As noted in our Quick Poll this month, the majority of respondents (74%) feel that the ability to provide a contact lens care starter kit to patients has a direct influence on the practitioners’ care system prescribing patterns. This may be reflective of the practitioners who desire to recommend specific lens care products to patients.
In our annual report in 2017 (https://www.clspectrum.com/issues/2018/january-2018/contact-lenses-2017), we noted that 82% of practitioners prefer to prescribe a specific lens care product to their patients, which was primarily for comfort and safety reasons. While there are costs associated with these starter kits, perhaps these monies are well spent relative to practitioners continuing to be able to prescribe what they feel is best for their patients.
Jason J. Nichols, OD, MPH, PhD
Essilor of America and American Academy of Optometry Announce New Academic Student Challenge
Essilor of America and the American Academy of Optometry announced a new event for students—Essilor Academic Challenge @ Academy Stadium. The competition will be comprised of digital competition components by teams at each school and college of optometry, culminating in a final showdown at Academy 2018 San Antonio on Nov. 8 from 7:00 to 10:00 p.m.
School teams will be comprised of three students at varying points in their academic career and one faculty coach. These academic teams will compete against each other in an entertaining environment to see which team has what it takes to win the coveted title. All Academy 2018 San Antonio attendees are invited to attend the live competition event held during the meeting.
Aveo Hello Contact Lenses Available Via Online Subscription
Aveo Hello contact lenses are available for online subscriptions this spring 2018. With a monthly plan, Aveo Hello contact lenses cost $1 a day and shipping is always free. According to the company, the lenses feature biocompatible AquaLock Technology to help improve wettability. In addition, the Aveo Hello BlissEdge Design features a dual-tapered edge that allows more water and oxygen around the lens and keeps the lens centered, according to the company. Aveo says that the Aveo Hello aspheric optics design provides HD vision. Aveo's lenses are made with omafilcon A with 58% water content. The lenses utilize a Class II UV Blocker that prevents on average 97% of UVB and 87% of UVA radiation.
These U.S. Food and Drug Administration-cleared lenses are available with a base curve of 8.6mm, a diameter of 14.2mm, a center thickness (at –3.00D) of 0.07mm, and a light blue visibility tint.
AccuLens Hires New Western Region Sales Manager
AccuLens named Brett Cochran western regional sales manager. Mr. Cochran was employed as a chief deputy district attorney for 14 years prosecuting criminals in the Denver area. As western regional sales manager, he will be based in Denver and will serve the western United States helping eyecare practitioners integrate specialty contact lenses in their practices.
New Drug-Eluting Contact Lens to Provide Timed Drug Delivery Directly to Eye
A new, extended wear contact lens, developed by biomedical researchers at Rowan University and Auburn University, controls the release of anti-inflammatory, antibiotic, and pain-reducing drugs that are delivered evenly over time. The new technology can potentially reduce recovery time and postoperative complications, thereby reducing health care cost, according to the announcement.
OcuMedic is expected to begin clinical studies necessary for U.S. Food and Drug Administration (FDA) clearance this year, first as an in-vivo study for the FDA to navigate into the Phase 1/2 human trials in 2019.
The technology is covered by nine U.S. patents and is expected to be the first product of its kind on the market, once approved.
Mark E. Byrne, PhD, founding head and professor of Biomedical Engineering at Rowan University, inventor of the technology, and previously a distinguished professor at Auburn University and chief technical officer of OcuMedic, Inc., and OcuMedic have received approximately $1.85 million in funding to date, including research funding from the National Institutes of Health, and have recently received an undisclosed amount from a national angel investor group and are staging for a Series A funding in the $4 million range.
ABDO Appoints New Head of CET
The Association of British Dispensing Opticians (ABDO) has appointed Alexandra Webster to take over from the outgoing head of continuing education and training (CET), Paula Stevens. Ms. Webster will take over for Ms. Stevens in August. In the meantime, Ms. Stevens will handle the distance learning aspect of ABDO CET.
