One of the things most all practitioners agree on is the excessive use of eye cosmetics can complicate contact lens wear. We know that particles can seep into the tear film and cause dry eye like problems, including contact lens discomfort and even intolerance. Please check out the full article associated with this week’s abstract as it is a great review of this highly important clinical issue.
Jason J. Nichols, OD, MPH, PhD
New Ownership for Valley Contax
Valley Contax, an independent custom contact lens manufacturer founded in Eugene, Oregon in 1981, has recently changed ownership. Founder Stephen G. Young made his final step toward retirement in September, selling the company to his two longest serving employees, company president, Janice Adams, and vice president, Josh Adams.
Janice Adams began her 35-year optical career as an apprentice optician in Eugene, Oregon. She has been active in nearly every area of operations - financial, marketing, customer service, production, staff education and continual development of the company's relationship with strategic alliances and partners. She served for fifteen years as a member of the board of the Contact Lens Manufacturers Association which included positions as Treasurer, Vice President and President. Janice completed an Oregon Executive MBA (OEMBA) degree from the University of Oregon in 2011.
Josh Adams began his 23-year optical career as an apprentice on the manufacturing line in 1992 and was promoted to the Laboratory Manager position in 1997. His responsibilities include the production, customer service, and consultation departments. He has served as a member of the board of the Contact Lens Manufacturers Association.
To find out more about Valley Contax, you may visit their website at valleycontax.com.
New Euclid Orthokeratology International Certification Program
Euclid Systems Corporation announces an Orthokeratology (Ortho-K) education and training program to ultimately yield a significantly higher level of expertise among eyecare practitioners throughout China. The new Euclid Orthokeratology International Certification (EOIC) program is the collaborative milestone of Euclid, the Illinois College of Optometry and Tianjin Medical University. Qualified eyecare practitioners will have the opportunity to receive a first-of-its-kind, 5-day intense orthokeratology education and hands-on training program. Unlike the abbreviated Ortho-k training Chinese eyecare practitioners still receive today, Euclid’s program will include 25 hours of lectures and wet labs for fitting of actual patients.
The EOIC program is expected to launch on October 26, 2015 in Tianjin.
Euclid Systems Corporation, headquartered in Herndon, Virginia, has offices in Shanghai and Beijing, China. Euclid's Emerald lens has received FDA approval in the U.S. as well as regulatory approvals from numerous countries in Asia and Europe. For more information on Emerald, visit http://www.euclidsys.com/emeraldsb/practitioner-whatisemerald.shtml.
Don’t Miss the 10th Global Specialty Lens Symposium
The 10th Global Specialty Lens Symposium will be held January 21 – 24, 2016 at Caesars Palace 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.
The 2015 event was attended by almost 600 registrants from 36 countries, 42 states, Puerto Rico and Guam. It continues to be the largest conference of its kind in the U.S.
Join your peers in 2016 for the 10th anniversary in Las Vegas! Visit www.GSLSymposium.com for more information and to register.
American Academy of Ophthalmology Warns Consumers
About Non-Prescription Decorative Lenses
Research published in September in Eye & Contact Lens found chlorine in three types of non-prescription costume contact lenses, with one pair leaching potentially harmful chlorine after a routine rinse. Iron was found on four pairs of lenses.1 The chemicals may come from colorants used to tint and create playful patterns on the lenses, says the study, which was conducted in Japan where decorative lenses are extremely popular and largely unregulated.
The Academy’s consumer warning included Costume Contact Lens Safety Guidelines for consumers and the organization’s public information website, www.geteyesmart.org, also highlights the information.
1. Hotta F, Eguchi H, Imai S, Miyamoto T, Mitamura-Aizawa S, Mitamura Y. Scanning Electron Microscopy Findings With Energy-Dispersive X-ray Investigations of Cosmetically Tinted Contact Lenses. Eye Contact Lens. 2015 Sep;41(5):291-6.
Are You Working With Trial Lens Sets?
With new developments like hybrid lenses, scleral lenses and lenses with sophisticated designs such as quadrant specified lenses, the need for trial lens sets has increased. On the other hand the need for safe hygienic management causes insecurity about handling, disinfection and storage of contact lenses used on multiple patients.
Therefore, ISO is working on developing new standards for trial lens handling and usage. It is the goal to develop a safe standard without complicated procedures.
The project leader is gathering information about the use of trial lenses. The online form will take no more than a couple of minutes to complete. All information will be confidential. To participate, visit https://www.umfrageonline.ch/s/b14dc36.
Post RK and LASIK with Corneal Ectasia Edward Boshnick, OD, Miami, FL
This eye underwent radial keratotomy in 1988 followed by LASIK in 2002. Shortly thereafter corneal ectasia developed with symptoms that included blurred distorted vision, dry eye and ocular pain. A 17 mm scleral lens was fit on this eye which has allowed this eye to see 20/25 with excellent comfort and all day lens wear.
We thank Dr. Boshnick for this image and we 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 an explanation of the photo and your full name, degree or title and city/state/country.
