The coronavirus obviously continues to take its toll on our community. As noted in the news, the Dutch Contact Lens Congress scheduled for March 15-16, 2020 was postponed as a preventative measure as it relates to the outbreak (https://www.contactlenscongress.com /en/featured/important-update-ncc2020-postponed). In addition, Katherine M. Mastrota, MS, OD, provides some pertinent information in the Ocular Surface Update column below.
CooperVision Announces Availability of Biofinity Toric Multifocal Contact Lenses
CooperVision, Inc. has announced the availability of its new Biofinity toric multifocal contact lenses. The company has begun initial shipments of the lenses, with nationwide availability expected in May.
Biofinity toric multifocal features Optimized Toric Lens Geometry, which includes uniform horizontal iso-thickness, an optimized ballast band design, a large toric optical zone, and a smooth continuous surface, as well as Balanced Progressive Technology that offers multiple zones of vision correction and is optimized for each sphere and add power, with the option of fitting a center D or center N lens.
Biofinity toric multifocal lenses are available in sphere powers from +10.00D to –10.00D (0.50D steps after ±6.00D), with cylinder powers from –0.75D to –5.75D (0.50D steps), axes of 5º to 180º in 5º steps, and add powers of +1.00D, +1.50D, +2.00D, and +2.50D.
Alcon Launches Precision1 in the United States
Alcon announced that its Precision1 contact lenses are now available nationwide in the United States. The lenses are manufactured in verofilcon A material, include a Class 1 UV blocker (≥ 90% of UVA, ≥ 99% of UVB), have a core water content of 51%, and have a Dk/t of 100 at –3.00D. The lenses are available with a diameter of 14.2mm and a base curve of 8.3mm in the following powers: –0.50D to –6.00D (0.25D steps), –6.50D to –12.00D (0.50D steps), +0.50D to +6.00D (0.25D steps), and +6.50D to +8.00D (0.50D steps).
Menicon America Expands Miru 1month Toric Parameters
Menicon America has announced a parameter expansion for its Miru 1month Toric lens in the United States. This latest addition completes a full, “around the clock” toric offering.
Miru 1month Toric now offers an axis range of 10° to 180° in 10° increments. The newly added axes are: 30°, 40°, 50°, 60°, 70°, 110°, 120°, 130°, 140°, and 150°. Miru 1month Toric is available in three cylinder options, –0.75D, –1.25D, and –1.75D, and across a power range of plano to –10.00D.
MyopiaCare Updates Myappia
MyopiaCare, an online educational platform for myopia specialists and parents, announced an update of the Myappia calculator with the addition of real patient data and MyoCalc, an axial eye length graphic growth curve to illustrate the impact of myopia. According to the company, entering eye length measurements and dates into the MyopiaCare platform provides an actual visualization of myopia progression for each child. Originally developed in 2016 as an Android App, the Myappia calculator can now also be found at www.myopiacare.com.
Bad Habits “The EyeDocs of Rock” to Perform at Vision Expo East Opening Party
Bad Habits “The EyeDocs of Rock,” the longtime rock band comprised of several practicing optometrists, will perform at Vision Expo East’s opening night party. Co-hosted by Vision Source and ODs on Facebook and sponsored in part by Marketing4ecps, Vision Expo, Ocuco, PentaVision (publisher of Contact Lens Spectrum and Contact Lenses Today), Uprise, and EdgePro, the party will take place on March 27 at Sony Hall inside New York City’s Paramount Hotel from 9 p.m. until midnight. Free drinks will be offered from 9 p.m. to 10 p.m.
Soul singer Katie Kadan, who was a finalist on Season 17 of The Voice, will make a special guest appearance courtesy of Mondottica Eyewear.
All Vision Expo attendees are invited to the opening night party. Attendee badges are required for entry. Free tickets are available by visiting sponsors in the Exhibit Hall at Vision Expo.
Alcon introduced Systane Hydration Preservative-Free (PF). It features proprietary HydroBoost Technology, a combination of inactive ingredients including sodium hyaluronate, (a moisturizing substance that occurs naturally in tears) and HP-Guar, which helps provide better moisture coverage and absorption by forming a web-like layer over the eye, according to the company. Systane Hydration PF will be available in 30 single-use vials in select retail stores and online beginning in early March 2020.
