Article Date: 4/1/2006

practice pulse

Amended CL Legislation Passes in Utah

Several bills regarding contact lens prescriptions have been introduced in various states over the last few months. The legislation is an effort by retailer 1-800 Contacts to restrict the sale of what it calls "doctors-only" lenses. Several versions have been introduced and language varies somewhat from state-to-state.

In Utah, the bill (SB 176) passed by a vote of 21 to 7. Beginning July 1st, the new legislation requires manufacturers that do business in the state to certify annually with the attorney general that their lenses are "made available in a commercially reasonable manner," to alternative channels of distribution, defined as any mail order company, Internet retailer, pharmacy, buying club, department store or mass merchandise outlet.

Exempt from the law are GPs, bitoric GPs, lenses for keratoconus and custom-made lenses. Manufacturers that knowingly and intentionally violate the law will be guilty of a class-A misdemeanor and may be subject to a civil action or injunction by the attorney general. Earlier versions of the bill had included penalties for subscribers as well, but these were not included in the final legislation.

A similar bill was introduced and defeated in Indiana. The Indiana Optometric Association (IOA) believes the legislation was not based on health or safety concerns, but on protecting one company's market share. In a public policy statement, the IOA says, "The issue at hand is a business issue between 1-800 Contacts and the national manufacturers of contacts." The statement further explains that it's unlikely that all 80 contact lens manufacturers will go through the process of certifying their brands with the state of Indiana, making some lenses unavailable to patients in the state.

A representative for contact lens manufacturer Vistakon says, "We believe that no law should interfere with a physician's professional judgment in prescribing the best product for the patient, or restrict a manufacturer's right to determine what channels of distribution to use for distributing their products."

In other legislative news, a North Carolina law that would have required children to have an eye exam within six months of entering kindergarten has been put on hold. A Superior Court judge in Raleigh, N.C., signed an order that prevents the state from enforcing the law until July 1, 2007 and prohibits any further court proceedings until October.

Judge Leon Stanback consoli-dated two lawsuits: one was filed on behalf of the North Carolina School Boards Association and local school boards; the other was filed by a parent. Opponents claim the exams are too expensive and unnecessary because children are already required to have a vision screening before entering school. They want the law declared unconstitutional, arguing that it denies children a free public education and creates an unreasonable barrier to access to public schools.

CooperVision Fights Back

CooperVision announced it has retained legal council and lobbyists in part of an intensive lobbying campaign to defeat the
proposed contact lens legislation in various states (see above). In a recent press release, the company says the language of the legislation is ambiguous and does not define standards such as "commercially reasonable" and "nondiscriminatory manner." CooperVision also says these bills would limit the choices available to O.D.s and unfairly subjects manufacturers to civil and criminal liability for legitimate commercial practices.

The company also asserts the belief that manufacturers should continue to have the right to determine which distribution channels and business partners are best for the competitiveness of the industry and for patients. "Federal and state laws traditionally support free market practices," says Jeff McLean, president of CooperVision Americas. "Manufacturers of medical devices in hundreds of industries have the discretion to choose distributors in order to improve their competitiveness and the quality of their distributors, and it is essential that contact lens manufacturers be allowed to retain that same discretion," he continued.

More information is available on the company's web site.

CIBA Resumes Distribution of Solutions

CIBA Vision announced that it has resumed shipping contact lens cleaning solutions Clear Care and Aosept in North America. Con-sumers will see increasing supplies of these products on the shelves of major retailers nationwide this month. The company anticipates that shipments of AQuify will follow in the second quarter.

In late 2005, the company voluntarily suspended production as a cautionary measure in response to concerns about the manufacturing process. The move caused some shortages in a few markets. CIBA implemented strict monitoring of the process and retraining, and assures that no products that did not meet its requirements left the manufacturing facility.


In March 2005, Optometric Management published the article, "A Case in Clinical Ethics." OM would like to acknowledge that the six-step method for analyzing cases of clinical ethics, which is detailed in the article, was taken from chapter 2 (Ethical Decision Making in Clinical Practice) of the book "An Optometrist's Guide to Clinical Ethics," (R. Norman Bailey, O.D., and Elizabeth Heitman, Ph.D.).

SECO Announces Awards, Products and Services

►The 2006 SECO International Congress, held in Atlanta, offered optometrists 18 free hours of continuing education, over 200 technical exhibits and a number of networking opportunities. One of the largest shows in eyecare (it attracts about 7,000 optometrists, opticians, technicians and paraoptometric professionals), SECO regularly includes a host of announcements from the companies and organizations that serve optometry. Optometric Management includes a selection of this information below.

