It is highly likely that you know several people who have been affected by the flu this year, although the Centers for Disease Control and Prevention’s most recent data are showing that there is finally an overall decrease in influenza activity in the United States (https://www.cdc.gov/flu/weekly/index.htm). This year’s primary culprit has been the H3N2 strain of influenza A. However, even though there has been a decline in overall flu activity, the proportion of influenza B activity has been increasing; this can account for why a very small portion of people have gotten the flu twice this season.
This season has reminded many of us to remain vigilant as a part of the primary healthcare provider network in the fight against common, contagious diseases. Obviously, recommending that patients get vaccinated for the flu is the biggest factor in prevention; but, you can also take other steps to help prevent the spread of influenza, such as avoiding close contact, covering your mouth and nose, and washing your hands with soap and water.
Jason J. Nichols, OD, MPH, PhD
FTC Holds Workshop on the Contact Lens Rule and the Contact Lens Marketplace
On Mar. 7, 2018, the Federal Trade Commission (FTC) held a one-day public workshop titled “The Contact Lens Rule and the Evolving Contact Lens Marketplace.” The Contact Lens Rule, originally introduced in 2004, implemented the Fairness to Contact Lens Consumers Act (FCLCA). Among its provisions, eyecare practitioners (ECPs) are required to provide their patients with a contact lens prescription once a successful fit has been achieved. It also allows for passive verification in which, if a practitioner fails to respond to a prescription request within eight business hours, the lenses can be provided by the requesting group. In Nov. 2016, on the basis of public comments, the FTC decided that compliance with the Contact Lens Rule could be improved and proposed that the rule be amended. After receiving thousands of comments pertaining to this amendment, including 800 from practitioners, the FTC decided to hold this public forum.
Forums were held on: 1) Overview of the contact lens marketplace; 2) Contact lens health and safety issues; 3) Competition in the contact lens marketplace; 4) Examining the verification process; 5) Prescription release and consumer choice; and 6) Looking ahead: potential market disruptions and their impact on competition, consumer protection, and the Contact Lens Rule. Panelists included representatives from the FTC, the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), online contact lens companies, national consumer coalitions, contact lens industry, the American Optometric Association (AOA), and notable academic institutions.
Those against the FTC proposal emphasized the challenges inherent with the current passive verification system. They argued that there should greater enforcement of vendors’ violation of this act and that practitioners should be able to set limits on the number of lenses and refills to ensure that patients do not go several years without a contact lens evaluation and comprehensive examination. Those in favor of the amendment said that their support was based on the fact that compliance by ECPs is not optimum in providing patients with their contact lens prescriptions. They also indicated concerns about the prescribers also being the sellers.
Safety issues were also discussed, such as contact lens infiltrates, infection, and other complications if lenses are received without a valid prescription. These concerns were countered by statistics regarding the necessity of yearly eye exams, depending on the patients’ age.
In addition, representatives from the CDC and the FDA emphasized the differences between lens designs as well as materials, making the argument that a generic lens is difficult to achieve. However, the need for an unbiased prospective study was recommended.
Essilor to Allocate French Tax Refund to the Philanthropic Initiatives
Essilor announced that it will invest a further €19 million in its philanthropic and inclusive business activities that have a goal of eradicating poor vision in one generation. This investment follows a one-off dividend tax refund from the French tax authorities, which Essilor’s board of directors has decided to allocate to activities that support the company’s mission.
Alcon Renews Support for Think About Your Eyes
Alcon announced its continuing commitment to the Think About Your Eyes (TAYE) consumer education campaign for the fourth year in a row, with an additional $2 million donation in 2018.
TAYE is a national campaign presented by The Vision Council and the American Optometric Association that is designed to educate the public about the benefits of eye health and to promote the importance of annual comprehensive eye exams. In 2017, the TAYE campaign led to an estimated 1.4 million eye exams. Eyecare professionals interested in having their practice listed on the TAYE practitioner locator and accessing digital banners for use on their practice websites should visit ThinkAboutYourEyes.com.
BCLA to Host Contact Lens Area at Optrafair
The British Contact Lens Association (BCLA) will host a dedicated contact lens area during Optrafair, which is being held April 14 to 16 in Birmingham, United Kingdom.
Show attendees will be able to find out how they can get the most out of contact lenses and the management of ocular surface health, with BCLA experts available to answer questions at the Contact Lens Hub. A number of peer review sessions will also be held in partnership with Alcon and CooperVision, offering CET points on topics such as dry eye and fitting children.
Imprimis Pharmaceuticals to Custom Compound Ophthalmic Formulations
Imprimis Pharmaceuticals, Inc. has launched a new program to provide ophthalmologists and optometrists with custom compounded ophthalmic medications that the company says are increasingly difficult to find and typically needed on an urgent basis. The goal of this program is to provide high-quality compounded medications from an Imprimis FDA-inspected facility and ship them within 24 to 48 hours, according to the company. The program will be available in all 50 U.S. states. Physicians can order custom compounded formulations on an as-needed basis for their patients.
2018 Comprehensive Searchable Contact Lens Database for Canadian Market
The Centre for Ocular Research & Education (CORE) announced that the Contact Lens Compendium is now available. This free resource details the most up-to-date listing of products—including the latest parameters on lenses, solutions, and rewetting drops—currently available on the Canadian market.
Albert White to Succeed Robert Weiss as CEO of the Cooper Companies
The Cooper Companies, Inc. announced that its board of directors has named Albert G. White III president and CEO of The Cooper Companies effective May 1, 2018. Mr. White will succeed Robert S. Weiss, who will retire as president and CEO on Apr. 30, 2018 and then act in an advisory capacity until Dec. 31, 2018, to ensure a smooth transition.
