I recently attended a lecture on communication—something we often take for granted in our daily lives and in clinical practice. I was reminded that so-called surface communication, while important, sometimes does not resonate with our audience in a way that imparts meaning. For example, when educating a patient about proper lens care, a handout, while important, might not resonate fully in the way that is needed. A deeper discussion of the handout may be what is required in order to change behavior. As George Bernard Shaw said “The single biggest problem in communication is the illusion that it has taken place.”
Jason J. Nichols, OD, MPH, PhD
Menziuso Named President, North America, for J&J Vision Care
Johnson & Johnson Vision Care, Inc. announced the appointment of Peter Menziuso to the role of President, North America, Johnson & Johnson Vision Care, Inc. In his new role, Menziuso will be responsible for the Vision Care U.S. and Canadian businesses.
Menziuso has over 20 years of experience building business and brands at Johnson & Johnson (J&J). He began his career in the company’s pharmaceutical business, advancing to positions of increasing responsibility across sectors, functions and global markets. Most recently as Worldwide Vice President of Marketing for the J&J Diabetes Care Companies, Menziuso guided the company’s increasing competitiveness in the consumer medical device marketplace.
Prior to this role, Menziuso held several leadership positions within LifeScan, including Vice President of North America Sales & Market Development. There he oversaw North American Animas (insulin delivery), OneTouch (LifeScan blood glucose monitoring) and Janssen (oral Type 2 diabetes therapy) sales and marketing activities. He also served as General Manager of LifeScan Canada.
Menziuso begins his new role March 14, 2016, succeeding Laura Angelini who has accepted a new leadership position within Johnson & Johnson.
FDA Issues Consumer Update on Safe Use of Hydrogen Peroxide CL Solutions
The U.S. Food and Drug Administration (FDA) recently released a Consumer Update entitled Contact Lens Solutions with Hydrogen Peroxide: To Avoid Injury, Follow All Instructions. The update included information on the required disinfecting process of hydrogen peroxide solutions for contact lens care and a Checklist for Solutions with Hydrogen Peroxide for consumers to review key points on safety and proper use. The article emphasized the importance of following all product instructions and noted that consumers should never change their lens-care system before consulting their eyecare provider.
We Are Looking for the Most Influential People in Contact Lenses
A feature article in September’s Contact Lens Spectrum’s 30th Anniversary Issue will present the 30 most influential people in the field of contact lenses over the last 30 years (1986-2016). The list may include anyone (practitioners, researchers, educators and industry leaders) who has made a significant impact in the field of contact lenses over the last 30 years. We are looking for people who have contributed or are contributing to the betterment and/or advancement of contact lenses during this period.
We are asking you to nominate people for this honor. There is no limit to your nominations, so please put forward all those you think are worthy of this distinction. Please include any comments about the specific accomplishments of your nominees. Nominations are due by March 18, 2016. Please send your nominations to Dr. Jason Nichols at email@example.com.
See Your Interesting Case Photo Here in the Next Issue
Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in Contact Lenses Today in the coming weeks!
We welcome photo submissions from our 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.
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
The Zika Virus
The mosquito-carried and transmitted Zika virus is suspected to cause birth defects, specifically microcephaly, in newborn children. In addition, it is reported that 35% of Zika-infected infants tested showed signs of viral-associated retinal scarring suggesting that the effects of Zika are not limited to the brain. For children and adults, the most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis. Other common symptoms include muscle pain and headache.
Other documented modes of Zika virus transmission include intrapartum transmission from a mother with viremia (the presence of virus in the blood) to her infant, sexual transmission (the virus is present in semen longer than in blood), and laboratory exposures. Additionally, blood transfusion and organ or tissue transplantation pose theoretical risks for transmission.1
Considering Zika is transmitted through blood and body fluids, concern must be expressed that transmission may occur through direct contact between an infected person’s body fluids and a healthy person’s mucous membranes. A person infected with Zika may develop conjunctivitis, but can a healthy person contract Zika thru the conjunctiva, a mucous membrane? I am not sure we know the answer to that just yet, but the virulence of the Zika virus is yet another reminder that we must be vigilant in our infection control in our practices.
It’s Time to Get with the Program… Global Trends in Myopia Management Attitudes and Clinical Strategies
Myopia prevalence rates are increasing globally at alarming rates. The implications of myopia are far reaching and include ocular health issues as well as quality of life and economic burden issues. Yet, when I frequently speak on this topic and take a poll of attendees in the audience that have incorporated myopia progression management in their clinical practice, it is typically a small minority of the group who respond positively. I report to you this week on a survey study recently published that looked at eyecare practitioners’ awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies.1
In this study a self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eyecare practitioners globally. Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Corneal Reshaping / Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5% (±37.8) prescribed single vision spectacles or contact lenses as the primary mode of correction for young myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%). The authors concluded that regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.
This study confirms my strong suspicion that myopia progression management is only being utilized in a small minority of eyecare practices, especially in the United States. I think it is time for all of us to accept the fact that myopia should be considered not only as a refractive error, but as a disease. We should further accept the fact that we now have effective clinical treatment strategies at are evidence based to address progressive myopia. Yes, we have much to do in advancing this area of clinical care, but we need to take action in our practices now. I believe that in the not too distant future myopia progression management for young myopes will be considered a standard of care.
1. Wolffsohn JS, Calossi A, Cho P, Gifford K, Jones L, Li M, Lipener C, Logan NS, Malet F, Matos S, Meijome JM, Nichols JJ, Orr JB, Santodomingo-Rubido J, Schaefer T, Thite N, van der Worp E, Zvirgzdina M. Global trends in myopia management attitudes and strategies in clinical practice. Cont Lens Anterior Eye. 2016 Feb 16.(16)30014-5. Epub ahead of print.
A Review on Therapeutic Contact Lenses for Ocular Drug Delivery
Contact lenses for ophthalmic drug delivery have become very popular, due to their unique advantages like extended wear and more than 50% bioavailability. To achieve controlled and sustained drug delivery from contact lenses, researchers are working on various systems like polymeric nanoparticles, microemulsion, micelle, liposomes, use of vitamin E, etc. Numerous scientists are working on different areas of therapeutic contact lenses to treat ocular diseases by implementing techniques like soaking method, molecular imprinting, entrapment of drug-laden colloidal nanoparticles, drug plate/film, ion ligand polymeric systems, supercritical fluid technology, etc. Though sustained drug delivery was achieved using contact lens, the critical properties such as water content, tensile strength (mechanical properties), ion permeability, transparency and oxygen permeability were altered, which limit the commercialization of therapeutic contact lenses. Also issues like drug stability during processing/fabrication (drug integrity test), zero order release kinetics (prevent burst release), drug release during monomer extraction step after fabrication (to remove unreacted monomers), protein adherence, drug release during storage in packaging solution, shelf life study, cost-benefit analysis, etc. are still to be addressed.
This review provides an expert opinion on different methodology to develop therapeutic contact lenses with special remark of their advantages and limitations.
Maulvi FA, Soni TG, Shah DO. A review on therapeutic contact lenses for ocular drug delivery. Drug Deliv. 2016 Jan 29:1-10. [Epub ahead of print]