In 2015, Contact Lens Spectrum partnered with an international team of scientists and practitioners to evaluate strategies and practices on myopia management on a global basis. This work was published in Contact Lens and Anterior Eye in 2016 (https://www.ncbi.nlm.nih.gov/pubmed/26895778). Now, in 2018, it is time to re-evaluate where we are with myopia management. Please take a few moments to complete the survey listed below, specific to your language. It will be exciting to see where the world is with regard to managing myopia in 2018.
Jason J. Nichols, OD, MPH, PhD
A Few Minutes of Your Time Please
There has been a growing academic interest in myopia management over the past few years, but there is little information on what is actually happening in clinical practice. A partnership, between Contact Lens Spectrum and various international organizations such as the British Contact Lens Association, is conducting a follow-up global survey to one conducted in 2015 on myopia management. The 2018 survey can be found at https://www.surveymonkey.co.uk/r/Myopia2018en . We would really value your time, which should take less than five minutes, to share your current thoughts and practice. The information gathered will allow us to report back what is happening across the globe as well as what your peers are thinking/doing. Thank you in advance for your time.
FTC Orders 1-800 Contacts to End Search Restriction Deals
The Federal Trade Commission (FTC) has held that 1-800 Contacts unlawfully entered into a web of anticompetitive agreements with rival online contact lens sellers.
A Commission Opinion, authored by Chairman Joseph J. Simons, ruled that the agreements between 1-800 Contacts and 14 online sellers of contact lenses constitute unfair methods of competition, in violation of Section 5 of the FTC Act. The agreements prevent online contact lens retailers from bidding for search engine result ads that would inform consumers that identical products are available at lower prices. The opinion held that the agreements harm competition in bidding for search engine key words, artificially reducing the prices that 1-800 Contacts pays as well as the quality of search engine results delivered to consumers. Although the opinion directly addresses restraints to search engine advertising for contact lenses, it carries broader implications for preserving competition through online advertising.
The commission’s order requires 1-800 Contacts to cease and desist from enforcing the unlawful provisions in its existing agreements and from entering into similar agreements in the future. It prohibits 1-800 Contacts from agreeing with other contact lens retailers to restrict search advertising or to limit participation in search advertising auctions.
The Commission’s Opinion stems from an August 2016 administrative complaint and upholds Chief Administrative Law Judge D. Michael Chappell’s October 2017 Initial Decision, which similarly found that the agreements were unfair methods of competition.
1-800 Contacts may file a petition for review of the ruling with a U.S. Circuit Court of Appeals within 60 days after service of the Final Order.
EyePoint Pharmaceuticals Announces Assignment of Permanent J-Code for Dexycu by CMS
Eyepoint Pharmaceuticals announced that the Centers for Medicare and Medicaid Services (CMS) has assigned a specific and permanent reimbursement J-code through the Healthcare Common Procedure Coding System (HCPCS) for Dexycu (dexamethasone intraocular suspension) 9%. Dexycu is an FDA-approved, single-dose, sustained-release, intracameral steroid for the treatment of postoperative inflammation. The code, J1095, will become effective on Jan. 1, 2019 and will replace the previously issued C-code (C9034) that became effective on Oct. 1, 2018. The company still retains transitional pass-through status for Dexycu from CMS for approximately three years.
CLMA Elects Officers and Board of Directors for 2019
The Contact Lens Manufacturers Association (CLMA) membership has elected its Board of Directors officers and members to begin a one-year term of office in Jan. 2019. The board officers are: President – Kurtis Brown, Menicon America, Inc.; Vice President – Josh Adams, Valley Contax, Inc.; and Secretary Treasurer – Derrell James, X-Cel Specialty Contacts, Inc. Board members include: Daniel Bell, Acuity Polymers, Inc.; Michael Fischer, Misupco, Inc.; John Hibbs, Contamac US, Inc.; Troy Miller, AccuLens, Inc.; Chris Pantle, DAC International, Inc.; Keith Parker, Advanced Vision Technologies, Inc.; Dr. Michael Ross, Euclid Systems Corp.; and Daren Nygren, Custom Craft Lens Service of Nevada, Inc. (Immediate Past President).
