Modern scleral contact lenses have come a tremendous way over the last 10 years. This is in large part due to advances in contact lens polymers, providing increased oxygen permeability amongst other improvements. Better materials in combination with improved designs, associated in part with modern manufacturing technologies, have led to this well-known revitalization of this modality. Contact Lens Spectrum has just published a comprehensive supplement to our October issue of the journal focused entirely on scleral contact lenses written by some of the most accomplished scleral lens practitioners in the world. We think you will find this material quite helpful, no matter if you’re new to scleral lenses or a veteran of working with this modality: http://www.clspectrum.com/supplementtoc.aspx?sn=CLS_10_2016_supp_1&tm=10/01/2016
Jason J. Nichols, OD, MPH, PhD
Tangible Hydra-PEG GP Surface Coating Cleared by FDA
Contamac Ltd. announced the FDA clearance of Tangible Hydra-PEG (K161100). Tangible Hydra-PEG is a novel contact lens coating technology that encapsulates the Optimum GP material in an ultra-thin layer of a PEG-based polymer (polyethylene glycol), creating a lens surface that is extremely wettable and very lubricious.
Recognizing the need for a new technology that could help end the frustrations caused by contact lens discomfort, Tangible Science LLC (formerly Ocular Dynamics) sought to develop a technology that would reduce the disruption to the ocular surface caused by placing a lens on the eye to create a more comfortable wearing experience. This disruption can be characterized or exacerbated by non-wetting lens surfaces, surface water evaporation, decreased tear break-up time (TBUT), deposits, and friction, which have all been identified as contributors to contact lens discomfort. According to the company, Tangible Hydra-PEG seeks to tackle those issues by creating a surface that is highly wettable, with increased surface water retention due to the high water content (90%) of the PEG-based polymer. Additionally, Tangible-Hydra-PEG creates an incredibly lubricious surface that can reduce both protein and lipids deposits, as well as reduce the friction caused by the interaction between the lid and contact lens during the blink.
The Tangible Hydra-PEG technology will be installed in Optimum GP authorized laboratories throughout the remainder of 2016, with a nation-wide launch planned for January 2017. Please contact your favorite specialty contact lens laboratory for more information about the availability of Tangible Hydra-PEG on their lens designs.
Novaliq GmbH announced the appointment of Christian Roesky, PhD, as the company’s Chief Executive Officer (CEO), effective November 1, 2016. Dr. Roesky will lead Novaliq as it develops and brings to market innovative therapeutics for a broad range of ophthalmic indications, including dry eye, glaucoma and retina diseases. Bernhard Günther, formerly Novaliq’s CEO, will take on the new role of Chief Innovation Officer.
Roesky holds a PhD in Chemistry and brings more than 15 years of eye care as well as extensive operational experience at multiple international pharmaceutical companies to Novaliq. Previously, Roesky was general manager of Bausch + Lomb GmbH / Dr. Mann GmbH in Berlin; managing director of the Diagnostics Division, and general manager and speaker of the Country Management Board of Abbott GmbH & Co. KG in Wiesbaden; and, general manager of Alcon German & Austria (Novartis).
Novaliq’s proprietary EyeSol technology enhances the topical bio availability, stability and safety of traditionally insoluble or unstable drugs improving the delivery, efficacy and convenience of treatments for ocular surface diseases including dry eye through preservative free and multi dose formulations. Novaliq’s most advanced product is NovaTears with CE-marking based on Novaliq’s proprietary EyeSol technology. NovaTears is marketed under the brand name EvoTears in Europe. More on www.novaliq.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.
CooperVision Renews Global Gold Sponsorship of OGS
Optometry Giving Sight announced that CooperVision, Inc. has renewed its commitment as a Global Gold Sponsor for another three years, effective January 2017.
Clive Miller, CEO of Optometry Giving Sight noted that CooperVision’s cumulative support for vision care projects that are helping to eliminate uncorrected refractive error is expected to exceed USD$2 million by the end of 2016. In addition to its charitable donation, the company also contributes funding through a patient rebate donation program in the United States, now in its fifth year with more than 80,000 patients having participated; the One Bright Vision cause-related marketing program in Europe, and its global Fight for Sight employee fundraising campaign with matching support from The Cooper Companies in support of the World Sight Day Challenge.
CooperVision also supports a number of specific programs in partnership with Optometry Giving Sight, providing funding as well as sending experts on site for professional guidance and observation. The aforementioned One Bright Vision initiative will screen 30,000 children ages 7-12 in the Chennai region of India during 2016, following a similar effort that screened 100,000 children in Tanzania from 2013 to 2015. Another initiative funded in part by CooperVision is helping introduce optometry as a course of study in Vietnam.
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
The lid margin is one of my favorite topics. Examination of the lid margin includes evaluation of the eyelashes. Changes in the integrity of the eyelashes or lash loss can be a clue to underlying disease processes, ocular or otherwise. Madarosis is a terminology that refers to loss of eyebrows or eyelashes.1 This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Chronic blepharitis (bacterial or from Demodex overpopulation), is the most common condition associated with madarosis,2 however dermatologic disease can also cause inflammation of the lid margin with subsequent lash loss. Atopic dermatitis, seborroeic dermatitis, and rosacea can be responsible for eyelash loss in this manner. Remember systemic and endocrine disease can cause blepharitis such including alopecia areata and discoid lupus. Trichotillomania, oral medications and chemotherapy agents, toxicity and benign and malignant eyelid tumors can cause lash loss. Consider that cosmetic eyelash extensions can be responsible for keratoconjunctivitis and allergic blepharitis.3 Eyelashes…remember to take a look.
