With Halloween fast approaching, the topic of cosmetic/colored lenses has been popping up in the media. However, the theatrical use of these lenses does not make up a significant portion of their use. In fact, regardless of the time of year, cosmetic/colored contact lenses make up only a small percentage of contact lens fits overall—perhaps a few percent—and this has been holding steady for the past several years.
But why have we not observed more of an upward trend? I think that there are a few reasons. Many practitioners tell me that they dislike fitting colored contact lenses; they find it inconvenient to their workflow and problematic in terms of stocking yet more trials in limited space.
I am confident that there is indeed a demand for cosmetic/colored lenses—perhaps greater than we might think. I believe that recent and new technologies in this space will perhaps help grow this important category.
Jason J. Nichols, OD, MPH, PhD
Allergan Expands Refresh Portfolio
Allergan plc launched three new over-the-counter (OTC) Refresh Relieva products: Refresh Relieva, Refresh Relieva PF (preservative-free) multidose, and Refresh Relieva for Contacts. This new line of artificial tear formulations are specially formulated to relieve discomfort due to eye dryness and to prevent further irritation, according to Allergan. According to the company, Refresh includes carboxymethylcellulose (CMC), hyaluronic acid (an inactive ingredient), glycerin, and HydroCell technology, Allergan’s proprietary sodium chloride-free, glycerin-based solution that enables hydration and maintains the volume of cells on the ocular surface.
TecLens and Servimed Industrial Spa Announce a Partnership
TecLens, a medical device manufacturer, and Servimed Industrial Spa, an ophthalmic medical devices manufacturer and distributor, announced their partnership aimed at development and U.S. Food and Drug Administration (FDA) clearance of a new combination product to treat keratoconus. The new product under development will combine TecLens’ CXLens “on-eye” cross-linking system for corneal remodeling with Servimed’s trans-epithelial Ribocross riboflavin drug formulation.
TecLens and Servimed will pursue FDA clearance for the combination product of CXLens/Ribocross to treat keratoconus. Servimed’s Ribocross holds an FDA orphan drug designation for its proprietary riboflavin formulation for the treatment of keratoconus in patients undergoing corneal cross-linking procedures.
PECAA Launches New Health Plan
Professional Eye Care Associates of America (PECAA), a nationwide doctor alliance group, announced the launch of its new association health plan. Member practices will leverage the buying power of the larger organization to purchase health care benefits for their practitioners, staff, and families at competitive rates, regardless of individual practice size.
PECAAHP, as the plan is being called, is a private, non-profit, level-funded benefits plan offered through the Aetna network. PECAAHP will offer multiple medical plans to choose from, including preferred provider organization (PPO) and health savings account (HSA) options. Members and non-members alike can get a free, no-obligation quote.
Eyeris announced the creation of trial lens packaging made from its own recycled contact lens molds. Eyeris’ goal is to utilize what would typically be a throw-away trial lens mold and recycle the plastic for reuse as multiuse packaging, according to the company. The case is eye-shaped and has the Eyeris logo and bright color gradient of the Eyeris brand colors. It also utilizes radio frequency identification (RFID) technology in the lens parameter label. This trial lens packaging was the brainchild of CEO and co-founder Andy Barrow.
BHVI Announces New Acting Executive Director
Brien Holden Vision Institute (BHVI) has named Tim Fricke as acting executive director of BHVI’s social enterprise delivering improved eyecare to those most in need in Australia and across the world. He will manage the team while Leigh Cleave, BHVI executive director, is traveling for the next year. Mr. Fricke is a senior research fellow with BHVI. He is an optometrist, researcher, and international development practitioner and has held management and leadership roles in private, public, and community health.
Kyriakos Telamitsi, Limassol, Cyprus
Fitting scleral lenses is always a challenge. It is necessary for practitioners to have extra skills and advanced instruments. In the picture, you can see that both eyes were fitted with scleral lenses that included microvaults.
We thank Kyriakos Telamitsi 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
Considering Sclerals for Myopia Control
Myopia is fast becoming a global health concern and is of particular concern in developing countries. Holden et al1 estimated that by the year 2050, nearly 5 billion will be impacted by myopia and that approximately 1 billion will be impacted by high myopia (defined as –5.00D or less) compared to current estimates by Saw et al2 of 1,950 million of myopia and 277 million who have high myopia globally. Factors that have been associated with an increase in myopia include decreased outdoor time and increased near work activities as well as a genetic predisposition to myopia.1 Traditional forms of myopia control include bifocal spectacles or bifocal contact lenses, orthokeratology, or atropine treatment. However, with the increased availability and prescribing trends of scleral lenses, should we consider using scleral contact lenses for myopia control?
