One of the more common questions being asked today related to eye care, contact lens practice, and COVID-19 is “Can COVID-19 be transmitted through the ocular surface to a patient or a practitioner?” For example, if practitioners are applying or removing contact lenses to or from a patient’s eyes, should they wear gloves?
The scientific evidence to date shows that while SARS-CoV-2 can be found in the tears, it is found infrequently and inconsistently across studies and case reports. Likewise, there is controversy about the presence of the ACE2 receptor on the ocular surface tissues, as noted by this week’s abstract (the ACE2 receptor appears to be the portal of entry of the virus into our cells, which then allows the virus to replicate in the host). The literature also shows a very low frequency (< 0.5%) of conjunctivitis in patients who have confirmed COVID-19.
There is no clear guidance on the question of wearing gloves as it relates to the application and removal of contact lenses by clinic personnel. To date, most public health authorities suggest treating everyone as COVID-19 positive. And, it would seem that an abundance of caution might be advisable as it relates to direct physical contact with the ocular surface and tear film.
Will you be using gloves in your practice if you have direct physical contact with the ocular surface or tear film? We would like to get your thoughts on this issue. Please email us directly at firstname.lastname@example.org.
Jason J. Nichols, OD, MPH, PhD
Contact Lens Spectrum Offers No-Fee CE on COVID-19 and Contact Lenses
Contact Lens Spectrum is now offering a new No-Fee CE course titled “Key Considerations for Contact Lens Practitioners During the Coronavirus Pandemic.” In this CE activity, you will learn evidence-based information to help advise patients, with an emphasis on contact lens wearers, on the best steps to take to maintain safe contact lens wear during the pandemic. The course faculty are Lyndon Jones, PhD, DSc, FCOptom; Karen Walsh, BSc, MCOptom, PGDip; Mark Willcox, PhD, DSc; Philip Morgan, PhD, MCOptom; and Jason J. Nichols, OD, MPH, PhD. This continuing education activity is supported by unrestricted grants from CooperVision and Johnson & Johnson Vision. For more information and to take the course, visit https://www.clspectrumce.com.
Visionary Offers “Stay Well Kit”
Visionary Contact Lens is offering a free “Stay Well Kit” with the purchase of any specialty lens product made in Boston (Bausch + Lomb) materials to assist consumers during the COVID-19 crisis. This kit includes extra-deep-well lens cases, Boston Advance cleaning and disinfection solution, contact lens wear instructions, and disinfecting wipes, all conveniently packaged in a clear plastic travel bag.
FDA Approves Quidel’s Sofia 2 Antigen Test
Quidel announced that it has received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration to market its Sofia 2 SARS Antigen Fluorescent Immunoassay (FIA), a rapid point-of-care test for the detection of COVID-19.
The Sofia 2 instrument offers two workflows: the Sofia 2 SARS Antigen FIA cartridge is placed inside Sofia 2 for automatically timed development (Walk Away Mode); or test cartridges can be placed on the counter or bench top for a manually timed development and then placed into Sofia 2 to be scanned (Read Now Mode), allowing users to markedly increase testing throughput per hour, according to Quidel.
The assay is currently available for sale in the United States under EUA. Healthcare professionals can purchase the Sofia 2 SARS Antigen FIA through distribution representatives for Cardinal Health, Fisher Healthcare, Henry Schein, or McKesson.
Online Certification Training Available for CooperVision’s Brilliant Futures Myopia Management Program
This month, CooperVision unveiled an online training curriculum so that eyecare professionals (ECPs) can certify to prescribe the Brilliant Futures Myopia Management Program featuring MiSight 1 Day contact lenses. Initially, CooperVision planned in-person trainings at partnering optometry schools throughout the nation but decided to postpone them and provide an online learning option due to the unforeseen circumstances associated with the onset and impact of COVID-19. The online option allows ECPs and their practices to become certified without meeting in-person so that they can prepare to offer the program to their patients and parents. The first online training session opened on April 20, with several more sessions planned through July. CooperVision is also suspending the $1,000 certification fee associated with the training.
