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Sunday, April 3, 2011

Care Solution Editor's Corner Commentary Susan J. Gromacki, Jason J. Nichols, OD, OD, MS, FAAO MGD Redefined: International Workshop on MPH, PhD, FAAO MGD Report Available

The Tear Film & Ocular Surface Society (TFOS) reported I must admit, I like the "big In our recent discussion of the conclusions and recommendations of the International box" stores. I shop at them infiltrative , we've looked Workshop on Meibomian Gland Dysfunction (MGD). The frequently, for probably the at the frequency of this Workshop was conducted to provide an evidence-based same reasons as most complication and noted that evaluation of meibomian gland structure and function in everyone else: price and 56% of practitioners felt it was health and disease. The just issued Report required over convenience. I have filled in at being seen at the same rates or two years to complete and involved the efforts of more than my colleagues' professional even on the decline, while 44% 50 leading clinical and basic research experts from around practices within some of these felt they were seeing it more the world. locations and have been frequently. This past week, impressed. So let it be known "This report will have a significant impact on the diagnosis we've asked about your that this column is not and treatment of lid disease and evaporative dry eye. It is impressions of four factors personal, but rather, intended to be a stimulus for future MGD research that will commonly associated with informational. benefit the clinical care of patients around the world for infiltrative keratitis in contact years to come," said Kelly Nichols, OD, MPH, PhD, wearers. Overwhelmingly, It is estimated that almost half Associate Professor, Ohio State University and Chair of the respondents think that patient of today's contact lens care MGD Workshop Steering Committee. non-compliance is the most products are purchased at significant factor associated with three leading "big box" The MGD Report was published by the Association for this complication—to a much retailers: Kmart, Walmart, and Research in Vision and in a special issue of greater extent than contact lens Target.1 This may or may not Investigative Ophthalmology & Visual Science (IOVS) and material characteristics, care surprise you. But what may made available to scientists and clinicians worldwide. A solution characteristics and surprise you, is that one of downloadable version of the document may be obtained even overnight lens wear. them (Walmart) decided to through a link on the TFOS website (www.TearFilm.org). remove Clear Care (CIBA Complete or partial translations of the report will be offered As I have said numerous times, Vision) from its shelves in numerous languages, including English, Dutch, French, clinical experience is a critical recently. It only makes sense German, Greek, Italian, Japanese, Polish, Portuguese, first step in identifying a clinical that a retailer that carries its Spanish, Turkish and Russian. problem, but clinical research is own, private label ("generic") the way to solve the problem. brand would eventually TFOS received funding for the MGD workshop from Putting this all together, I think it eliminate some of its Laboratoires Théa, Pfizer, Inspire, Bausch + Lomb, TRB is important that we maintain competition. But at what cost? Chemedica, Santen Pharmaceutical, Allergan, Alcon, perspective before getting Clear Care (along with other Johnson & Johnson, Advanced Vision Research, Senju, ahead of ourselves on the premium solutions like Biotrue CIBA Vision and SOOFT Italia. issues surrounding infiltrative from Bausch + Lomb, Opti- keratitis. For example, I have heard numerous opinions about Free RepleniSH from Alcon -- ADVERTISEMENT -- and RevitaLens OcuTec from specific contact lenses and care

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and RevitaLens OcuTec from Abbott Medical Optics) plays solutions thought to be an important role in our associated with infiltrative armamentarium as contact keratitis. While some of this lens practitioners. Many of our discussion could turn out to be patients (approximately 14.6% true, we must consider this of over 30-35 million CL information anecdotal until wearers in the United States properly designed and 2,3 controlled studies address the alone) benefit from the use issues at hand. of this product. Why, I ask, should a mass retailer remove such an important clinical CLToday Quick Poll product from its shelves?