►SECO presented awards for 2006 Optometrist of the South (to Gordon Jennings, O.D., Wytheville, Va.), 2006 Young Optometrist of the South (Tammy Than, O.D., Birmingham, Ala.), and 2006 Paraoptometric of the South (Sandra Sisk, C.P.O.A., Salisbury, N.C.).

►The Women of Vision presented the panel discussion, "Opportunities for Women in the New Millennium," sponsored by Bausch & Lomb.

Bausch & Lomb (B&L) announced the U.S. launch of the PureVision multi-focal (balafilcon A) visibility tinted contact lens. The multifocal completes the company's U.S. silicone hydrogel contact lens portfolio, which also includes spherical and toric designs.

►The Vision Care Institute of Johnson & Johnson Vision Care, in partnership with Marco Ophthalmic, OfficeMate, Optos and Eyemaginations, presented a film entitled, "The Practice of the Future." The film introduced viewers to a practice that leveraged technology to simplify data collection, improve data accuracy and provide a seamless flow of information among doctor, staff and patient. The result: a system that frees the doctor to focus on compassionate care.

Michael E. Kehoe

A CIBA Vision announced the appointment of Michael E. Kehoe as chief executive officer. Kehoe has served as president of the global oral care business of Procter & Gamble. During his 27-year tenure with P&G, he served in various leadership positions in Europe and North America. Mr. Kehoe, a Canadian national, holds a bachelor of commerce degree from Queen's University in Kingston, Canada.

CIBA Vision introduced the first daily disposable contact lens in the United States, FreshLook ONE-DAY color contact lens. The lenses incorporate CIBA's FreshLook ColorBlends technology into the company's Focus DAILIES platform. An advantage of the lens is that if patients already wear Focus DAILIES, then they don't require a refit, noted Jeff Cohen, CIBA's vice president of marketing, North America.

►In conjunction with the CIBA press conference, Optometry Giving Sight (OGS) announced funding of eyecare projects in the tsunami devastated areas of Sri Lanka. Through OGS funding, more than 17,500 survivors of the 2004 tsunami received primary eyecare and prescription glasses in 2005. OGS is a joint initiative of the World Optometry Foundation, the International Agency for the Prevention of Blindness and International Centre for Eyecare Education (ICEE).

M&S Technologies introduced the Smart System computerized visual acuity and contrast sensitivity system. The new system offers new hardware options, expanded vision tests, enhanced display and more user friendly options.

M&S also announced a partnership with Eyemaginations. Each Smart System will contain a built-in interface with Eyemaginations software, the 3D animated communication platform developed for the eyecare industry.

►The Association of Regulatory Boards of Optometry (ARBO) ( Council on Endorsed Licensure Mobility for Optometrists (CELMO) presented CELMO certificates to the first optometrists completing all CELMO requirements. According to ARBO, the program will be helpful to those who serve in the Armed Forces by providing them with "obtainable licensure options" once they complete their military service. ARBO reported that it will host a National Optometric Continuing Education Conference to be held in Chicago on May 13 and 14, immediately following the Midwest Vision Congress & Expo 2006.

The National Glaucoma Society is a non-profit organization that offers healthcare practitioners a variety of research, educational seminars, conferences, newsletters and various media distribution related to glaucoma. NGS also educates the public on the prevention and treatment of glaucoma. The site describes these offerings and includes membership information and sections for case studies, practice management and pharmacology.

B&L Suspends Sales of ReNu in Singapore and HK

Certain parts of Asia have reported an unusual incidence of fungal keratitis among contact lens wearers. Although the majority of the patients in those cases remembered using Bausch & Lomb's multipurpose solutions (ReNu), B&L says that reports indicate a variety of lens care products produced by different manufacturers were used, which suggests that "the root cause of these infections is not related to a specific product."

The Singapore Ministry of Health has also said that there is no definitive link between any particular product and the infection. However, B&L agreed to voluntarily suspend sales of the solutions in Singapore and Hong Kong while the investigation proceeds. ReNu is the market-leading brand in those locations, so "it is not surprising that that those patients remembered the Company's brand name," says a company statement.

Reports of an outbreak of contact lens-related Fusarium keratitis in Singapore and Hong Kong first came to B&L's attention in mid-February. The Singapore health authorities said that most of the contact lens-related fungal keratitis infections in that country involved patients with histories of poor contact lens care practices.

