We were honored to recently recognize your top 30 influencers in the field of contact lenses over the last 30 years (http://www.clspectrum.com/articleviewer.aspx?articleID=114659). We wish to not only honor these individuals, but also thank you for contributing to the process through your nominations of these individuals. We are also excited to celebrate our 30-year history with you, and look forward to another 30 years of contact lens successes!
Jason J. Nichols, OD, MPH, PhD
In Memoriam: Krist Jani
Krist Jani of Scottsdale, AZ, passed away this past week from injuries suffered in a motorcycle accident. He was 64.
Mr. Jani had more than 30 years of experience in marketing, sales, and domestic and international business development within the ophthalmic marketplace. Throughout his career, he was instrumental in the development of a number of contact lens material technologies. He started his career as an optician, but soon joined Dow Corning Ophthalmics in Sales Management and Product Marketing Management. He later joined and invested in Paragon Vision Sciences, ultimately advancing to vice president of marketing and sales.
Mr. Jani also served as director, key market sales and public relations at CooperVision, Inc. His most recent role was as part of the management team of Optical Polymer Research, Inc.
In 2001, Mr. Jani was awarded the Contact Lens Manufacturers Association’s (CLMA) Industry Enhancement Award. He also sat on the board of directors for the CLMA, the Contact Lens Society of America, and the American Optometric Association Ophthalmic Council.
CooperVision’s Second Annual Search for Optometry’s Best Practices
CooperVision Inc. has announced its second annual nationwide search for honorees for its Best Practices initiative, which seeks to recognize U.S. eyecare professionals who have found unique ways to make their businesses thrive and can share a refreshing perspective with the entire profession.
All U.S. optometry practices currently fitting contact lenses are invited to participate. Innovation will be evaluated on contributions to the betterment of eye health and education, leveraging technology in interesting ways to grow the practice, and advancing the eyecare profession among the public. Industry leadership will be rated on how a practice advances the profession and leads the industry regionally, nationally, and even globally. And, patient experience will be judged on how a practice delivers excellent eyecare experiences and education to its patients as well as unique aspects of patient care.
Candidates can choose to submit their stories via written responses or video at eyecarebestpractices.com. Applications will be accepted through Nov. 27, 2016. The 2016 Best Practices will be announced in early 2017.
OGS Leads Coalition in Support of World Sight Day Challenge
Leading North American optometric companies, networks, schools, and practices will once again join forces in a coalition led by Optometry Giving Sight in support of World Sight Day (Oct. 13) and the World Sight Day Challenge, which runs throughout September and October.
This is the 10th year of the challenge, which encourages all members of the vision care community to make a donation or participate in a fundraising event to help fund sustainable eye health projects for people who are needlessly blind or vision impaired. This year will have a specific focus on the need for effective, sustainable eye health initiatives for children and adolescents as part of the Our Children’s Vision campaign.
Coalition members include ABB Optical Group, Alcon Foundation, AllAboutVision.com, Bausch + Lomb, CooperVision, Essilor, EyePromise, FYidoctors, Vision Source, VOSH International and VSP Global. They will be joined by A&A Optical, Acuity Pro, Advance Optical, Allergan, Amcon, Art Optical, Bard Optical, Clearvision, DAC Vision, De Rigo REM, Europa, Eye Recommend, GPLI / CLMA, Heidelburg, Hilco, Jobson, Johnson & Johnson Vision Care (Canada), Linden Optometry, Match Eyewear, MODO, Nikon/Elaine Turner, Optos, OSI, PECAA, Primary Care Optometry Magazine/Slack Inc., Reptile Sun, Ron's Optical, RX Optical, Signet Armorlite, Synergeyes, Texas State Optical, Tura, Vision One Credit Union, VmaxVision, Wave Contact Lens, Westgroupe, White Ophthalmic Supply Ltd, Wiley X, and Zeiss (Canada).
For more information about the World Sight Day Challenge, visit givingsight.org or call (888) OGS-GIVE in the United States and (403) 670-2619 in Canada.
ABB Optical Group, a distributor of optical products servicing two-thirds of practicing optometrists nationwide, released information on trends in the multifocal sector of the contact lens market.
Multifocal contact lens sales are a key driver of growth in the market. ABB Optical’s data shows that:
Overall, on a dollar basis, the multifocal contact lens segment is up 17% through the first half of the year, fueled predominantly by growth in daily disposable multifocals, which are up more than 90% year-to-date.
