The abstract of the week for this week made the national news circuit this past week and should serve as a reminder as to the significant impact that microbial keratitis (MK) has on our patients. One thing not discussed in terms of the data presented is the morbidity associated with MK, with the obvious potential for vision loss. While the abstract notes that the greatest risk factor for MK is contact lens wear, I think we all know that non-compliant and/or overnight lens wear play significant roles in the infectious process. To this point, we cannot emphasize enough in our practices just how important compliant contact lens wear is in the continued safe wear of contact lenses.
SynergEyes, Inc. has expanded its doctor resources with the release of eight video tutorials for Duette Progressive, their lens for astigmatic presbyopes. The videos, each only a few minutes in length, are available through the â€œVideo Tutorialsâ€ link on the homepage of www.synergeyes.com/professional.
Providing information to assist dispensing and optimize the fit of the Duette Progressive lens, the step-by-step tutorials cover: lens design, lens calculator, fitting guide, lens dispensing, optimizing fit, optimizing near vision, optimizing distance vision and optimizing patient compliance. The videos address the vision optimization made possible by the recent expansion of lens parameters to 0.1mm increments, which facilitate even more precise alignment fitting, creating optimal centration and clear, stable vision at all distances for even more patients.
Combining GP optics with SoftCushion comfort technology, Duette Progressive provides crisp, clear vision for astigmatic presbyopes, according to the company. A patientâ€™s initial pair of Duette Progressive lenses can be designed empirically based on a refraction and corneal curvature measurements. Utilizing a near center aspheric add zone in combination with a distance asphere, Duette Progressive provides a seamless progression of powers from distance to near. The lens offers a choice of three add powers, features an 84 Dk silicone hydrogel skirt around the 130 Dk center, and includes UV-blocking materials.
Professor Brien Holden, from University of New South Wales (UNSW), Australia, and CEO of Brien Holden Vision Institute, who has been a global leader in research and innovation in the measurement, correction, management, treatment and social and economic impact of vision correction and blindness prevention, received the Charles F. Prentice Medal at the annual American Academy of Optometry meeting in Denver.
The Charles F. Prentice Medal Award (established in 1958) is awarded annually to a distinguished scientist or clinician scientist in recognition of a career-long record of advancement of knowledge in vision science. The award is considered to be the most prestigious of the Academyâ€™s awards for achievement in research.
From his PhD research on myopia control and corneal reshaping with orthokeratology, to corneal endothelial changes with soft contact lenses, to the definition of the oxygen needs of the eye to avoid corneal edema, and the effects of long-term extended contact lens wear on the cornea, Holden has been at the forefront of research that underpinned the huge growth in soft contact lens wear globally. More recently his focus has been on development of new methods to control the progression of myopia, to help meet the growing threat of blindness associated with high myopia, which is increasing in prevalence globally.
Professor Holden has also made a major contribution to the next generation of researchers, through opportunities provided by the Brien Holden Vision Institute and UNSW Australia, to over 160 postgraduate students.
Join us January 22 - 25, 2015 for Global Specialty Lens Symposium at Ballyâ€™s Hotel & Casino in Las Vegas. The GSLS is a comprehensive meeting focusing on the latest techniques and technologies for the successful management of ocular conditions using today's specialty contact lenses. The meeting includes information for vision care professionals in all disciplines, with both surgical and non-surgical options covered. Accredited for continuing education under COPE, NCLE, and JCAHPO, the meeting will offer approximately 30 credit hours.
Attended annually by more than 500 participants from 30+ countries it is the largest conference of its kind in the U.S.
Register before December 15th and save! For complete conference details and to register now, visit GSLSymposium.com.
NovaBay Pharmaceuticals, Inc. has signed a nationwide distribution agreement with McKesson Corporation. The agreement covers NovaBayâ€™s i-Lid Cleanser, a prescription lid and lash hygiene product for the management of debilitating eye conditions such as blepharitis, Meibomian gland dysfunction and associated dry eye.
NovaBay recently launched a major marketing effort with a dedicated sales force for i-Lid Cleanser calling on optometrists and ophthalmologists. With the agreement with McKesson, which provides products and supplies to 45,000 pharmacies, eyecare professionals now can be assured that patients will be able to easily fill prescriptions for i-Lid Cleanser.