FDA Provides Clearance for Contact Lenses

►The FDA has cleared the SynergEyes PS hybrid contact lens for daily wear in patients with post surgical and post trauma refractive error. This is the fourth FDA market clearance SynergEyes has received in the last six months.

SynergEyes plans to introduce the new SynergEyes PS lens in the third quarter of 2006. SynergEyes launched the SynergEyes A lens for astigmatism, hyperopia and myopia last September and will roll out the new SynergEyes KC lens for keratoconus in May, 2006. The SynergEyes M lens for presbyopia is planned for launch in late 2006.

The FDA has cleared an expanded post-surgical indication for Bausch & Lomb's Boston XO, Boston EO and Boston ES gas permeable (GP) contact lenses for use in non-diseased eyes that require a rigid contact lens for the management of irregular corneal conditions such as keratoconus, pellucid marginal degeneration (PMD), or following penetrating keratoplasty or refractive (e.g., LASIK) surgery. These new lens designs must be cleaned and disinfected using an FDA-approved chemical disinfection system for gas permeable lenses.


►Dan L. Mennen, O.D., a graduate of Pacific University College of Optometry, has assumed a two-year term as chairman of the board at Vision Service Plan. The Oregon native is a former commander in the United States Naval Reserve.

►Gerber Scientific named Rodney Larson as president of Gerber Coburn, the worldwide provider of computer integrated optical lens processing systems. Prior to Gerber Coburn, Mr. Larson was vice president of Key Technology, Inc., a provider of process automation systems.


►The Vision Care Institute of Johnson & Johnson (TVCI) has opened its first European facility in the Czech Republic. Located in Prague, the facility will educate eye care specialists throughout Europe. TVCI also operates facilities in Jacksonville, Fla., Seoul, Korea and Taipei, Taiwan.

►Transitions Optical named Diversified Ophthalmics as the 2005 Transitions Lab of the Year. The Cincinnati-based lab was recognized among an international crowd of more than 1,000 industry professionals during the 10th-annual Transitions Academy in Universal Studios, Orlando, Fla.

►The Internet portal Eyefinity announced e-commerce partnerships with Tura, a manufacturer of frames and sunglasses, REM, a designer and marketer of fashion eyewear, and VersaSuite, the practice management software developed by Universal Software Solutions.

►VisionWeb and AIT Industries' announced the integration of VisionWeb's online ordering service, Essential, and the Delta Scan 3D Tracer. This integration will offer practices the ability to attach a trace file to lab orders that are submitted electronically. The process will reduce turnaround time for receiving finished, edged lenses.

►In the United States district court in California, OASIS Medical has sued Johnson & Johnson and Johnson & Johnson Vision Care, Inc. alleging that their use of the name OASYS infringes and dilutes OASIS Medical's trademark rights.

►Allergan reports that the Committee for Medicinal Products for Human Use (CHMP) has recommended that the European
Commission approve Ganfort, Allergan's Lumigan/timolol (bimatoprost/timolol ophthalmic solution) combination product for the treatment of glaucoma. The company expects EC approval in the second quarter of 2006.


►The American Society of Corneal and Refractive Technologies (ASCRT), announced its 2006 Annual Meeting will be held in Scottsdale, Ariz., June 1-4, 2006. For more information, visit


►Transitions Optical has introduced a series of five new educational posters, encouraging patients to consider the many factors that could impact their vision. For a complimentary set, call Transitions Customer Service at (800) 848-1506.

Imperial Optical introduced a one-tier pricing structure. This new structure will give many independent practitioners the same price points that are generally reserved for higher-volume practices. For a price list, call 800-367-8422.

ABB Optical has launched a service called the "ABB Soft Lens Retail Price Monitor." Each quarter audits the retail pricing of 26 best-selling soft lens brands and publishes the data in a summary report, which is available through ABB sales representatives.

Treating trichiasis

A clinical trial has concluded that a single dose of azithromycin taken orally after surgery reduces the recurrence of trichiasis, the vision-threatening eyelid condition that occurs in communities with little access to clean water, waste water treatment or healthcare. The conventional treatment is a six-week regimen of tetracycline ointment applied directly to the eye. The results of the study are published in the March 2006 issue of Archives of Ophthalmology.

Contact lens measures blood sugar

Scientists in the United Kingdom are developing a contact lens that senses glucose levels so that diabetics will no longer have to take daily blood samples. Using "sensor hologram" technology, the lens senses glucose levels in tear film, which may be linked to the concentration of glucose in the blood. Smart Holograms and the Department of Trade and Industry (U.K.) are funding the research.

Optometric Management, Issue: April 2006