Practices that are more active in multifocal fittings tend to be growing their total contact lens portfolios faster. Those that have at least 15% of their total contact lens revenue in multifocals are growing their total contact lens portfolios nearly 60% faster than the market.
A multifocal fit typically drives 52% more dollar margin compared to the equivalent spherical fit.
Practices that bank a multifocal are growing their multifocal sales 3.1 times faster than the market.
Studies Demonstrate Promising Results of PiXL Procedure
Non-surgical photorefractive intrastromal corneal collagen cross-linking (PiXL) from Avedro is a promising new treatment for vision improvement for low myopia, according to the results of two studies (at Ruhr University Eye Hospital in Bochum, Germany; and one at the Eagle Eye Centre in Singapore) announced at the XXXIV Congress of the European Society of Cataract and Refractive Surgeons (ESCRS).
Avedro’s PiXL procedure offers the potential to provide non-invasive vision improvement for low myopia without compromising corneal biomechanical integrity. PiXL treats myopic refractive errors through the topical application of riboflavin followed by exposure of the cornea to UVA light delivered by the Mosaic device, which uses advanced eye-tracking technology to deliver controlled cross-linking.
The Mosaic device has received both the CE mark in Europe, and approval from Health Canada. The PiXL procedure and Mosaic device are not available in the United States.
Influence of a Scleral Contact Lens on PSF S. Barry Eiden, OD, FAAO
Below is an example of the influence a scleral contact lens can have on point spread function (PSF) of a patient in our practice with keratoconus. It is apparent that the contact lens dramatically reduces the distortion of the point light source; however, internal higher-order aberrations (HOAs) due to a mild cataract causes the reduction of HOAs totally in the visual system to be somewhat less than the reduction of corneal HOAs as seen in the relative PSF images (total vs. corneal vs. internal). For more information, please see the Research Review column below.
We thank Dr. Eiden 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.
More Than Visual Acuity…Contact Lens Influence on High Order Aberrations and Accommodative Response in Keratoconus
Your keratoconic patients will typically inform you that their vision deficit goes far beyond the ability to discern letters on a high contrast visual acuity chart. Other elements of visual performance are significantly hampered by the irregularity of the corneal surface in keratoconus. High-order aberrations (HOAs) are dramatically increased in keratoconus with vertical coma being a classic hallmark of the disease in many cases. Accommodative response to near stimuli can also be hampered in the disease. A study was recently published that looked at both aberrometry and accommodative response in keratoconus patients.1 The researchers wanted to specifically evaluate the accommodative response to different accommodative stimuli and to determine the changes in ocular higher-order aberrations with accommodation in keratoconus patients fit with mini-scleral lenses.
The study included 15 keratoconus patients wearing mini-scleral lenses and 15 keratoconus patients wearing rigid corneal GP lenses. A Hartmann-Shack aberrometer was used for the evaluation of accommodation and to measure high-order aberrations. Accommodative responses to the accommodative stimulus ranging from 0.5D to 5.0D with intervals of 0.5 D were recorded. Spherical, coma, trefoil aberration, and root mean square (RMS) of total HOAs (third to sixth orders) at baseline, at 2.5D stimulus, and at 5.0D stimulus were also recorded.
The outcomes found that although accommodative response to accommodative stimulus of 0.5D to 2.5D (with 0.5D intervals) was similar in both lens type groups, accommodative response to accommodative stimulus of 3.0D to 5.0D was significantly lower in keratoconus group wearing mini-scleral lenses. The coma, spherical, trefoil aberrations, and the RMS of total HOAs at baseline, at 2.5D stimulus, and at 5.0D stimuli were not significantly different between the groups. However, changes in the coma and trefoil aberrations and RMS of total HOA with 2.5D and 5.0D stimuli were significant only in the corneal GP group. The researchers concluded that accommodative response to increasing accommodative stimulus was found to be impaired in keratoconus patients wearing mini scleral lenses, while HOAs were increased for the corneal GP wearing group.
The most important point is the ability of all contact lenses that are fit for keratoconus to improve visual performance over spectacle correction in elements of vision that go beyond simple high-contrast visual acuity measurements. Today, we have clinically useful instruments that can measure both low and high-order aberrations at relatively affordable price points. The amount of information provided by these instruments greatly enhances our ability to understand and improve upon the visual performance of our patients.