In other news, Alcon introduced Systane MyEyes, a new patient support program focused on increasing continuity of care and retention. Systane MyEyes, in combination with DEEP (Dry Eye Excellence Program), can help practitioners with education, implementation, and patient retention after initial iLux treatment, according to Alcon. It is a comprehensive program focused on supporting and educating patients about the chronic and progressive nature of meibomian gland dysfunction (MGD) and the need for ongoing treatment. Following iLux treatment, eyecare professionals (ECPs) can offer patients the opportunity to enroll in Systane MyEyes by visiting SystaneMyEyes.com or by using a unique QR code mapped to their specific practice. Once enrolled in the program, patients will receive an iLux patient care kit, ongoing communication about what to expect after treatment, tips for maintenance between visits, coupons for the Systane family of products, and email reminders that direct patients back to their ECP for follow up and additional treatment.
NCC 2020 Postponed
Following the recent developments around the coronavirus (COVID-19), the Dutch Contact Lens Congress (NCC) board and its partnering organizations have decided to postpone the upcoming ‘NCC2020 – Beyond 2020’ clinical conference, which was scheduled for March 15 and 16 in the Netherlands. The conference will be rescheduled to a later date this year, for which an announcement will follow.
SwissLens Expands to Ukrainian Market
SwissLens acquired certification in the Ukrainian market. According to the company, this certification enables the Ukrainian eyecare specialist community to have access to a complete portfolio of Swiss-made specialty lenses, all delivered directly to Ukraine eyecare professionals. The company also noted that a local customer service agent is being established.
Eyevance Pharmaceuticals Launches Tobradex ST in the United States
Eyevance Pharmaceuticals announced the U.S. launch of Tobradex ST (tobramycin/dexamethasone ophthalmic suspension) 0.3%/0.05% following the company’s acquisition of the product in late 2019. Tobradex ST 0.3%/0.05% is a U.S. Food and Drug Administration (FDA)-approved, fixed-dose topical antibiotic and corticosteroid combination indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and in which superficial bacterial ocular infection or a risk of bacterial ocular infection exists.
Tobradex ST includes a suspension technology (ST) formulated with pharmaceutical grade xanthan gum, an inactive ingredient designed to stabilize the combination and allow greater delivery and ocular surface retention of tobramycin and dexamethasone to the eye. Eyevance’s ST delivery technology, now known as XanGen, is designed to enhance bactericidal activity, ocular surface retention time, and enhanced bioavailability, allowing for a lower concentration of dexamethasone and little-to-no blurriness or intraocular pressure (IOP) spikes.
We Value Your Input
Contact lens (CL) practice across the world is at a critical juncture, with some potential opportunities (such as contact lenses for myopia control, multifocal lenses for presbyopia, and specialty lenses) along with looming threats (such as increasing competition from online business). Anecdotal discussions with eyecare professionals have revealed different levels of optimism regarding the future of CL practice.
Hence, a partnership between Contact Lens Spectrum and organizations across the world—including the International Association of Contact Lens Educators and the British Contact Lens Association—has formed to better understand these issues.
To help us gather what you perceive to be the opportunities and threats to CL practice, please take about 5 minutes to fill out this survey: https://forms.gle/7gPWKQemgnivZ6oH8. The findings of this study will help the industry to design targeted strategies to enhance CL practice and address the perceived threats.
Boris Severinsky, OD, Atlanta
This image shows a well-centered, front-toric, double-notched mini-scleral lens over a keratoconic cornea. Note how the notches on the temporal and nasal sides clear the pingueculae and help to stabilize the lens and prevent rotation. The patient’s final visual acuity was 20/25 (limited due to nuclear sclerosis).
We thank Dr. Severinsky 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
Taking Anterior Segment OCT to the Next Level
Anterior segment optical coherence tomography (AS-OCT) is used in a variety of ways that assist eyecare professionals in the assessment and management of ocular diseases. The exquisite manner in which AS-OCT can image the cornea and other anterior segment structures allows practitioners to understand details of these structures in quantitative detail. A recent study was published that attempted to describe the diagnostic accuracy of three-dimensional (3D) endothelium-Descemet’s membrane complex thickness (En-DMT) in Fuchs’ endothelial corneal dystrophy (FECD) and to determine its potential role as an objective index of disease severity.
In the study, 104 eyes of 79 participants (64 eyes of 41 FECD patients and 40 eyes of 38 healthy controls) were enrolled. All participants received high-definition OCT imaging. FECD was classified clinically into early-stage (without edema) and late-stage (with edema) disease. Automatic and manual segmentation of corneal layers was performed using a custom-built segmental tomography algorithm to generate 3D maps of total corneal thickness (TCT) and En-DMT of the central 6mm cornea. Regional En-DMT, regional TCT, and central-to-peripheral total corneal thickness ratio (CPTR) were evaluated and correlated to the clinical severity of FECD.
