There is a lot of interest today in the neurobiological aspects of dry eye disease in addition to contact lens wear (note this week’s abstract). While there is much to investigate, we are seeing the field move toward trying to develop a better understanding of sensations associated with the front of the eye, and the neurobiological aspects of these sensations. Many are even proposing that some forms of dry eye disease, and perhaps even contact lens dry eye, are neurotrophic conditions—and although the exact mechanism of this is unknown, many possibilities are being explored. Stay tuned for in-depth coverage of this in our July Dry Eye Issue of Contact Lens Spectrum.
Jason J. Nichols, OD, MPH, PhD
Papa Assumes Role of Chairman and CEO of Valeant Pharmaceuticals
Valeant Pharmaceuticals International, Inc. announced that Joseph C. Papa has assumed the role of Chairman and Chief Executive Officer. Joseph C. Papa succeeds J. Michael Pearson.
Papa has more than 35 years of experience in the pharmaceutical, healthcare services and specialty pharmaceutical industries, including 20 years of branded prescription drug experience. Papa has been CEO of Perrigo since 2006 and was appointed as Chairman of the Board of Directors of Perrigo in 2007. During his tenure, he led dramatic and consistent growth across the company, building it into a global leader with net sales of more than $5 billion. Prior to Perrigo, he served from December 2004 to October 2006 as Chairman and Chief Executive Officer of the Pharmaceutical and Technologies Services segment of Cardinal Health, Inc. From 2001 to 2004, Papa served as President and Chief Operating Officer of Watson Pharmaceuticals, Inc. Papa has held management positions at DuPont Pharmaceuticals, Pharmacia Corporation, G.D. Searle & Company and Novartis AG. While at Novartis and Pharmacia /Searle, he was responsible for overseeing the successful launches of Diovan, Celebrex and Lotrel.
Mr. Papa serves as a director of Smith & Nephew, a developer of advanced medical devices. He is a graduate of the University of Connecticut with a bachelor's degree in pharmacy and he earned his MBA from Northwestern University's Kellogg Graduate School of Management.
TearScience Introduces LipiScan for Rapid High Definition Meibomian Imaging
TearScience, manufacturer of LipiView II and LipiFlow, for the treatment of meibomian gland dysfunction (MGD), announced the release of LipiScan, the first and only dedicated high definition (HD) gland imager that allows eye care professionals (ECPs) to efficiently evaluate meibomian glands in busy practices.
The new rapid imager was created with end users in mind. According to the company, LipiScan is fast and intuitive and harnesses patented dynamic meibomian imaging (DMI) technology to produce high definition images of meibomian glands. LipiScan allows ECPs to assess meibomian gland structure during routine workups in any practice setting.
In the past year, TearScience embraced the feedback of ECPs by significantly adjusting prices of LipiView II and LipiFlow equipment and treatment Activators (Disposables). The introduction of LipiScan will allow busy practices to efficiently integrate assessment of meibomian glands and do so at an affordable price.
Last Patient Enrolled in Phase 2 Clinical Trial of CyclASol
Novaliq GmbH, a pharmaceutical company with a disruptive drug delivery platform that transforms poorly soluble drugs into effective therapeutics for ophthalmology, announced the completion of enrollment in its Phase 2 clinical trial that is evaluating the safety, efficacy and tolerability of CyclASol for the treatment of moderate to severe dry eye disease (DED). CyclASol is a clear, preservative-free ophthalmic solution of cyclosporine A formulated using Novaliq’s proprietary EyeSol technology.
The double-masked, placebo-controlled, multi-center Phase 2 trial enrolled 207 patients who were randomized to one of four treatment groups that included two CyclASol groups, a placebo (vehicle control) group and an open label cyclosporine A 0.05% ophthalmic emulsion group. Study subjects are self-administering one drop twice daily, and returning for examination periodically and at the end of the trial at four months. The trial is being conducted in four sites in the U.S. Topline results are anticipated by the end of 2016.
Survey Reports Many Americans Putting Vision at Risk from Sun Damage
Three-quarters of Americans are concerned about potential eye problems from the sun's ultraviolet (UV) rays, yet only 31 percent protect their eyes with UV-protective eyewear every time they go outside, according to a new report by The Vision Council. Based on a nationwide survey of more than 10,000 adults, the report finds 34 percent of adults have experienced symptoms of prolonged UV exposure, such as eye irritation, trouble seeing, and red or swollen eyes.
The report, Spare Your Sight: Using Shades for Protection and Style, shows that even though Americans fear vision loss, taking the protective measure of wearing sunglasses is not a high priority. Sunglasses are often forgotten or just not kept on hand, while the protective value of sunscreen and hats to shield skin from UV damage seems to be better understood and more frequently practiced. In the survey, Americans were much more likely to identify the long-term effects of the sun on skin – such as skin cancer (51 percent) and sunburn (42 percent) – compared with the serious UV impacts on vision, such as sunburned eyes (31 percent), cataracts (26 percent) or age-related macular degeneration (21 percent).
Other key findings from the survey include:
Many Americans are only sporting sunglasses when they are outside for two or more hours (39 percent).
Parents are more likely to wear shades always or often (56 percent) than their children (29 percent).
Millennials are least likely to protect their vision: 55 percent of people in their 20s never, rarely or only sometimes wear sunglasses.
