A recent study published in JAMA Internal Medicine compared human physician diagnoses to 23 web-based “symptom checkers” intended to help patients self-diagnose across 45 different clinical scenarios.1 There were 234 physicians who participated in the study, who more than twice as often, listed the correct diagnosis first across all clinical scenarios compared with the web-based systems (72% vs 34%, p < 0.001). Further, physicians were also significantly more frequent in listing the correct diagnosis in their top three differentials than the web-based systems (84% vs 51%, p < 0.001). We continue to hear of online “solutions” for traditional in-office health care—specifically as it relates to refractions in the eyecare domain. While computer-aided algorithms may be helpful supplements to a physician diagnosis, it appears as though evidence continues to show a physician diagnosis remains the gold standard in healthcare.
1. Semigran HL, Levine DM, Nundy S, Mehrotra A. Comparison of Physician and Computer Diagnostic Accuracy. JAMA Intern Med. Published online October 10, 2016. doi:10.1001/jamainternmed.2016.6001
Jason J. Nichols, OD, MPH, PhD
PolyVue Introduces HD Dailies
PolyVue Inc. announced the addition of HD Dailies contact lenses. Patients can now enjoy the company’s patented HD optics and a healthier wearing experience with Hioxifilcon material in a 1-day lens.
HD Dailies will provide the same High Definition Aspherics as the HD/HD2 products, which provides true HD Optics, and can be fit for single vision and emerging presbyopes with up to a +1.00D add. HD Dailies Comfort Perfected lens edge design and Hypathin make the lenses exceptionally comfortable to wear. Unlike other aspheric lenses on the market, PolyVue incorporates the ideal aspheric curvature for each soft lens power and thickness, and compensates for aberrations caused by lens flexure on the eye, according to the company. Hioxifilcon 59% water content material keeps the lenses fresh all day.
Lenses are sold in a 90-pack and fitting kits are available. For more information, please contact PolyVue at 877-734-2010.
Visionary Optics, the manufacturer of the Jupiter and Europa brand of scleral contact lenses, announced the addition of the Europa for Presbyopia scleral lens.
Europa for Presbyopia scleral lens is designed to deliver crisp, clear vision at all distances to let patients focus on near objects, as well as enhancing distance vision. The lens is a concentric bifocal with a near center front surface and the back surface is that of the Europa scleral lens. Europa for Presbyopia can be ordered with up to +3.50 ADD and the near zone is adjustable.
There is no additional fitting set required to fit Europa for Presbyopia. The Europa for Presbyopia comes with a 90-Day Warranty and three exchanges with full cancellation.
The Europa Scleral Lens is also available in a bitoric (front toric & toric haptics). For additional information on their scleral lens designs, contact Visionary Optics at 1-877-533-1509 or www.visionary-optics.com.
The 2017 Global Specialty Lens Symposium will be held January 26-29, 2017 at the Rio Hotel in Las Vegas, Nevada.
The GSLS is a must-attend meeting, brought to you by Contact Lens Spectrum, focusing on the successful management of ocular conditions using today's specialty contact lenses. This meeting will include insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.
ABB Optical Group has unveiled a dynamic, new state-of-the-art website designed to enhance the online customer experience.
The ABBOptical.com website provides a single sign on feature, which automatically directs customers to the appropriate ordering platform based on their login information. Customers also can now access contact lens ordering, Ophthalmic, GP and specialty information all on one website, an added time-saving benefit.
In addition to a clean, streamlined design, a content-rich site experience and easy-to-navigate functionality, ABBOptical.com offers access to Digital Eye Lab, a division of ABB Optical Group. Customers will enjoy an inside look at the state-of-the-art lab, where the latest advancement in lens technology is used to create customized eyewear. Other features of the refreshed design include access to educational videos and tools such as Retail Price Monitor and patient retention resources that will sharpen a practitioner’s competitive edge and increase practice efficiency and patient satisfaction.
The International Forum for Scleral Lens Research (IFSLR), scheduled for Monday, December 5, 2016 has announced its program. The IFSLR will be following the 33rd Annual Cornea, Contact Lens & Contemporary Vision Care Symposium at The Westin Houston Hotel, Memorial City. The IFSLR is the first scientific meeting in the world dedicated to scleral gas permeable contact lenses (SGP) and the research that advances this field.
