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September 23, 2018
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Sjögren’s syndrome is a terrible disease that has a significant impact on the quality of life of our patients. In years past, patients who have Sjögren’s were often bounced among specialists who did their best to treat them; sometimes, however, the disease went undiagnosed for years. As noted by an article and research conducted by the Sjögren’s Syndrome Foundation, the time-to-diagnosis of the disease has been reduced from six years to just under three years (https://www.sjogrens.org/home/about-the-foundation/breakthrough-goal-/5yearupdate). We are thankful to such organizations that are taking on initiatives that have a true impact on patient care.
 Jason J. Nichols, OD, MPH, PhD

In Memoriam: Thomas Anastor
Thomas E. Anastor, president of Art Optical Contact Lens, Inc. from 1967 to 2018, died at the age of 74 on Sept. 17 as a result of an extended illness.
After taking the helm of his father’s lens manufacturing company, he dedicated 50+ years to the ophthalmic industry. Under his direction, Art Optical grew from a regional laboratory to a global producer of high-performance GP and custom soft lenses.
He was a dedicated supporter of optometry and optometric education, a member of the Grand Rapids Lions Club, and a recipient of several state and national industry awards, including the 2008 Trailblazer Award presented by the Contact Lens Manufacturers Association (CLMA). His vision and legacy continue under the direction of Jill Anastor, president.
He is survived by his wife Jill; his children Thomas E. Anastor II, Tony Anastor, and Stephanie Anderson (Erik); and his two grandchildren CJ Anastor and Zoey Anderson.
Sun Pharma, SPARC Get FDA Approval for Xelpros
Sun Pharmaceutical Industries Ltd. and Sun Pharma Advanced Research Company Ltd. (SPARC) announced U.S. Food and Drug Administration (FDA) approval for the New Drug Application (NDA) of Xelpros (latanoprost ophthalmic emulsion) 0.005% for the reduction of elevated intraocular pressure (IOP) in patients who have open-angle glaucoma or ocular hypertension. Sun Pharma in-licensed Xelpros from SPARC in June 2015.
Xelpros is a form of latanoprost that is not formulated with benzalkonium chloride (BAK), a preservative that is commonly used in topical ocular preparations. Xelpros is developed using SPARC’s proprietary Swollen Micelle Microemulsion (SMM) technology. Xelpros will be commercialized in the United States by Sun Ophthalmics, the branded ophthalmic division of Sun Pharmaceutical Industries Ltd.’s wholly owned subsidiary.
IACLE Releases New Distance Learning Program
The International Association of Contact Lens Educators (IACLE) has fully revised and updated its Distance Learning Program (DLP) in line with the IACLE Contact Lens Course (ICLC). The program is now available to IACLE members via its website, www.iacle.org.
The DLP is designed as a self-study aid for the ICLC to assist educators with their teaching. The program guides members through the course module-by-module with an assignment of multiple-choice questions after each section submitted to IACLE for marking and feedback. The new DLP consists of 12 assignments in four phases based on the new ICLC modules, each requiring the completion of two to four assignments.
The following FIACLEs in India contributed significant new material: Ajay Shinde, Sankara College of Optometry; Rajeswari Mahadevan, Sankara Nethralaya Medical Research Foundation; Prema Chande, Lotus College of Optometry; Gauri Kunjeer Patel, Nagar School of Optometry; Anitha Arvind, Sankara College of Optometry; and Pancham Kulkarni, Lotus College of Optometry.
ABB Optical Group to Participate in 2018 World Sight Day Challenge
To raise funds for Optometry Giving Sight, ABB Optical Group is once again participating in the organization’s World Sight Day Challenge. Observed annually on the second Thursday in October, World Sight Day is an international day of awareness designed to focus global attention on blindness and vision impairment. As part of the initiative, ABB Optical Group will donate a percentage of its Digital Eye Lab Network sales through the month of October to Optometry Giving Sight.
For more information about Optometry Giving Sight’s World Sight Day Challenge, visit GivingSight.org.
AAO Holds Inaugural The Research Academy Program
The American Academy of Optometry held its inaugural program, The Research Academy, in Columbus, Ohio on July 17 to 19, 2018, with 60 vision researchers, graduate students, optometric leaders, and health agency officials in attendance. The Research Academy was designed to help optometry faculty attendees develop ideas that will result in extramural funding for both basic and patient-oriented research in optometry and vision science.
