Article Date: 12/1/2008

Eyecare Professionals Provide Vision to Less Fortunate
Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

Eyecare Professionals Provide Vision to Less Fortunate

SIX ORGANIZATIONS OFFER OPPORTUNITY TO GIVE BACK.

■ British Prime Minister Winston Churchill once said: "We make a living by what we get, but we make a life by what we give." In the spirit of holiday giving, we have listed six organizations that play a role in helping the less fortunate obtain eye care. (For information on how you can make a difference to peope who are blind or visually impared due to refractive error, please see "Optometry's Challenges in Global Vision," of this December issue.)

International Association for the Prevention of Blindness (IAPB). In 1975, the World Blind Union (WBU) and the International Council of Ophthalmology (ICO) became the founding members of the IAPB, which was established as a coordinating umbrella organization to lead an international effort in mobilizing resources for blindness prevention. Visit: www.iapb.org.

Optometry Giving Sight (OGS). Formed by the IABP, the WOF and the ICEE, OGS addresses the needs of the 300 million people around the world who are blind or vision impaired due to refractive error. Visit: www.givingsight.org.

The International Centre for Eyecare Education (ICEE). A not-for-profit organization whose vision is to "create a world where every individual has access to affordable eye care." Visit: www.icee.org.

Volunteer Optometric Services to Humanity (VOSH)/International (VI). A non-governmental organization dedicated to the provision of eye and vision care services for those below poverty level and without access to local eye care. VI is the parent organization of 34 regional chapters and 25 student chapters comprised of optometrists, ophthalmologists, opticians and other volunteers. Visit: www.vosh.org.

World Health Organization (WHO). The directing and coordinating authority for health within the United Nations system. Visit: www.who.int.

The World Optometry Foundation (WOF). A complementary, not-for-profit corporation established to finance eyecare projects (i.e. education, blindness prevention, etc.) that foster self-sufficiency and long-term independence among developing nations. Visit: www.worldoptometry.org.

Survey Reveals M.D. Dry Eye Treatment Perceptions

OPHTHALMOLOGISTS SAY MODERATE TO SEVERE DRY EYE REQUIRES MORE TREATMENT OPTIONS.

■ Although 80% of U.S. ophthalmologists feel that current dry eye treatments are effective against mild disease, only 33% feel that way regarding moderate disease, and 67% feel they're only somewhat effective or not very effective against moderate disease, says a survey conducted by Aton Pharma Inc. — makers of Lacrisert (hydroxypropyl cellulose ophthalmic insert) for dry eye.

Also, only 5% feel that current dry eye treatments are effective for severe disease, while 56% feel they are somewhat effective, and 38% not very or not at all effective. In addition, 83% feel a treatment gap exists between artificial tears and more aggressive treatments for moderate to severe dry eye. Further, 94% believe moderate to severe dry eye requires more treatment options than currently available.

Other revealing results:

► A total of 74% said their chief goal in treating moderate to severe dry eye is maintaining and protecting the ocular surface, while 67% said lubricating and hydrating the ocular surface is their chief goal.

► A total of 84% said that a key consideration when selecting treatment products for moderate to severe dry eye is its ability to provide continuous relief, while 74% said ability to use the treatment longterm; 66% said length of time in preserving the tear film; 66% said dosing frequency; and 63% said length of time to effectiveness.

Aton Pharma Inc. invited U.S. M.D.s via e-mail to participate in the online survey. It asked those respondents who treated four or more moderate to severe dry eye patients per month to complete the survey. The 245 respondents included corneal specialists and comprehensive/ general ophthalmologists, among others, the company says.

Annual AAO Press Meeting Demonstrates Diversity of Optometry

FROM STUDENT DEBT TO GLOBAL CHARITIES

■ The American Academy of Optometry (AAO) Professional Press Conference, held during the AAO's annual meeting, in Anaheim, Calif., provided insights into the latest advancements across a broad spectrum of ophthalmic concerns and issues. It included scientific papers and industry presentations on contact lenses, dry eye, low vision, nutrition and diagnostic equipment, as well as a few unexpected topics (fluorescent vs. incandescent bulbs and student debt). Presentation highlights follow:

PEDIATRICS

► Convergence insufficiency patients appear to achieve a significantly greater improvement in their symptoms and clinical measures of near point of convergence and positive fusional vergence, and a greater percentage of them reach the predetermined criteria of success when compared with home-based pencil push-ups and home-based computer vergence/accommodative therapy with pencil push-ups, according to the 12-week Convergence Insufficiency Treatment Trial (CITT).

► A survey of 41 children who wear contact lenses showed that through a two-year period, these children showed no change with time in the number and type of microorganisms recovered from their lids and the conjunctival surface (Markoulli M, De la Jara PL, Sankari-durg P, et al. "The Lid and Conjunctival Microbiota in Children With Contact Lens Wear").

DRY EYE

► In a study of 30 patients fit in a lotrafilcon B (02 Optix, CIBA Vision) lens, thicker lipid layers were associated with reduced rates of prelens tear film thinning (i.e., evaporation). Meanwhile, the lens and lens solution (Opti-Free Replenish, Alcon) was associated with pre-lens tear film distribution (i.e., lipid layer thickness) (Nichols J, Nichols K, King-Smith E. "Role of The Lipid Layer as a Barrier to Pre-Lens Tear Film Thinning").

LOW VISION

► In 2,500 procedures at four European sites, patients implanted with the intraocular lens for visually impaired persons, Vision Advantage International (IOL-Vip) experienced a minimum two-line improvement, and 60% gained greater than three lines of vision (www.visionadvantage.net).

