Article Date: 8/1/2009

Dr. J. Pat Cummings, Leader, Advocate and Colleague
Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

Dr. J. Pat Cummings, Leader, Advocate and Colleague

By Dick Wallingford, O.D., Rockwood, Maine

All of us in the vision care community lost an extraordinary colleague when Dr. J. Patrick Cummings, 56, died in a private plane crash in Florida on July 11, 2009.

Pat's career began in 1977 when, following his graduation from the Pacific College of Optometry, he went into practice in Sheridan, Wyo. and also served as a consulting optometrist at the local Veteran's Administration Hospital. Little did anyone know at the time that he would go on to become one of the most influential and widely respected optometrists in the country.

Back then, optometry was in the middle of a number of legislative battles, and many in the field began to recognize Pat's influence and leadership skills, as he lobbied on behalf of the Wyoming Optometric Association. The American Optometric Association (AOA) quickly took notice and asked Pat to serve as a volunteer to assist other State leaders. By 1994, he was elected to the AOA's Board of Trustees, and in 2002 he became the organization's 81st president.

"Pat was deeply concerned with issues surrounding public health," recalls AOA President Randy Brooks, O.D. "He used his position at the AOA to advocate for the eye care and health needs of patients across the country, and his legacy lives on today through programs, such as Healthy Eyes Healthy People and InfantSEE."

In 2003, following the tragic loss of his son, Patrick, in an automobile accident, Pat made a big career change, leaving Wyoming to join Vistakon in Jacksonville, Fla., as its vice president, professional affairs. Stan Yamane, O.D., Pat's predecessor at Vistakon, notes, "It was a pleasure watching as Pat took the position to new heights."

Naomi Kelman, former Vistakon president, agrees. "Pat joined Vistakon with the goal of making a difference for the profession that he loved and the patients he dedicated his life to," she says. "He felt that he could leverage the company's resources to do good, and he was right. Pat was the embodiment of humanity."

"It is rare in life that we meet individuals who have so many positive qualities," adds Paul Karpecki, O.D. "Pat had a brilliant business mind, but what stands out for many of us was his kindness, his compassion; the time he made for others no matter how busy he was, and how his presence enhanced the energy of all those around him. He will be greatly missed by the profession, industry and all who were blessed to share time with such a great and caring individual."

"We have lost one of the finest men optometry and the ophthalmic industry has ever known," says former AOA Executive Director Mike Jones, O.D.

Personally speaking, no one in my life led the way for me more than Pat. Through our time together at the AOA, the World Council of Optometry and Vistakon, I had the opportunity to witness the influence he had on people and the depth of his character. I also had the opportunity to witness the love he had for his family, for his friends and for quality patient care. He was an exceptional person, and we will miss him dearly.

The AOA has established a Memorial Fund in Pat�s name. You can send donations to the: Dr. Pat and Patrick Cummings Memorial Fund, Optometry's Charity, AOA National Office, 243 N. Lindbergh Blvd, St. Louis, Mo. 63141.

Bausch & Lomb Opens Global Pharmaceutical Headquarters

EYECARE COMPANY MAKES HOME IN N.J.

■ Bucking the trend toward employee layoffs and business consolidation, Bausch & Lomb has been able to expand despite the persistent economic downturn.

New Jersey Gov. Jon Corzine officially welcomed Bausch & Lomb to its new global pharmaceutical headquarters in Madison, N.J., on July 20, citing it as evidence that "the state remains an attractive location for major pharmaceutical companies to grow and thrive."

B&L CEO Gerald Ostrov and Gov. Jon Corzine at the ribbon-cutting ceremony for B&L's new global pharmaceutical headquarters in Madison, N.J.

Indeed, New Jersey's existing pharmaceutical and biotech industries may have been a key factor in Bausch & Lomb's decision to establish its pharmaceutical headquarters in Madison: A total of 15 of the world's top 25 drug companies have either world or North American headquarters or significant operations in the state, according to the Healthcare Institute of New Jersey.

