Looking back, I can see that there were several major meetings held during the past few months. This got me thinking. Over the course of a year, there are probably 10 or more major meetings that occur in which we have continuing education and exhibits available to us. That does not include any of the smaller specialty or regional meetings. What is it about a meeting that attracts you to attend? High-quality continuing education? Exhibits? Cost? Convenience? Reputation? I’d very much like to hear your thoughts on this as we continue to plan for, and report on, future events (firstname.lastname@example.org).
Last week’s Abstract discussed the relationship between scleral lens wear and intraocular pressure (IOP). A few of our readers had their own thoughts on the topic:
“The abstract in CLT this week reported that IOP was not elevated after scleral lens removal.1 Some readers might assume from this finding that sclerals don’t elevate pressure. However, ‘after removal’ tonometry does not inform the ‘before removal’ IOP if sclerals do elevate IOP. For example, we found that raised IOP very rapidly returns to baseline levels immediately after a finger pad indentation is removed.2 Therefore, the time it takes for lens removal and then tonometry is more than enough for a return to baseline.” –Charles W. McMonnies, DSc, Honorary Professor, School of Optometry and Vision Science, University of New South Wales
1. Shahnazi KC, Isozaki VL, Chiu GB. Effect of Scleral Lens Wear on Central Corneal Thickness and Intraocular Pressure in Patients With Ocular Surface Disease. Eye Contact Lens. 2019 Oct 24. [Epub ahead of print]
2. McMonnies CW, Boneham GC. Experimentally-increased intraocular pressure, using digital forces. Eye Cont Lens. 2007 May;33:124-129.
“I think the association between scleral lens wear and IOP is important to follow, as scleral lens wear has increased dramatically over the last few years. There are some conflicting studies in the literature, so it makes this topic even more interesting to discuss. I honestly didn't start measuring IOP regularly during my scleral lens follow-up visits until the last few years. Hopefully, more [practitioners] will start doing this so we can learn more about effects from different scleral lens designs and other patient groups.” –Gloria B Chiu, OD, USC Roski Eye Institute, Keck Medical Center of USC
Jason J. Nichols, OD, MPH, PhD
New Landing Page for Eaglet Eye ESP and More Design Algorithms
Eaglet Eye BV announced that a new landing page has been unveiled for its Eye Surface Profiler (ESP) at www.scleralfitting.com. Eaglet has also enhanced its commitment to lab neutrality by offering almost 40 lens algorithms. According to the company, this allows practitioners to enjoy simplified fitting with the majority of major specialty lens designs. Eaglet will continue to add design algorithms as they become available. Eaglet is making the new algorithms available to ESP users worldwide at no charge.
AccuLens Announces Limbal Clearance Indicator Markings on Maxim and EasyFit Scleral Lens Designs
Acculens is now offering trial lens sets with laser-etched limbal curve indicator (LCI) markings. According to the company, these markings will assist in determining proper lens diameter and limbal vault. Practitioners will be able to identify whether the lens diameter is too small, causing insufficient limbal clearance.
CooperCompanies Announces Global Support for Optometry Giving Sight and March of Dimes
CooperCompanies has selected Optometry Giving Sight and March of Dimes as the beneficiaries of its new global charitable giving program. Through the Cooper Giving program, company employees can donate year-round to both nonprofits, with Cooper providing a one-for-one match, up to $5,000 annually per employee.
In parallel to these globally recognized causes, the company will continue to encourage local philanthropic efforts, supporting communities in which employees live and work. These contributions are part of Cooper’s alignment with the United Nations Sustainable Development Goals, including a focus on good health and well-being as well as establishing complementary partnerships.
TruForm Optics Offers Tangible Hydra-PEG on B+L Boston GP Lens Materials
TruForm Optics announced the availability of the Tangible Hydra-PEG custom contact lens coating technology with Boston XO, Boston XO2, Boston EO, and Boston ES GP lens materials.
Harris Poll Says Parents Need to Be Educated About Myopia
A CooperVision study completed by The Harris Poll found that while one in four children in the United States is myopic, only 33% of parents know what the term means or how it can affect their children’s eyesight. The survey included 1,000 U.S. parents who have children between the ages of 8 and 15. For an infographic on the study results, visit https://coopervision.com/protect-kids-vision.
AAOF Announces 2019 Vincent Salierno Scholarship Recipients
The American Academy of Optometry Foundation (AAOF) announced the recipients of the 2019 Vincent Salierno Scholarships. The recipients include Kenneth Dang, New England College of Optometry; Mark Calixte, Nova Southeastern University School of Optometry; Christopher Muegge, Southern College of Optometry; Ryan Sandberg, Southern California College of Optometry at Marshall B. Ketchum University; and Sarah Supak, University of Houston College of Optometry.
Students pursuing a doctorate of optometry degree are nominated by their institution for this scholarship. Each recipient will receive $2,000 to apply to their tuition. The Vincent Salierno Scholarship is eligible for automatic renewal provided that the recipient maintains a 3.0 cumulative grade point average and is enrolled in a full-time course of study leading to a doctorate of optometry degree. Continued eligibility shall be determined annually.
