A report released recently by the Centers for Disease Control and Prevention (CDC) in Morbidity and Mortality Weekly Report (MMWR) shows that more than 85% of adolescent contact lens wearers report habits that increase eye infection risk. The habits that increased the risk of eye infection in adolescents included sleeping or napping while wearing contact lenses (30% of adolescents), not visiting an eyecare practitioner once a year (44%), and swimming while wearing contact lenses (27%).
The report also indicated that 81% of young adults aged 18 to 24, and 87% of adults aged 25 and older, have habits that increase their chance of eye infection that could threaten their vision. The most frequently reported risky habits among both young adults and adults included not replacing lenses as often as prescribed (52% of young adults and 45% of adults); additionally, about 41% of young adults and 42% of adults do not replace lens cases on a regular basis, and 33% of both groups sleep while wearing contact lenses. It is important that we recognize these potentially “risky” behaviors in our lens-wearing patients so that we can educate them to help prevent poor outcomes and complications.
Jason J. Nichols, OD, MPH, PhD
Visioneering Technologies, Inc. Appoints Dr. Douglas P. Benoit as Executive Director of Professional Affairs
To better support the practice needs of eyecare professionals (ECPs), Visioneering Technologies, Inc. (VTI) has named Douglas P. Benoit, OD, to the newly created position of executive director, Professional Affairs. In his new position, Dr. Benoit will be responsible for interfacing with ECPs to increase awareness and use of the NaturalVue 1 Day Contact Lenses product line. He will also be working with professional organizations and educational institutions to raise awareness of VTI and its NaturalVue products.
Dr. Benoit’s leadership in the contact lens industry spans more than 30 years. For approximately 21 years, Dr. Benoit served on the executive committee for the American Academy of Optometry’s Section on Cornea, Contact Lenses, and Refractive Technologies, including chair of the Section in 2011 and 2012. He is a Diplomate in this Section of the Academy, a title earned by less than 170 eyecare professionals worldwide. He is a Distinguished Practitioner and Fellow in the National Academies of Practice-Optometry Section and a Diplomate of the American Board of Optometry. He has conducted multiple U.S. Food and Drug Administration clinical studies, published numerous articles, and he lectures frequently on contact lenses and external disease. Dr. Benoit received his Doctor of Optometry degree from The New England College of Optometry in Boston.
Advanced Vision Technologies Announces New Naturalens Scleral
Advanced Vision Technologies announced the newest addition to its Naturalens family of GP lenses—the Naturalens Scleral. The Naturalens Scleral offers several new design features, including diagnostic markings on the limbal zone to help identify proper lens diameter, four adjustable zones, and the Tangible Hydra-PEG (Tangible Science) coating.
The Naturalens Scleral simplifies the proper diameter selection with the Maximum Limbal Indicator (MLI) markings, according to the company. Four zones–Central Optical Zone, Para-Central Zone, Limbal Zone, and the Haptic (landing) Zone–are independently adjustable to create an ideal fit. The lens is available in front toric, toric PC, and back aspheric multifocal designs with a secondary distance zone to help alleviate glare and flare at night.
Additionally, all Naturalens Sclerals come standard with Tangible Hydra-PEG, a 90% water polyethylene glycol (PEG)-based polymer coating that envelopes the Optimum GP (Contamac) material. The Naturalens Scleral utilizes a 21-lens diagnostic set and a simplified fitting guide to ensure a successful fit for patients ranging from normal to extremely irregular corneas, according to the company. The standard fitting set includes three diameter options—15.9mm, 16.9mm, and 17.9mm; MLI markings to indicate the ideal size of the lens based on how the limbal zone of the lens positions over the limbus; Sag options from 4.20D to 6.50D in even 300µm steps; haptic zone options in each diameter with one flat and one steep steps; and a toric PC option in each diameter.
Contamac Announces FDA Clearance of HEXA100 (Hexafocon A)
Contamac announced that the U.S. Food and Drug Administration (FDA) has cleared HEXA100 (hexafocon A) for several indications including spherical, toric, multifocal/bifocal, irregular cornea, and orthokeratology as well as for use with the Tangible Hydra-PEG coating. HEXA100 will be available in the fourth quarter of 2017.
Hubble Contacts Closes Series A-III Financing to Support Global Growth
Hubble, a direct-to-consumer contact lens brand, closed a $10 million Series A-III financing round, and the company’s first step toward international growth, with a launch in Canada. The Series A-III raise, which will aid Hubble’s international expansion plans, was led by existing investors, including FirstMark Capital, Greycroft Partners, Founders Fund, Wildcat Capital Management, and Two River. Hubble also plans to launch into Europe over the next year.
