This month’s poll results are in, and it appears as though your patients have listened and sought eye care for their children—92% of respondents said that they examined about the same as or more children in the past month than before that. This is critically important because children are now back at school, and we must continue to stress the importance of ensuring that our children are seeing their best to achieve optimal academic performance.
Jason J. Nichols, OD, MPH, PhD
Prevent Blindness Names October Contact Lens Safety Awareness Month
Prevent Blindness has declared October as Contact Lens Safety Awareness Month to educate the public on the best ways to care for their eyes through the safe use and care of contact lenses. Prevent Blindness strongly recommends that contact lens wearers contact an eyecare practitioner if they experience the following: unexplained eye discomfort or pain, redness of the eye, watering eyes, or vision change. For more information on contact lens safety, visit http://www.preventblindness.org/wearing-contact-lenses.
AAOF Announces Grant and Fellowship Recipients
The American Academy of Optometry Foundation (AAOF) named Laura Downie, BOptom, as this year’s recipient of the Korb-Exford Dry Eye Career Development Grant. Dr. Downie is currently senior lecturer in the Department of Optometry and Vision Sciences and is faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne, Australia. Her proposal to develop a novel point-of-care medical device for eye diagnosis was chosen out of nine very competitive submissions. She will receive a $25,000 grant to help her advance eye care and improve outcomes for people who have dry eye disease.
In addition, the AAOF, in partnership with the Allergan Foundation, announced Loretta B. Szczotka-Flynn, OD, PhD, as the 2019-2020 recipient of the Allergan Foundation Research Grant. Dr. Szczotka-Flynn is a professor of ophthalmology and visual sciences at Case Western Reserve University. She has been awarded a $60,000 grant for her project, “Modeling Corneal Endothelial Cell Health Parameters as Predictors of Keratoplasty Stress.” Her co-investigators include Tracy Nguyen, OD, PhD, SUNY College of Optometry; Tim McMahon, OD, University of Illinois at Chicago; Muriel Schornack, OD, Mayo Clinic Department of Ophthalmology; Christine Sindt, OD, Iowa Department of Ophthalmology; and Langis Michaud, OD, Montreal School of Optometry. This grant is awarded to talented optometrists and/or vision scientists who are Academy members and are currently undertaking cutting-edge research in the areas of glaucoma and/or the anterior segment. This is the sixth year that the Allergan Foundation has sponsored this grant through the AAOF.
Finally, the AAOF, in collaboration with the Beta Sigma Kappa International Optometric Honor Society, announced Sima T. Mozdbar, OD, as the 2019 recipient of the Beta Sigma Kappa (BSK) Research Fellowship. Dr. Mozdbar is an adjunct clinical professor at the University of Houston College of Optometry. The fellowship is designed to provide support for early career optometric and vision science faculty research. This award will fund Dr. Mozdbar’s project, “Cognitive Dysfunction and the 25-Item National Eye Institute Visual Function Questionnaire.”
CooperVision Seeks Submissions for 2020 Best Practices Honorees
CooperVision, Inc. announced its fifth annual search for the nation’s 2020 Best Practices. All U.S. optometry practices currently fitting contact lenses are eligible to apply. Best Practices candidates are encouraged to submit practice profiles and stories, sharing their insights and experiences in the following areas: “Innovation” will be evaluated on contributions to the betterment of eye health and education, leveraging technology in meaningful 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 and on unique aspects of patient care in which it leads. Candidates can submit their stories via written response at EyeCareBestPractices.com/applying through Nov. 21, 2019. Applications will be reviewed by a panel of judges including past Best Practices honorees, industry experts, and CooperVision leaders.
Honorees are also brought together at the annual Best Practices Summit, which provides a forum for education and collaboration on a variety of practice management and clinical practice topics. New this year, CooperVision also announced a Best Practices scholarship program, which will provide third-year optometry students with the opportunity to attend the educational summit.
Myco Industries, Inc. Issued Patent for the AB Max
Myco Industries, Inc. announced that the U.S. Patent and Trademark Office issued U.S. Patent No. 10,404203 on Sep. 3, 2019 for the AB Max, a new treatment for anterior blepharitis. John Choate, chairman of Myco, designed the AB Max to provide medical professionals with advanced functionality utilizing two onboard computers and proprietary tips specifically designed to treat anterior blepharitis, according to the company.
