Article Date: 6/1/2009

Vision Council Provides Anti-Reflective Lens Curriculum Grant
Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

Vision Council Provides Anti-Reflective Lens Curriculum Grant

OPTICAL ORGANIZATION HOPES TO INCREASE U.S. ANTI-REFLECTIVE LENS USE

■ Current anti-reflective lens use in the United States is at 34%, while this use is roughly 70% in Europe and 98% in Japan, says John Quinn, chairman of The Vision Council's Anti-Reflective Steering Committee. To increase U.S. usage, The Vision Council announced it will provide an educational grant to the Association of Practice Management Educators (APME) to design and deliver learning modules to the 17 U.S. schools of optometry. The purpose of the modules: to advance the awareness and understanding of optometry students in prescribing anti-reflective lenses. (Currently, none of the optometry schools require anti-reflective lens technology education.)

"…Anti-reflective lenses can provide better vision," Mr. Quinn says. "We are pleased to be able to assist APME and optical educators across the country, so that eyecare professionals of the future fully understand the visual benefits of prescribing these lenses."

The APME board recently approved the "prescribing anti-reflective lenses" learning module. It will be included as part of the required practice management curriculum for all 17 optometry schools this fall.

Educators will present the module to second- or third-year students, and materials and tools in each on-campus clinic will support the module. Specifically, students will receive course back-up materials via flash drive, and they'll have the opportunity to use lorgnettes in the clinic when working with patients.

"Partnerships like the one with The Vision Council can go a long way to increase the implementation of new technologies in patient care all across the country," says Sam Quintero, APME's president. "We envision these types of programs will enable us to provide our students with the tools, information and product experience that will give them a solid foundation to become tomorrow's leaders in eye care."

HEALTH Notes
• Although previous studies have shown PDE5 inhibitors can cause changes in electroretinography and visual function, men who took a 50-ml dose of sildenafil citrate (Viagra, Pfizer) or a 5-ml dose of tadalafil (Cialis, Lilly USA) daily for six months showed no higher rates of vision loss or other eye complications compared with placebo, says a study in April's Archives of Ophthalmology.

• The Food and Drug Administration (FDA) granted clearance to the Carl Zeiss Meditec's Cirrus HD-OCT 4.0 software. The new software includes anterior segment imaging, guided progression analysis, normative retinal nerve fiber layer and macular thickness data and change analysis, which allows you to monitor disease progression and therapeutic outcomes for glaucoma and retinal disease.

TGF-beta, a growth factor, is necessary to retina blood vessel health, and blocking it can induce retinal dysfunction, says a study in the April 2 issue of PLos ONE. Therefore, the growth factor may play a significant role in the prevention and treatment of eye diseases, such as age-related macular degeneration (AMD) and diabetic retinopathy.

U.S. women are significantly more likely than U.S. men to experience several eye conditions, such as cataract, and vision problems, such as eyestrain. Also, they are more likely to identify health and environmental factors, such as diabetes and glare/bright light, respectively, that can adversely affect their vision. Further, women are more likely than men to wear sunglasses. This data comes from a Transitions Optical, Inc. online survey comprised 2,207 U.S. adults. A total of 52% were women and 48% were men.

E10030 (Ophthotech Corp.), an anti-platelet-derived growth factor (anti-PDGF), used in conjunction with an anti-vascular endothelial growth factor (anti-VEGF) to treat wet AMD resulted in 59% of patients gaining three lines of vision three-months post-treatment and 100% demonstrating neovascular regression, says a phase 1 clinical study that assessed the efficacy of the two drugs used together. Ophthotech presented this data at this year's Association for Research in Vision and Ophthalmology (ARVO) 2009 Annual Meeting in Fort Lauderdale, Fla.

• One-month, once-daily use of hydroxypropyl cellulose ophthalmic inserts (Lacrisert, Aton Pharma) by moderate to severe dry eye patients resulted in improvements in discomfort (25% decrease); burning (35% decrease); dryness; (42% decrease); grittiness (29% decrease); stinging (29% decrease) and light sensitivity (19% decrease). Also, patients reported improvements in clinical signs, such as keratitis, conjunctival staining and tear volume and in their ability to read, drive at night and watch TV, says a multicenter open-label study funded by Aton Pharma and presented at this year's ARVO Meeting.



See a lot of patients who wear makeup? Then, the Prevent Blindness (PBA) Web site www.preventblindness.org/resources/factsheets/FS15_cosmetics.PDF is the perfect resource for your patients. The site offers fast and simple suggestions on how to keep eyes safe during the wear and application of makeup and provides tips on how to wear contact lenses and eye cosmetics together safely.

Houston College of Optometry Researchers Land NEI Grant

GRANT FOCUSES ON HIGHLY-ABERRATED EYES AND SOFT CONTACT LENS WEAR

■ The National Eye Institute (NEI) has granted a team of researchers at the University of Houston College of Optometry a five-year $1.25 million grant to investigate custom aberration-correcting (e.g. those that correct above sphere and cylinder) soft contact lenses for the keratoconic eye. The grant was funded in early 2009.