1. Yildiz E, Toklu MT, Vural ET, Yenerel NM, Bardak H, Kumral ET, Bardak Y. Change in Accommodation and Ocular Aberrations in Keratoconus Patients Fitted With Scleral Lenses. Eye Contact Lens. 2016 Sep 7. [Epub ahead of print].
OCULAR SURFACE UPDATE Katherine M. Mastrota, MS, OD, FAAO
Dry Eye and Allergies
Dry eye and ocular allergy are two complex syndromes that have parallel signs and symptoms. Often the interplay of these pathologic disorders makes for a challenging therapeutic patient management plan.
It is helpful to me in evaluating patients with ocular symptoms to ask about/look for other signs of allergy. Examples are queries regarding rhinitis, post-nasal drip, cough, or history of sinusitis, headaches, asthma history, skin disorders, or rashes suggestive of atopy. Allergic shiners (dark circles under the eyes caused by increased blood flow near the sinuses) can be an additional allergy clue found on patient examination. A history of childhood allergy also is helpful when considering symptoms in your ocular surface disease patients. Food allergies can also overlap with hay fever. Known as “oral allergy syndrome” or OAS, this is a type of food allergy is classified by a cluster of allergic reactions in the mouth in response to eating certain (usually fresh) fruits, nuts, and vegetables that typically develops in adults with hay fever. OAS is perhaps the most common food-related allergy in adults.
I generally reference pollen counts to understand my local risk for allergy patients and take the counts into consideration when reviewing a patient’s history on the days before and on their examination. A good place to find the most accurate pollen count information is on the American Academy of Allergy, Asthma and Immunology website: https://www.aaaai.org.
Identifying and appropriately managing ocular allergy in your dry eye patients can significantly improve their quality of life.
Latanoprost-Eluting Contact Lenses in Glaucomatous Monkeys
The purpose of this preclinical efficacy study is to assess the ability of latanoprost-eluting contact lenses to lower the intraocular pressure (IOP) of glaucomatous eyes of cynomolgus monkeys. Study participants were female cynomolgus monkeys with glaucoma induced in one eye by repeated argon laser trabeculoplasty.
Latanoprost-eluting low-dose contact lenses (CLLO) and high-dose contact lenses (CLHI) were produced by encapsulating a thin latanoprost-polymer film within the periphery of a methafilcon hydrogel, which was lathed into a contact lens. The researchers assessed the IOP-lowering effect of CLLO, CLHI, or daily latanoprost ophthalmic solution in the same monkeys. Each monkey consecutively received one week of continuous-wear CLLO, three weeks without treatment, five days of latanoprost drops, three weeks without treatment, and one week of continuous-wear CLHI. On two consecutive days before initiation of each study arm, the IOP was measured hourly over seven consecutive hours to establish the baseline IOP. Two-tailed Student t tests and repeated-measures analysis of variance were used for statistical analysis.
The study found that latanoprost ophthalmic solution resulted in IOP reduction of 5.4±1.0 mmHg on day 3 and peak IOP reduction of 6.6±1.3 mmHg on day 5. The CLLO reduced IOP by 6.3±1.0, 6.7±0.3, and 6.7±0.3 mmHg on days 3, 5, and 8, respectively. The CLHI lowered IOP by 10.5±1.4, 11.1±4.0, and 10.0±2.5 mmHg on days 3, 5, and 8, respectively. For the CLLO and CLHI, the IOP was statistically significantly reduced compared with the untreated baseline at most of the time points measured. The CLHI demonstrated greater IOP reduction than latanoprost ophthalmic solution on day 3 (P = 0.001) and day 5 (P = 0.015), and at several time points on day 8 (P < 0.05).
The researchers concluded that sustained delivery of latanoprost by contact lenses is at least as effective as delivery with daily latanoprost ophthalmic solution. More research is needed to determine the optimal continuous-release dose that would be well tolerated and maximally effective. Contact lens drug delivery may become an option for the treatment of glaucoma and a platform for ocular drug delivery.
Ciolino JB, Ross AE, Tulsan R, Watts AC, Wang RF, Zurakowski D, Serle JB, Kohane DS. Latanoprost-Eluting Contact Lenses in Glaucomatous Monkeys. Ophthalmology. 2016 Aug 24 [Epub ahead of print]