Don’t Assume Expertise in Health Care Makes a Difference! This Study Looked at Comparative Knowledge and Behavior of Contact Lens Care between Medical and Non-Medical Students.
My prior two columns reviewed a study on the demographics and risk behaviors for contact lens related eye infections. Great lessons can be learned from that study. As a follow up this week I review a study that compared the knowledge and behavior related to contact lens care between medical and non-medical students. Participants consisted of 200 medical students (M) and 200 non-medical students (N) who wore contact lenses within the recent one year. A structured questionnaire was filled in by the subjects.
Non-medical students wore color lenses significantly more than medical students. Non-medical students bought lenses from internet and markets significantly more than medical students did. For the knowledge component, the contact lens-related complications which participants can name were significantly different in both groups including allergic conjunctivitis (M: 73.2%, N: 61.3%), corneal abrasion (M: 58%, N: 36.7%), corneal ulcer (M: 61.6%, N: 45.7%), and corneal neovascularization (M: 29.8%, N: 18%). The five common improper behaviors of lens care that were similar in both groups included wearing lenses longer than recommended, not changing lens storage solution daily, swimming while wearing lenses, using tap water for rising lenses and not washing hands before handling lenses. The authors concluded that both groups of students lacked adequate contact lens knowledge and were both non-compliant with contact lens care instruction.
So what can we gain from the outcomes of this interesting study? I would suggest that we cannot assume anything about the contact lens wear and care behaviors of our patients regardless of the type or level of their educational experience. We should all assume lack of knowledge and poor compliance. We should ask the appropriate questions of our patients in terms of their lens wearing behaviors frequently and in greater detail than is typically done in clinical practice. We should put in place the most effective educational systems in order to inform our patients about the importance of appropriate lens wearing behaviors and the implications of failure to comply with them. This will increase the likelihood of our patients having the ability to wear contact lenses in a safe and effective manner.
Leeamornsiri S, Titawattanakul Y. Comparative Knowledge and Behavior of Contact Lens Care between Medical and Non-Medical Students. J Med Assoc Thai. 2015 Apr;98 Suppl 3:S16-23.
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
My new passion is the conjunctiva; I want to know everything about it.
The conjunctiva is a mucous membrane that forms the majority of the ocular surface. It is of integral importance to providing immunological defense, and to sustain a healthy tear film, which in turn prevents ocular infection and desiccation of the corneal epithelium, thus preserving vision.1
Histologically, the conjunctiva is composed of the superficial epithelium and the underlying substantia propria, or stroma, which is richly vascularized and contains numerous different cell types for innate defense and immune protection. The conjunctival epithelium is a stratified, nonkeratinized, secretory epithelium, and its cell type varies depending on location from columnar in the tarsal and cuboidal in the bulbar area to prismatic in the forniceal area and squamous near the lid margins and limbus.
The conjunctiva is continuous with the nasal mucosa through the lacrimal puncta, with the corneal epithelium at the corneoscleral limbus and with the eyelid skin at the mucocutaneous junction, known as the Marx's Line. The conjunctival surface can be divided into six zones: starting from the lid margin these are the marginal, palpebral (or tarsal), orbital, forniceal, bulbar and limbal conjunctiva.
Of importance, the conjunctiva is self-renewing. Interestingly, conjunctival stem cells are rich in the medial canthal and inferior forniceal areas. These locals may provide greater physical protection, are especially concentrated in goblet cells, intraepithelial mucous crypts, vasculature, melanocytes, and immune cells, features that are common to other stem cell niches.2 Additional studies are required to characterize the conjunctival stem cell niche and the mechanism of conjunctival epithelial renewal.
1. Gipson IK. Distribution of mucins at the ocular surface. Exp Eye Res. 2004; 78: 379–388.
2. Stewart RM, Sheridan CM, Hiscott PS, Czanner G, Kaye SB. Human Conjunctival Stem Cells are Predominantly Located in the Medial Canthal and Inferior Forniceal Areas. Invest Ophthalmol Vis Sci. 2015 Feb 26;56(3):2021-30.
Impact of Eye Cosmetics on the Eye, Adnexa, and Ocular Surface
Despite the fact that cosmetic products undergo rigorous testing to ensure they are safe for human use, some users report mild discomfort following their application. The cutaneous changes, such as allergic dermatitis, are well reported, but the ocular changes associated with eye cosmetic use are less so. Some pigmented cosmetic products may accumulate within the lacrimal system and conjunctivae over many years of use, but immediate reports of eye discomfort after application are most common. Changes to the tear film and its stability may occur shortly after application, and contact lens wearers can also be affected by lens spoliation from cosmetic products. Additionally, creams used in the prevention of skin aging are often applied around the eyes, and retinoids present in these formulations can have negative effects on meibomian gland function and may be a contributing factor to dry eye disease. The aim of this review is to summarize current knowledge regarding the impact of cosmetic products on the eye, ocular surface, and tear film.
Ng A, Evans K, North RV, Jones L, Purslow C. Impact of Eye Cosmetics on the Eye, Adnexa, and Ocular Surface. Eye Contact Lens. 2015 Sep 21. [Epub ahead of print]