The AB Max features forward and reverse functionality as well as a patented pulse mode that is specifically engineered to remove even the most tenacious scurf and debris, while massaging the outer eyelid margins, according to Myco.
B+L Files Proposed Settlement in Pricing Lawsuit
Bausch + Lomb (B+L) will pay $10 million to consumers who allege that the contact lens company conspired with others to raise prices of soft lenses. The company filed the proposed settlement agreement with the court stating that it denies violating any laws and maintains that its conduct was proper.
The consumers argue that B+L, along with Alcon, Johnson & Johnson, and CooperVision, conspired with each other to stop the discounting of reusable contact lenses, which would ensure that the retailers would charge a minimum price for the lenses. The plaintiffs also allege that the companies threatened retailers who sold the lenses below a mandated price. If the retailers did not abide by these terms, the companies would impose a restriction on their supply to them.
In addition, the contact lens class action claims that the companies created a Unilateral Pricing Policy (UPP) that was used to fix the prices of the contact lenses. The company claims that the UPP in relation to the B+L lenses have been stopped and are no longer in effect.
According to the proposed settlement agreement, B+L will put the $10 million into an escrow account within 14 days of preliminary approval, and the plaintiffs will have the right to terminate the settlement agreement if this doesn’t happen.
Walgreens Settles Contact Lens Price Fixing Class Action Suit
Walgreens and Vision Direct recently agreed to settle antitrust class action claims against them, leaving 1-800 Contacts as the only remaining defendant in the litigation. In light of the settlement, U.S. Magistrate Judge Dustin B. Pead issued an order that will stay all deadlines for Walgreens and Vision Direct. The details of the settlement are not currently available, but the motion for a stay notes that the settlement will include “monetary payment plus specified cooperation.”
Plaintiffs filed their antitrust class action lawsuit against 1-800 Contacts, Walgreens, Vision Direct, and other companies in Oct. 2016. The plaintiffs alleged that the companies were involved in an antitrust scheme that suppressed competition and fixed the online prices of contact lenses.
The contact lens antitrust class action was prompted by a Federal Trade Commission (FTC) complaint against 1-800 Contacts claiming that the agreements gave the company unfair advantages in advertising. According to the FTC, the agreements allowed 1-800 Contacts to secure advertisements on Google and Bing without competition from other online contact lens companies.
Bruder Introduces Hygienic Eyelid Cleansing Wipes
Bruder Healthcare announces availability of Bruder Hygienic Eyelid Cleansing Wipes. The wipes feature a leave-on, no-rinse formula that helps dissolve and remove excess oils and debris from eyelids and lashes to improve overall ocular health, according to the company. The pre-moistened, individually wrapped wipes are hypoallergenic and free of harsh chemicals.
Bruder Hygienic Eyelid Cleansing Wipes are available in a box of 30 as well as in the Bruder Hygienic Eyelid Cleansers Combo Pack that includes 30 wipes and 1 fluid ounce of Bruder Hygienic Eyelid Solution (0.02% pure hypochlorous acid).
BCLA Details Pioneers & Visionaries Conference Program
Registration is now open for the Pioneers & Visionaries conference, a one-day event being held at the Royal Society of Medicine in London on Nov. 26.
The 2019 British Contact Lens Association (BCLA) Pioneers Lecture, entitled “Understanding Contact Lens Discomfort” will be presented by Professor Michel Guillon, honorary professor in The School of Life and Health Sciences at Aston University.
The day will also feature lectures on key topics of relevance to everyday contact lens practice and ocular surface management. Sessions will cover all key subject areas facing those working within contact lens and anterior segment practice. Highlights include “Is OrthoK for Myopia correction or myopia control?” and “Is there a place for mini sclerals?” Additionally, the dry eye management session will discuss National Health Service changes to dry eye product prescriptions and how this will affect patients. The day will close with a glimpse into the future as Reena Chopra from Moorfields, along with others, will examine the role of artificial intelligence and anterior segment grading.
The event is being staged in conjunction with BCLA partners Alcon and CooperVision, platinum sponsors Johnson & Johnson Vision, gold sponsors Menicon and SEED with UltraVision, technology sponsor Topcon, and premium sponsors Mark’ennovy and Visioneering Technologies. For more information or to register, visit www.bcla.org.uk.