Hubble contact lenses are now available at ca.HubbleContacts.com for $40 CAD per month. Every new customer gets the first two weeks of lenses for free (+$4 CAD s/h), and subscriptions can be canceled at any time (including during the free period).
Oculus Incorporates Oculus Canada
Oculus Optikgeräte GmbH has incorporated Oculus Canada as its ninth international subsidiary. Oculus Canada will support new and existing customers throughout the region.
BHVI and Mark’ennovy Partner in Contact Lens Development
The Brien Holden Vision Institute (BHVI) and Mark’ennovy, a manufacturer of monthly replacement contact lenses, have signed a worldwide exclusive licensing agreement to bring to market a portfolio of new design soft silicone hydrogel contact lenses specifically targeted to address myopia control and presbyopia.
The two companies have decided to combine their strengths to offer extended depth of focus (EDOF) designs powered by BHVI in tandem with precision custom-made frequent replacement contact lenses by Mark’ennovy.
Call for Abstracts for NCC
Under the theme of “Make A Difference,” practitioners are encouraged to contribute to the science stream and submit case reports to the Nederlands Contactlens Congress (NCC). All abstracts will be published in Contact Lens and Anterior Eye. A pre-screening service is available to aid authors in developing abstracts that will meet the above criteria. The deadline for pre-screening is Oct. 31; final submissions must be made by Dec. 15.
NCC 2018 will take place on March 11 and 12 in Veldhoven, The Netherlands. To get more information, visit www.ncc2018.com.
B+L Introduces Ocuvite Eye Vitamin Adult 50+ Formula Minigels
Bausch + Lomb (B+L) launched Ocuvite Adult 50+ Formula Minigel daily eye vitamins that help replenish vital nutrients that eyes can lose as they age, according to B+L. The new minigels, which will replace the currently offered Ocuvite Adult 50+ soft gels, now include highly concentrated fish oil. Ocuvite Adult 50+ Formula also provides vital eye nutrients, including lutein, zeaxanthin, and omega-3.
To promote awareness about the importance of eye vitamins, B+L is launching a new consumer campaign featuring TV and digital ads, a revamped website, and a refreshed design for the Ocuvite Adult 50+ Formula packaging. B+L says that the campaign will educate consumers on the importance of eye nutrition for maintaining good eye health and will suggest eye vitamins as a part of their daily health regimen.
Johnson & Johnson Vision Completes Acquisition of TearScience
Johnson & Johnson Vision (J&J Vision) has completed its acquisition of TearScience, Inc., a medical device manufacturer dedicated to evaluating meibomian gland health and treating meibomian gland dysfunction. According to the company, the acquisition is another step in J&J Vision’s strategy to become a broad-based, global leader in eye health and further expands the company’s leading eye health portfolio.
J&J acquired TearScience, Inc., through its surgical vision operating company, Abbott Medical Optics Inc. Sales will be reported in the Medical Devices segment, under Vision Care. Financial terms of the transaction have not been disclosed.
Personalize Your Experience. Attend Courses From All Tracks
Join us November 2-5 for the 13th annual Optometric Management Symposium in Orlando, FL. We now have four tracks of learning: Clinical Management, Clinical Business, Retail Strategies and Specialty Contact Lenses. Our education faculty secures the very best speakers in the industry with timely topics to teach you what you need to know to grow your skills, your business and your employees! For more information or to register, visit www.omconference.com.
Do you concurrently prescribe a saline solution with a hydrogen peroxide-based care system to your contact lens wearers?
Your Interesting Case Photo Here in the Next Issue
Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in Contact Lenses Today in the coming weeks!
We welcome photo submissions from our 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.
CARE SOLUTION CORNER
Andrew D. Pucker, OD, PhD
Contact Lens Rewetting Drops
Dry eye is a highly prevalent condition that frequently affects contact lens wearers.1 In fact, there is even a dry eye subtype–contact lens-induced dry eye–for which contact lens use is the instigator of symptoms.2 While ocular dryness during contact lens use may just seem like a nuisance, it is actually a primary reason why patients permanently drop out of contact lenses.3 One first-line treatment for improving contact lens comfort is contact lens rewetting/lubricating drops.4
In 1997, the U.S. Food and Drug Administration (FDA) defined rewetting/lubricating drops in its premarket notification (510(k)) guidance document for contact lens care products as “an in-eye solution for use with contact lenses” that contains “one or more active ingredients (e.g., ophthalmic demulcents) in sufficient concentration to alleviate symptoms of discomfort from contact lens wear by physical means.”4 These solutions are considered a lubricating drop if they contain an ophthalmic demulcent and are considered a rewetting drop if they do not contain a demulcent.4 The FDA separately classifies artificial tears in its Ophthalmic Drug Products for Over-the-Counter Human Use monograph as topical drops that contain specific types of demulcents or emollients.5 Therefore, artificial tears used with contact lenses are considered an off-label use, although it is done frequently.
