Article Date: 5/1/2012

Practice pulse


Augmented Reality Technology Sets Sights on Eyewear

Jennifer Kirby, senior editor

■ After being told a cyborg assassin is after her, The Terminator's Sarah Connor replies: “… They cannot make things like that yet,” to which her rescuer answers, “Not yet. Not for about 40 years.” Roughly 30 years post-1984 (the film's release and story year), several entities are either working on or have already made available a part of the Terminator's technology: augmented reality (AR), or the view of real-word and computer-generated data, on one's person.

A Project Glass prototype.

In the pipeline

Google Inc. revealed a spectacle-like device that would project through a small ophthalmic lens various “smart” applications, while enabling the wearer to still see their environment. It's called “Project Glass” (see

In addition, Oakley, Inc.'s Chief Executive Officer, Colin Baden, told Bloomberg that the company has been working on “heads-up technology,” for 15 years. He further said that Oakley would initially market the technology to athletes, should it come to fruition.

Also, Michael Abrash, a developer at Valve Software, a video game company, revealed via blog ( that he's investigating “wearable computing” for the company.

Further, professor Babak Parviz at the University of Washington, in Seattle, and Semprius, Inc., a high concentration photovoltaic (HCPV) solar module company, have said they're pursuing AR contact lenses (CL).

Finally, Innovega, Inc., a personal media eyewear technology company, has created CL-enabled eyewear. Called iOptik Technology, the CL allows the retina to receive each image in focus simultaneously by allowing the light from the heads-up display to enter the pupil's middle and the surrounding environment's light to enter the pupil's rim. The Defense Advanced Research Projects Agency (DARPA), the U.S. Military's version of 007's “Q,” has ordered a fully functioning prototype, the company's Chief Executive Officer, Steve Willey, told the BBC. Mr. Willey also said he believes the technology will be available to the U.S. public for general media purposes in 2014, pending FDA approval.

A total of 22.8% of the U.S. population suffered from allergies last month, surpassing April 2011 (20.8%) and even last year's peak of 22.1% in May 2011, according to Gallup-Healthways data. Further, the rise in spring allergy numbers was likely spurred by the unseasonably warm winter, the company says.

Currently available

The following companies currently offer unobtrusive transparent AR eyewear:

Brother (the AirScouter)
Lumus (Optical Engine Module [for OEM] and the Wearable Display Development Kit)
Vuzix (Star 1200)
Recon Instruments (Recon-Zeal Transcend, MOD [Micro Optics Displays] and MOD Live goggles.

Mod Live, by Recon Instruments.

Ocular health issues

Scot Morris, O.D., F.A.A.O., OM's “Tech Time” columnist, who's also working with two of the aforementioned companies, says fixations disparity, vergence, accommodative and ocular motility issues along with visual confusion will make the use of these technologies “very challenging” for as much as 20% of the U.S. population.

“Even more of a problem is that all of these displays are currently being positioned in plano power lenses. For the 1/3 of the U.S. population that has some form of ametropia, these lenses simply will not work,” he explains. “Granted, some of this population will be able to wear contact lenses. However, this technology will create issues for people wearing some forms of multifocal lenses and definitely cause an issue for many toric lens wearers since the virtual images will not be positioned directly ahead of the viewer, which can cause problems with lens centration and, thus, overall visual function.”

Innovega's iOptik contact lens.

He adds that those who have media opacities or retinal issues will also have difficulty with these virtual images.

Optometry's role

These device's inventors must solve many of the issues presented to gain wide-spread adaption, says Dr. Morris. That said, he says he believes this technology, much like 3D technology, will spawn a new niche type of practice for high-tech practices around the country.

Justin Bazan, O.D., a well-known early adapter, agrees, saying it won't be long before such practices are offering this technology in their opticals.

Jerome A. Legerton, O.D., M.S., M.B.A., F.A.A.O. and Co-founder, Director and Chief, Clinical and Regulatory Officer of Innovega, Inc., says the Innovega contact lens will be a medical device that requires licensed professionals in the delivery system.

“Since the eyewear and the contact lenses are expected to perform optimally with proper alignment and visual axis registration, technology-enhanced fitting is envisioned, and the professional judgment resident with optometry will greatly enhance the consumer experience,” he says.

As for the companies currently working on augmented reality technology, to paraphrase the Terminator, they'll no doubt, “be back.” OM

FDA News

Eyedrop for AMD Moves into Phase III Study

■ Based on positive feedback regarding its end-of-Phase II meeting with the FDA, MacuClear, Inc. has begun Phase III studies for MC-1101, a proprietary, topically administered eye drop for both treating and halting AMD progression, the company announced via press release. Specifically, the eyedrop is designed to treat and halt the progression of AMD from early stage dry AMD to wet AMD by increasing ocular blood flow in the choroidal vessels.
“… We undoubtedly believe we're at the forefront of providing patients with AMD a means of preventing this terrible disease from advancing to its later stages,” says MacuClear's CEO Philip G. Ralston.

In other FDA news:
■ The RTVue XR SD-OCT, from Optovue, has received FDA 510(k) clearance. The device acquires 70,000 A-scans-per-second. This speed can reduce the occurrence of motion artifacts while enabling greater scan averaging output, the company says. The result: tissue detail of the retina and choroid layers of the eye.
■ The new Anterior Segment Module for Spectralis, from Heidelberg Engineering GmbH, has received FDA clearance. The Module affords high-resolution images of the cornea, anterior chamber angle and the sclera using the company's Noise Reduction technology for enhanced detail. Clinicians can study both chamber angles at the same time using a 16mm-wide angle-to-angle OCT scan.
■ An FDA advisory committee evaluating the labeling of a postocular surgery anti-inflammatory eye drop bottle recently voted against labeling that would state a single bottle of anti-inflammatory drops could be used bilaterally, citing concerns of cross contamination and the potential for infection. The government agency is now considering special packaging, such as dual packs with the bottles marked L and R (left and right), for post-op patients who've undergone bilateral surgery.