The move "opens up opportunities to partner with other pharmaceutical companies and to drive commercialization of new products," says Bausch & Lomb CEO Gerald M. Ostrov, who cited the company's recent co-promotion agreement with Pfizer as an example. "We're looking forward to growing our presence here, which in turn will help us bring the best possible eye health products and services to people around the world."

B&L expects to create 70 new high-paying full-time jobs at the 30,000-square-foot facility.

Nidek Founder Ozawa Leaves Legacy
The global ophthalmic industry lost one of its pioneers with the recent passing of Hideo Ozawa, 79, the founder and chairman of the board of Nidek.
In 1971, Mr. Ozawa founded Nidek in Gamagori, Japan. Starting with six employees, his goal was to link optics and electronics. This goal was soon realized, as the company developed the first Xenon photocoagulator in Japan, which became a huge success in 1973. Nidek introduced the first auto-refractor in 1982.



Mr. Ozawa's global vision led to the company establishing successful subsidiaries in the United States, France and Italy. Today, Nidek operates in 100 countries. Mr. Ozawa spent much of his time traveling to meet with doctors and industry leaders. He developed new technologies in optics, lasers, coating and diagnostic devices. In 2004, the Emperor of Japan awarded Mr. Ozawa the prestigious "Order of the Rising Sun," which recognizes exceptional civil or military merit.
In speaking with Ophthalmology Management (also published by Wolters Kluwer), Daniel S. Durrie, M.D., recalls sharing a sketch with Mr. Ozawa for an intra-operative topography device. From the simple napkin sketch, Mr. Ozawa "had done all the engineering design and produced it in just a few months," says Dr. Durrie. Soon after, Mr. Ozawa showed Dr. Durrie a working model of the device.

Topical Bevacizumab May Reduce Corneal Neovascularization

SEVERAL RECENT STUDIES SUGGEST NEW USE FOR AVASTIN

■ Bevacizumab (Avastin, Genentech) in topical form may decrease corneal neovascularization (CNV), say recent studies.

The most recent study, for instance, revealed that of 10 CNV eyes from 10 patients treated with 1.0% topical bevacizumab for three weeks and followed up for 24 weeks, 47.1% experienced mean reductions in the neovascular area from the baseline visit to the last follow-up visit, while 54.1% experienced mean reductions for vessel caliber, and 12.2% for the invasion area.1 Of note: The decreases in the neovascular area and the vessel caliber were statistically significant (P = .001 and P < .001, respectively), and changes in the invasion area didn't achieve statistical significance (P = .19). Further, the researchers noted no significant changes in visual acuity and central cornea thickness.

A similar study showed that seven of 10 CNV eyes from seven patients that received 1.25% of bevacizumab twice daily for three months experienced reduced CNV, usually within one month of the treatment. Researchers noted, however, that generally by the second treatment month, six of the 10 eyes developed epitheliopathy, one resulting in corneal thinning.2

Genentech does not comment on the off-label uses of its medications, says a company spokesperson.

1. Dastjerdi MH, Al-Arfaj KM, Nallasamy N, et al. Topical bevacizumab in the treatment of corneal neovascularization: results of a prosepective, open-label, noncomparative study. Arch Ophthalmol. 2009 Apr;127(4):381-9.
2. Kim SW, Ha BJ, Kim EK, et al. The effect of topical bevacizumab on corneal neovascularization. Ophthalmology. 2008 Jun;115(6):333-8. Epub 2008 Apr 24.

HEALTH Notes
• The Crystalens HD in quarter diopter steps, from Bausch & Lomb, has received FDA market approval. Quarter diopters are now available for models HD500 and HD520 in the 18 to 22 range. The accommodating intraocular lens is shaped to enhance the depth of focus to improve near vision without compromising intermediate or distance vision, the company says.

Alcon, Inc. has discontinued developing anecortave acetate for intraocular pressure (IOP) reduction associated with glaucoma after finding the amount of IOP reduction and the responder rate provided by even the highest dose of the single anterior juxtascleral injection during a phase II trial weren't sufficient to support its use as an alternative to eye drop therapy.