Last Chance to 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.
This 46-year-old patient was being refit into a scleral lens from a GP that was scarring his cone. On examination, a loose conjunctiva was noted. This anterior optical coherence tomography (OCT) photo shows a conjunctival prolapse under the inferior edge of a 17mm prolate scleral lens.
We thank Mr. Gildea 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.
SPECIALTY LENS SPACE
Karen DeLoss, OD
Irregular or Abnormal Cornea
I recently had a patient on my schedule who was in for a routine eye exam. Her chart showed a prescription of –17.00 +4.00 x 090. When I went into the room and proceeded to discuss contact lenses with her, she replied “Everyone has always told me that I cannot wear contact lenses.” So, I began to consider all of the possibilities that would prevent contact lens wear. She has no amblyopia, no keratoconus, and no evidence of any corneal pathology; she just happened to have a high prescription that would take some extra time and patience. When I told her that I may have contact lens options for her, she was shocked, and I was thankful to be able to help her out. With busy schedules, it can be easy to let these patients slide out of our offices without having these conversations. However, taking a few extra minutes to let them know their options can help increase patient satisfaction and referrals.
It shouldn’t be shocking that this patient’s corneas had with-the-rule astigmatism. Irregular corneas are due to either surface disorders (such as dry eye) or obstacles (such as Salzmann’s nodule degeneration). Irregular astigmatism implies that the two principal meridians are not 90º apart.1 Examples of irregular astigmatism include keratoconus, post-laser-assisted in situ keratomileusis (LASIK) ectasia, and post-corneal transplant.
In any case, take some time to talk with this patient population about options—such as specialty soft lenses, corneal or scleral GP lenses, or hybrids—and note that it will take a few visits to obtain an optimal fit. Advanced planning will ultimately help improve your patients’ vision and perhaps help your day run a bit smoother.
1. Kovacich S. Irregular Astigmatism, Part 1. Contact Lens Spectrum. 2016 Apr;31:36-38,55.
MATERIALS & DESIGNS
David L. Kading, OD
Solutions Can Be a Problem
I was on the forefront during the solution wars of 2005 to 2010. I was a huge advocate for one of the players and lectured internationally about the importance of using the right solution. I am still on the forefront of this debate, but my champion has changed. No longer do I battle for the best solution for patients’ lenses; I now champion no solution for our patients. With 95% of my contact lens-wearing patients using daily disposables, we have moved away from solutions almost entirely. We now experience only a few patients coming into the office each year who have a solution-related complication, and this used to be a weekly occurrence. In fact, the total number of contact lens complications is now almost nonexistent in our practice.
Multipurpose solutions (MPSs) had been reinventing themselves constantly to be cutting edge and to be compatible with the two-week and monthly lenses that were being released. However, not much has happened in the MPS space in the last five years. Since the last wave of new lenses was released into the market, we have not had a new MPS solution released in large scale in the United States. Although there are still advantages to MPSs in their wetting of the lens surface, we have converted nearly all of our existing extended-replacement patients to a hydrogen peroxide-based solution in an effort to reduce any chemical toxicity.
I encourage you to look at your care solution recommendations for your patients. Review whether you are prescribing a solution at all. And, if you are, make sure that it is biocompatible for a patient’s ocular surface and lens interaction.
A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society
The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of dry eye described dry eye disease as follows: “Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage.” The report emphasized the instability of the tear film and the importance of visual dysfunction in association with dry eye, highlighting the importance of the evaluation of tear film stability. The report also discussed the concept of tear film-oriented therapy, which stemmed from the definition and which is centered on provision of insufficient components in each tear film layer and the ocular surface epithelium.
The current ADES report proposes a simple classification of dry eye based on the concept of tear film-oriented diagnosis and suggests that there are three types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation. The authors suggest that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended.
The ADES classification report also suggests that, for a practical use of the definition, diagnostic criteria and a classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and is performed only through the use of fluorescein, which is available even to non-dry eye specialists and which is believed to contribute to an effective diagnosis and treatment of dry eye.
Tsubota K, Yokoi N, Watanabe H, et al; Members of The Asia Dry Eye Society. A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society. Eye Contact Lens. 2019 Aug 13. [Epub ahead of print]