What is your philosophy on the use of multipurpose versus hydrogen peroxide care solutions? Do you reserve hydrogen peroxide for “problematic” lens wearers? Or, do you use hydrogen peroxide as your “go-to” care solution? Please send your thoughts to email@example.com.
Jason J. Nichols, OD, MPH, PhD
Alcon Names Dr. Carla Mack Global Head of Professional Affairs for Vision Care
Alcon announced that Dr. Carla Mack has been named global head, Professional Affairs. In her new role, Dr. Mack leads Professional Affairs within Alcon’s Global Vision Care Franchise, reporting to Andy Pawson, president and general manager, Global Vision Care Franchise. As global head, Dr. Mack is responsible for coordinating and consolidating the company’s Vision Care professional affairs strategy and initiatives, working in partnership with regional professional leaders and teams.
In her previous role as head, Professional Strategy & Development – US Vision Care, Dr. Mack was responsible for all US Vision Care professional training and education through the Alcon Experience Academy, overseeing the training of eyecare professionals via the Alcon Experience Center.
Prior to joining Alcon in 2014, Dr. Mack held roles in global medical affairs and global professional marketing at Bausch + Lomb, was a professor at The Ohio State University (OSU) College of Optometry, and was clinic director of the OSU Campus Optometry Services. She also served as the chief editor of Contact Lens Spectrum and the Contact Lenses Today e-newsletter.
CooperVision Launches Soft Contact Lens Recycling Program in Sweden
CooperVision has launched an initiative in Sweden that offers consumers free soft contact lens recycling for all brands and manufacturers. The CooperVision Contact Lens Recycle Program aims to reduce plastic waste by providing a practical and easy way for wearers to recycle lenses as well as blister and foil packaging, according to the company.
Wearers have the option of sending contact lens materials directly to CooperVision’s recycling partner, TerraCycle, using prepaid mailing labels or dropping those materials off at a participating optical store in Sweden. The company also says that the program will help consumers understand the impact of their efforts, highlighting how the materials will be recycled for everyday use as plastic lumber, park benches, and fence posts.
FDA and NMPA Approve New Euclid Contact Lens Manufacturing Facility
The U.S. Food and Drug Administration (FDA) and Chinese Regulatory Authority (NMPA) have approved Euclid Systems Corporation to manufacture the Euclid Emerald line of contact lenses in a new, state-of-the-art facility located in Sterling, VA. The new space is more than triple the size of the company’s current facility. Euclid also plans to transition to a custom automated platform for manufacturing, which, according to the company, will help it better serve its customer base around the world.
In unrelated news, Euclid is also hosting a webinar about myopia on Sept. 10 from 8:00 p.m. to 9:00 p.m. (EDT). The webinar, titled “Proactive Myopia Management: Ensuring High Success with Your Ortho-K Fits,” will be presented by Sheila Morrison, OD, MS, and will provide valuable fitting and clinical insights about orthokeratology and the Euclid Emerald design. For more information or to register, visit https://euclidsys.zoom.us/webinar/register/3615670978512/WN_OP82tcf0QuCdICmW5jEZvQ.
CooperCompanies Introduces Refreshed Brand and New Website
CooperCompanies introduced an updated corporate brand name, brand identity, and new website at www.coopercos.com. According to the CooperCompanies, its design approach and aquamarine-inspired color palette represent the organization’s vibrancy and energy. The new website integrates these elements and provides substantially expanded content that illustrates the company, its people, and the many ways in which they’re improving lives, according to the company.