The online training program uses an autonomous learning approach that allows ECPs to progress at their own pace and at the time and place of their choice. It includes a five-course syllabus; optional engagement opportunities with peers, faculty partners, and CooperVision’s Myopia Management Team via discussion boards as well as Ask the Expert conference call sessions on key topics; and an optional opportunity to gain Paragon CRT certification. Upon successful completion of the curriculum and online exam, ECPs will work with their dedicated CooperVision Myopia Management Specialist to activate their Brilliant Futures account.
J&J Vision Announces Global Initiatives for During COVID-19 and Beyond
Johnson & Johnson Vision (J&J Vision) is deploying solutions around the world to help address the challenges facing eyecare professionals (ECPs) and their patients amid the COVID-19 pandemic. The company is working to minimize new burdens placed on ECPs to allow them to focus on their patients, business, and families. This includes offering payment terms extensions, contract extensions, and rebate programs, as appropriate. Second, J&J Vision is introducing new virtual professional education resources, providing live trainings, webinars, and on-demand podcasts to help practitioners stay up-to-date on product innovations, clinical techniques, and resources for small business owners. Third, it is collaborating with professional bodies worldwide to support students. Finally, J&J Vision is collaborating with experts in all regions to develop educational resources and materials for ECPs, consumers, media, and government officials, offering educational content on contact lens safety at ACUVUE.com/coronavirus, hosting a Live Chat Agent to address real-time patient questions, and a full program of expert webinars for ECPs in Europe, the Middle East, and Africa.
For the most up-to-date COVID-19 news and tips for eyecare providers, visit bit.ly/2WxiFbA.
And, you can now sign up to receive the weekly PentaVision COVID-19 News Roundup newsletter, a joint publication from Contact Lens Spectrum, Eyecare Business, and Optometric Management.
CooperVision Announces Expansion in Prescription Options for Clariti 1 Day Toric
CooperVision has expanded options for its Clariti 1 Day Toric contact lenses. Expanded options for axes in the –2.25D cylinder power (plano to –6.00D: 70º, 80º, 100º, and 110º) and plus powers (+0.25D to +4.00D: 10º, 80º, 100º, and 170º) are immediately available for shipment.
Valley Contax Releases New Boost Marketing Program
Valley Contax released its new Boost Marketing Program that provides practitioners with complimentary professionally designed and custom branded marketing pieces. The program includes several media options from which to choose—such as patient guides, social media posts, magazine ads, and videos—most of which can be customized with the practice name, logo, photos, and other information. There’s no cost to order as long as the practitioner is a qualified Custom Stable fitter. Those who qualify and want to participate should visit the company’s website, preview the available options, and choose the pieces they’d like to order, enter their information, and upload their logo and photos to finish placing their order. Valley Contax’s marketing department then customizes each piece, and delivery is typically made within a few weeks.
MoonLens Myopia Management Lens System Now Available from Art Optical
Art Optical Contact Lens Inc. announced the availability of MoonLens, a new myopia management orthokeratology lens system developed by the Katt Design Group. The MoonLens Orthokeratology Contact Lens System for overnight use has a progressive design and fitting system that helps manage and temporarily correct myopia as well as mild astigmatism, according to Art Optical. The MoonLens also includes a myopia management feature, allowing customization for a wide range of patients from children to adults. The lens can be built from simple K readings or customized with topography data. According to the company, additional benefits of the MoonLens system include the availability of toric peripheries at no additional charge, a complimentary patient starter pack with each order, and discounted spare lens pricing.
The MoonLens is backed by Art Optical’s No-Worry Warranty program that includes unlimited exchanges, full cancellation privileges, and no lens returns required for fit and Rx changes for 120 days as well as consultation support and expedited manufacturing and shipping options.
MoonLens is made in Boston (Bausch + Lomb) lens materials. And, as part of the Bausch + Lomb Vision Shaping Treatment/VST Program, professional training/certification is required to prescribe the lens. Certification is accessible at artoptical.com/mooncertification.
Blanchard Contact Lenses Launches Onefit Spotlight Program
Blanchard Contact Lenses announced the launch of its new Onefit Spotlight program, which was designed to highlight the great work of those who are fitting the Onefit family of scleral lenses. Practitioners are asked to submit case reports for their Onefit, Onefit Med, Onefit Med+, or Onefit Asian fits using a standardized form. Cases selected will be posted to the Blanchard website and shared with the specialty eyecare community via social media channels, email blasts, and though partners such as Contamac (which is sponsoring the program). In addition, Blanchard will sponsor some of their favorite cases for poster submission to the 2021 Global Specialty Lens Symposium.