In 2004 at the Global Orthokeratology Symposium, Cary M. Herzberg, OD, first introduced the idea of scleral contact lenses for use in overnight orthokeratology, and it was later patented. The advantage of a scleral lens over traditional corneal GP designs is predominantly the ability for these lenses to center. The drawback of a scleral lens for overnight orthokeratology is mainly that the impact of a scleral lens on corneal physiology is still poorly understood.3 However, with an increasing number of scleral lens designs coming out with multifocal options and an increase in popularity for scleral lenses for normal corneas, I wonder whether we should consider multifocal scleral lenses as a viable option for myopia control in the future?
1. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036-1042.
2. Saw SM, Matsumura S, Hoang QV. Prevention and Management of Myopia and Myopic Pathology. Invest Ophthalmol Vis Sci. 2019 Feb 1;60:488-499.
3. Fadel D, Herzberg C. Is Ortho-k Possible with Corneo-Scleral Lenses? Contact Lens Spectrum. 2016 Dec;31:48-50.
MATERIALS & DESIGNS
David L. Kading, OD
How Money Makes You a Better Practitioner
Regardless of the setting in which you practice, I’m sure that you are making money. If you are losing money as a practitioner, you will soon go out of business or lose your job. Exceptions such as a Minnesota-based nonprofit eye clinic notwithstanding, most providers cannot afford to pay for their patients to get good care. And, phrasing it that way may be more palatable than saying that for practitioners to be exceptional at their job, they have to charge patients and make money. As a whole, eyecare providers tend to shun the concept of profit and charging patients.
I take exception to this rule, because my patients have taught me some valuable lessons. One of the most important lessons is that patients enjoy seeing a provider who is innovative. They frequently share how impressed they are to come to our clinic and see all of these “new machines.”* They also always ask what is new in contact lenses this year even though I fit them into a new lens the year before and they are not reporting any problems. The reason why my patients are more interested in technology relates to the way we educate them. It’s important to tell patients why the technology is important and how it is being used to ensure their long-term (i.e., not just short-term) health and comfort.
Regardless of their economic situation, we have patients who are willing to pay more for what they find to be valuable. Some patients literally cannot afford something, while others appear to be far wealthier than I am. Value is more important than the amount of money that is in a paycheck. As such, I hold my head high and provide the same level of care, give the same recommendations, and prescribe the same products to everyone. Being on the front line of eye health and vision means that we have to have technology that catches disease earlier. As a result, we need to use products that cost more and bring more value. When presented correctly, most patients will be grateful.
*Yes, Mrs. Jones, this is a new machine for you. However, we have had it at our clinic for four years; we just didn’t need to perform that test on you last year.
Effect of Orthokeratology Lens on Contrast Sensitivity Function and High-Order Aberrations in Children and Adults
Overnight orthokeratology (OOK) lenses are used to temporarily decrease myopic refractive error and improve uncorrected vision. OOK lenses significantly increase ocular and corneal higher-order aberrations (HOAs) and compromise contrast sensitivity function (CSF) to a degree correlated with the myopia correction achieved. In Taiwan, OOK lenses are mainly used in children for myopia control. However, information regarding its effects in this population remains limited. The purpose of this study was to discuss the change in HOAs and CSF after 28 nights of OOK lens use in children compared to that in adults.
In total, 46 children (9 to 18 years) and 26 adults (>18 years) who visited the ophthalmology department of Mackay Memorial Hospital from Oct. to Dec. 2013 were enrolled. Contrast sensitivity and ocular/corneal total HOAs, coma aberrations, and spherical aberrations (SAs) were tested before OOK treatment. After 28 days of overnight use, CSF and topography were re-examined, and data were collected and analyzed using t-test and Pearson Correlation coefficients.
In total, 23 eyes of 23 children and 14 eyes of 14 adults were evaluated. The treatment resulted in a significant increase in ocular total HOAs, coma aberrations, and SAs in both groups. However, CSF declined more in adults than in children.
This study revealed that OOK lenses decrease CSF to a greater extent in adults than that in children despite no significant differences in the change of ocular HOAs between both subject groups. The authors proposed that children may have better neural adaptation to compensate for optical aberrations induced by OOK lens use.
Chang CF, Cheng HC. Effect of Orthokeratology Lens on Contrast Sensitivity Function and High-Order Aberrations in Children and Adults. Eye Contact Lens. 2019 Oct 1. [Epub ahead of print]