The program included a video presentation by Dr. Israel Goldberg of Health Research Associates and featured a mock National Institutes of Health-style study section with experienced reviewers so that attendees could experience how submitted grants are evaluated. Components of a viable research idea, an overview of the National Eye Institute and its funding mechanisms, and federal changes to the regulations that govern biomedical research were also emphasized.
New Scleral Lens Resource Available
The Clinical Guide for Scleral Lens Success is a hands-on practical resource to use daily in clinical practice. This unified international guide covers everything from staff training to patient and family communication, step-by-step scleral lens fitting, scleral lens care and aftercare, and follow-up schedules. The Clinical Guide for Scleral Lens Success—authored by Melissa Barnett, OD, and Daddi Fadel, DOptom—is a collaborative work between the Accademia Italiana Lenti Sclerali (AILeS) and the Scleral Lens Education Society (SLS), with the purpose of providing a unified protocol for scleral lens fitting. Support for the guide was provided by Contamac.
Alcon Experience Academy Launches
Alcon unveiled the Alcon Experience Academy, a program that offers face-to-face training and online educational resources by leading specialists from around the world to provide the best patient care possible. As part of this effort, Alcon launched a new online portal, AlconExperienceAcademy.com.
The website includes a library of more than 500 training videos, with additional content added regularly to an easy-to-navigate home screen. It will also feature webcasts developed by leading eyecare specialists from around the world, along with personalized videos and curricula across several disease states and focus areas. The website materials primarily focus on real-world surgical case studies using the latest innovations in eye care. Resources specific to optometry are due to be released early next year.
AAOF Announces the 2018 AAOF Student Travel Fellowship Recipients
The American Academy of Optometry Foundation (AAOF) announced the recipients of the 2018 AAOF Student Travel Fellowships. The fellowships are supported by past and present AAO Presidents, donors, and members of both the Academy and the Foundation Boards. Each recipient will receive a travel grant to attend the Academy annual meeting in San Antonio.
The recipients are: Beta Sigma Kappa (BSK) Student Travel Fellowship – Lea Hair, University of Houston College of Optometry; Brett G. Bence Clinical Student Travel Fellowship – Alex Saunders, University of Houston College of Optometry; Brett G. Bence Leadership Student Travel Fellowship – Jennifer Chu, New England College of Optometry; Elmer H. Eger Memorial Student Travel Fellowship – Monica Chan, Indiana University School of Optometry, and Danielle Kolschefski, University of California Berkeley School of Optometry; Kirschen Family Student Travel Fellowship –Yuyeng Lor, Massachusetts College of Pharmacy and Health Sciences; Lois Schoenbrun Student Travel Fellowship –Josiah Henry Tsiquaye, Kwame Nkrumah University of Science and Technology; and N. Rex Ghormley Student Travel Fellowship –Linda Yan, Nova Southeastern College of Optometry.
Participate in Contact Lens Spectrum’s Practice Profile Survey
How does your contact lens practice stack up against those of your peers? The best answer is determined by you. Contact Lens Spectrum needs your feedback for our annual Practice Profile Study that we field to vision care professionals. Your responses, trended with previous years' results, will be featured in Contact Lens Spectrum’s annual report in its January issue. You will find invaluable information about trends in the contact lens field relative to contact lens materials, designs, and fitting.
Please take a few minutes to complete the questionnaire to which we provided a link below. If you provide an email address, you will be entered into a blind drawing for one of three $50 American Express gift cards. .
To participate, go to: https://www.surveymonkey.com/r/DFHWLGH.
GSLS Track at OMS
Join us November 1 to 4 for the 14th annual Optometric Management Symposium in Orlando, FL. Our education faculty has lined up a sampling of the courses and speakers that you would see at the Global Specialty Lens Symposium. Attend up to six hours of targeted specialty lens sessions, or mix and match with courses in the Clinical Management and Retail Strategies tracks.
For more information or to register, visit www.omconference.com.
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What unique situations arise in your clinical practice in which contact lens rebates play no significant role in your prescribing? (Please indicate all that would apply for you in this situation.)
Click here to vote.
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Hamed Momeni-Moghaddam, BSc, MSc, Mashad, Iran
An iris epithelial cyst was first observed two years after penetrating keratoplasty in a 36-year-old woman who has keratoconus. It then enlarged during a three-month time period. To prevent endothelial touch, the cyst was removed surgically. These epithelial implantation cysts have a corneal origin attached to iris tissue.