The Vision Council commissioned the VisionWatch Survey in December 2015, surveying 10,279 adults 18 and older through an online survey tool. To view or download a copy of the report, visit www.thevisioncouncil.org/uv.
Men, we are disgusting. We are pathetic. One of the worst things about walking into a men’s restroom at the airport, or anywhere for that matter, is seeing what men do, or rather DON’T DO. An exorbitant number of them do not wash their hands. This is disgusting, revolting, horrible, repulsive, and nauseating. This is the same man that shakes my hand, sits next to me on an airplane, touches the door handle that I grab, and puts a contact lens in his eye. (Woman, I realize that although you are the fairer sex, you’re pretty bad too).
Honestly folks, patients are the worst. It doesn’t matter whether your patient is a scleral lens wearer or a single use patient, if they do not wash their hands, nasty, ghastly, and vile things are going to end up in the eye ball.
As dentists have penetrated our habit bank with brushing our teeth, let’s work to breach the vault with hand washing. I know we teach patients when they begin contact lens wear, but maybe we should remind them at each exam. (FYI: I finally helped my patient who instinctively licked his finger every time he inserted his lens.)
Please share with our community some of the stories of how silly your patients are via our social mechanisms @CLSpectum and @davekading on twitter.
CARE SOLUTION CORNER Andrew D. Pucker, OD, PhD, FAAO
Reusing Daily Disposable Contact Lenses
One reason why we fit our patients in daily disposable contact lenses is because patients who wear these contact lenses are more likely to replace them on time compared to patients who wear 2-week or 1-month contact lenses.1 Nevertheless, 15% to 18% of daily disposable contact lens wearers fail to replace their contact lenses on schedule.1 While patients indicate that there are a number of reasons (e.g., forgetfulness, lack of perceived harm) why they are noncompliant, daily disposable contact lens wearers most frequently cite cost.1 This corner-cutting may seem harmless to patients; however, it is our job to fully advise our patients about the potential risks associated with this practice.
Daily disposable contact lens wearers may increase their wearing days by either continuously wearing their contact lenses overnight, which increases their chances of developing a microbial keratitis, or they may alternatively take out and store their contact lenses overnight and reuse them the next day.2, 3 Improper storage of daily disposable contact lenses is particularly concerning because eye care providers generally do not prescribe care systems for this modality; without a clear plan for lens storage, patients may store their contact lenses in their old blister packs, which again may increase their chances of being exposed to harmful microorganisms.3 We can combat this problem by educating all of our patients about the importance of replacing their contact lenses on schedule. You could also prescribe a multipurpose care system to all of your daily disposable contact lens wearers, impressing upon them the importance of proper contact lens care. Having a readily available multipurpose solution could also prove to be useful to your patients when they need to clean a dirty contact lens midday, and it could even help them avoid storing their daily disposable contact lenses in blister packs when they are misbehaving.
1. Dumbleton K, Richter D, Woods C, Jones L, Fonn D. Compliance with contact lens replacement in Canada and the United States. Optom Vis Sci 2010;87:131-139.
2. Stapleton F, Keay L, Edwards K, Holden B. The epidemiology of microbial keratitis with silicone hydrogel contact lenses. Eye Contact Lens 2013;39:79-85.
3. Boost M, Poon KC, Cho P. Contamination risk of reusing daily disposable contact lenses. Optom Vis Sci 2011;88:1409-1413.
Effects of Long-term Soft Contact Lenses on Tear Menisci and Corneal Nerve Density
The researchers investigated the relationship between tear menisci and corneal subbasal nerve density (SND) in long-term soft contact lens (CL) wearers.
Three groups were enrolled for this study: asymptomatic non-CL controls (N-CL group), asymptomatic soft CL wearers (A-CL group), and symptomatic soft CL wearers with self-reported moderate to severe dryness (S-CL group). Upper and lower tear menisci height (UTMH, LTMH) and area (UTMA, LTMA) were measured by optical coherence tomography. This was followed by measurements of fluorescein tear breakup time, fluorescein staining, and the Schirmer I test. In vivo confocal microscopy measured the SND in the nasal, central, and temporal regions of the cornea.
The UTMH, UTMA, LTMH, and LTMA were significantly lower in the S-CL group compared with the N-CL group (P<0.05). The combined corneal SND of the temporal and nasal regions of the S-CL group was lower than for the N-CL group (P<0.05). The LTMH was correlated with the SND of the temporal (r=0.410), nasal (r=0.423), combined temporal and nasal (r=0.516), and combined temporal, nasal, and central regions (r=0.430, all P<0.01). The LTMA was also correlated with the SND of the temporal (r=0.379), nasal (r=0.292), combined temporal and nasal (r=0.422), and combined temporal, nasal, and central regions (r=0.367, all P<0.05). The temporal and nasal corneal SNDs were more strongly correlated with the LTMH and LTMA than with the UTMH and UTMA.
The authors concluded that soft CL wearers with dry eye symptoms have reduced tear menisci. The alteration of midperipheral corneal SND may contribute to dry eye symptoms.
Hu L, Chen J, Zhang L, Sun X, Huang J, Xie W, Zhang D, Wang Q. Effects of Long-term Soft Contact Lenses on Tear Menisci and Corneal Nerve Density. Eye Contact Lens. 2016 Apr 13. [Epub ahead of print]