AAO and AAOF Travel Fellowships and Residency Awards Announced
The AAOF also announced the recipients of the 2019 Johnson & Johnson Vision Residency Awards. The 2019 residents were chosen by peer review members from the AAO Section on Cornea, Contact Lenses & Refractive Technologies and from the Binocular Vision, Perception and Pediatric Optometry Section. Each recipient will receive $2,000 toward their graduate education and a $750 travel fellowship to attend Academy 2019 Orlando & the 3rd World Congress of Optometry. This year’s recipients are Paula Kutzner, OD, Southern California College of Optometry—Terrance N. Ingraham Pediatric Optometry Residency Award; Laurel Roberts, OD, Illinois College of Optometry—Sheldon Wechsler Contact Lens Residency Award; and Alexandria Lui, OD, Indiana University, and Andrew Fischer, OD, Indiana University—George Mertz Contact Lens Residency Award.
Finally, Jocelyn Ou, OD, was named this year’s recipient of the Bert C. and Lydia M. Corwin Contact Lens Residency award. Dr. Ou, a cornea and contact lens resident at the Ketchum Health University Eye Center, was chosen by a committee of members in the Section on Cornea, Contact Lenses & Refractive Technologies of the AAO. She will receive a $2,000 education award and a $750 travel fellowship to attend Academy 2019 Orlando and the 3rd World Congress of Optometry.
Oculus Releases Myopia Master for Myopia Management
Oculus has introduced the Myopia Master, a device designed to combine all of the important measurement methods of myopia management: axial length, refraction values, and the central corneal radii. The Oculus Myopia Master creates a myopia report for each patient, giving due consideration to such myopia risk factors as having myopic parents, time spent outdoors, or time spent on near-vision activities. Oculus says that the Myopia Master assists in educating patients. The device can be mounted on a workstation or on an ophthalmic table. The software can be operated either directly via the display or from a connected computer.
MyopiaCare Launches MyAppia
MyopiaCare announced the integration of the MyAppia calculator, a visual aid for eyecare practitioners to illustrate the impact of myopia.
Developed by myopia specialist Thomas Aller, OD, the online calculator uses the age, current prescription of the child, and risk factors to build a visual prediction for the prescription development over 10 years. It then adds various treatment options (atropine, orthokeratology, spectacles, or soft multifocal contact lenses) to outline their predicted outcomes. These are displayed in an easy-to-understand visual format that ECPs can use to show parents and patients how their treatment choices may alter their future myopia progression outcomes. According to the company, MyAppia also allows eyecare specialists to assess the treatment effectiveness and adapt it in an ongoing way, as per the patients’ needs and evolution.
Originally developed in 2016 as an Android App, the MyAppia calculator can now also be found at www.myopiacare.com.
Luneau Technology Unveils Dry Eye Module and Eye Refract Station
Luneau Technology announced an optional Dry Eye Module that can be added to its VX120+ Anterior Segment Analyzers. The optional Dry Eye test battery includes tear breakup time, tear meniscus measurement, and color imaging of the meibomian glands.
Luneau also announced a new refraction station that allows eyecare professionals (ECPs) to conduct full and accurate refractions on a single instrument table. Combined with the highly automated Eye Refract on a bespoke instrument table, full and accurate refractions can now be completed by staff in less than four minutes in a space smaller than four feet wide, according to the company. Eye Refract generates a prescription for review and sign off by an ECP. In addition, the VX25 Space Saving Chart uses internal mirrors to replicate standard distance but requires only 31 inches of space from the Eye Refract instrument. The VX25 Space Saving Chart includes independent lighting, natural conditions, a selection of acuity tests, and anti-reflective coating.
In unrelated news, Luneau Technology has established a Clinical Application Specialist (CAS) team, focused on pre- and post-sale client support. The CAS team will act as clinical liaisons to ophthalmologists, optometrists, and ECPs currently using or interested in using Visionix devices. Melissa Renfrow has joined Luneau’s CAS team, bringing 16 years’ experience as a certified ophthalmology professional. Previously, she worked at Alcon and iScreen Vision.
PECAA Co-Founder Dr. Lance Anderson Joins Executive Team
PECAA (Professional Eye Care Associates of America) announced the return of one of the organization’s co-founders, who has accepted a newly developed role on the company’s executive team. Dr. Lance Anderson will now be serving as the organization’s vice president of Strategic Initiatives. Dr. Anderson brings more 25 years of private practice ownership experience and 13 years of executive experience to the doctor alliance group space. He currently serves as a member of the board of directors for Rev-360, the ownership group for PECAA, RevolutionEHR, and Visionary Partners.