• A total of 98% of corneal arcus patients also had metabolic issues related to diseases such as diabetes and high blood pressure, says a VSP and the Columbus Research Foundation study. In fact, follow-up testing for corneal arcus patients revealed 88% had high fasting blood sugar; 45% had an elevated hemoglobin A1c; 66% had an elevated body mass index; and 64% had high blood pressure. Until now, the ocular condition has been linked with high cholesterol, VSP and the Columbus Research Foundation say.

• A total of 399 open-angle glaucoma and ocular hypertension patients who used a fixed-combination of the alpha-2 adrenergic agonist brimonidine 0.2% (Alphagan, Allergan) and the beta-adrenergic antagonist timolol 0.5% (Timolast, Alcon) (FCBT) for two months, twice daily experienced a reduced mean IOP from 21.0mm Hg at baseline to 16.3mm Hg, and treatment na�ve patients achieved a 9.3 mm Hg IOP decrease from 25.5mm HG at baseline, according to a poster presented at the World Glaucoma Society meeting. Also, when researchers replaced existing IOPlowering therapy with FCBT, patients achieved an additional 4.1mm Hg (18.4%) decrease from baseline. Further, when patients used FCBT as an adjunctive therapy, they achieved an additional 4.5mm Hg (19.7%) from baseline. Finally, overall, the percentage of patients achieving a target pressure of less than 18mm Hg increased from 41% at baseline to 76% at the two-month mark.

Contact Lens Wear May Improve Girls Overall Self-Worth

GIRLS WHO SWITCHED FROM GLASSES TO CONTACT LENSES REPORTED SELF-ESTEEM BOOSTS

■ Contact lens wear betters a girl's overall self-worth, says the randomized, single-masked Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study, which assessed the effects of spectacle- and contact lens wear on the self-perception of myopic children ages eight to 11-years-old.

"I'm not surprised that many girls aged between 8 and 11 years old feel better about themselves when they wear contact lenses rather than spectacles," says Elizabeth Hartley-Brewer, author of Raising Confident Girls: 100 Tips for Parents and Teachers (Da Capo Press, 2001). "Pre-teens are becoming super conscious of their looks, due to commercial pressure and the celebrity culture, and very sensitive to their friends' opinions. They want to fit in rather than look different — though fancy spec frames can be a fashion statement and talking point!"

The study's researchers arrived at this outcome using the Self-Perception Profile for Children scale, which is comprised of five domain-specific sub scales (e.g. Scholastic Competence, Social Acceptance, Athletic Competence, Physical Appearance and Behavioral Conduct) and one global measure of self-worth.

A total of 484 eight to 11-year-old myopic children (59% female) participated in the three-year study, which took place at five U.S. clinical centers. Researchers randomly assigned children to wear either spectacles (n=237) or contact lenses (n=247) between September 2003 to October 2007. Those girls who at baseline reported low levels of satisfaction with spectacles experienced a statistically significant change in global self-worth through the three years of the study.

The study was supported by funding from Johnson & Johnson Vision Care Inc. and The Vision Care Institute, LLC, a Johnson & Johnson Company.

Unmasking The Need For Toric Lenses

PATIENT EDUCATION DEVICE

For those astigmatic patients who would benefit from a visual demonstration of toric contact lenses, Bausch & Lomb has developed the Toric Unmasker. The tool, about the size of a small magnifying glass (pictured), helps you discuss with patients moving from spherical lenses to toric lenses, says the company.

Wearing spherical-correction contact lenses, patients who have astigmatism should notice an improvement in their vision once you align the Toric Unmasker properly within their line of sight. You can receive a complementary Toric Unmasker as well as toric lens fitting tips at www.bausch.com/torictips.

Sixth annual eye injury survey reveals compelling statistics
Nearly Half of Eye Injuries Occur at Home

A total of 47.6% of the 2.5 million eye injuries Americans suffer annually occur in and around the home, says the annual Eye Injury Snapshot, a clinical survey conducted by the American Academy of Ophthalmology (AAO) and the American Society of Ocular Trauma (ASOT) that assesses U.S. eye injuries.
Survey key findings:
• A total of ¾ injured were male.
• Children age 12 or younger represented one in five injuries — well above the previous five-year survey average of 15.5%.
• The yard and garden were the places most people were likely to suffer an injury in the home.
• More than 45% of injuries occurred between noon and 6:00pm.
To combat the rate of household injuries, the AAO and ASOT are recommending that every U.S. household have at minimum one pair of ANSI-approved protective eyewear to be worn when performing home projects and activities.
This year's survey was conducted between May 17 and May 24 2009.