AOA to Host Virtual Learning Livecast
The American Optometric Association (AOA) will be hosting the AOA 2020 Virtual Learning Livecast on June 24 through 27. The event will feature four days of interactive continuing education and professional development. The AOA will offer more than 60 continuing education (CE) and professional development courses specifically designed for doctors of optometry, paraoptometric staff, and students. Attendees will be able to earn up to 26 hours of CE credits. Additionally, many of the courses will be offered in the evening to accommodate school and work schedules. The full event course schedule will be available soon. Preregister prior to June 23 at www.aoa.org/virtuallearninglivecast.
Dr. Carol Alexander Named 2020 Distinguished Alumna
In recognition of her career-long commitment to eye health, mentorship, and advancing the optometric profession, The Ohio State University College of Optometry Alumni Society has named Carol Alexander (OD ’87) as the recipient of its 2020 Distinguished Alumna Award.
Dr. Alexander received her Doctor of Optometry degree from The Ohio State University College of Optometry in 1987. And, after working for two Toledo-area optometrists, she established her own independent private practice in Sylvania, OH in 1991. Early in her career, she was recognized as both the Ohio (’92) and the national (’97) Young Optometrist of the Year. Her contributions included the active, successful pursuit of therapeutic legislation in Ohio and spearheading quality assurance initiatives in the profession at both state and national levels, including chairing the American Optometric Association Commission on Quality Assessment and Improvement (’98-’99). She was elected to the Ohio Optometric Association (OOA) Board of Trustees in 1994 and was the first woman to serve as president of the OOA in 1999-2000. During her presidential term, she chaired the Strategic Planning Committee to change the basic operations of the organization. She was named Ohio’s OD of the Year in 2006.
In 2008, Dr. Alexander’s career focus changed from direct patient care to prioritizing eye health within the eyecare industry. Her current position as head of North America Professional Relations for Johnson & Johnson Vision allows her to strengthen the company’s relationship with the optometric community in the United States and to partner with national optometric associations and organizations to advance eye health and patient care. In 2018, she received the Dr. Rodger Kame Award for Outstanding Service to the American Optometric Association Contact Lens & Cornea Section, and she twice has been named one of Vision Monday’s Most Influential Women.
This prestigious honor traditionally is bestowed upon the winner during the College of Optometry’s convocation ceremony after a rigorous selection process by the Optometry Alumni Society Board. This year, due to COVID-19, the celebration has been postponed. Dr. Alexander will be honored with the Class of 2020 when it is safe to celebrate as a group.
TearLab Announces Acquisition By Accelmed Partners
TearLab Corporation announced that it has entered into a definitive agreement pursuant to which Accelmed Partners II (AP-II) will acquire TearLab. In connection with the acquisition, AP-II has agreed to an investment of $25 million over two tranches that will occur in conjunction with the company delisting from the “over the counter” OTCQB market. Additionally, TearLab and its senior secured lender, CR Group, has agreed to restructure the terms of the company’s outstanding senior secured indebtedness. Post-transaction, TearLab will be a private company, and AP-II will be the controlling shareholder. Proceeds from the AP-II investment will be used to pay down a portion of TearLab’s existing debt and will fund both organic and inorganic growth opportunities.
As part of the transaction, Dr. Uri Geiger, founder and managing partner of Accelmed Partners, will become chairman of the Board, and Accelmed Partners’ general partner, Lior Shav, who led the transaction, will join the company’s board of directors. Seph Jensen, TearLab’s CEO, will remain a board member.
TearLab’s Board of Directors has unanimously approved the transactions and recommended that its shareholders approve the acquisition. Closing of the transaction is subject to approval by TearLab shareholders. The transaction is expected to close in the second quarter of 2020 and is not subject to any financing condition.
AbbVie Inc. Completes Acquisition of Allergan plc
Allergan plc announced that AbbVie has now completed the acquisition of Allergan pursuant to a scheme of arrangement under Chapter 1 of Part 9 of the Irish Companies Act 2014, which became effective on May 8, 2020. Payment to Allergan shareholders of the consideration to which they are entitled under the scheme will be made within 14 days in accordance with the terms of the scheme and is expected to commence as soon as practicable.