"Thus far, we've tested custom lenses in a laboratory setting on a small sample of subjects, so we're in the very early stages of this work. As a whole, the subjects qualitatively report good comfort, though achieving excellent visual acuity has been more of a challenge," explains Jason Marsack Ph.D. and a member of the core research team that includes Raymond Applegate O.D., Ph. D., a a research optometrist, research lab manager and a manufacturing technician. "These early tests have highlighted challenges with the technology. In essence, the grant is aimed at conducting the science to solve problems associated with successful custom lens wear for highly aberrated eyes."

Dr. Marsack initially got involved with the research, in part, for personal reasons: "I have keratoconus myself. However, I am a bit of an anomaly in that I can successfully wear traditional sphero-cylindrical soft contact lenses. I knew this wasn't the case for many keratoconic patients," he says. "Personally, I feel that integrating wavefront technology in a soft lens form may eventually provide clinicians with another routine tool in their arsenal for meeting the needs of the more traditional keratoconus patient," he explains.

Annual Exams Impact Value-Based Medicine

NEW VSP STUDY SHOWS NEARLY $3 BILLION IN SAVINGS

■ We all know that an eye exam can help in the early detection of chronic disease. But in this era of value-based medicine, could you put a price on such a benefit? VSP Vision Care has, and it reaches nearly $3 billion annually for VSP customers.

A study by Human Capital Management Services (HCMS) on behalf of VSP analyzed healthcare costs for 90,000 employees at five major U.S. corporations that are VSP clients. The study looked at costs for diabetes, hypertension and high cholesterol. It found, for example, that through early detection with annual eye examinations, companies avoided spending $2,900 annually on medical-related costs for each diabetic employee. The savings are based on costs directly associated with the companies' health plans, disability and early termination.

When HCMS applied the results of its study to the past three years for each of its five corporate clients, it found that as a result of an annual eye exam, nearly 2,000 members received early treatment for diabetes, high cholesterol and hypertension.

The Ferris State University community dig in to the site of the school's Michigan College of Optometry/Center for Collaborative Health Education building on May 8th. The estimated 87,000 square-foot facility, which has a price tag of $26.9 million, is scheduled to open for student classes and business with the public during the spring semester (probably January) 2011, says a spokesperson.

If you apply the study's findings over the entire 55 million VSP membership, the results show that of the 1.45 million diabetic individuals, 20% (291,500) received early treatment as a result of an eye exam. In addition, of the 2.18 million people with hypertension, 30% (655,875) received early treatment. If these two early treatment populations, totaling 974,375, are multiplied by $2,900, the product is $2.74 billion.

Transitions Publishes Diabetes Education Paper

CLINICAL PAPER FOCUSES ON EYEWEAR

■ Comprehensive eye care and sight-enhancing eyewear are two ways to protect the eyes of children who have diabetes, says the paper, "Healthy Sight Counseling Diabetes and the Eye: Children," published by Transitions Optical, Inc.

According to the company, the percentage of children who have newly diagnosed type 2 diabetes has increased from below 5% prior to 1994 to 30% to 50% in subsequent years. Childhood obesity is cited as a key factor in this increase.

Children warrant special attention because the progression of diabetes in children "can be especially quick and severe," says Cathy Rauscher, global marketing specialist, Transitions Optical Inc.

A high number of cases of childhood diabetes go undetected, according to the paper, and eyecare professionals are often the first to detect the disease. Once diagnosed, the paper recommends that you, the eyecare professional, stress "Healthy Sight Counseling," an approach that promotes preventive eye care, professional awareness and patient education. For protection against ultraviolet radiation and glare, the paper endorses the use of UV-blocking photochromic or fixed-tint lenses combined with anti-reflective coatings.

The paper is the third in a series on diabetes. Print copies, as well as educational posters and patient brochures, are available through Transitions Optical, Inc.'s customer service, phone: (800) 848-1506.

Ongoing Trials Shed Light on AMD

GENETICS AND ANTI-VEGF TREATMENTS EXPLORED

By Barbara Anan Kogan, O.D., Washington, D.C.

■ The National Institute of Health's (NIH) National Eye Institute (NEI)-funded genes and environment studies division seek to identify epidemiology and combination therapies for age-related macular degeneration (AMD). A description of two of the ongoing studies follows:

"Bedside to community" study investigates the Amish

In, "Age-Related Macular Degeneration: A Genetic Epidemiology Study in the Amish," the NEI plans to examine members of the Old Order Amish community in Lancaster and Franklin Counties in Pennsylvania. The purpose of the study: to investigate genetic factors in the development of AMD among participants, ages 50 and older.

Each participant will undergo a dilated fundus exam, which includes digital imaging of the macula and optic disc. Patients will answer a questionnaire concerning occupations, smoking and exposure to sunlight.