Mr. White has held a number of senior management roles in the company including, most recently, executive vice president, CFO, chief strategy officer, and CEO of Cooper Medical, Inc., the holding company for CooperSurgical. He joined Cooper in 2006 and has helped lead and execute many of the company’s investments and strategic decisions.
X-Cel Specialty Contacts Introduces Toricolors
X-Cel Specialty Contacts announced the expansion of its product line with an opaque frequent replacement toric contact lens—Toricolors Comfort Cosmetic Lens. Toricolors is the outcome of a partnership between PolyDev LTD and X-Cel Specialty Contacts.
Toricolors is a monthly replacement lens and is powered by Extreme H2O Toric LC (low cylinder) and Extreme H2O Toric MC (mid cylinder) lenses. Toricolors are available in Seabreeze Blue, Emerald Green, Golden Amber, and Horizon Grey. The lenses are available in 0.25D steps from plano to –2.50D and in 0.50D steps from –2.50D to –4.00D. LC axis are: 15° -90°-180°; and MC axis are: 10° -90°-180°.
Thomas Arnold, OD, Sugar Land, TX
This 54-year-old gentleman had a bad day at the golf course when his golf ball hit a small stone off the tee box and struck his left eye. He suffered a macula-off retinal detachment, a shattered crystalline lens, and a crushed cornea. After multiple surgeries, his best-corrected visual acuity (BCVA) was 20/400 in spectacles.
The patient was referred to us for a scleral lens fitting utilizing impression molding technology. Previous attempts with scleral lenses had failed.
The impression-based lens provides a BCVA of 20/50 and is comfortably worn 14 to 15 hours per day.
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
Will This Be the Answer to Contact Lens Microbial Keratitis?
All contact lens wear is associated with a relative risk of infectious keratitis or microbial keratitis (MK). We know that overnight/continuous wear of contact lenses significantly increases that risk along with a number of other associated risk factors. There was great hope and optimism when hyper-Dk silicone hydrogel (SiHy) contact lens materials were developed that we would see a significant drop in MK rates and that safe continuous wear of contact lenses would finally become a reality. Unfortunately, this was not found to be the case. Continuous wear of SiHy contact lenses still had unacceptable rates of MK. Since then, the “holy grail” of safe continuous wear of contact lenses has remained undiscovered.
In a paper regarding current developments in antimicrobial contact lenses and contact lens cases,1 the authors stated that “Antimicrobial agents are being examined with the aim of developing antimicrobial contact lenses and new forms of antimicrobial lens cases. It is hoped that these developments will result in reduced contact lens-related microbial adverse events. In this review, we assess aspects of various antimicrobial strategies, such as cationic metals and peptides, selenium, quorum sensing inhibitors, and various biocidal and non-cidal agents. We highlight the historical challenges, the current scenario of this field, and recommendations for future antimicrobial strategies.”
Will the development of new technologies such as antimicrobial contact lenses end up being that “holy grail” that could lead to safe continuous wear of contact lenses? Time will tell; however, we most likely have to look at a variety of attributes that may allow us to achieve this goal. No single element is likely to be the entire answer. Let’s keep trying!
1. Dutta D, Willcox MD. Antimicrobial contact lenses and lens cases: a review. Eye Contact Lens. 2014 Sep;40:312-324.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
On a recent tour of my daughter’s college dorm room vanity, I found a bottle of micellar water. “Mom, this is the greatest stuff to remove eye and face makeup,” my daughter offered. I was immediately intrigued. What is micellar water?
Micelles are lipid (surfactant) molecules that arrange themselves in a spherical form in aqueous solutions. Micelles are closed lipid monolayers that have a fatty acid core and polar surface. A typical micelle in aqueous solution has hydrophilic “head” regions in contact with surrounding solvent, sequestering the hydrophobic single-tail regions in the micelle center. Micellar water is made up of cleansing micelle particles suspended in soft water. These tiny oil particles draw makeup, sebum, and impurities from the skin.
We know that micelles have emerged as one of the most promising drug delivery platforms for the management of ocular diseases affecting the anterior (dry eye syndrome) as well as the posterior (age-related macular degeneration, diabetic retinopathy, and glaucoma) segments of the eye. As a drug delivery platform, the mucoadhesive nature of micelles results in enhanced contact with the ocular surface, while their small size allows better tissue penetration. Being highly water soluble, micelles generate clear aqueous solutions, which allows easy application in the form of eye drops without any vision interference.
The question is, how does micellar water (used for eye makeup removal) that seeps onto the ocular surface impact it? I have no answer to this question and await data on this query.
Optical and Pharmacological Strategies of Myopia Control
Recent increases in global myopia prevalence rates have raised significant concerns, as myopia increases the lifelong risk of various sight-threatening ocular conditions. This growing public health burden has generated significant research interests into both understanding its etiology and developing effective methods to slow down or stop its development, methods collectively termed myopia control. The growing body of research has demonstrated benefits of various optical and pharmacological treatments, resulting in myopia control management increasingly becoming a part of mainstream clinical practice.
The purpose of this review is to discuss the peer-reviewed literature on the efficacy of various myopia control interventions including multifocal spectacles and contact lenses, orthokeratology, and pharmaceutical eye drops as well as potential future research directions.
Kang P. Optical and pharmacological strategies of myopia control. Clin Exp Optom. 2018 Feb 28. [Epub ahead of print]