The answer is because it can. Last week's question: They can choose to carry and Which of the following factors sell whatever they want to; do you feel most strongly that's a retailer's prerogative relates to infiltrative keratitis in (it's ours, too, for that matter). your contact lens wearers? Where they cross the line is if and when they make 1. Contact lens material recommendations – which, in characteristics my opinion, is prescribing – on 5% which solutions to substitute. And some stores have done 2. Multipurpose care solution just that. Lagado's Tyro and Onsi GP Materials characteristics What can we do? We and our 11% patients could contact Receive Expanded Indications from FDA corporate headquarters to 3. Overnight contact lens wear communicate how this Menicon Co., Ltd announced that Lagado Corporation's Tyro decision affects eye care. (hofocon A) and Onsi (onsifocon A) gas permeable contact 19% Individually and collectively lens materials have received an expanded indication from (through our professional the U.S. Food and Drug Administration (FDA) for managing 4. Patient non-compliance with organizations like the AAO irregular corneal conditions (in non-diseased eyes) for lens care or wear and AOA) we could boycott , pellucid marginal degeneration, post 65% shopping at such locations. On penetrating keratoplasty, post radial keratotomy and post a local level, we should inform LASIK surgery. each and every Clear Care patient that his or her care With oxygen delivery (Dk 56) and superior hydrophilic system is no longer available surfaces, Onsi has been used for patients with refractive Abstract at Walmart. And lastly, we errors including , hyperopia, , and should continue to prescribe, . Class I SCL Prevents UVB- rather than recommend, our The expanded indication positions Tyro as an option for the Induced Ocular Effects in the patients' care systems, management of certain irregular corneal conditions requiring Rabbit In Vivo educating each patient why high oxygen delivery (Dk 97) and surface performance our chosen solution is properties, according to the company. Tyro is supplied to UVB radiation from is 4,5 optimal. With this extra custom lens laboratories in standard as well as large known to be a risk factor for knowledge in tow, our patients diameters blanks of 17mm, 21mm and 25mm. human . The purpose of will be less likely to let this study was to investigate the business decisions alter how For more information, visit www.lagadocorp.com. ability of a Class I UV-blocking they care for their contact soft contact lens to protect lenses. against UVB-induced effects on EyeXam App for iPhone Exceeds One ocular tissues of the rabbit in We at Contact Lenses Today vivo. will continue to keep you Million Downloads - Now Available for iPad informed on this issue, as well Eyes of rabbits were exposed to Global EyeVentures, LLC, announced that its EyeXam as any others that may affect UVB light for 30 min (270-360 iPhone application exceeded one million downloads and is how we practice contact lens nm, peak at 310 nm, 1.7 now available for the iPad. EyeXam features a self-guided, care. mW/cm(2) on the ). Eyes patent-pending method for assessing one's own visual were irradiated in the presence acuity at distance and near, color vision plates, an Amsler 1. Smythe JL. What's in a of either a UV-blocking grid, and information about eye care products. Solution Name? Contact Lens senofilcon A contact lens, a Spectrum. May 2003. minimally UV-blocking lotrafilcon

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Spectrum. May 2003. minimally UV-blocking lotrafilcon 2. AC Nielsen, Solution Use in With a broad user base, EyeXam has proven to be a valuable tool for patients looking for eye related information, A contact lens, or no contact 2010 Year to Date, lens at all. Effects on the cornea Percentage by Brand. and is a high value asset for industry vendors seeking to reach the app users, according to Nikki Iravani, OD, and lens were evaluated at December 25, 2010. various times after exposure. 3. Nichols JJ. Marking an Founder and CEO of Global EyeVentures. Industry Anniversary. Contact Eyes irradiated with no contact Lens Spectrum. March 2011. EyeXam is sponsored by several industry companies including Alcon, All About Vision, Crystalens (Bausch + lens protection showed corneal 4. Gromacki SJ. Promoting epithelial cell loss plus lens Adherence to Your Prescribed Lomb), Focus Laboratories, Vision Service Plan, and Vision Source. epithelial cell swelling, vacuole Care Regimen, Part 1. Contact formation, and DNA single- Lens Spectrum. December EyeXam is available for free download through the App strand breaks, as well as lens 2009. store: http://itunes.apple.com/us/app/eyexam/id357290178? anterior subcapsular 5. Gromacki SJ. Promoting mt=8. opacification. The senofilcon A Adherence to Your Prescribed lens protected nearly completely Care Regimen, Part 2. Contact against the UVB-induced Lens Spectrum. February Report Shows CL Industry Growth Across effects, whereas the lotrafilcon 2010. A lens showed no protection. Five Major Markets in Asia in 2010 The researchers concluded that Ocular The contact lens industry continued to perform well in 2010, the results indicate that use of a registering a healthy 12 percent growth and more than USD senofilcon A contact lens is Surface 623 million in sales across the five combined markets beneficial for protecting ocular Update monitored by GfK Asia: Hong Kong, South Korea, tissues of the rabbit against the Kelly K. Nichols, Singapore, Malaysia and Taiwan. According to GfK's full harmful effects of UVB light, OD, MPH, PhD, year retail audit findings, all these markets expanded in including photokeratitis and FAAO value within the range of 9 to 12 percent. cataract.