Nicox S.A., the international ophthalmic company, announced that Valeant Pharmaceuticals International, Inc. has acquired Nicoxâ€™s U.S. diagnostics subsidiary Nicox Inc., in a deal worth up to $20 million. Nicox intends to concentrate its commercial and development resources on ophthalmic therapeutics as part of its strategy to build an international ophthalmic company in Europe and in the United States.
Under the terms of the transaction, Valeant has acquired most of the Nicox commercial infrastructure in the U.S. associated with diagnostics, while Nicox has retained a number of U.S.-based employees focused on therapeutics. Those employees retained by Nicox have transferred to Nicoxâ€™s new U.S. subsidiary Aciex Therapeutics, Inc., which was acquired in October 2014.
Valeant has acquired Nicox Inc. for $10 million in cash, plus further cash payments of up to $10 million based upon Valeant achieving certain sales targets with the transferred products. The transaction is effective immediately. Nicoxâ€™s operations outside the U.S. and its recent acquisition of Aciex are not affected by this transaction.
In June 2014, Nicox Inc. rolled-out SjÃ¶, an advanced diagnostic panel for the early detection of SjÃ¶grenâ€™s syndrome, throughout the U.S. That month, Nicox Inc. also launched expanded access to the RetnaGene portfolio of tests to assess the risk for advanced age-related macular degeneration (AMD).
MediNiche, Inc., a St. Louis, Missouri pharmaceutical company, announced an introductory offer for new Lash Advance, lash and brow gel, in order to help support eyecare professionals (ECPs) improve Lash Advance visibility in their practices. The company is offering new trade customers deep discounts, free goods, free counter displays, free shipping, free staff training materials, free customer brochures and free optical shop merchandising materials, along with exceptional customer service, to assist ECPs in account setup. The offer is valid for new customers only and good only while supplies last.
Lash Advance is the first non-Rx lash product targeted exclusively for optical shop distribution and sale. Lash Advance is formulated with a blend of natural ingredients that help lashes recover from environmental, chemical and physical damage by hydrating, improving flexibility, and minimizing breakage. According to the company, with regular use, lashes return to a healthy state in as little as two weeks. Lash Advance does not contain drugs, parabens, petroleum products, propylene glycol, fragrances, or colorants. In addition, it does not contain bimatoprost, the active ingredient in Latisse (Allergan) and will not darken eyelids or change iris pigmentation. Lash Advance does not contain any known allergens which makes it ideal for use with sensitive eyes. The company further states that it is also suitable for patients with contact lenses, eyelash extensions, permanent makeup, and those who have had visual correction surgery.
This eye has Peters Anomaly, a rare genetic condition characterized by an opaque, irregular, neo-vascularized cornea, no iris and glaucoma. We fit this eye with a black soft lens with a 7mm pupil over which was placed a scleral lens. Visual acuity without correction is finger counting at 8". With this soft-scleral lens combination corrected vision is 20/250.
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OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
Observations from AAO
Returning from the American Academy of Optometryâ€™s meeting this past week, I am glad to report that there was much interest in the physiology and the "wellness" of the ocular surface.
The Academy's Anterior Segment Sectionâ€™s symposium focused on the same, with discussions led by both researchers and clinicians. We learned that desiccating stress may have a direct effect on meibomian gland function, leading to a significant increase in basal acinar cell proliferation, abnormal meibocyte differentiation, and altered lipid production.1
An overarching theme of surface wellness and contact lens wearing success was lid maintenance and hygiene. Akin to the dental model, active cleaning and debridement of debris from the lid margin and orifices of the meibomian glands was discussed. The exhibition hall echoed the demand for commercial products to support this effort with a robust selection of cleansers, instruments and oral supplements. Exhibit hall posters compared techniques for warming the tarsus to enhance lipid flow from the meibum producing glands within it. New technology for imaging the meibomian glands was introduced.
I am delighted and encouraged by the excitement surrounding the lid margin and look forward to supporting the ocular health of my patients by reinforcing daily practices to support this exquisitely balanced, yet taxed, system.