Ms. Webster is a dispensing and contact lens optician as well as a practical examiner for ophthalmic dispensing, a probationary contact lens examiner, and a practice visit assessor for ABDO.
Mark’ennovy Launches in Australia
Mark’ennovy launched its current portfolio of lenses in Australia; they will be available via a new ordering platform that has been specifically designed for Australia. The local team will be led by Asia Pacific managing director Mr. Chris Harous, a contact lens specialist with more than 40 years of experience in the industry.
Prior to its arrival in Australia, Mark’ennovy announced a partnership with the Brien Holden Vision Institute (BHVI) to bring to market new designs of soft contact lenses that aid with myopia management and address presbyopia. The silicone hydrogel myopia management lens is set to be released in September and will feature BHVI’s patented Extended Depth of Focus design. It will also be available in an extended range of diameters, base curves, and spherical powers.
Does your ability to use contact lens care starter kits influence your prescribing patterns associated with contact lens care solutions?
Hamed Momeni-Moghaddam, BSc, MSc, and Mohammad-Reza Sedaghat, MD, Mashhad, Iran
A 19-year-old young woman presented with sudden onset and rapid progression of ocular pain, redness, tearing, photophobia, and blurred vision in her right eye from the day before, after several hours of wearing a colored soft contact lens. On examination, the most important clinical features were a corneal epithelial defect, a stromal infiltrate, and corneal edema associated with a ring configuration in the superior paracentral area of the cornea. (Figure 1A and Figure 1B). The clinical characteristics indicated a bacterial keratitis caused by a gram-negative organism, most likely Pseudomonas aeruginosa.
Treatment was started with more frequent use of intensive fortified combined topical antibiotics including amikacin (semi-synthetic aminoglycoside), cefazolin (cephalosporin), and ceftazidime (cephalosporin). In addition, complete culturing and microbiological evaluation identified the causative agent to be Pseudomonas aeruginosa.
The patient was re-evaluated one and three days later. At three days later, assessment showed significant improvement in patient symptoms and visual recovery. The infiltration decreased, and the eye had quieted significantly, although a slight thinning was apparent in the slit lamp examination in the affected area (Figure 1C and Figure 1D). At this phase, tapering of antibiotic therapy was started very slowly, and the course and prognosis of the disease were described again for the patient.
We thank Hamed Momeni-Moghaddam and Dr. Sedaghat for these images 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
Long-Term Safety and Efficacy of Corneal Reshaping/OK
The controversies over both efficacy for myopia management and safety profiles for corneal reshaping (a.k.a. overnight orthokeratology [OK]) are diminishing based on a preponderance of evidence that supports this modality of vision correction. A study was recently published that looked at the long-term response to overnight corneal reshaping.1 The intent of this study was to compare rates of myopia progression and adverse events between orthokeratology (OK) and soft contact lens (SCL) wearers over a 10-year period in schoolchildren.
Medical records of consecutive patients (≤16 years of age at baseline) who started OK for myopia correction and continued the treatment for 10 years were retrospectively reviewed. For the control group, patients who started using soft contact lenses (SCLs) for myopia correction and continued to use them for 10 years were also reviewed. Clinical data, including sex, age, manifest refraction, visual acuity, prescription lens power, and adverse events during the 10-year period, were recorded. A total of 104 eyes of 53 patients who underwent OK treatment and 78 eyes of 39 patients who wore SCLs fulfilled the criteria.
The estimated myopia progression over the 10-year period in the OK and SCL groups was –1.26D ± 0.98D and –1.79D ± 1.24D, respectively; this difference was statistically significant (p = 0.001). Additionally, lower myopia progression was found in the OK group in comparison to the SCL group at all baseline ages (p = 0.003 to p = 0.049) except at 16 years old (p = 0.41). There was no significant difference in the number of adverse events found between the OK (119) and SCL (103) groups (p = 0.72). The authors of the study concluded that the results support long-term efficacy and safety of OK lens wear in reducing myopia progression in schoolchildren.
