Article Date: 7/1/2004

practice pulse
Tips, Trends & News You Can Use

FDA Approves Three Ortho-k Lenses for Overnight Wear

The U.S. Food and Drug Administration recently approved three orthokeratology (ortho-k) contact lenses for overnight wear: Euclid Systems' Emerald lens and C&E GP Specialists' Fargo and GP Express lenses.

Before June, the Paragon Corneal Refractive Therapy (CRT) contact lens was the only corneal reshaping lens approved by the FDA for overnight wear. Optometrists should welcome the additional lenses, says John Mark Jackson, O.D., assistant professor at the Southern College of Optometry.

"One of the big hurdles practitioners faced was that lenses didn't have FDA approval," says Dr. Jackson. "The Paragon CRT lens lifted a burden from optometrists when it received approval. It validated CRT. These new lenses offer further validation and more options for clinicians and patients."

Incidentally, tens of thousands of patients have been fitted with Paragon CRT lenses since the lens received FDA approval in 2002. During sleep, the lenses reshape the cornea, allowing users to see clearly during waking hours without contact lenses or glasses.

According to Euclid CEO Bruce DeWoolfson, the best candidates for ortho-k are people who have 5.00D of myopia or less. He says that fitting the lenses can prove challenging, rewarding and profitable for any clinician who fits GP lenses. "Price is a challenge for practitioners and patients because ortho-k has a much higher fee than other contact lens treatments," says Dr. Jackson. "But when you compare the price to refractive surgery -- and consider that there's no permanent change to the cornea -- the price is fair."

Screening Children Under Five

Eyecare practitioners should screen children under the age of five years in the primary eye care setting for vision problems, according to a recommendation from the U.S. Preventive Services Task Force published in the May/June issue of Annals of Family Medicine. The Task Force, an independent panel of experts sponsored by the Agency for Healthcare Research and Quality (AHRQ), found that screening tests can lead to detection of amblyopia, strabismus and refractive errors.

The Task Force based its conclusions on reports from research teams led by AHRQ's Evidence-Based Practice Center at RTI-International-University of North Carolina at Chapel Hill and Oregon Health & Science. You can find the recommendations for screening visual impairments in children younger than five years of age as well as materials for clinicians at or by calling (800) 358-9295.

Lens Solution Ingredients Made a Difference

Contact lens care solutions differ in their formulations and contain a complex list of ingredients that can directly affect patient comfort.

One ingredient that differentiates lens solutions is the surfactant or wetting agent. The ideal wetting agent should provide maximum surface wettability throughout the entire lens wearing time.

Surfactants differ in their chemical properties and in their ability to clean and wet the lens surface. The most common surfactant categories used in lens solutions are Pluronic and Tetronic, which differ in their molecular and functional properties. For example, an abstract and poster ("Dynamic wetting behavior of pHEMA-MAA and silicone hydrogel contact lenses") presented at the 2004 Association for Research and Vision in Ophthalmology annual meeting concludes that Tetronic 1304 provides the optimum surface wettability of a contact lens. The result is lasting, end-of-day lens wear comfort for patients.

The Magic of Goal Setting
By Bob Levoy, O.D.

Goal setting helps us discover what we really want to accomplish in life -- both personally and professionally. It forces us to make commitments and reduces unnecessary conflict over what to do. Writing goals down on a sheet of paper goes a step further. It makes them more specific and concrete. Once goals have a visible identity, you can scrutinize them more closely -- analyze them, refine them, ponder them. And when conditions or values change, you can update, alter or even abandon, your goals.

Substantial evidence indicates that goals are more achievable if they are broken down into their most manageable parts. For example, for most of his NBA career, Michael Jordan kept his scoring average at 32 points each game. He retired in 1999 with an NBA record of 31.5 point career average. It didn't matter who his teammates were, what defense they were running, what injuries he was nursing, or who was guarding him. Michael Jordan would get his 32 points.

When reporters asked him how he consistently maintained that average for more than a decade, Mr. Jordan replied, "I simplified it a few years ago. Thirty-two points each game is really just eight points each quarter. I figure I can get that in some kind of way during the course of a game."

ACTION STEP: Make a list of the practice goals that are most meaningful to you. These can include: weekly, monthly or yearly production goals; collection percentage; accounts receivable over a span of 60 and 90 days; number of new patients you've seen; numbers of multifocal or tinted contact lenses you've dispensed. Then break this list of goals down into manageable, bite-sized mini goals.

REALITY CHECK: "It is near impossible to know how you and your practice have performed without written goals," says Dr. Gerald M. Snyder, Palm City, Fla. "With established goals, a monthly review will let you know whether you are closer or further away from the practice you desire."

