computer-generated lenses offer pre-determined colors that can be stacked together in an almost unlimited number of ways to generate a nice match to a patient’s fellow eye. Finally, hand-painted custom prosthetic lenses (as the name alludes to) offer the greatest chance of a perfect match to the fellow eye.1,3 In many cases, companies will also offer concierge services in which a photo can be sent (with the patient’s permission) to allow for a higher rate of customization.
With any of these lenses, its best to check the fitting guides and become friendly with the labs.
1. Lam, D. Soft contact Lenses for Prosthetic Fitting. Contact Lens Spectrum. 2015 Mar;30:33-39.
2. Cole CJ, Vogt U. Medical uses of cosmetic colored contact lenses. Eye Contact Lens. 2006 Jul;32:203-206.
3. Yildirim N, Basmak H, Sahin A. Prosthetic contact lenses: adventure or miracle. Eye Contact Lens. 2006 Mar;32:102-103.
MATERIALS & DESIGNS
David L. Kading, OD
Are You Tired of Talking About Scleral Lenses Yet? I’m Not.
It seems like at every meeting that we attend, there is a workshop and/or lecture about sclerals. Scleral lenses have certainly made a dent in most of our practices, and if you are someone who has not given them a try, it is time.
There are some incredible resources and some incredibly passionate people devoted to educating the rest of us. I still hold to the notion that practitioners should get acquainted with a lens and devote their full attention to that lens. For example, my primary scleral lens is flexible enough to work for around 95% of my patients. If practitioners are still struggling a lot with fitting scleral lenses, perhaps it is time to try another design.
However, that being said, I have visited offices that have eight different scleral lens fitting sets. Although I think that it is a great idea to spread the wealth around, don’t fall into the trap of missing the mark and expecting the lens to do all of the fitting for you. In reality, each of the lens laboratories’ designs works wonderfully, but if it isn’t working wonderfully for you, give another lens a try. If that lens isn’t working well for you, I would suggest that you do some workshop training and see whether there are some ways that you might be able to enhance your abilities. Scleral lenses are not one-size-fits-all, but many times a lab can find a way to make you successful. If not, try another and then look inward.
Recurrent Corneal Erosion: A Comprehensive Review
The purpose of this study was to comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management.
RCE usually presents with sharp, unilateral pain upon awakening in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit lamp examination of both eyes coupled with a high degree of suspicion.
Several treatments are commonly used for RCE, but new therapies have been introduced recently. Conservative treatment consists of antibiotic and preservative-free lubricating drops, with topical cycloplegics and oral analgesics to control pain. Patients who are unresponsive to these therapies may benefit from therapeutic bandage contact lenses. Newer therapies include oral matrix metalloproteinase (MMP) inhibitors, blood-derived eye drops, amniotic membrane graft application, and judicious application of topical corticosteroids. Once the epithelium is healed, a course of hypertonic saline solution and/or ointment can be used.
Surgical procedures may be performed in patients who fail with conservative therapy. Punctal occlusion with plugs increases the tear film volume. Epithelial debridement with diamond burr polishing (DBP), anterior stromal puncture (ASP), or alcohol delamination should be considered in selected patients. DBP can be used for patients who have basement membrane dystrophies and is the preferred treatment overall due to a low recurrence rate. ASP can be used for erosions outside of the central visual axis. Excimer laser phototherapeutic keratectomy is an attractive option in eyes with central RCE, because it precisely removes tissue while preserving corneal transparency. In patients who have RCE and who are also candidates for refractive surgery, photorefractive keratectomy can be considered.
The authors concluded that newly introduced therapies for RCE enable therapy to be individualized and lower the recurrence rate.
Miller DD, Hasan SA, Simmons NL, Stewart MW. Recurrent corneal erosion: a comprehensive review. Clin Ophthalmol. 2019 Feb 11;13:325-335.