While many practitioners, including myself, have commonly recommended the use of artificial tears with contact lenses, we should be trying our best to instruct our patients to follow the manufacturer’s intended use of a product because each product has been formulated for a specific purpose (e.g., using rewetting drops to treat contact lenses discomfort), a practice that will likely result in healthier outcomes and better patient satisfaction.
It’s no secret that most patients who drop out of lens wear do so because of discomfort and dryness. And, patients who make it to 45 years old as contact lens wearers are rare.
These days, dry eye in contact lens wearers is certainly at an all-time high. I used to turn a blind eye and attempted to solve the problem by switching my patients to a new monthly or two-week lens or to a new solution. Then, I started shifting them all to daily disposables. Like many of you, these improvements brought about some short-term gains as well as declines in the levels of discomfort. However, our dropouts from contact lens wear have stayed at nearly the same level despite our innovations. So, many practitioners have started treating the root of the problem for patient, which I believe is inflammation. My experience has been that some anti-inflammatory drops have done wonders to improve our patients’ lens comfort and have translated into a long-term decline in lens irritation.
The manufacturers of these medications recommend that patients not use them while wearing contact lenses. Like other medications, applying the drops while wearing a lens may affect the medication’s ability to absorb into the ocular surface. Additionally, it may have a negative effect on the lens or fit. Of course, the effects on the lens are less of an issue for patients wearing daily disposables. Since medications in this category that are currently FDA-approved for this indication are preservative free, we do not need to worry about accumulated preservative buildup within the lens that may negatively affect the ocular surface. Additionally, because these patients are replacing their lenses on a daily basis, the medications likely have no or only minimal effect on the lens.
If your patients are wearing monthly or two-week lenses, make sure to share the importance of waiting a full 15 minutes after drop application before applying their lenses. If they wear daily disposable lenses, the recommendation should still stand despite the fact that the medication may affect the lens less.
If your patients are experiencing discomfort and dryness, blame the ocular surface first. Treat the underlying pathology and put them in the best lens choice possible.
Risk Factors and Causative Organisms in Microbial Keratitis in Daily Disposable Contact Lens Wear
This multisite prospective case-control study investigated independent risk factors and causative organisms in microbial keratitis in daily disposable contact lens (CL) wearers. Cases were daily disposable CL wearers attending Moorfields Eye Hospital who had microbial keratitis and patients who reported through a one-year surveillance study in Australia and in New Zealand. A population-based telephone survey identified daily disposable CL-wearing controls. Subjects completed a questionnaire describing CL wear history, hygiene, and demographics. The sample used for risk factor analysis was weighted in proportion to the CL-wearing population at each location. Corneal scrape results were accessed. Independent risk factors were determined using multiple binary logistic regression. Causative organisms in different CL wear modalities were compared using a chi square test.
In the study, 963 daily disposable CL wearers were identified, from which 67 cases and 374 controls were sampled. Independent risk factors included wearing CLs every day compared with less frequent use (OR 10.4x; 95% CI 2.9-56.4), any overnight wear (OR 1.8x; 95% CI 1.6-2.1), less frequent hand washing (OR 1.8x; 95% CI 1.6-2.0), and smoking (OR 1.3x; 95% CI 1.1-1.6). Certain daily disposable CLs (OR 0.2x; 95% CI 0.1-0.2) had protective effects. Environmental organisms were less frequently recovered with daily disposable CLs (20%) compared with other modalities (36%; p < 0.02).
The authors concluded that overnight wear, increased exposure in daily wear, smoking, and poor hand hygiene are significant risk factors for microbial keratitis with daily disposable CLs. Risk varied with daily disposable CL type. The profile of causative organisms is consistent with less severe disease.
Stapleton F, Naduvilath T, Keay L, Radford C, Dart J, Edwards K, Carnt N, Minassian D, Holden B. Risk factors and causative organisms in microbial keratitis in daily disposable contact lens wear. PLoS One. 2017 Aug 16;12(8):e0181343.