It is the time of year again when the sale of "decorative" contact lenses starts to increase, most likely associated with costumes for the Halloween holiday in the United States. Several professional organizations help remind the public of the potential dangers of the use of unregulated contact lenses. As eyecare providers, we also share in the responsibility to educate our patients and the public about the hazards of self-prescribing lenses that have not been approved by the proper regulatory authorities for use. Have you had an experience with a patient self-prescribing unregulated contact lenses? Tell us about it at firstname.lastname@example.org.
Jason J. Nichols, OD, MPH, PhD
Visioneering Technologies, Inc. Enters European Market
Visioneering Technologies, Inc. announced that Medilens Nordic AB has been named an Authorized Distributor for the NaturalVue (etafilcon A) Brand 1 Day Contact Lenses. Headquartered in Helsingborg, Sweden, Medilens Nordic AB is Visioneering’s first European distributor. This partnership marks Visioneering’s entry into the European market. Medilens Nordic AB operates in Sweden, Norway, Denmark, Finland, and Iceland.
AOA Launches Campaign to Combat Illegal Contact Lens Vendors
In the spirit of Halloween, the American Optometric Association (AOA) kicked off its annual "31 in 31" letter-writing campaign to warn about a real fright—damage from wearing unprescribed decorative contact lenses. The campaign combats against the pervasiveness of illegal contact lens sales by calling out 31 online vendors, brick-and-mortar shops, and other sellers who have been reported to the AOA as having inappropriate contact lens sales practices, which put the public’s eye and vision health at risk.
The AOA hopes the letter will put a scare into retailers who illegally distribute corrective, novelty, or bogus contact lenses in violation of the Fairness to Contact Lens Consumers Act (FCLCA) and Contact Lens Rule. The campaign also serves as a way to inform the general public about the dangers of using contact lenses without the supervision of a trained eyecare professional.
Prof. Brian Layland Resigns as Chair and Director of BHVI
Professor Brian Layland has resigned as chair and director of the Brien Holden Vision Institute (BHVI) board. The resignation will take effect on Oct. 31. Professor Layland has also resigned as a member of both the BHVI and the BHVI Foundation, with immediate effect. The board has elected Frank Back as the new chair, and Sandra Bailey has assumed all of Prof. Layland’s functions and powers as alternate director with immediate effect.
Ms. Bailey is a board member of the BHVI Foundation. She is the former CEO of the Aboriginal Health and Medical Research Council of NSW, a position she held for 25 years. She will be formally appointed to the board at a general meeting on Oct. 31.
AVT Acquires Continental Soft Lens, Inc.
Advanced Vision Technologies, (AVT) announced the recent acquisition of Continental Soft Lens, Inc. Kim McQuarrie, owner of Continental Contact Lens, has retired after 37 years to spend time with his family and friends. He will continue to assist AVT in the technology transfer of all specialty designs that Continental Soft Lens has provided for decades.
SynergEyes Launches Tangible Hydra-PEG Coating on UltraHealth and Duette Hybrid Lenses in Canada
SynergEyes, Inc. announced that the Tangible Hydra-PEG (Tangible Science) coating is now available in Canada on both Duette and UltraHealth hybrid lenses. The lubricous polymer coating was launched in the United States in 2017.
ISCLS Elects Its First Australian President
The International Society of Contact Lens Specialists (ISCLS) has elected optometrist Damon Ezekiel, owner of Ezekiel Eyes in Nedlands Perth, as its president at the ISCLS’ 46th Congress in Washington, DC; this is the first time the leadership of the 65-year-old organization has been awarded to an Australian.
Also at the Congress, Damon Ezekiel and British optometrist, Caroline Hodd, were awarded the Herschel Medal, given "in recognition of outstanding original contributions to contact lens design techniques and of fitting and application in clinical practice, in the education of students and in the advancement of the status of contact lens practice." Ms. Hodd is the only woman to ever design and market a contact lens to help people who have unusual eye conditions.
Jaime Ibanez, OD, Villavicencio, Colombia
Opposite Shapes: This is a radial keratotomy (RK) case that has very deep incisions that cause visual impairment in this patient due to the highly irregular cornea. On the left is a scleral lens with its posterior aspheric geometry. The fluorescein pattern shows the contrast of opposite shapes of the anterior cornea and the posterior contact lens. This causes midperipheral touch on the most elevated areas of the cornea and a high negative power to neutralize the positive post lens fluid. On the right is a tailor-made scleral lens (same sagittal height and diameter) that has highly inverted posterior curves to match the oblate shape of the anterior cornea; this clears the bearing areas and allowed a significant decrease in negative power. The lens was a real relief for this patient.
We thank Dr. Ibanez 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.
S. Barry Eiden, OD
Overnight use of scleral contact lenses for persistent epithelial defects
Management of persistent epithelial defects of the cornea can be clinically challenging. Use of topical pharmaceutical agents, bandage soft contact lenses, and amniotic membrane placement among others have been used widely. A recent clinical case series looked at outcomes of the use of continuous wear scleral GP contact lenses for the treatment of persistent corneal epithelial defects.1
Eight eyes of eight patients who have persistent corneal epithelial defects were treated with the Blanchard Onefit 2.0 Scleral lens, the BostonSight Scleral lens, and the BostonSight PROSE device and were observed for defect resolution and improvement in best-corrected visual acuity over the duration of treatment. All eyes underwent complete re-epithelialization with a mean time of 11.1 ± 5.5 days. At the conclusion of the treatment, visual acuity improved in all but one patient. No complications were observed during treatment. The authors concluded that scleral lenses provide the corneal epithelium with hydration, oxygen permeation, and protection from mechanical forces, thereby facilitating healing of persistent corneal epithelial defects. They believe that this case series demonstrates the successful use of continuous wear scleral lenses in a number of patients for the treatment of persistent epithelial defects refractory to other interventions.