Transitions Offers Guide to Facebook.com

SOCIAL MEDIA 101

■ Did you know that of the 45.3 million active users of Facebook.com in the United States, the fastest growing demographic is women older than age of 55? Yes, in a few short years, social media has become mainstream. If you're looking for an introduction to social media, consider the guide, "Putting your practice on facebook, a guide to facebook for eyecare professionals."

Published by Transitions, the 12-page guide explains how social media can help you connect with both professionals and patients. Also, it provides step-by-step instructions to help you get started with your own Facebook page. And for the uninitiated, the guide includes a complete glossary of social media

You can find a complimentary download of the guide at www.transitions.com/fb.

The Optometric Historical Society is celebrating its 40th birthday. The Society was founded in September 1969 by optometrists Henry Hofstetter, John Levene, Arthur Hoare, Sol Tannebaum and American Optometric Society librarian Maria Dablemont. It currently boasts nearly 75 members, historical gems from the profession (one is pictured above) and Hindsight: Journal of Optometry History, which is available quarterly. Current society president, Irving Bennett, O.D., urges you to check out the Optometric Historical Society Web site at www.opt.indiana.edu/ohs/optohiso.html.

O.D. NOTEBOOK
■ On July 1, 2009, optometric services for adult Medi-Cal (California's version of Medicaid) beneficiaries age 21 and older were cut due to the state's budget crisis. Optometric services are considered optional because the Federal Medicaid law doesn't consider O.D.s physicians. To supersede this decision, the California Optometric Association is actively working on getting the "Optometric Equity in Medicaid Act," or H.R. 2697, passed. The bill would require Medicaid coverage of O.D. professional services that are physician-covered.

Alcon announced that it has entered into a five-year collaborative research agreement with AstraZeneca for the exclusive ophthalmic discovery and potential development rights to AstraZeneca's compound library. The two companies plan to develop drugs to treat ocular conditions, such as glaucoma, wet and dry age-related macular degeneration and other retinal diseases, as well as ocular allergy, dry eye and other inflammatory eye conditions.

CareCredit has recently become a supporter of Eyemaginations' 3D-Eye Home, a patient education and marketing tool. You can obtain information on CareCredit's patient financing programs in key surgical sections of the software where patients most frequently search for financing alternatives.

■ The Association of Regulatory Boards of Optometry announced the winners of its 2009 elections. William B. Rafferty, O.D. of Winston-Salem, N.C., was elected president for the 2009 to 2010 term. Other officers elected include Jerry A. Richt, O.D. (Cleveland, Tenn.) as vice president; Michael W. Ohlson, O.D. (West Union, Iowa) as secretary/ treasurer and Christina M. Sorenson, O.D. (Scottsdale, Ariz.) as immediate past president. For more information, visit www.ARBO.org.

Prevent Blindness America has partnered with OneSight, a Luxottica Group Foundation, to provide free eyeglass frames and prescription lenses to underserved populations. Through the "Healthy Eyes Eyeglass Program," patients can receive cards to obtain the free eyewear at any participating Lens-Crafters, Sears Optical, Target Optical or select Pearle Vision locations. For more information, visit www.preventblindness.org.

■ Congratulations go to Aarlan Aceto, a New England College of Optometry student who won the annual Varilux Optometry Student Bowl at the annual American Optometric Association Congress in Washington, D.C. Mr. Aceto took home the prized crystal Student Bowl trophy and $1,000 in prize money. Essilor of America sponsored the event.

Davis Vision announced that its 2009 community outreach program has provided more than $200,000 to date in free vision care services to members of underserved populations. In fact, the community outreach program has provided free services, including vision screenings, eye exams and eyeglasses to more than 1,500 people.


Optometric Management, Issue: August 2009