A significant increase in En-DMT, CPTR, and TCT was found in FECD compared to controls (P < 0.001). For identifying FECD, average En-DMT of paracentral and peripheral regions achieved 94% sensitivity and 100% specificity, whereas CPTR showed 94% sensitivity, with a 73% specificity (cutoff, 0.97). Regarding early-stage FECD, average En-DMT of central zones achieved 92% sensitivity and 97% specificity, whereas CPTR showed 90% sensitivity and 88% specificity. The average En-DMT of central, paracentral, and peripheral regions was correlated highly with FECD clinical stage (Spearman’s ρ = 0.81, 0.79, and 0.72, respectively; all P < 0.001), compared with CPTR and mean TCT of paracentral zones (0.67 and 0.48, respectively; P < 0.001). The authors concluded that regional 3D En-DMT is a novel diagnostic tool of FECD that can be used to quantify the disease severity with excellent reliability.
With the majority of eyecare professionals now thought to have OCT technology in their offices, this platform can be used in a multitude of ways to evaluate retina, optic nerve, and anterior segment disease states. This study shows just another potential use for this amazing technology. The question now being debated: “Is OCT becoming standard of care for certain situations?” A great topic for consideration.
1. Eleiwa T, Elsawy A, Tolba M, Feuer W, Yoo S, Shousha MA. Diagnostic Performance of 3-Dimensional Thickness of the Endothelium-Descemet Complex in Fuchs’ Endothelial Cell Corneal Dystrophy. Ophthalmology. 2020 Jan 19. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
The Ocular Side of Coronavirus
As ocular surface disease specialists, seeing "red eye" in the exam chair is not uncommon. Please keep in mind the following coronavirus (COVID-19) alerts from the American Optometric Association (AOA) and the American Academy of Ophthalmology (AAO). Note: These statements are being updated periodically.
In a recent statement, the AOA Health Policy Institute (HPI) consolidated relevant information on the coronavirus, general public health guidance, and infection control protocols that all doctors of optometry should be aware of and actively employ, bearing in mind the evolving nature of the outbreak.1 In it, the organization notes that the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) acknowledge that current understanding of the disease remains very limited, yet there are several points that doctors of optometry need to know.
COVID-19 may cause ocular signs and symptoms, including photophobia, irritation, conjunctival injection, and ocular discharge. As of Feb. 10, new information is emerging that identifies the conjunctiva as an alleged route of exposure; COVID-19 may enter the body through the eyes and spread to the whole body through the superficial blood vessels within the conjunctiva. All front-line medical staff should pay attention to eye protection.
Infection control protocol2 and proper hygiene must be observed—including thorough handwashing and use of protective gloves and disinfecting equipment in addition to other CDC recommendations3—no matter the size of the practice.
In addition, the AAO and federal officials recommend protection for the mouth, nose, and eyes when caring for patients potentially infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was previously known by the provisional name 2019-nCoV.4 The virus that causes COVID-19 is very likely susceptible to the same alcohol- and bleach-based disinfectants that ophthalmologists commonly use to disinfect ophthalmic instruments and office furniture. To prevent SARS-CoV-2 transmission, the same disinfection practices already used to prevent office-based spread of other viral pathogens are recommended before and after every patient encounter.4
In addition, the AOA recommends monitoring potential coronavirus activity in your community or region as well as encouraging ill patients to remain at home.1
Be vigilant in your practice to contain the spread of this virus.
The Impact of Short-Term Fenestrated Scleral Lens Wear on Intraocular Pressure
The purpose of this study was to examine the influence of short-term fenestrated scleral lens wear on intraocular pressure (IOP) in healthy eyes.
IOP was measured before, during, and after a brief period (1 to 2 minutes) of fenestrated scleral lens wear, using a rebound tonometer, in 50 young healthy adults (mean age 23 ± 4 years) who had normal corneas.
Immediately following lens application, 48 of the 50 (96%) participants displayed an increase in IOP (mean ± SD increase in these participants of 3.8 ± 2.0 mmHg). Immediately following lens removal, 50% of participants displayed a reduction in IOP, equal to or lower than the pre-application IOP (–1.0 ± 0.8 mmHg lower than baseline). The remaining 50% of participants displayed an IOP slightly greater than the pre-application IOP (1.6 ± 1.0 mmHg greater) after lens removal.
The researchers reported that short-term fenestrated scleral lens wear resulted in a small, but statistically significant, increase in IOP in 96% of young healthy participants (< 4 mmHg on average), which decreased to a level similar to pre-lens application IOP levels immediately following lens removal. They noted that further research is required to determine if this measured change in IOP during scleral lens wear is artefactual or an elevation in the true IOP.
Cheung SY, Collins MJ, Vincent SJ. The impact of short-term fenestrated scleral lens wear on intraocular pressure. Cont Lens Anterior Eye. 2020 Feb 19. [Epub ahead of print]