AAOF Announces 2020 Johnson & Johnson Vision Award of Excellence in Contact Lens Patient Care Grant Recipients
The American Academy of Optometry Foundation (AAOF) announced the 2020 Johnson & Johnson Vision Award of Excellence in Contact Lens Patient Care Grant recipients. This award recognizes outstanding fourth-year student clinicians who have demonstrated skillful knowledge of the contact lens field. Each winner will receive a $500 educational award and a personalized plaque commemorating his or her accomplishment. The 2020 recipients and institutions attended include:
Alice Han, Illinois College of Optometry
Tyler Kerr, Indiana University, School of Optometry
Patrick Patterson, Inter American University of Puerto Rico, School of Optometry
Nicholas Pike, Massachusetts College of Pharmacy and Health Sciences, School of Optometry
Abigail Zielke, Michigan College of Optometry at Ferris State University
Taylor Erhardt, Midwestern University Arizona, College of Optometry
Esther Lee, New England College of Optometry
Kristen Moore, Northeastern State University Oklahoma College of Optometry
Crystal Victor, Nova Southeastern University, College of Optometry
Jasmine Barker, The Ohio State University, College of Optometry
Liandra Jung, Pacific University, College of Optometry
Janice Chau, Pennsylvania College of Optometry at Salus University
Taylor Kiyota, Southern California College of Optometry at Marshall B. Ketchum University
Jared Freedman, Southern College of Optometry
Mariya Klyuzner, State University of New York, College of Optometry
Mohammed Haque, University of Alabama at Birmingham, School of Optometry
Connie Chen, University of California Berkeley, School of Optometry
Megan Wagner, University of Houston, College of Optometry
Caroline Mendus, University of Missouri-St. Louis, College of Optometry
Camille Leblanc, University of Montreal, School of Optometry
Nitya Murthy, University of Pikeville, Kentucky College of Optometry
Brooke Segerstrom, University of the Incarnate Word, Rosenberg School of Optometry
Angela Zhang, University of Waterloo, School of Optometry and Vision Science
Esther Lautz Abuata, Western University of Health Sciences, College of Optometry
Envision Dallas Names Amy Britton Vice President of Development
Envision named Amy Britton vice president of development for Envision Dallas. In her new role, she will develop and execute a comprehensive fundraising plan for Envision Dallas consisting of individual giving and corporate giving, major gifts, special events, and grant development. Envision Dallas serves 150,000 individuals who are blind or have low vision living in 11 North Texas counties: Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Hunt, Kaufman, Navarro, and Rockwall.
The CDC is relaxing its recommendation to postpone routine eyecare and to use CMS guidance for re-opening facilities. How fast do you plan to ramp up clinical activities for non-emergent eye care?
This patient suffered trauma that eventually resulted in a traumatic iridectomy. We are in the process of fitting her with a prosthetic lens to help with induced glare.
We thank Dr. Gulmiri 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 New Normal…Telehealth’s Role in Contact Lens Practice
As many eyecare practitioners (ECPs) are just beginning to re-enter comprehensive and more regular live care, we all are traversing this new world the best way that we can. The use of telehealth has allowed many of us to address some of the less serious and severe urgent care situations during our stay-at-home period. Now that we are returning to our “new normal” of regular care (hopefully in a protected and safe way), can telehealth play a significant role from this point forward? Specifically, can it be utilized in our contact lens practice?
A paper was recently published that explored this question.1 In it, the authors stated that “the indeterminate period over which conventional practice will be suspended, and the risk that resumption of ‘normal’ practice could be impeded by a potential secondary peak in COVID-19 cases, hastens the need for practitioners to adapt their delivery of eyecare. Specifically, it is prudent to reflect upon supportive evidence for more comprehensive approaches to telehealth in contact lens practice.” They further go on to caution ECPs with regard to current technologies associated with telehealth by mentioning that “digital photographs, may be useful for detection of gross anterior eye changes, but subtle changes are less discernible. For the assessment of visual acuity, many electronic test charts have been validated for use by practitioners. Research into self-administered visual acuity measures remains limited. The absence of a comprehensive evidence base for telehelath limits ECPs, particularly during this pandemic. Knowledge gaps ought to be addressed to facilitate development of optometry specific evidence-based guidance for telecare. In particular, advances in ocular self-imaging could help move this field forwards.”