The installation of the 2019 CLMA Board of Directors will take place during the Rising Stars Reception being held Jan. 26, 2019 during the Global Specialty Lens Symposium in Las Vegas.
Second Global Myopia Awareness Coalition Meeting
Building on the success of the initial meeting in June, the Global Myopia Awareness Coalition (GMAC) met at the American Academy of Optometry annual meeting last week and approved a governance structure and funding mechanism to formally launch its efforts through the creation of a coalition, appointment of a board, and providing funding to develop and deploy public-facing messaging. More than 20 industry leaders attended this meeting, aligning to focus their efforts collectively on public education about the growing myopia epidemic. The World Council of Optometry (WCO) will serve as a host for the GMAC to support its global efforts.
Matt Oerding, CEO and co-founder of Treehouse Eyes, led a session sharing how public messaging in a coordinated fashion has been effective in other categories. Kovin Naidoo, OD, PhD, senior vice president of Inclusive Business, Philanthropy and Social Impact at Essilor, proposed a governance structure and mission for the GMAC, which was endorsed by the group. And, documentary filmmaker Jane Weiner gave the group an update on the progress of her important film, "Losing Sight: Inside the Myopia Epidemic." The meeting concluded successfully with commitments made from several companies to contribute financially to the GMAC and to form the board to start execution work.
SNEC, SERI, and J&J Vision Announce Research Collaboration
The Singapore National Eye Centre (SNEC), the Singapore Eye Research Institute (SERI), and Johnson & Johnson Vision (J&J Vision) announced a $26.35 million research collaboration to tackle myopia. Specifically, J&J Vision is making a $15.78 million investment, comprising cash and in-kind contributions, while SERI’s investment is $10.57 million in cash and in-kind contributions.
The first-of-its-kind public-private strategic partnership in Asia focused on myopia will create a deeper understanding of how the condition develops, how it progresses, and how it may be intercepted. It will focus on developing predictive tools to identify those who may be at risk to develop high myopia, conduct research on the underlying mechanisms of myopia, progress novel therapies, and discover and validate methods to prevent the onset and progression of the condition.
Due to the complexity and scale of myopia, SNEC, SERI, and J&J Vision intend to build on these efforts and convene other stakeholders to support broad-based strategies.
CooperVision’s Myopia Management Expert Forum
A panel of global authorities in myopia management gathered in Texas last week, preceding the American Academy of Optometry (AAO) Annual Meeting, to seek ways to help eyecare professionals better assess and manage the growing myopia epidemic among children. The Myopia Management Expert Forum was conceived by CooperVision, which hosted the series of lectures, guided discussions, and professional networking sessions. Discussions covered new study data regarding contact lens management for slowing myopia progression, the impact of orthokeratology in China, the safe use of contact lenses by children, and more.
Do you believe that silicone hydrogel materials are generally a healthier option for your patients than hydrogel materials?
This 87-year-old white male presented to the clinic after cataract surgery complaining of no vision and eye pain. This photo shows endophthalmitis with a subconjunctival hemorrhage about seven days after cataract surgery.
We thank Dr. Woo 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
Will Cross-Linking Change the Landscape Long Term?
Corneal cross-linking was first introduced in the early 2000s, with the goal of stabilizing the keratoconic eye and targeting disease progression.1,2 Corneal cross-linking works to stabilize collagen bonds, which, in turn, strengthens the cornea and makes it resistant to enzymatic degradation. Various studies have shown that patients who undergo cross-linking demonstrate substantial improvement in refractive power, both spherical and cylindrical.3,4 In addition, post-cross-linking retrospective studies reveal a reduction and stabilization of topography by up to 2.0D.3 Given stabilization of the cornea and overall flattening of the corneal topography, the question remains as to the best time to resume contact lens wear or when to refit the patient.
The cornea will continue to heal up to 12 months post-cross-linking.5 Most patients will still need specialty contact lenses for improvement in visual acuity long term. The time frame to initiate or reinitiate fitting depends on the type of cross-linking. With an epi-on procedure, fitting can be done in as little as one month due to limited disruption to the corneal epithelium.6 For an epi-off procedure, the general thought is to start fitting no sooner than six months post-cross-linking.5 For the first year following cross-linking, patients should be monitored at three-month intervals for changes in vision and contact lens fit.6 The cornea has a tendency to flatten; thus, most lenses will need to be altered when compared to lens parameters prior to treatment. An exception may be scleral lenses with which the tear film can ameliorate any topographical changes.