CONTACT LENS

► Bausch & Lomb introduced the SofLens daily disposable contact lens and SofLens daily disposable contact lens for Astigmatism, both non-ionic hilafilcon B daily disposable lenses with "High Definition" optics and an aspheric design to reduce spherical aberration, the company says. (www.bausch.com).

► CIBA Vision announced a parameter expansion for its Air Optix for Astigmatism contact lens: plano to -6.00D in 0.25D parameter steps; -6.50D to -9.00D in 0.50D steps and +0.25D go +6.00D in 0.25D steps (www.airoptix.com).

► CooperVision explained that its recently released Avaira two-week silicone hydrogel contact lens is made from a material that attracts and binds water within the lens itself, keeping it moist without surface treatments or wetting agents (www.coopervision.com).

► While lens and solution factors have been linked with silicone hydrogel contact lens wear discontinuation, discontinuation due to adverse events (AE) was more likely to be associated with solution factors, and non-AE discontinuation was more likely to be associated with lens factors (Evans V., et al. "Multivariate Analysis of Factors Associated With Discontinuation of Silicone Hydrogel Contact Lens Wear")

► In a study of 15 cats, epithelial changes (modulation of thickness across the cornea) in eyes wearing orthokeratology contact lenses for one month appear to be fully reversible within one week after the cessation of wear. (Choo J, Caroline P. "Recovery of Orthokeratology Epithelial Changes After Cessation of One Month of Lens Wear").

FINANCE

► Optometry student debt continues to rise, pushing students from the traditional 10-year payout to 30-year payouts. Research is needed to measure debt's impact on a new O.D.'s career path. (Bacigalupi M. "Student Loan Debt For The Graduating Optometry Students of 2008).

NUTRITION

► Jeffrey Anshel, O.D., president of the Optometric Nutrition Society, introduced the society, which is dedicated to educating professionals in the role of nutrition in systemic and ocular health (www.optometricnutritionsociety.org).

COMPUTER VISION

► With brief use of hand-held displays, 34 adults showed significant differences in viewing distance, blink frequency and subjective discomfort, which seems to result from the nature of the task (Tai YC, Sheedy J, Hayes J, et al. "The Viewing Distance and Visual Discomfort While Using Handheld Displays").

ACUITY CHARTS

► VisionScience Software presented Acuity Pro v7.0 suite computer-generated eye charts and Eye Central News, an in-office patient education and marketing tool that includes real-time news and weather reports, information about eye health and general health and general trivia and motivational quotes (www.visionsciencessoftware.com)

GLAUCOMA

► Heidelberg Engineering introduced a glaucoma module for the Spectralis, which combines confocal scanning laser ophthalmoscopy (cSLO) and spectral-domain OCT (SD-OCT) (www.heidelbergengineering.com).

GLOBAL

► Volunteer Optometric Services to Humanity (VOSH) International presented its initiatives to eliminate refractive error blindness and low vision as well as its partnership with Optometry Giving Sight (OGS), which would guarantee OGS funds raised in the United States be directed to VOSH-initiated vision care projects (www.vosh.org, www.givingsight.org).

ENVIRONMENT

► Energy-saving compact fluorescent lamps (CFLs) can replace similar wattage incandescent lamps. However, spiral and spherical designed CFLs are a more appropriate equivalent to incandescent bulbs than are linear construction-type bulbs (Dain, S, Yuen, G).

HEALTH Notes
• DiaVis (Science-Based Health) is a dietary supplement that supports the visual and overall health of diabetes patients.

• ISTA Pharmaceuticals filed a New Drug Application with the Food and Drug Administration (FDA) for bepotastine ophthalmic solution (Bepreve) — a drop for allergic-conjunctivitis-caused ocular itching.

• At total of 60% of end-stage age-related macular degeneration patients implanted with a telescope prosthesis (VisionCare Ophthalmic Technologies, Inc.) acquired three or more lines of best-corrected visual acuity two years post-implantation vs. 10% of fellow control eyes, says November's American Journal of Ophthalmology.

• Glycemic control in Type 1 diabetes patients is linked with a major decrease in diabetic retinopathy (DR) progression and further improvement in DR, independent of disease duration and DR level at baseline, says November's Ophthalmology.

Ophthalmic Group Expands Nationally

PECAA AIMS TO MAKE DOCS MORE COMPETITIVE

■ In these challenging economic times, a Portland, Ore.-based company, which provides information and business services to private-practice optometrists, announced it will expand across the United States.

Professional Eye Care Associates of America (PECAA), a for-profit corporation, offers education, group-purchasing discounts and reduced-cost target marketing.

"With one monthly fee, PECAA provides both buying power and consulting power, and includes marketing resources as well," says PECAA President Brad Smith, O.D. The company, comprised of independent optometric and ophthalmology offices in the Northwest, plans to expand to all U.S. regions "within the next two to three years," says Dr. Smith.

For a flat monthly fee, PECAA services include a "Practice Strategies" program and quarterly coaching to help practices increase growth and reduce expenses "for an overall positive increase to their bottom line," says Dr. Smith.

In addition, the company allows practices to advertise on television and the Web "in ways that few have ever considered, and fewer yet have ever done," says Dr. Smith. The secret: PECAA bundles practices into regional areas and then negotiates reduced advertising rates.

Dr. Brad Smith

"We hear from doctors and other eyecare professionals that they feel as though they are on an island by themselves, without support or valuable feedback" says Dr. Smith. "We address these concerns … for the eye doctor as well as their staff."

For information, contact PECAA at (503) 805-5233, e-mail pecaofa@mac.com, or visit their Web site: www.pecaofa.com.



Optometric Management, Issue: December 2008