Daily replacement contact lenses continued to dominate with Giblin FJ, Lin LR, Leverenz VR, 46 percent of the total industry sales value. However, a key Dang L. A Class I (Senofilcon I write this after spending the driver and currently strongest growth segment of the A) Soft Contact Lens Prevents day at one of the "new" seven industry is the silicone hydrogel lens. All five markets UVB-induced Ocular Effects, wonders of the world, Chichen showed rising market share of this contact lens type though including Cataract, in the Rabbit Itza, Mexico. Just walking at different rates of adoption. While over a fifth of contact in vivo. Invest Ophthalmol Vis through this sacred place lens revenue generated in Singapore, Malaysia and Hong Sci. 2011 Mar 18. [Epub ahead causes one to reflect on the Kong last year came from silicone hydrogel, this proportion of print] significant sacrifice and sheer was significantly lower in Taiwan and South Korea. "contribution" of the original builders. In today's fast paced GfK Asia is part of the global GfK Group and has over 25 world, it is rare to create or be years of experience providing reliable retail and technology part of something long-lasting, market data in Asia. The GfK Retail Panel is a regular audit when newer and better are monitoring sales of specific products and product categories, just around the corner. using a range of Internet, retail outlets and companies to provide trade and industry highly accurate and up-to-date This week the report of the information on various segments of the market. International Meibomian Gland Workshop was published in Record COPE accreditation for BCLA 2011 IOVS. This two year process, sponsored by the Tear Film The 35th British Contact Lens Association (BCLA) Clinical and Ocular Surface society Conference and Exhibition has received COPE accreditation through generous industry for a record 13 hours of continuing education (CE), with a support, will provide an further three hours pending approval. evidence based framework to move basic, clinical, and BCLA 2011 will take place in Manchester from May 26–29. translational research, and ultimately clinical care in COPE-accredited sessions include: ocular surface disease, forward. Clinical Spotlight: Non-spectacle Correction of Presbyopia: the Holy Grail for Eyecare Practitioners And while this event Oxygen – featuring keynote speaker, Dr. Joe represents a large group effort, Bonanno (USA) and one not without toil, it may The Alliance of Compliance – featuring keynote only reflect a snapshot of the speaker Dr. Kathy Dumbleton (UK) field today with a blueprint for – featuring keynote speaker Professor William Ayliffe tomorrow. Indeed, this

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tomorrow. Indeed, this (UK) Therapeutics Academy – featuring Professor "contribution" is more like one John Flanagan (Canada) of the many limestone rocks Increasing the Safety and Comfort of Contact Lens on the way up the Chichen Wear by Professor Mark Willcox (Australia) Itza steps, a small but Clinical Spotlight: Myopia Control...How Far Have We contributory part to the big Gone? picture of ocular surface Contact Lenses and General Health – chaired by Dr. disease. Lisa Keay (Australia)

The report and executive For more information and to register for BCLA 2011, visit summary are available in PDF www.bcla.org.uk. open access at www.iovs.org with weblinks at www.tearfilm.org. A free two- This month at www.siliconehydrogels.org: Ethnic differences page pull-out summary of the in ocular physiology, tear mixing and contact lens-related report will be included in the adverse events, risk factors for inflammatory and May issues of Contact Lens mechanical events, and our synopsis of the 2010 meeting of Spectrum, Optometric the American Academy of Optometry. Management, and Ophthalmology Management compliments of TFOS.

Important Links: To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088. To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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