As you probably have seen, there have been a number of stories in the popular news media about complications associated with cosmetic contact lenses. This is usually the case around Halloween in the United States, and these stories always remind me about the dangers of non-prescribed and non-compliant contact lens wear. Stay vigilant in your education of patients and the public on safe contact lens wearing habits.
Jason J. Nichols, OD, MPH, PhD
TearScience Announces New Pricing Strategy
TearScience has announced a 50% price cut, effective immediately, on the single-use activators used with the LipiFlow treatment platform for Meibomian Gland Disease (MGD). The move is just one component of an overall strategy to make the LipiFlow and LipiView Technologies more accessible to eyecare professionals (ECPs), who can then, in turn, use them to evaluate and intervene earlier in MGD for the benefit of individuals suffering from this chronic and progressive obstructive gland disease.
According to the company, after recent growth in use of its LipiFlow technology, TearScience is achieving the economies of scale necessary to reorganize and expand its supply and manufacturing capabilities. Furthermore, TearScience brought on board a new management team with a renewed mission to meet a market need of technology and treatment accessibility. Earlier this year, TearScience lowered the price of its technologies and removed imaging fees.
MGD causes signs and symptoms that may mimic several eye diseases, making its evaluation and assessment difficult using standard clinical measures. TearScience has sought to facilitate the ECP’s ability to evaluate and assess MGD by designing, manufacturing, and distributing technology to evaluate the structure and function of the meibomian glands. TearScience bolstered this commitment with the introduction earlier this year of Dynamic Meibomian Imaging (DMI), a new paradigm in imaging of meibomian glands that provides exceptional clarity in visualization of the gland structure.
Alden Optical Simplifies Pricing and Expands Consultation Team
Alden Optical announced that effective Monday, November 2, 2015 it will eliminate Divisional Pricing currently associated with the company’s HP and Classic line of custom spheres and torics. From this point forward, pricing for any Rx power of these designs will be at the current Division I level. According to the company, divisional pricing is a vestige of another era when there was real difference between high and low Rx lenses in the cost to manufacture. With Alden’s state-of-the-art digital lathing, the company can make a minus 14D lens for literally the same cost as a minus 2. This change simplifies pricing for our customers and for the company. In the United States Alden Optical lenses are available either direct from the company or via The ABB Optical Group, the company’s exclusive U.S. distributor.
Alden also announced that Andy Taddeo, FCLSA, NCLE-ADV has joined the company as a Product Specialist. Taddeo’s primary responsibility will be to consult with eyecare practitioners on complex specialty fitting towards successful outcomes with Alden designs. He brings to Alden over 30 years of hands-on specialty fitting in several Central New York practices and is infinitely familiar with the Alden Optical line of custom and specialty lenses.
Don’t Miss the 10th Global Specialty Lens Symposium
The 10th Global Specialty Lens Symposium will be held January 21 – 24, 2016 at Caesars Palace Las Vegas, Nevada. The GSLS is a must-attend meeting, brought to you by Contact Lens Spectrum, focusing on the successful management of ocular conditions using today's specialty contact lenses. This meeting will include insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.
The 2015 event was attended by almost 600 registrants from 36 countries, 42 states, Puerto Rico and Guam. It continues to be the largest conference of its kind in the U.S.
Join your peers in 2016 for the 10th anniversary in Las Vegas! Visit www.GSLSymposium.com for more information.
How Contact Lenses Were Made in 1948
A newsreel unearthed by British Pathé and presented on Smithsonian.com, opens with a close-up shot of a woman without glasses. "This girl is wearing glasses," a narrator says, but of course, she's wearing contact lenses. The video goes on to describe and show how the lenses were made by an Australian optician, Penrhyn Thomas.
Click here to view this short video blast from the past.
AOA Submits Comments to FTC on Contact Lens, Eyeglasses Rules
Citing the need to address those who undermine and undo essential patient safeguards, the American Optometric Association (AOA) submitted formal comments to the Federal Trade Commission (FTC) in response to its 10-year review of the Contact Lens Rule as well as the Ophthalmic Practice (Eyeglasses) Rule.
The AOA's comments urge the FTC to take action to ensure the regulations which implement the Fairness to Contact Lens Consumers Act (FCLCA) are fair and effective among patients and their doctors, and retailers. According to the AOA, this process is an opportunity to advocate for patients and begin to address serious problems with the existing Contact Lens Rule, such as the deeply flawed passive verification process.
AOA submitted detailed formal comments to FTC officials, along with state affiliate associations, individual optometrists and the Coalition for Patient Vision Care Safety (PVCS), who also submitted well researched and well supported comments to FTC.