Martin Guzman, OD, Caracas, Venezuela
These images show my most challenging case ever: a 45-year-old patient who underwent bilateral penetrating keratoplasty 30 years ago. Both clear and healthy corneas presented with bulging ectasia in both eyes. They also had a height of more than 6,800 microns (at a 15mm chord). These images are of the left cornea; I’m still working on the right one.
We thank Dr. Guzman 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
Go with the Flow
One of the most common complaints that I hear at the annual exams of my scleral lens patients who suffer from ocular surface disease is “the fluid drains out.” On our end, we are able to physically look to see whether that is the case. Here are a few pearls that I have learned when discussing the common possibilities of fluid leakage and/or air bubbles.
First, if patients struggle with application and removal, they have may an application bubble. This will cause air entrapment. And, if it is large enough, it will cause pain and irritation with wear throughout the day. Second, while patients fill the bowl with a recommended fluid, once they apply the lens to the eye, much of that is pushed out. While that may seem obvious to practitioners, it’s effective to remind patients of these logistics; that way, patients will better understand that, when they remove the lens, there will be less fluid. Third, there could be edge awareness. With this, patients receive a signal that their eye feels something abnormal, but they are not able to differentiate the true issue. Simply pulling the lids away to see whether that alleviates the pain can help practitioners determine whether this is the reason for the patient complaint. Buffing the edges or working with a lab to improve edge profile is helpful. In more extreme cases, you may have to refit the patient into a different diameter lens. Finally, it’s important to keep in mind that all the structures of the eye, including lids and palpebral area, are also dry. Often, this will cause a patient to come in with this complaint. Lubrication is the key to this, and education is always a key component to long-term success.
MATERIALS & DESIGNS
David L. Kading, OD
Do Lenses Need Treatments/Coatings?
“I’ve been doing this for 20 years, and I have never needed those fancy ‘add-ons’ that this new laboratory is trying to upsell to me.” It’s true, we didn’t use to have “add-ons” for our GP materials. It used to be that the lens was ordered and then we didn’t touch it again for four years…or did we?
When I first started in the GP industry, modification and polishing of GP lenses was still happening. We would work to try to improve the scratches and to clean off the proteins that patients had on their lenses. As lens materials have changed, we have improved wettability and have made lenses thinner. We do not regularly do any type of polishing on standard GP lenses in our office anymore because the lenses are ordered so much thinner than they used to be.
Today, we have treatments such as “plasma treatments” that the laboratories do. We still request plasma treatment for all of our lenses. The treatment, which uses electrical energy in a sealed chamber, works on the lens surface to make it ultra clean. Of note, there is nothing added to the lens surface, it is just cleaner.
For the last couple of years, patients have been benefiting from a polyethylene glycol (PEG)-based coating that has a polymer encapsulating the lens. This improves wettability and increases surface water retention to increase lubricity and reduce deposits. A cool thing about the coating is that it can be used on both GP and soft lenses; there are commercially available soft lenses that have the coating on them.
So, what is the benefit of these treatments and coatings? They make the lenses better. Yes, so true. When lenses are treated with plasma, it makes the lenses cleaner; when they are treated with PEG, they are wetter and more lubricated. These are good things for our patients.
When lenses are better, patients feel better and practitioners are more successful. So, treat it, coat it, and make everyone better.
Sagittal Height Differences of Disposable Soft Contact Lenses
The purpose of this study was to improve contact lens fitting by using an innovative and simple photogrammetry imaging system to find the sagittal height (SAG) of soft contact lenses.
Eleven different types of commercially available soft contact lenses were measured, and five different lenses per package of each lens type were evaluated. The lenses were inserted in a polymethylmethacrylate cell with parallel faces containing a solution of saline and fluorescein to improve the contrast against the background. For every lens, two photographs from the top view and five photographs from the side view were taken. Using homothetic transformations, the researchers calculated the sagittal height.
The SAG of all lenses ranged from 3,450μm to 3,907μm. Differences can be appreciated between the SAG of different materials. Performing an ANOVA (analysis of variance) test, the authors confirmed that the intra-packaging sagitta is reliable for every lens. Comparing the measured SAG with the calculated spherical one, they confirmed that the majority of lenses, eight out of 11, have a spherical geometry for the internal side. Finally, they were able to group the type of lenses that present similar SAG apart from the data reported on the blister.
Optical coherence tomography measurement of the eye sagitta over a given chord helped with finding the first lens to fit, because matching contact lens sagitta and ocular sagitta is the key for a good fitting. During the study, the authors determined that the majority of brands use a single-sphere geometry for the internal surface of disposable soft contact lenses.
Giovanzana S, Ţălu Ş, Nicoară SD. Sagittal height differences of disposable soft contact lenses. Int Ophthalmol. 2019 Nov 1. [Epub ahead of print]