We have all seen these patients—the ones who tend to overuse cosmetics around their eyes, even when attending their eye examination. Throw contact lenses on top of that, and you get lots of interesting deposits on the lenses and debris in the tear film. What sometimes surprises me is that some of these patients seem to go on with their lives otherwise asymptomatic and without a problem, while others have significant problems with dry eye and meibomian gland dysfunctions. It would be great to see more in the literature to help us understand the basis for these clinical phenotypes.
Jason J. Nichols, OD, MPH, PhD
NBEO Settles Class Action in Alleged Data Breach
The National Board of Examiners in Optometry (NBEO) will allot $3.25 million in a cash settlement fund to compensate some 61,000 victims of an alleged data breach. In a court ruling, District Judge James K. Bredar of Maryland gave preliminary approval to the class action settlement that establishes a means of financial reimbursement and credit monitoring services for affected individuals and outlines steps that the NBEO will take to significantly upgrade its data security practices.
The class action settlement comes nearly three years after large numbers of optometry students and doctors of optometry nationwide began reporting identity theft, particularly stolen Social Security numbers (SSNs) and other personal information used to apply for Chase Amazon Visa credit cards. Following the breach, 13 doctors of optometry filed three separate actions against NBEO—which were since consolidated into the current case—claiming that the targeted information was available and maintained by the testing organization as a requirement for certifying exams and credentialing. However, the NBEO still disputes that it was the source of the breach.
Although Judge Bredar gave preliminary approval to the settlement, a final approval hearing is scheduled for July 12, 2019, after the claims process has run, and settlement benefits may begin once the court enters a final judgement. In the meantime, notices of settlement will be sent to up to 61,000 people believed affected by the alleged data breach with detailed instructions and information about the settlement and how to submit a claim.
J&J Vision Announces Availability of Acuvue Oasys with Transitions
Johnson & Johnson (J&J) Vision announced the availability of Acuvue Oasys with Transitions Light Intelligent Technology in both the United States and Canada starting on April 1. The photochromic contact lens adapts to changing light, helping eyes recover from bright light up to five seconds faster, reducing halos and starbursts at night, and delivering more effortless sight with less squinting, according to the company.
J&J Vision has also collaborated with professional baseball player Bryce Harper to serve as an Acuvue Oasys with Transitions ambassador. He is wearing Acuvue Oasys with Transitions on the field during the 2019 season and sharing his firsthand experience through a video content series.
CooperVision Unveils 2019 Best Practices Honorees
Following a nationwide search for eyecare practices that elevate the profession through innovation, industry leadership, and patient experience, CooperVision has named its 2019 Best Practices honorees. Now in its fourth year, CooperVision’s Best Practices program recognizes and celebrates practices in the United States that go above and beyond to find ways to differentiate themselves and deliver extraordinary care to their patients, even in the face of increasing competition.
This year’s honorees are Azman Eye Care Specialists/Global Complex Eye Care – Timonium, MD; Briggs Vision Group – Dunwoody, GA; Drs. Quinn, Foster & Associates – Athens, OH; Lakeline Vision Source – Cedar Park, TX; Northeast Ohio Eye Surgeons – Kent, Stow, and Akron, OH; Shoreline Optometry – Mountain View, CA; Spring Hill Eyecare – Spring Hill, TN; Vancouver Vision Clinic – Vancouver, WA; Vision Source of Farr West – Farr West, UT; and West Shore Eye Care – Ludington, MI. To learn more about this year’s honorees, visit www.eyecarebestpractices.com.
EyePromise Introduces Screen Shield Teen
EyePromise introduced Screen Shield Teen, an ocular nutrition supplement specially formulated to preserve and support visual comfort and wellness for children ages 4 to 17 years, to its EyePromise eye vitamin line.
EyePromise’s Scientific Advisory Board assisted the company in developing EyePromise Screen Shield Teen, an all-natural zeaxanthin (not synthetic) fruit-punch flavored chewable vitamin for children ages 4 and up. The vitamins are GMO- and gluten-free and are manufactured in U.S. Food and Drug Administration Current Good Manufacturing Practice (CGMP) and National Sanitation Foundation Certified for Sport facilities.
EyePromise Screen Shield Teen is also designed to complement a child’s current daily multi-vitamin. It is not intended to treat, cure, or prevent any disease.