The AOA's comments encouraged the FTC to best protect patients by:
Fixing the broken passive verification system;
Ensuring retailers can't sell lenses based on an expired prescription;
Stopping 'robocalls' that often are difficult to understand or are incomplete;
Shutting down online retailers that allow patients to purchase lenses without a prescription;
Ensuring consumers are well-informed about patient agency, and preventing retailers' deceptive practices to assert patient agency;
Stopping retailers from encouraging patients to stockpile lenses that far exceed the prescription length;
Stopping retailers' business practices that misguide patients on the requirements of the Rule;
Shutting down retailers that do not following the requirements of the Rule and target patients through social media and e-commerce sites;
Ensuring retailers provide a reliably accessible live-contact person for doctors to discuss prescription problems, as outlined in the Rule.
The PVCS coalition (comprised of AOA, Alcon, Bausch & Lomb, Cooper Vision, and Johnson & Johnson Vision Care) will continue to be active in enlisting Congressional support on the implementation of these comments.
ABB OPTICAL GROUP Announces Winners of Second Annual ABB Cares Program
ABB Optical Group announced that seven charitable non-profits, nominated by eyecare professionals nationwide through the company's second annual ABB Cares program, will receive grants ranging from $1,000 to $5,000 in recognition of the charities' exceptional programming and community impact. This year proved to be more challenging in selecting only seven finalists out of nearly 100 outstanding nominations.
The 2015 ABB Cares grant recipients include:
Marengo Community Center of Marengo, Iowa – a $5000 Platinum Grant
Family Promises of the Verdugos in Burbank, CA – a $2500 Gold Grant
South Jersey Eye Center in Camden, NJ – a $2500 Gold Grant
Domestic Violence Crisis Center of Minot, ND – a $1000 Silver Grant
Backpack Buddies of Fort Dodge, Iowa – a $1000 Silver Grant
Lestonnac Free Clinic in Orange, CA – a $1000 Silver Grant and
Butterfly Dreams in Watkinsville, GA – a $1000 Silver Grant
In the Editorial in a recent Contact Lenses Today we asked for your thoughts on creative ways you have solved the challenge of keeping in your office an inventory of trial lenses and an inventory of contact lenses for purchase by patients. Here is another view from a reader in the UK.
On a regular basis company representatives introduce “new” lenses or “special” purchase offers so that, if we buy a bank of stock for sale, we can get a preferential price. They claim to analyze our inventory needs and send the lens powers we most commonly use.
This is an unquestionable pain… Lenses go out of date; powers don’t get used; and for the ones we need we only have 2 boxes available when a patient needs a 3/12 supply, etc.
Our solution: We refuse to take inventory stock. We throw it right back at them. If their IT is so good, and it darn well ought to be better than anything we have, then it can work for mutual benefit.
What we ask for is a VIRTUAL INVENTORY STOCK. We buy maybe a month (1/12th of our normal purchasing) up front at the nice new discount price we’d pay if we bought actual stock. This is done on boxes independent of SKU. The bank is run down and when empty we purchase the next load.
This supports practices; the discount could even match the online/mail order prices. It keeps the companies honest, avoiding aggressive sales representatives. And, in this day and age of courier delivery, we get the stock fast enough overnight. It rewards good users.
Just an idea… Nicholas J. Rumney MScOptom, FCOptom, DipTP, ProfCertMedRet, FIACLE, FAAO, FBCLA, FEAOO
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
Making It Stick
I am a big proponent of eyelid hygiene and am convinced of its importance in maintaining not only a healthy ocular surface but the integrity of the lid margin and eyelashes. A "sick" lid margin is unable to support the needs of the lash follicle which is an important stem cell niche. Likewise, I wonder about the effect of cosmetics applied to the lashes and lid margin and imagine that removing such is important in long term eye/eyelid health. I am delighted that there are numerous commercially available lid cleaning products that address a variety of potential therapeutic areas.
As eyecare practitioners, we are interested in removing products applied to the lids and lashes. Conversely, the cosmetic industry assiduously compounds eye make-up products that have water-proofing properties to make ensure that their colors do not smudge or wash away easily and remain intact despite water or perspiration. Most research has focused on composition and components of make-up products, and not on the level of its "waterproofness". A recent study however aimed to find methods to assess the waterproof degree of eyeliners and mascaras in an effort to better define this cosmetic characteristic.1 Basically, how well does the cosmetic stick (which I translate as "how difficult is it to remove")?
I presume we will have to work a bit harder with better products formulated to clean and protect the delicate eye area. Stay abreast of what's available and prescribe lid hygiene devised for your patients' clinical needs.
1. Kim MJ, Seo YK, Boo YC, Koh JS. A proposal of a standardized protocol to evaluate waterproof effect of eyeliner and mascara. Int J Cosmet Sci. 2015 Oct 12.
Don’t Assume Acuity Tells All When It Comes to Multifocal Contact Lenses.