Giving Something Back

Take a look at some of the charitable donations that industry companies have recently made:

Transitions and CPS Team Up

Transitions Optical and Comprehensive Professional Systems (CPS) joined forces recently for a strategic partnership to promote healthy vision solutions to CPS's plan members. They'll use cooperative marketing and consumer education to reach eyecare professionals at approximately 400 CPS provider locations, as well as its 1.5 million plan members.

The partnership offers Transitions lenses as an upgrade option for members on benefit vouchers. CPS and panel stores will also have access to custom educational and marketing tools.

AOA Sports Vision Section Celebrates 25 years

The American Optometric Association's Sports Vision Section (AOA SVS) celebrated its 25th anniversary recently. Optometric Management asked the organization about it's roots and its raison d'etre.

Gerard Santinelli, left, president and chief executive officer of Santinelli International, received an award of recognition for his support of the Special Olympics Lions Club International Opening Eyes at a recent Nidek Worldwide Summit meeting. The program works to improve the vision care of persons with disabilities throughout the world. With Mr. Santinelli are Hideo Ozawa, of Nidek (middle) and Dr. Paul Berman of the Special Olympics.

Q: Why was the SVS founded?

A: "The wheels were set in motion during the AOA Board of Trustees Fall 1977 interim meeting," Public Relations Manager Susan Thomas explained. The Board adopted a motion calling for the president to appoint a project team that would investigate and implement the creation of additional AOA Sections. While several sections were considered, only the request for a sports vision section received many letters of petition supporting it. At the 1978 AOA congress, the House of Delegates voted for its creation.

Q: Who heads the SVS now?

A: The current chair is Dr. Sue E. Lowe.

Q: What are the most common sports vision concerns?

A: Dr. Lowe lists three as equally important:

1) Protection. Athletes' eyes need goggles that will protect them both from injury and from ultra-violet light.

2) Correction. Spectacle wearers require a sports goggle that will also correct their vision, while contact lens wearers may need a different lens than their everyday one. For example, skiers, Dr. Lowe says, spend their time in cold, dry conditions and need a contact lens that will provide more moisture.

3) Vision enhancement. Athletes often need help enhancing their binocularity or depth perception.

"It's all about getting people the proper 'hardware' that will help them perform best," Dr. Lowe says.

Q: How many O.D.s are involved in sports vision?

A: Sports vision includes vision protection and correction, and nearly all optometrists do contact lenses and protective eye wear. However, more than 650 of the AOA's members are SVS members.

Q: Are there any practice management benefits associated with working with sports vision?

A: Dr. Lowe says there are many benefits because nearly every patient an O.D. sees is involved in some kind of sport, from bowling to golf to bike riding. The O.D. needs to inform the community of the ramifications of sports vision treatment, regardless of the sport.

FDA Clears B&L's Generic Anti-Infective ANDA

The FDA has granted Bausch & Lomb approval to manufacture and sell ofloxacin ophthalmic solution, 0.3% (Ocuflox) for use in treating bacterial eye infections including bacterial conjunctivitis and corneal ulcers. The company's generic version of the prescription eye drop is available immediately in 5mL and in 10mL volumes.



l Name Change for Optima FW. Bausch & Lomb's Optima FW spherical contact lens will now be known as the SofLens 38 brand lens. The lens will also get new packaging.

l Allergan signs licensing agreement. Allergan and Senju Pharmaceuticals entered an exclusive licensing agreement in Japan to market and develop Lumigan (bimatoprost ophthalmic solution 0.03%%).


l Inspire gains a VP. Inspire Pharmaceuticals appointed Kim Brazzell, Ph.D., Senior Vice President of Ophthalmic Research and Development.

l New director at B&L. Carlos Navarro joined Bausch & Lomb as its new director of Global Consumer Health, Ocular Nutritionals.

l Zeiss promotion. Carl Zeiss Optical promoted Shay Tutton to director, technical operations. He will be responsible for service, sales support and operational and product service quality within the company's System Technology Division.


l Beyond product sales. In addition to products, sales consultants must provide eyecare practitioners with techniques that help grow practices, urges a training course ("The $2,000 Minute") from Optical Services International, a leading association of independent wholesale labs.

l Climb for Sight 2005. The Volunteer Optometric Service to Humanity of Pennsylvania invites you to join its fifth annual "hike of a lifetime" to the top of Mt. Kilimanjaro, plus three days safari on Jan. 29 through Feb. 9 2005. Proceeds will benefit children in Guatemala in need of sight-restoring surgery. No ropes or climbing experience necessary. For more information, call (386) 734-1783 or go to


Optometric Management, Issue: July 2004