GSLS Seeks Award of Excellence Nominations
The Global Specialty Lens Symposium (GSLS) Program Committee is honored to accept letters of nomination of individuals for the GSLS Award of Excellence. The award is given to distinguished clinicians, scholars, and/or scientists to recognize their lifelong achievements in the field of contact lenses, including development, practice, translation of knowledge and education, and scholarly activity, all of which move the field of contact lenses forward in seminal ways. To make a nomination (including a self-nomination) for the 2020 GSLS Award of Excellence, please send a letter of nomination to email@example.com. All nominations must be received by April 15, 2019.
Call for Submissions to BCLA Photography Contest
The British Contact Lens Association (BCLA) invites eyecare practitioners to submit their entries into the 2019 BCLA Diane Gould Photography Competition.
Winners and runners-up will be announced at the BCLA Clinical Conference in Manchester on June 1.
New for 2019, the BCLA would like to make the images available to members, via an image library, with all due accreditation. During the submission process, entrants will be able to indicate whether they wish to participate in the image library.
Entries to the competition are accepted from delegates who are attending the conference. Entries can be submitted via the online form at www.bcla.org.uk. Entries are due by May 3, 2019.
I-Pen Osmolarity System Now Available in Brazil Through Partnership with DryCom
I-Med Pharma signed an exclusive agreement with DryCom for distribution of its I-Pen Tear Osmolarity System in Brazil.
The I-Pen is a point-of-care, electronic diagnostic testing device to detect and indirectly measure the tear film osmolarity levels associated with marginal, mild, moderate, and severe dry eye disease. The I-Pen Osmolarity System, used in conjunction with the I-Pen Osmolarity Single-Use-Sensor (SUS), provides a quick and simple method for determining tear osmolarity from the tear-soaked palpebral conjunctiva, according to the company.
Prevent Blindness Declares April as Women’s Eye Health and Safety Month
Prevent Blindness has designated April as Women’s Eye Health and Safety Month in an effort to educate women about these issues as well as to provide recommendations on the best ways to take care of vision. Long-time Prevent Blindness partner OcuSoft Inc. will support April’s Women’s Eye Health and Safety Month with a donation to Prevent Blindness.
This image shows slowly recurring central haze following ethylene diamine tetra-acetic acid (EDTA) chelation therapy for band keratopathy resulting from ruptured globe trauma.
We thank Dr. Potter 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
The More We Try, the More Things Stay the Same
As the years go by, new contact lens designs are developed, new materials are brought to market, and new diagnostic and therapeutic technologies are made available. Eyecare professionals are exposed to research outcomes that bring a greater understanding of the benefits and risks of contact lens wear. You might think that all of these wonderful developments would have a positive effect on patient behavior while wearing contact lenses. Unfortunately, the more things change, the more things stay the same.
A recent study was published that evaluated soft contact lens replacement, overnight (ON) wear, and contact lens case compliance in a sample of CL-wearing subjects.1 The researchers recruited 297 subjects for the study. Adult (≥ 18 years) soft contact lens wearers completed a survey about contact lens replacement, ON contact lens wear, and contact lens case replacement habits.
They found that two-week-replacement lenses (according to the manufacturer's replacement schedule [MRS]) were most common (45.5%), followed by monthly (34.3%) and daily replacement (20.2%). Noncompliance with replacement schedule was reported in 38.7% of subjects. Age (p = 0.02), years of lens wear (p = 0.02), and MRS (p < 0.0001) affected replacement compliance. Post-hoc analysis showed that daily replacement wearers were more compliant than two-week (p < 0.0001) and monthly (p < 0.0001) replacement wearers were with prescribed lens replacement. Noncompliance with prescribed ON wear was reported in 23.9% of subjects. Subjects who were noncompliant with lens replacement were more likely to be noncompliant with ON wear (p = 0.02) and had worn contact lenses for less time (p = 0.02).
Of the subjects who used contact lens cases, 74.6% were unsure of when they should replace their case. Frequency of case replacement was not associated with age (p = 0.5), gender (p = 0.5), years of contact lens wear (p = 0.7), MRS (p = 0.4), replacement compliance (p = 0.3), or ON wear compliance (p = 0.7).