With the increasing popularity of cross-linking, while patients may stabilize and avoid progression, the need for specialty contact lenses does not seem to be disappearing.
1. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-A-induced collagen cross-linking for the treatment of keratoconus. Am J Ophthalmol. 2003 May;135:620-627.
2. Wollensak G. Corneal cross linking: New horizons. Expert Rev Ophthalmol. 2010 Apr;5:2001-2015.
3. Razmjoo H, Kobra Nasrollahi A, Salam H, Karbasi N, Najarzadegan MR. Topographical corneal changes after collagen cross-linking in patients with corneal keratoconus. J Res Med Sci. 2013 Oct;18:882-886.
4. Caporossi A, Mazzotta C, Baiocchi S, Caporossi T. Long-term results of riboflavin ultraviolet a corneal cross-linking for keratoconus in Italy: the Siena eye cross study. Am J Ophthalmol. 2010 Apr;149:585-593.
5. Peyman A, Kamali A, Khushabi M, et al. Collagen cross-linking effect on progressive keratoconus in patients younger than 18 years of age: A clinical trial. Adv Biomed Res. 2015 Nov 23;4:245.
6. Michaud L, Breton L. Contact lens fitting post-corneal cross-linking. Contact Lens Spectrum 2018 Mar;33:30-34. Available at https://www.clspectrum.com/issues/2018/march-2018/contact-lens-fitting-post-corneal-cross-linking. Accessed on Nov. 5, 2018.
MATERIALS & DESIGNS
David L. Kading, OD
Thank You Contact Lenses
Next week is Thanksgiving here in the United States. As with every year, we have a lot for which to be thankful. On the top of many lists is family and our workplaces. In addition, patients always rank high on my list; it’s awesome that they keep coming back and providing me and my team with a pay check.
One group that you may not have reached out to recently to thank is the contact lens manufacturers. Practitioners are heroes every day because of what their lens laboratories do for them. I wouldn’t be able to do it without them. Soft lens companies are always working to teach practitioners how to better fit their lenses and improve patient outcomes. We could not be where we are without them.
Jump on the horn and talk to the laboratory. Grab the contact lens reps next time they are in the office—after they have shared the new information—and share with them how much you appreciate the hard work and effort that they put into helping to make you a Contact Lens Superstar.
Improving Your Spectacle Patients' In-Practice Experience with Contact Lenses During Frame Selection
A market research survey was conducted to assess the impact of offering complimentary contact lenses (CLs) to spectacle-only wearing patients during frame selection with regard to their in-office experience, the transaction amount for their eyewear purchase, and the likelihood of proceeding with a comprehensive contact lens fitting.
Five optometry offices in the United States participated. An initial interviewing phase served as a control during which optometrists treated spectacle-only wearing patients in the usual manner for frame selection. After this, the offices transitioned into a test phase in which patients were offered the opportunity to wear CLs while selecting new spectacle frames. Only patients 18 or older who had not expressed an interest in CLs were invited to participate. A brief survey was completed on an iPad following the visit by all patients in both control and test phases.
The study had 410 patients (205 test, 205 control) participate. Of the test group, 63% elected to wear CLs (40% spherical, 20% toric, 35% multifocal, and 5% monovision). Patients wearing CLs spent more on their eyewear purchase ($708 versus $593, p = 0.04), were greater than 2.5 times more likely to have received or scheduled a CL fit (p = 0.01), and were greater than three times more likely to consider scheduling a CL fitting in the future (p = 0.0003). Additionally, 93% reported that they were highly satisfied with the experience, and 86% said that they would wear CLs to select frames again (86%).
The authors determined that offering CLs to spectacle-only patients positively impacts eyewear selection and purchase and can grow the overall CL business.
Mayers M, Jansen Bishop M, Walerius D, et al. Improving your spectacle patients' in-practice experience with contact lenses during frame selection. Cont Lens Anterior Eye. 2018 Nov 1. [Epub ahead of print]