When we began treating patients by using overnight corneal reshaping following U.S. Food and Drug Administration (FDA) clearance (now almost 20 years ago!), the evidence for its ability to control myopia progression was limited, although we surely saw clinical evidence of such. The safety issues for overnight use were based on the outcomes of the FDA trials (Note: use for myopia control is still off-label).
However, since then, extensive research and study has been performed that supports both the efficacy of corneal reshaping for correction of myopia and control of myopia progression as well as the safety of the treatment when compared to other modalities of contact lens wear. The controversy should be put aside, and all eyecare professionals should consider overnight corneal reshaping/OK to be an acceptable modality of vision correction.
1. Hiraoka T, Sekine Y, Okamoto F, Mihashi T, Oshika T. Safety and efficacy following 10-years of overnight orthokeratology for myopia control. Ophthalmic Physiol Opt. 2018 May;38:281-289.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Reducing Ocular Redness
It is very exciting to have a new option available to reduce and relieve eye redness (ocular surface injection).
After review of the many eye conditions that precipitate conjunctival redness, with and without inflammation, there are potential opportunities in which simple “aesthetic relief” would be paramount to patients’ satisfaction, perhaps precluding surgical management for the basis of eye redness. Eyecare practitioners (ECPs) have considered a number of conjunctival pathologies that include degenerative disorders of the conjunctiva such as conjunctivochalasis, pingecula and pterygia… Can dry eye be included in this list?
Similarly, ECPs await clinical and evidence-based research on how and whether ocular redness reduction could change the natural course of conjunctival pathology, impact ocular rosacea and meibomian gland dysfunction (MGD), or enhance patient compliance—all as they manage other ocular conditions. ECPs also wonder how and whether a remedy to ocular redness will mask serious pathologies, but they are confident that an eye’s other warning signals of dysfunction will continue to bring patients to us for care.
However, a clinically tested, safer therapeutic option to currently marketed ocular vasoconstrictors is welcomed as we counsel our patients who are troubled by their eye redness.
Hybrid Contact Lenses for Visual Management of Patients After Keratoplasty
This purpose of this study was to report the outcomes of new-generation hybrid contact lenses for visual rehabilitation of post-keratoplasty patients.
Twenty eyes of 20 patients post-keratoplasty were fitted with hybrid lenses. Each patient's keratometric values, ocular surface irregularity indices, central corneal thickness (CCT), uncorrected visual acuity (UCVA), spectacle-corrected visual acuity, contact lens-corrected visual acuity, contact lens fitting data, and contact lens daily wearing time were recorded. Follow-up examinations were performed at the one-week, one-month, and three-month visits after successful fitting of the lenses.
The mean age of the patients was 38.42 ± 4.89 years. The mean spherical component of refractive error was –4.46D ± 2.10D, and the mean astigmatism was –5.31D ± 1.55D. The median UCVA was 1.00 logMAR, which improved to 0.40 logMAR after spectacle correction. The median visual acuity with hybrid contact lenses was 0.05 logMAR. The median CCT was 544.4μm and increased to 549.2μm at three months after contact lens wear. The difference was not statistically significant (P = 0.38). The mean follow up of patients was 4.32 ± 0.45 months. Eighteen of 20 patients reported a mean of 8.37 ± 1.95 hours of comfortable wearing time per day during this period. Two patients discontinued contact lens wear due to conjunctival hyperemia. No graft-related complications such as decompensation, rejection, and infection were documented during the follow-up period.
The researchers concluded that the new-generation hybrid contact lenses can be considered helpful in the visual management of post-corneal graft patients, particularly those who are unable to achieve an adequate visual outcome with spectacles.
Altay Y, Balta O, Burcu A, Ornek F. Hybrid contact lenses for visual management of patients after keratoplasty. Niger J Clin Pract. 2018 Apr;21:451-455.