The authors stated that daily replacement wearers were most likely to be compliant with contact lens replacement, but all subjects, including daily replacement wearers, had similar ON wear noncompliance. Noncompliant lens replacement was associated with noncompliant ON wear, but contact lens case replacement was not related to either compliance category. The majority of subjects had no knowledge of proper contact lens case replacement, despite compliance in other categories.
Compliance to prescribed contact lens wearing schedules (DW versus ON), replacement schedules, and other prescribed patient behaviors continues to be a challenge. That being said, our clinical experience tells us that properly educated patients tend to be more compliant. When patients are not only made aware of proper CL wearing behaviors, but also are informed as to why these behaviors result in healthier lens wearing outcomes, we find that they tend to comply at higher rates. Patient education is key and is worth the extra effort.
1. Rueff EM, Wolfe J, Bailey MD. A study of contact lens compliance in a non-clinical setting. Cont Lens Anterior Eye. 2019 Mar 16. [Epub ahead of print].
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Dry Eye, Dry Mouth
This week, our practice is hosting "Healthy Lifestyle Week," a week of informational health lectures and screenings aimed at awareness, compliance, and patient proactivity in healthcare. As I sat and listened to the lecturer from our dental department speak about the concerns of dry mouth, I realized that the information parallels that of dry eye.
Similar to dry eye, many medications contribute to the development of a dry mouth. Antidepressants, anti-anxiety medications, decongestants, antihistamines, muscle relaxants, appetite suppressants, diuretics, overactive bladder medications, and numerous other oral therapies are included in the list of drugs that can cause dry mouth in our patients.
Dry mouth, akin to dry eye, puts the local environment at risk and ultimately results in loss of function. We appreciate the signs and symptoms of dry eye. Dry mouth results in risk of bad breath, cavities, and oral infections. Like dry eye, therapies to increase oral lubrication are available.
Perhaps we should be proactive on the oral health front and remind our patients of this association.
Antimicrobial and Physicomechanical Natures of Silver Nanoparticles Incorporated into Silicone-Hydrogel Films
The purpose of this study was to investigate the effects of silver nanoparticles (AgNPs) incorporated in silicone hydrogel films on their physicochemical properties and microbial activity. Silicone hydrogel composite films (SiHCFs) were prepared by in-situ chemical reduction of silver ions added in different concentrations (0ppm, 10ppm, 20ppm, 30ppm, 40ppm, 60ppm, and 80ppm) followed by ultraviolet (UV) casting. The reduction of silver ions into AgNPs was confirmed by transmission electron microscopy (TEM) and absorption spectroscopy over ultraviolet and visible (UV-vis) wavelengths. Incorporation of AgNPs into SiHCFs was confirmed by UV-vis absorption spectroscopy, scanning electron microscopy (SEM), and energy-dispersive X-ray (EDX) spectroscopic mapping. The physiomechanical properties of the SiHCFs were evaluated. Antimicrobial activity and biofilm formation of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were assessed.
TEM, UV-vis absorption, SEM, and EDX mapping showed that silver ions were reduced in the mixture of co-polymerizing monomers, and incorporation of AgNPs into SiHCFs was achieved. Mechanical properties of the SiHCFs were enhanced with increasing AgNP concentration, without affecting their chemical and thermal properties. SiHCFs exhibited transmittance greater than 90% at a wavelength of 600nm. Bacterial growths in the solutions bathing the SiHCFs with increasing silver concentration were 95%, 78%, 4%, 2%, 0%, 0%, and 0% respectively, for Escherichia coli; 95%, 82%, 4%, 0.6%, 0%, 0%, and 0% for Pseudomonas aeruginosa; and 93%, 79%, 4%, 0.5%, 0%, 0%, and 0% for Staphylococcus aureus.
The researchers concluded that incorporation of AgNPs into SiHCFs demonstrated sufficient release of AgNPs to inhibit bacterial growth and reduce biofilm formation, with collateral enhancement of some mechanical properties of SiHCFs.
Mourad R, Helaly F, Darwesh O, Sawy SE. Antimicrobial and physicomechanical natures of silver nanoparticles incorporated into silicone-hydrogel films. Cont Lens Anterior Eye. 2019 Feb 28. [Epub ahead of print]