Survey Reveals Consumer Disconnect Regarding Lens Material

■ A new survey, sponsored by PPG Industries, shows that the majority of consumers are more focused on their frame selection than on their lenses, yet they also say lens technology is important to them.

“… The lens material is the foundation of the lens,” says PPG Industries' general manager of optical materials,” Christine Camsuzou. “It plays an important role in helping eyecare professionals offer their patients a more complete eyewear experience, by complementing advanced lens designs, treatments and coatings to provide the clearest, most comfortable vision and protect vision for a lifetime.”

Specifically, in an online survey of 500 spectacle wearers, almost 67% said they didn't know which lens material was used to make their glasses. Also, when asked to name lens materials, glass (21%), plastic (18%), polycarbonate (11%), photochromics, AR coatings, progressives and metal and titanium were mentioned.

Still, 71% of respondents said it's important to them that their eyeglasses are made with the most advanced lens technology. Also, when asked to prioritize the most significant features of an ophthalmic lens, on average, respondents ranked clearest vision the highest followed by price, prescription availability/durability, scratch resistance, weight/thinness, UV protection, photochromic treatment and brand. Further, when asked how they choose a lens material, most patients (38%) replied a combination of lens attributes (e.g. optics, thinness, weight, etc.) was most important. Finally, 90% said they would go with their eyecare professional's recommendation.

Optical Designer Launches Furniture Line

Barbara Wright Design has joined forces with Illusion Optical Displays to launch the Barbara Wright Signature Optical Display collections. The new line of displays is comprised of three collections ranging from contemporary to classic. The piece in this photo is part of the Newport collection. To celebrate the partnership, the companies are offering a $10,000 Facebook contest. Official rules can be found at


Caffeine May Be Good for Dry Eye Syndrome

● Although caffeine has been associated with and suggested as a tear dysfunction cause, a recent study in Ophthalmology reveals caffeine intake actually appears to increase tear volume. Specifically, the net increase in tear meniscus height was 0.08mm greater when participants ingested a caffeine capsule vs. a placebo.
Additional research notes:
Recycled spectacles aren't a cost-saving means of correcting refractive error, as only 7% have been deemed suitable for use, and those that are suitable actually end up costing more than twice the cost of supplying ready-made spectacles due to delivery costs, says March's Optometry & Vision Science. Therefore, they should be discouraged as a strategy for eliminating uncorrected refractive error in developing countries, the study's researchers say.
● The progression of dry AMD to the wet form may be mediated by IL-18, an inflammatory component, says April 8's Nature Medicine. So, controlling or changing IL-18 levels in dry AMD patients may prevent Wet AMD onset.
● The Sjögren's International Collaborative Clinical Alliance has proposed the following new classification for Sjögren's syndrome, based on objective tests: A Case must have at least two of the following three items: (1) positive serum anti-SSA and/or anti-SSB or (positive rheumatoid factor and antinuclear antibody titer ≥1:320), (2) ocular staining score ≥3, or (3) presence of focal lymphocytic sialadenitis with a focus score ≥1 focus/4mm in labial salivary gland biopsy samples, says April's Arthritis Care & Research.
● Bromfenac ophthalmic solution (Prolensa, Ista Pharmaceuticals), a once-daily topical nonsteroidal anti-inflammatory agent for the treatment of ocular inflammation and pain post-cataract surgery, was shown statistically greater than placebo in quelling inflammation by day 15 and ridding ocular pain one day after surgery in a Phase III study of the drug, the company revealed during a poster session at the 2012 American Society of Cataract and Refractive Surgery Symposium. Therefore, Ista says it plans to file a New Drug Application with the FDA.
Retinopathy appears associated with cognitive decline and greater brain lesions. This finding gives weight to existing evidence that retinopathy as a marker of small vessel disease is a risk factor for cerebrovascular disease that may affect cognitive performance and related alterations in the brain, says March's Neurology. Retinopathy may be a useful clinical tool if it reveals itself as an early marker related to neurologic outcomes, the study's researchers say.
● In older (age 74) male mild-to-moderate AMD patients, zeaxanthin-caused foveal MPOD elevation matched that of lutein, though also improved foveal cone-based visual parameters, while lutein enhanced parameters linked with gross detailed rod-based vision, with significant overlap between the two carotenoids, says November's Optometry.
Proliferative diabetic retinopathy patients appear to have increased vitreous and plasma VEGF levels. Yet, these levels significantly decreased post-intravitreal bevacizumab injection (Avastin, Genentech), and the effect lasted from 4.4 ± 2.2 days to 34.8 ± 33.7 days postinjection, says February's American Journal of Ophthalmology.
In addition, long-term use (two years) of intravitreous bevacizumab (Avastin, Genentech) for persistent center-involving clinically significant macular edema appears to have greater efficacy than macular laser therapy in terms of Early Treatment Diabetic Retinopathy Study best-corrected visual acuity, says the April 9 edition of Archives of Ophthalmology.
● Scientists have discovered that the epidemic disease-causing Streptococcus pneumoniae species is able to cause conjunctivitis by secreting a metalloproteinase called ZmpC, which selectively induces the shedding of membrane-associated mucins from the epithelium, leading to loss of the glycocalyx barrier function, says a March 7 online study in PLoS ONE.

Optometric Management, Volume: 47 , Issue: May 2012, page(s): 12 - 16