IFSLR is an open meeting where practitioners and laboratories interested in the latest developments and evidence-based information are invited to attend. The program outline includes topics such as midday fogging, scleral lens design, corneal oxygenation, and conjunctival prolapse. The meeting is organized to discuss seven focus areas, where a Keynote Speaker outlines a problem and the research designed to solve the problem, followed by short statements by acknowledged experts. Subsequently, approximately half of the time will be devoted to an open, moderated discussion on each focus segment.
The IFSLR is governed by a Scientific Executive Committee consisting of Jan Bergmanson, Chair, Melissa Barnett, Thomas Arnold, Ralph Stone, William Miller, Jan Svochak and John Hibbs. The IFSLR is supported by the experienced University of Houston College of Optometry educational meeting administration led by Marcus Piccolo, Jennifer Ebert and Amanda Johnson. Additional prominent participants, to mention just a few from the impressive slate of speakers, include: Ray Applegate, Joseph Barr, Greg DeNaeyer, Jason Jedlicka, Lynette Johns, Langis Michaud, Clarke Newman, Muriel Schornack, and Maria Walker.
This meeting is sponsored by Bausch & Lomb, Contamac, Essilor, Metro Optics, ART Optical Contact Lens and TruForm Optics.
TearLab Corporation announced that it has entered into a definitive co-promotion agreement with PRN Physician Recommended Nutriceuticals (PRN) whereby PRN and TearLab will jointly promote PRN's patented omega-3 formulations, including Dry Eye Omega Benefits. According to the companies, PRN's marketed omega-3 formulations have been shown to reduce osmolarity levels in dry eye patients utilizing the TearLab Osmolarity System which provides an objective assessment to diagnose and manage patients with DED.
TearLab currently markets the TearLab Osmolarity System and has over 4,000 devices placed in the United States and more than six million tests performed globally since the commercial launch in 2012. Under the agreement, TearLab's sales force in the United States will now promote PRN's proprietary dry eye brands to the company's current and prospective customers.
PRN currently markets several patented omega-3 brands including Dry Eye Omega Benefits and Dry Eye Omega Benefits Liquid, which were developed and endorsed by medical thought leaders. PRN will retain the primary responsibility for sales, marketing, distribution and regulatory management of the co-promoted brands. In addition, PRN plans to continue its promotional strategies to current and prospective customers and retains full right to market the brands in any channel in the United States. The co-promotion does not include any markets outside of the United States.
Snap a Photo, Walk a Mile to Help Protect Children’s Eyesight
This year Johnson & Johnson Vision Care Companies is asking everyone to snap a photo or walk a mile for Sight For Kids, a Lions Clubs International Foundation (LCIF) program that helps raise local eye health awareness and identify, refer and correct visual impairment in underserved school children in Asia, Africa and Eastern Europe. It’s a free, fun and easy way to help protect a child’s vision.
So exactly how can you help?
Post one photo every day to the Sight For Kids cause through the Johnson & Johnson Donate A Photo App. For every photo uploaded on behalf of Sight for Kids, Johnson & Johnson will donate $1, up to $40,000*, to help the charity provide eye health education and eye exams to children in need. Sight for Kids has provided eye health education and free vision screenings to more than 24 million children in Asia Pacific, Africa and Eastern Europe since 2002. Participants can post up to one photo per day using the app, which is available from the iPhone App Store or Google Play for the U.S., the U.K. and Japan.
Track your walking, running or biking through the Charity Miles, a social good app that enables people to get moving for a purpose. Charity Miles donates up to 25 cents to the cause of your choice, including Sight For Kids, for every mile you walk, run or bike. The app is available globally through the iPhone App Store or Google Play.
*You can donate a photo to one cause, once a day. For every photo donated on behalf of Sight for Kids, Johnson & Johnson Services, Inc. will donate $1 to that cause. You can donate photos on behalf of Sight for Kids until January 15, 2017 or until it reaches its goal of $40,000, whichever comes first. Sight for Kids will receive a minimum of $20,000.
I want to be better. I am not the best, but think I am pretty good, but then someone comes along and makes me realize how far I need to go. I like looking back at how far I have come, but then realize that the more I know, the more I learn I need to know, and the hunger for knowledge grows even stronger.