We thank Mr. Momeni-Moghaddam 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.
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SPECIALTY LENS SPACE
Karen DeLoss, OD
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CL Options for Patients Who Have High Astigmatism
Astigmatism is one of the most common eye conditions, with an estimated prevalence of up to 77%.1 However, the prevalence of high astigmatism, starting at around 3.0D, is only around 3% to 5%, which is no shock to any eyecare provider.2 Nevertheless, there is still some demand for contact lenses in this patient population. As industry continues to evolve, more options are available.
Silicone hydrogel soft contact lens options for patients who have high astigmatism have been limited to few options beyond –2.25D (meaning above –2.75D) for many years. The increase in parameters manufactured and available for this patient population makes it easier to fit and retain these patients.
Currently, several companies have the option of astigmatism correction in silicone hydrogel of –2.75D, and even one offers cylinder powers up to –5.75D. In addition, several hydrogel lenses are available for higher astigmatism, and multiple custom soft lenses can be prescribed for patients who have high astigmatism.
While not common to encounter this type of patient, eyecare practitioners should keep themselves up to date on currently available options for this patient demographic. As they say, it’s not rare if it is in your chair!
1. Pokharel GP, Negrel AD, Munoz SR, Ellwein LB. Refractive Error Study in Children; results from Mechi Zone, Nepal. Am J Ophthalmol. 2000 Apr;129:436-444.
2. Hashemi H, Khabazkhoob M, Yekta A, et al. High Prevalence of Astigmatism in the 40-to-64 year old population of Shahroud, Iran. Clin and Exp Optom. 2012 Apr;40:247-254.
MATERIALS & DESIGNS
David L. Kading, OD
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It’s Time for Torics
When eyecare practitioners (ECPs) think about fitting toric lenses on their patients, they each have a threshold for how high of a cylinder correction a patient needs before going to a toric lens. Whether they select a toric lens and there is lens rotation or a lens is not locking in where it needs to be, their patients’ vision fluctuates or is blurry. However, if patients don’t have toric lenses, they will have blurry vision at all times. Many patients survive just fine with a lens corrected with a spherical equivalent; others notice the blur and require higher amounts of cylinder. Consider patients who have 1.00D of cylinder; for many practitioners, this can be corrected with a spherical lens.
Today’s lenses stabilize far quicker and better compared to prior lenses. Certainly, patients who have outside-the-norm keratometry and horizontal visible iris diameter values continue to experience problems with these lenses, but the majority find stability. Neglecting a patient who has 1.00D of cylinder would be similar to correcting a 2.25D-cylinder patient with a 1.25D-cylinder lens. Most ECPs would balk at this, but they still will not correct 1.00D cylinder patients.
Currently available lenses provide the vision that these patients don’t even know that they are missing. Be a hero and help them.
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Sjögren’s Syndrome in Optometric Practices in North America
The purpose of this study was to describe the presentation of dry eye in Sjögren's syndrome (SS) in optometric practices, to report on the methodology used in dry eye monitoring, and to explore the level of corneal staining versus age and time of disease.
Records of SS patients were reviewed at six optometric sites. A standardized abstraction tool was developed to collect data from the records, including health history, medications, and symptoms and signs of dry eye. The methods of testing symptoms and signs of dry eye were recorded. Variables were recorded at each site and collated at the University of Waterloo. The first visit after Jan. 1, 2000 was selected for description in this paper.
The study included 123 charts. The average time since diagnosis was 7.2 years ± 5.1 years. Symptoms of dryness were recorded in 110 (89.4%) charts. Corneal fluorescein staining was recorded in 96 (78%) charts. MGD was recorded in 52% of charts. There were significant differences in the protocols and grading systems used at these six sites. Corneal staining levels did not change with greater age or length of disease.
The researchers determined that these 123 SS patients presented with a large variation in their symptoms and signs. Symptoms of dryness and corneal fluorescein staining were the most commonly recorded presentations. There was a great deal of inconsistency in dry eye protocols among offices. Future prospective research with standardized testing will contribute to an understanding of the best dry eye protocols for SS patients.
Caffery B, Harthan J, Srinivasan S, et al. Sjogren's syndrome in optometric practices in North America. Cont Lens Anterior Eye. 2018 Aug 18. [Epub ahead of print]
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