There has been a dramatic paradigm shift when it comes to the use of multifocal contact lenses (MFCL) over the past number of years. The 2014 Annual Contact Lens Report published in Contact Lens Spectrum found that 72% of surveyed practitioners preferred fitting presbyopes with multifocal contact lenses as compared to 20% preferring monovision and only 8% preferring spectacles worn over distance correcting contact lenses. This preference for fitting multifocal contact lenses has increased annually since 2008 when the preference rate for fitting multifocal contact lenses was only 59%. The actual reported fitting frequency of multifocal contact lenses in 2014 was 46% as compared to 36% for monovision contact lens fitting.1 When we consider performance outcomes with MFCLs, we may be missing things if we rely simply on visual acuity measures.
Two recent studies looked at a variety of visual performance outcomes in the evaluation of MFCLs. The first study compared visual performance of two soft MFCLs to that of a hybrid MFCL.2. In addition to acuity measures the researchers evaluated photopic contrast sensitivity and ocular aberrometry. No statistically significant differences were found in distance and near visual acuity achieved with the three different types of multifocal contact lens (p ≥ 0.05). Likewise, no significant differences between lenses were found in the monocular and binocular defocus curves (p ≥ 0.10). Binocularly contrast sensitivity differences between lenses were not significant (p ≥ 0.27). Furthermore, trefoil aberration was significantly higher with the soft MFCLs (p = 0.01) compared to the hybrid MFCL. The second study looked to characterize the effects on accommodation and binocular vision in young adults of two distance center multifocal soft contact lenses (MFSCLs), differing in add power.3 The researchers compared visual acuity, accommodation, near phoria, fixation disparity and stereopsis data collected with single vision (SV) SCLs to that of MFSCLs. Differences in distance and near acuities with MFSCLs compared to SVSCLs were small and clinically insignificant. Compared to responses with SVSCLs, MFSCLs increased accommodative lags with this change reaching statistical significance for the +1.50 D add lens. Furthermore, both MFSCLs induced significant shifts in near phorias in the exo direction. Finally, there were no significant differences in stereopsis and fixation disparity with MFSCLs compared to SVSCLs. The researchers concluded that since all of the measure differences were small and clinically insignificant the results predict good tolerance of MFSCLs in young patients if fit for myopia control.
These studies appropriately look deeper into visual performance outcomes with MFCLs and suggest that measures beyond visual acuity may be clinically important when determining success in the fitting of these lenses.
1. Nichols JJ. Annual report contact lenses 2013. Contact Lens Spectrum. 2014 January; 29(1): 22-28.
2. Piñero DP, Carracedo G, Ruiz-Fortes P, Pérez-Cambrodí RJ. Comparative analysis of the visual performance and aberrometric outcomes with a new hybrid and two silicone hydrogel multifocal contact lenses: a pilot study. Clin Exp Optom. 2015 Sep;98(5):451-8.
3. Kang P, Wildsoet CF. Acute and short-term changes in visual function with multifocal soft contact lens wear in young adults. Cont Lens Anterior Eye. 2015 Oct 15. pii: S1367-0484(15)30025-4 [Epub ahead of print].
Acute and Short-Term Changes in Visual Function with Multifocal Soft Contact Lens Wear in Young Adults
The purpose of this study was to characterize the effects on accommodation and binocular vision in young adults of two distance center multifocal soft contact lenses (MFSCLs), differing in add power.
Twenty-four young adult myopes (18-28 years; 20 females, 4 males) had baseline visual acuity, accommodation, near phoria, fixation disparity and stereopsis data collected with single vision (SV) SCLs. The same set of measurements was repeated immediately after subjects were fitted with each of two MFSCLs (with either +1.50 or +3.00 D add), and after 2 weeks of daily wear in each case. The order of testing was randomized and a one-week washout period was allowed between the first and second MFSCL trials.
Differences in distance and near acuities with MFSCLs compared to SVSCLs were small and clinically insignificant. Compared to responses with SVSCLs, MFSCLs increased accommodative lags with this change reaching statistical significance for the +1.50 D add lens. Furthermore, both MFSCLs induced significant shifts in near phorias in the exo direction. Finally, there were no significant differences in stereopsis and fixation disparity with MFSCLs compared to SVSCLs.
The authors concluded that differences in acuities, accommodation accuracy and binocular posture with MFSCLs compared to SVSCLs were clinically small and mostly not significant. These results predict good tolerance of MFSCLs in young patients fitted with them for myopia control.
Kang P, Wildsoet CF. Acute and short-term changes in visual function with multifocal soft contact lens wear in young adults. Cont Lens Anterior Eye. 2015 Oct 15. pii: S1367-0484(15)30025-4. doi: 10.1016/j.clae.2015.09.004. [Epub ahead of print]