This study may determine whether any candidate's regions or genes predispose an increased AMD risk. While pesticide use for environmental factors is not being tested, it may affect these individuals, says NEI's Epidemiology and Clinical Research Division Branch Chief, Epidemiologist, Mary Frances Cotch, Ph.D.

Enrollment for the observational, perspective study is still open and expected to reach 3,000.

Lucentis — Avastin Trial

The "Comparison of Age-Related Macular Degeneration Treatment Trials"(CATT) study at 19 nationwide sites seeks to determine the relative safety and efficacy of intravitreal injections bevacizumab (Avastin, Genentech) and ranibizumab (Lucentis, Genentech) in wet AMD patients.

The use Avastin, not yet approved by the FDA, has grown because of its molecular similarity to FDA-approved Lucentis as well as its low cost and availability. In addition to safety and efficacy, this study will attempt to answer whether a reduced dosing schedule of each of the anti-VEGF drugs is as effective as a fixed schedule of monthly injections. By changing dosage based on patient clinical response vs. maintaining a fixed scheduled, the study will investigate if an opportunity exists to reduce treatment burden to patients as well as to reduce the overall cost of therapy. Lucentis has been shown to slow vision loss and, in one-third of patients, improve vision.

Daniel F. Martin, M.D., chair of the Cole Eye Institute of the Cleveland Clinic and the CATT study chair, expects full enrollment in the trial by fall 2009, with interim data available in 2010.

O.D. NOTEBOOK
■ As we went to press, Bausch & Lomb announced that the FDA approved Besivance (besifloxacin ophthalmic suspension) 0.6% for the treatment of bacterial conjunctivitis. The new topical ophthalmic antibacterial drop treats a wide range of eye pathogens, including those that most commonly cause bacterial conjunctivitis, according to Bausch & Lomb.

■ You can order the free brochure, Healthy Eyes for Peak Performance, which discusses how to foster children's healthy vision, so they perform their best, by sending an e-mail request to peakperformance@inkandroses.com. Readers can order up to 50 copies or request a pdf version for your practice's Web site. The brochure is offered by the American Optometric Association's Sports Vision Section and Safe Kids Worldwide (a global network of organizations whose mission is to prevent accidental childhood injury.

CIBA VISION recently celebrated the one-year anniversary of its Academy for Eye Care Excellence (AECE), a global professional education platform that seeks to enable eyecare practitioners (ECP) to deliver the highest standard of patient care. In its first year, the AECE expanded to 20 countries, with more than 2,500 ECPs participating in the United States.

Carl Zeiss Meditec recently announced the 25th anniversary of the Humphrey Field Analyzer (HFA). According to Zeiss, it is estimated that more than 240,000 HFA examinations are performed each day throughout the world.

Essilor of America announced a three-year extension of Essilor International's partnership with the Special Olympics — Lions Clubs International Opening Eyes program, which is dedicated to providing eye care for people who have intellectual disabilities.

Alimera Sciences presented positive interim 12-month safety and efficacy results from the first human pharmacokinetic study (PK Study) of Iluvien (fluocinolone acetonide [FA] intravitreal insert) at the Association for Research in Vision and Ophthalmology Annual Meeting in Ft. Lauderdale, Fla. All study participants had diabetic macular edema. Results showed an improvement in best-corrected visual acuity associated with a reduction in center subfield thickness in a substantial number of patients for both doses, as well as no evidence of elevated intraocular pressure in the low dose.

The South Florida Business Journal awarded contact lens distributor ABB Concise with the 2009 Business of The Year Award.

The Glaucoma Research Foundation has received the four-star rating of "Exceptional" from Charity Navigator for the third consecutive year. Charity Navigator is an independent charity evaluator in the United States.

Loretta B. Szczotka-Flynn, O.D., M.S., and co-investigator Mahmoud Ghannoum, Ph.D., from Case Western Reserve University were among recent recipients of the 2009 Prevent Blindness America Investigator award. Drs. Szczotka-Flynn and Ghannoum received the award for the research project, "Prevention of Soft Contact Lens Associated Fusarium Biofilms."

Carl Zeiss Vision announced that it has expanded its exclusive Max Rx sunlens program with Nike Vision to now offer direct orders through all 17 Carl Zeiss Vision labs. VSP benefits will now apply to these orders.

■ High-Dk hybrid contact lens manufacturer SynergEyes has launched ClearKone, its next generation hybrid contact lens design for keratoconus. The lens is approved for marketing by the FDA.

■ A study of specially designed peripheral prism glasses for hemianopia patients showed that two-thirds of the patients continued to wear the glasses at the end of the study period and beyond, indicating a high level of success. Eli Peli, M.Sc., O.D., a senior scientist at Schepens Eye Research Institute and inventor of the glasses, said that the study also found that the brains of patients had not fully remapped to adjust for the prisms, which means that improved training in their use could further enhance the benefits of the glasses.


Optometric Management, Issue: June 2009