1. Suhalim JL, Parfitt GJ, Xie Y, De Paiva CS, Pflugfelder SC, Shah TN, Potma EO, Brown DJ, Jester JV. Effect of desiccating stress on mouse meibomian gland function.Ocul Surf. 2014 Jan;12(1):59-68.
How Dry I Amâ€¦ Tear Film Characteristics Influenced by the Use of Video Display Terminals
The dramatic increase in the use of digital devices over the past decade has had dramatic consequences in many ways. As eye care practitioners we are well aware that our patients experience dryness and discomfort symptoms with extended use of computers, tablets and smart phones. Evidence supporting deleterious effects of digital device use on the ocular surface is mounting.
The outcomes of a recent study were published which was designed to evaluate changes in symptoms and tear film characteristics in computer users. Fifty-one computer users and 26 controls were evaluated at the beginning and the end of the working day. Computer use duration, Ocular Surface Disease Index (OSDI) questionnaire, tear osmolarity, Schirmer test, tear break-up time (TBUT), and ocular surface vital dye staining were performed pre-vocationally and post-vocationally.
Results found that the mean reported computer use was 6.9 Â± 2.7 hours/day in computer users and 0.4 Â± 0.5 hours/day in controls. The mean pre-vocational and post-vocational values in computer users for OSDI, osmolarity, TBUT, and Schirmer test were 23.2 Â± 16.6 and 27.0 Â± 17.6, 306.6 Â± 14.9 and 311.0 Â± 12.5 mOsm/L, 13.9 Â± 4.0 and 13.2 Â± 3.8 seconds, 22.7 Â± 11.8 and 20.6 Â± 12.5 mm, respectively. The vocational change was significant for all parameters in the computer user group but not in the control group. The osmolarity-based dry eye diagnosis was 27.4% in the computer users while it was 15.4% in the control group. The researchers concluded that both symptoms and signs of dry eye increased significantly with computer use. Approximately 1 of every 3-4 computer users was found to have dry eye with higher tear osmolarity values.
We realize that the use of digital devices will not decrease as we continue to move towards a more technologically advanced society. It is imperative that we understand the influences of the use of these devices on the ocular surface and visual system in general. Contact lens wear further exacerbates dryness secondary to digital device use. Through the outcomes of well-designed research we will be able to develop effective management strategies.
Yazici A, Sari ES, Sahin G, Kilic A, Cakmak H, Ayar O, Ermis SS. Change in tear film characteristics in visual display terminal users. Eur J Ophthalmol. 2014 Oct 8:0. [Epub ahead of print]
Estimated Burden of Keratitis - United States, 2010.
Keratitis, inflammation of the cornea, can result in partial or total loss of vision and can result from infectious agents (e.g., microbes including bacteria, fungi, amebae, and viruses) or from noninfectious causes (e.g., eye trauma, chemical exposure, and ultraviolet exposure). Contact lens wear is the major risk factor for microbial keratitis; outbreaks of Fusarium and Acanthamoeba keratitis have been associated with contact lens multipurpose solution use, and poor contact lens hygiene is a major risk factor for a spectrum of eye complications, including microbial keratitis and other contact lens-related inflammation. However, the overall burden and the epidemiology of keratitis in the United States have not been well described.
To estimate the incidence and cost of keratitis, national ambulatory-care and emergency department databases were analyzed. The results of this analysis showed that an estimated 930,000 doctor's office and outpatient clinic visits and 58,000 emergency department visits for keratitis or contact lens disorders occur annually; 76.5% of keratitis visits result in antimicrobial prescriptions. Episodes of keratitis and contact lens disorders cost an estimated $175 million in direct health care expenditures, including $58 million for Medicare patients and $12 million for Medicaid patients each year. Office and outpatient clinic visits occupied over 250,000 hours of clinician time annually. Developing effective prevention messages that are disseminated to contact lens users and investigation of additional preventive efforts are important measures to reduce the national incidence of microbial keratitis.
Collier SA, Gronostaj MP, MacGurn AK, Cope JR, Awsumb KL, Yoder JS, Beach MJ. Estimated Burden of Keratitis - United States, 2010.MMWR Morb Mortal Wkly Rep. 2014 Nov 14;63(45):1027-30.