Of course I am talking about contact lens knowledge. I love attending lectures by other speakers to hear how they present their clinical experience. I enjoy hearing people from other countries who have experience with products that I have, but they use them ever so slightly different, and they have products that I don’t have access to, and perhaps should.
Now is the time to start making your plans for next year. Although it isn’t even the holidays yet, January is going to be here before we know it. I would urge you to attend one of our profession’s premier contact lens meetings: the Global Specialty Lens Symposium. Over 500 attendees from all over the world attend this meeting and speakers represent places from all over the globe. If you have not been even once in the last 10 years, you are missing out. Even if your practice is not a specialty contact lens practice, getting into the world of contact lenses and realizing what is possible can be liberating.
Plan early and plan to attend often so that you can realize how much you know and how far you have come.
The first time I viewed heavy eye makeup through a slit-lamp biomicroscope I was alarmed by its appearance, and I thought to myself that makeup must have some sort of negative ocular surface consequences. I had a similar experience the first time I saw a large mascara mark on a soft contact lens. While it has been reported that up to 87% of women under 55 years old have used makeup within the past twelve months, there is relatively little literature on how cosmetics (e.g., mascara, eye shadow, and eyeliner) affect the eye.1
Ng et al.’s recent review was able to address many of my unanswered questions. Specifically, the article reports that eye makeup can induce acute ocular irritation if the makeup is inadvertently applied to mucus membranes, and other research has found an association between ocular discomfort and cosmetic use.1 Evidence also indicates that cosmetics can cause ocular allergies, ocular pigmentation changes, tear lipid layer destabilization, permanent contact lens spoiling, and exposure to unwanted microbes secondary to product contamination.1 Similarly, contact lens exposure to makeup removers has been found to cause contact lens deformation, which suggests that contact lenses should always be removed before makeup is removed.1
Ocular cosmetics are generally safe; however, since they have the potential to be contaminated, cosmetics should be discarded as recommended by manufacturers.1 Likewise, patients should be educated to discard their cosmetics after an eye infection because continued use of cosmetics after an infection could result in re-inoculation.1 With this in mind, you could better direct your patients on how to maintain healthy contact lens use, and even eliminate the source of a long-standing allergy.
1. Ng A, Evans K, North RV, Jones L, Purslow C. Impact of Eye Cosmetics on the Eye, Adnexa, and Ocular Surface. Eye Contact Lens. 2016;42:211-220.
Risk Factors for Return to the Operating Room after Resident-Performed Cataract Surgery
The researchers’ objective was to investigate risk factors for unplanned return to the operating room after resident-performed cataract surgery.
In this retrospective case-control study, all patients with reoperation within 90 days of resident-performed phacoemulsification were matched to four control eyes which had surgery within 30 days of the reoperation at the same institution.
Billing codes were used to identify all patients who underwent resident-performed intended phacoemulsification with intraocular lens placement from January 2005 to December 2010.
Investigated risk factors for reoperation included cataract characteristics and preexisting ocular co-morbidities, including diabetic retinopathy, retinal detachment history, glaucoma, corneal pathology, and uveitis. Additional preoperative risk factors studied included resident training year, history of tamsulosin use, phacodonesis, pupillary dilation, presence of pseudoexfoliation, myopia, history of trauma, visual acuity, and monocular status. Intraoperative variables were the use of iris expansion devices, use of capsular stain, attending type, incision type, use of sutures, vitreous loss, anesthesia type, and phacoemulsification technique.
There were 67 returns to the operating room (i.e., cases) over five years that were assigned to 268 control eyes. In preoperative multivariate analysis, phacoemulsification done by a first- or second-year resident (OR 3.2, 95% CI: 1.7-6.0, p < 0.001) was associated with an increased risk of reoperation. In postoperative multivariate analysis, only the use of the divide-and-conquer technique (OR 4.0, 95% CI:1.7-9.2, p = 0.001) was associated with an increased risk of reoperation.
Phacoemulsification done by a junior resident or using the divide-and-conquer technique had the highest risk of reoperation.
Menda SA, Driver TH, Neiman AE, Blumberg S, Naseri A, Stewart JM. Risk Factors for Return to the Operating Room after Resident-Performed Cataract Surgery. Semin Ophthalmol. 2016 Sep 29:1-5. [Epub ahead of print]