The use of scleral contact lenses continues to grow in the eyecare field along with the number of clinical applications. This case series describes an additional application. Caution, however, should be applied along with a balanced consideration of the risks versus the benefits in the use of scleral lenses on an overnight wearing schedule due to concerns regarding oxygen transmission as well as the risk of microbial keratitis.
1. Khan M, Manuel K, Vegas B, Yadav S, Hemmati R, Al-Mohtaseb Z. Case series: Extended wear of rigid gas permeable scleral contact lenses for the treatment of persistent corneal epithelial defects. Cont Lens Anterior Eye. 2018 Sep 25 [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Never Underestimate the Gifts from Your Garden
My mother is an expert herbalist. I don’t think there is anything that she can’t cure with a snip of something from the garden. Once harvested, the garden goodie is either chopped or boiled, brewed or blended, and then rubbed, dabbed, plastered, or ingested to elicit the desired remedy.
Plant-derived tea tree oil-based products are an accepted therapy for managing eyelash follicle Demodex that are considered to be troublesome. However, manuka honey from a garden bee was proven to be an effective acaracidal in a recently published in-vitro study.1 In this report, the authors compared the in-vitro antiparasitic effects of MGO Manuka honey and tea tree oil against ocular Demodex.
Fifty-two viable Demodex mites were acquired from the epilated eyelashes of nine participants who have blepharitis and symptomatic dry eye. Viable mites were randomized to one of five treatment groups: cyclodextrin-complexed and uncomplexed manuka honey (cyclodextrins are naturally occurring glucose rings that improve stability and bioactivity of products), 100% and 50% tea tree oil, and no treatment. Following treatment application, mite viability was assessed for 240 minutes based on limb and body movement and/or the development of a crenated/translucent appearance.
Among the four treatments, survival probabilities were lowest with 100% tea tree oil and highest with uncomplexed honey. No difference was observed between complexed honey and 50% tea tree oil. To clarify, the in vitro efficacy of cyclodextrin-complexed manuka honey was comparable with 50% tea tree oil, an established treatment for ocular Demodex. The findings support future clinical trials investigating the therapeutic effects of complexed honey in demodectic blepharitis patients.
1. Frame K, Cheung IMY, Wang MTM, Turnbull PR, Watters GA, Craig JP. Comparing the in vitro effects of MGO™ Manuka honey and tea tree oil on ocular Demodex viability. Cont Lens Anterior Eye. 2018 Jul 6. [Epub ahead of print]
Impact of Dry Eye on Psychosomatic Symptoms and Quality of Life in a Healthy Youthful Clinical Sample
The purpose of this study was to determine the impact of dry eye on quality of life, depression, anxiety, and stress in a healthy, youthful clinical sample.
In this clinic-based cross-sectional study, subjects were patients who were visiting the University of Cape Coast Eye Clinic for comprehensive eye examination. The age range for recruitment into the study was 16 to 35 years. Eligible participants completed three questionnaires (the Ocular Surface Disease Index [OSDI]; the short version of the depression, anxiety, and stress scale [DASS-21]; and the dry eye quality of life score [DEQS]. All eligible participants underwent clinical assessment including meibomian gland expressibility, corneal staining, tear breakup time, and Schirmer 1 test. The Spearman correlation coefficient was used to determine the relationship between variables. Univariate and multivariate analyses of variance were used to determine the impact of the OSDI score on DASS-21 subscales scores and the dry eye quality of life scores.
All 211 subjects who met the inclusion criteria were included in the analysis. The mean age for the entire sample was 21.6 ± 3.0 years with a range of 17 to 31 years. Spearman correlation coefficient showed a statistically significant association between OSDI scores and DEQSs (P < 0.001), anxiety scores (P < 0.001), depression scores (P < 0.001), and stress scores (P < 0.001). Spearman correlation coefficient showed no statistically significant association between clinical test results and quality of life scores (P > 0.05), DASS-21 subscales scores (P > 0.05), except anxiety subscale and meibomian gland expressibility score (P = 0.026). There was no statistically significant association between clinical test results and OSDI scores (P > 0.05) except for the tear breakup time (P = 0.018). Using Pillai’s trace in the multivariate analysis of variance (MANOVA), there was a significant effect of OSDI severity classification on depression, anxiety, and stress subscales scores of the DASS-21, V = 0.37, F (3, 207) = 9.67, P < 0.001. Furthermore, separate univariate analyses of variances on the outcome variables revealed a significant effect of OSDI severity classification on depression F (3, 207) = 35.24, P < 0.001, anxiety F (3, 207) = 25.27, P < 0.001, and stress F (3, 207) = 13.08, P < 0.001. The MANOVA was followed up with a discriminant analysis, which revealed three discriminant functions. When subjects were classified according to the OSDI grading of severity, there were a statistically significant difference between all levels of severity dry eye symptoms for the DEQSs (F (3, 207) = 63.9.3 P < 0.001, η = 0.48).
The study showed that the severity of dry eye symptoms impacted psychosomatic symptoms and quality of life. The study also revealed that the severity of dry eye symptoms had a greater impact on the depressive symptoms compared to other psychosomatic symptoms in this youthful clinical sample.
Asiedu K, Dzasimatu SK, Kyei S. Impact of Dry Eye on Psychosomatic Symptoms and Quality of Life in a Healthy Youthful Clinical Sample. Eye Contact Lens. 2018 Aug 20. [Epub ahead of print]