As the vice president of Strategic Initiatives, Dr. Anderson will help identify new business opportunities for PECAA along with researching and developing new vendor relationships and conducting vendor negotiations and various key project development and implementation projects.
Prevent Blindness Declares September as Sports Eye Safety Month
Prevent Blindness has declared September as Sports Eye Safety Month to help educate the public on the best ways to keep eyes healthy while playing sports. For those who wear prescription glasses, an eyecare practitioner can provide a prescription for safe and effective sports protective eyewear. Monocular athletes (those who have only one eye that sees well) should consult a practitioner about what sports are safe to participate in.
Eye injuries from any sport may include infection, corneal abrasions, fracture of the eye socket, swollen or detached retinas, or a traumatic cataract. Eye injuries from water sports may include eye infections and irritations as well as scratches or trauma from other swimmers.
Over the last month, did you see a change in the frequency of children as patients in your office?
This image shows diffuse epithelial edema nine months after an otherwise excellent penetrating keratoplasty. The patient had an increase in intraocular pressure (IOP); IOP was measured at 44 mmHg via a Goldmann applanation tonometer. However, we must also consider increased central corneal thickness due to the edema.
We thank Dr. Potter 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.
S. Barry Eiden, OD
Corneal Reshaping/Ortho-K Lens Centration and Relationship to Corneal Topography—It’s Important
Corneal reshaping/orthokeratology (ortho-k) has become a mainstay of myopia management in many parts of the world. Obtaining optimal outcomes is critical to our ability to both correct vision during daytime hours without the use of optical correction and to control myopia progression. Lens designs that center well and therefore result in a centered treatment zone provide the highest quality of vision during the daytime and also can allow practitioners to apply the peripheral myopic defocus in the most effective way.
A recent published article looked at corneal topographic findings in relation to lens fit centration outcomes.1 The study investigated ortho-k lens decentration (LD) and its association with pretreatment corneal topographic parameters. Fifty right eyes of 50 myopes wearing ortho-k lenses were included in the prospective study. Corneal topography was conducted pretreatment to get topographic corneal parameters, including flat K (K1); steep K (K2); corneal astigmatism (CA), CA at 0mm to 3mm (3mm-CA), 3mm to 5mm (5mm-CA), and 5mm to 7mm (7mm-CA); surface asymmetry index (SAI); surface regularity index; the curvature of the best-fit sphere; the diameter of the cornea (DC); the distance from the corneal center to the corneal vertex (CCCV); flat eccentricity (E1), steep eccentricity (E2), and E1/E2 (E ratio); the corneal curvature differences between the nasal and temporal quadrants at 0mm to 3mm (3mm-Knt), 3mm to 5mm (5mm-Knt ), and 5mm to 7mm (7mm-Knt); and the corneal curvature differences between the superior and inferior quadrants at 0mm to 3mm (3mm-Ksi), 3mm to 5mm (5mm-Ksi), and 5mm to 7mm (7mm-Ksi). The relationship between these corneal topographic parameters and ortho-k LD was tested using stepwise multiple linear regression models.
Results indicated that the mean magnitude of LD was 0.51mm ± 0.23mm (0.06mm to 1.03mm). According to the stepwise analysis, four factors were associated with the overall LD (P < 0.01): SAI (β = 0.252), CCCV (β = 0.54), 5mm-CA (β = –0.268), and 3mm-Ksi (β = –0.374); five factors were associated with the horizontal LD (P < 0.01): DC (β = 0.21), CCCV (β = 0.88), 3mm-CA (β = -0.22), 5mm-Knt (β = 0.15), and 3mm-Ksi (β = –0.18); and three factors were associated with the vertical LD (P < 0.01): SAI (β = 0.54), 5mm-CA (β = –0.19), and 3mm-Ksi (β = –0.21).