So, the authors are telling us that in the new normal world in which we will all be practicing, we will need to adapt and that telehealth, although likely to take on a much greater role, may be limited in its application by the current state of the technologies available. That said, I am a firm believer that the “technology finds its way.” The obstacles will be addressed, and remote healthcare services, including contact lens services, will be a successful part of eyecare practice (and this will be sooner rather than later). My suggestion is to get on the telehealth train. At our practice, the use of telehealth is expanding exponentially since COVID-19 changed our world.
1. Nagra M, Vianya-Estopa M, Wolffsohn JS. Could telehealth help eye care practitioners adapt contact lens services during the COVID-19 pandemic? Cont Lens Anterior Eye. 2020 Apr 18. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
Implement Precautions in All Beauty Segments
By one business analyst’s April 2020 estimate, the false eyelashes market is poised to grow by $363.84 million during 2019 to 2023, progressing at a compound annual growth rate (CAGR) of 5% during the forecast period.1
The global false eyelashes market has been categorized by type as strip lashes, individual flare lashes, and single individual lashes. And, according to a Market Research Future Report analysis, the strip lashes segment is expected to hold the majority market share, and the same segment is projected to register the highest CAGR during the review period.2
On the basis of raw material, the global false eyelashes market has been segmented as synthetic hair, human hair, animal hair and fur, and others. The global false eyelashes market has also been bifurcated into machine-made and handmade based on the production process. The machine-made segment dominated the market in the year 2018. However, the handmade segment is expected to be the fastest growing segment during the forecast period.2
Finally, the false eyelashes market has been categorized, on the basis of the distribution channel, as store-based and non-store-based. The store-based segment has further been divided into supermarkets and hypermarkets, specialty stores, and others. The store-based segment is expected to account for the larger revenue share of the market. However, the non-store-based segment is expected to exhibit a higher growth rate during the forecast period of 2019 to 2024.2
In response to COVID-19, manufacturers and specialty trainers for false eyelash aestheticians have been conducting COVID-19 in-service sessions with trainers across the United States. The purpose of these sessions was to reinforce and implement additional safety, sanitation, hygiene, and infection-control operating procedures during training and for active practice.3
It will interesting to see how the downstream effects of the COVID-19 pandemic on the economics, supply chains, and patient perceptions and demands for this segment of the beauty industry will be impacted. What would be your prediction?
Expression of the COVID‐19 Receptor ACE2 in the Human Conjunctiva
SARS‐CoV‐2 is assumed to use angiotensin‐converting enzyme 2 (ACE2) and other auxiliary proteins for cell entry. Recent studies have described conjunctival congestion in 0.8% of patients who have laboratory‐confirmed SARS‐CoV‐2, and there has been speculation that SARS‐CoV‐2 can be transmitted through the conjunctiva. However, it is currently unclear whether conjunctival epithelial cells express ACE2 and its cofactors.
In this study, a total of 38 conjunctival samples from 38 patients—including 12 healthy conjunctiva, 12 melanoma, seven squamous cell carcinoma, and seven papilloma samples—were analyzed using high‐throughput RNA sequencing to assess mRNA expression of the SARS‐CoV‐2 receptor ACE2 and its cofactors including TMPRSS2, ANPEP, DPP4, and ENPEP. ACE2 protein expression was assessed in eight healthy conjunctival samples using immunohistochemistry.
The study’s results indicate that the SARS‐CoV‐2 receptor ACE2 is not substantially expressed in conjunctival samples on the mRNA (median 0.0 transcripts per million [TPM], min 0.0 TPM, max 1.7 TPM) and protein levels. Similar results were obtained for the transcription of other auxiliary molecules.
In conclusion, this study finds no evidence for a significant expression of ACE2 and its auxiliary mediators for cell entry in conjunctival samples, making conjunctival infection with SARS‐CoV‐2 via these mediators unlikely.
Lange C, Wolf J, Auw‐Haedrich C, et al. Expression of the COVID‐19 receptor ACE2 in the human conjunctiva. J Med Virol. 2020 May 6. [In Press]