1. Kumar A, Karthikeyan K. Madarosis: A Marker of Many Maladies. Int J Trichology. 2012 Jan-Mar; 4(1): 3–18.
2. Khong JJ, Casson RJ, Huilgol SC, Selva D. Madarosis. Surv Ophthalmol. 2006;51:550–60.
3. Amano Y, Sugimoto Y, Sugita M. Ocular disorders due to eyelash extensions. Cornea. 2012 Feb;31(2):121-5.
Uniquely Qualified – Contact Lens Training…We Do Much Better Working Together for the Good of Our Patients.
This week a patient was referred to our practice from an existing patient in order to address the poor vision he was experiencing with his habitual contact lenses. The patient was found to have a “Pellucid-like” form of keratoconus. Entering visual acuities with habitual soft monthly replacement toric contact lenses were OD 20/100 and OS 20/40-. The patient has been wearing standard design soft contact lenses for over 20 years and has been under the care of a general ophthalmologist during that time. Concurrently the patient had developed cataracts, had successful surgery and is being treated successfully for primary open angle glaucoma. We were able to successfully refit the patient into scleral gas permeable contact lenses and obtain visual acuities of OD 20/25 and OS 20/20+ with excellent comfort. So, what is my point? Let’s explore and I tell you later.
A paper was recently published that evaluated the perspective of ophthalmology residents in the U.S. about their residency programs and compared the competency of residency programs to international competency levels set by the International Council of Ophthalmology.1 A cross-sectional web-based survey was sent to program directors of ophthalmology residency programs in the U.S. to forward it to current program year-3 and 4 residents, and residency graduates from 2011 to 2014. Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs overall (93.6%). The satisfaction ratings for most surgical and medical elements of their programs were rated quite highly. However, clinic-based training was rated insufficient regarding exposure to low-vision rehabilitation (38.5%), refraction and contact lenses (38.5%) – all traditional strong points of optometric education.
So, is sharing the case above and the outcomes of the paper cited intended to be a knock on ophthalmology? For sure it is not. My point is simply that each of the two eye care professions has inherent strengths that should allow us all to work together for the betterment of our patients. When a more complex contact lens case presents to a practitioner of either profession who has limited experience and expertise in this area, it would be to our patient's benefit to be referred to a practitioner who meets the criteria of an expert in the field. In the case mentioned above, the ophthalmologist is relatively local to our practice and other associates in his practice frequently refer complex contact lenses to our practice – and reciprocally we refer complex glaucoma and cornea cases to their practice for higher level management. So, let’s continue to understand that with the ever increasing amount of knowledge and information in health care it is virtually impossible for any individual to be an expert in all of eye care. Inter-professional referrals are key to our patients’ well-being.
1. Abdelfattah NS, Radwan AE, Sadda SR. Perspective of ophthalmology residents in the United States about residency programs and competency in relation to the International Council of Ophthalmology guidelines. J Curr Ophthalmol. 2016 Jun 23;28(3):146-51.
Lack of Agreement Among Electrical Impedance and Freezing-Point Osmometers
The purpose of this study was to assess the interchangeability of tear osmolarity measurements between electrical impedance and freezing-point depression osmometers and to analyze inter-eye tear osmolarity variability measured with these osmometers in healthy subjects.
Tear osmolarity was measured using the TearLab osmometer (OcuSense Inc., San Diego, CA) and the Fiske 210 micro-sample osmometer (Advanced Instruments Inc., Norwood, MA). We randomly selected one eye in 50 subjects (29 women, 21 men; mean age, 33.16 ± 6.11 years) to analyze whether osmolarity measurements by these osmometers were interchangeable. Both eyes of 25 patients (15 women, 10 men; mean age, 34.32 ± 6.37 years) were included to analyze inter-eye osmolarity variability.
The mean tear osmolarity values measured with the TearLab osmometer were higher (305.22 ± 16.06 mOsm/L) than those with the Fiske 210 osmometer (293.40 ± 12.22 mOsm/L), with the intra-class correlation coefficient being 0.23 (p = 0.051). A Bland-Altman plot showed that the systems were not interchangeable because there was a systematic difference, with the limits of agreement being -17.93 to 41.57 mOsm/L. There were no statistically significant differences (p = 0.5006 and p = 0.6533, respectively) between an individual's eyes measured with either osmometer.
Because the TearLab tear osmolarity measurements were higher than those of the Fiske 210 measurements and the limits of agreement were too wide, the two osmolarity values cannot be used interchangeably. In healthy subjects, there is no difference in tear osmolarity between right and left eyes of the same individual measured with both instruments.
García N, Melvi G, Pinto-Fraga J, Calonge M, Maldonado MJ, González-García MJ Lack of Agreement among Electrical Impedance and Freezing-Point Osmometers. Optom Vis Sci. 2016 May;93(5):482-7.