The authors concluded that lens decentration is common, but in most cases, the amount of LD is moderate and acceptable. Further, the magnitude of LD can be predetermined by topographic corneal parameters. Surface asymmetry index, CCCV, 5mm-Knt, and 3mm-Ksi may be more preferable parameters in terms of the assessment of ortho-k LD.
The development of more customized lens designs for corneal reshaping/ortho-k such as toric designs, etc. are allowing practitioners to provide better centration and, as such, visual outcomes. Another area that should be examined would be residual astigmatism within the visual axis. Use of appropriate toric treatment zones is a natural development in corneal reshaping/ortho-k technology.
1. Gu T, Gong B, Lu D, Lin W, Li N, He Q, Wei R. Influence of Corneal Topographic Parameters in the Decentration of Orthokeratology. Eye Contact Lens. 2019 Aug 22. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
Smoking and the Ocular Surface
I have previously explored the known effects on cigarette smoking on the ocular surface.1 Now, on Aug. 15, 2019, the U.S. Food and Drug Administration (FDA) proposed new warning labels for cigarettes and cigarette advertising.
Once finalized, the proposed rule, “Required Warnings for Cigarette Packages and Advertisements,” would require new health warnings on cigarette packages and in advertisements to promote greater public understanding of the negative health consequences of smoking. The new warnings include harmful effects that people may not associate with smoking.
The 13 proposed FDA warnings feature text statements accompanied by photo-realistic color images depicting some of the lesser-known health risks of cigarette smoking, including the negative impact on the eye and vision. These warnings stand to represent the most significant change to cigarette labels in 35 years.2
Two of the new warnings focus on the leading causes of blindness in the United States: age-related macular degeneration and cataracts. Smoking can also lead to or contribute to other eye diseases including dry eye.
Short Interruptions of Imposed Hyperopic Defocus Earlier in Treatment Are More Effective at Preventing Myopia Development
The purpose of this study was to evaluate the effect of interrupting negative lens wear for short periods early or late during the development of lens-induced myopia in marmosets.
Sixteen marmosets were reared with a –5D contact lens on their right eye (plano on contralateral eye) for eight weeks. Eight marmosets had lenses removed for 30 mins twice/day during the first four weeks (early interruption) and eight during the last four weeks (late interruption). Data were compared to treated controls that wore lenses continuously (N = 12) and untreated controls (N = 10). Interocular differences (IOD) in vitreous chamber (VC) depth and central and peripheral mean spherical refractive error (MSE) were measured at baseline and after four (T4) and eight (T8) weeks of treatment. Visual experience during the interruptions was monitored by measuring refraction while marmosets were seated at the center of a 1m radius viewing cylinder.
At T4, the eyes that were interrupted early were not different from untreated controls (p = 0.10), and at T8, they had grown less and were less myopic than were those interrupted later (IOD change from baseline, VC: +0.07mm ± 0.04mm versus +0.20mm ± 0.03mm, p < 0.05; and MSE: –1.59 ± 0.26D versus –2.63 ± 0.60D, p = 0.13). Eyes interrupted later were not different from treated controls (MSE, p = 0.99; VC, p = 0.60) and grew at the same rate as during the first four weeks of uninterrupted lens wear (T4 to T0: 3.67µm/day ± 1.1µm/day, T8 to T4: 3.56µm/day ± 1.3µm/day, p = 0.96).
The authors concluded that peripheral refraction was a predictive factor for the amount of myopia developed only when the interruption was not effective. In summary, interrupting hyperopic defocus with short periods of myopic defocus before compensation occurs prevents axial myopia from developing. After myopia develops, interruption is less effective.
Benavente-Perez A, Nour A, Troilo D. Short Interruptions of Imposed Hyperopic Defocus Earlier in Treatment are More Effective at Preventing Myopia Development. Sci Rep. 2019 Aug 7;9:11459.