COMPANY PAYS $40,000 IN PENALTIES
Sites Charged with Illegal Contact Lens Sales
An Internet-based contact lens
seller will pay $40,000 in civil penalties under the Federal Trade Commission's
first enforcement of the Fairness to Contact Lens Consumers Act of 2003 (FCLCA).
The FTC alleged that the defendants, Walsh Optical
and owner Kevin Walsh, often failed to obtain or verify prescriptions when they
sold contact lenses through their Web sites:
contactlensworld.com. Under the FCLCA, prescription verification is required with
all contact lens sales.
The Commission files a complaint when it has "reason to believe"
that the law has been or is being violated. The FTC notes that the settlement is
not an admission by defendants of a law violation.
David Cockrell, O.D., a trustee of the American Optometric Association,
applauded the FTC's actions. He says he expects more cases "now that the FTC is
actively investigating complaints" related to prescription verification.
Dr. Cockrell says this illustrates why legislation, such as Senate
Bill 2480 (the "Contact Lens Consumer Protection Act," see OM May 2006, page
14), needs to further address prescription verification abuses "by making the FTC's
enforcement job easier and more effective, instead of empowering Internet vendors
to commit potential violations that may result in significant damage to patients'
The settlement also contains provisions that allow the FTC to
monitor compliance. Is the settlement sufficient? "If it ultimately stops this type
of behavior, then the answer is yes," says Dr. Cockrell. "but we will have to wait
THE NEW RESEARCH
AREDS 2 Continues Study of
AMD and Nutrition
Barbara Anan Kogan, O.D.
years after the ground-breaking Age-Related Eye Disease Study (AREDS), the National
Eye Institute is sponsoring the sequel.
AREDS 2 will investigate the effects of oral supplements of lutein,
zeaxanthin and omega-3 fatty acids on the treatment of AMD. The study will also
evaluate the role of the supplement on cataract progression prevention.
The randomized clinical study seeks to enroll 4,000 patients this
summer at more than 40 clinical centers. The study will include patients from the
ages of 55 through 80 who have either bilateral large drusen or advanced AMD in
one eye only and the presence of large drusen in the fellow eye (AREDS AMD categories
3 and 4).
The study will conclude in July 2007 and follow participants for
a minimum of five additional years. A secondary randomization will evaluate the
effects of reducing zinc and eliminating beta-carotene from the AREDS formula.
Participants in the study will receive one of the following supple-ments:
the AREDS supplements; the supplement with no beta-carotene; the supplement with
a low dose of zinc; or the supplement with no beta-carotene and a low dose of zinc.
(Beta-carotene was found to increase the incidence of lung cancer in patients who
The study will use fundus photographs, taken annually, to evaluate
participants for moderate vision loss, progression to AMD and cataract development.
The original AREDS study, which concluded in 2001, reported that
an oral supplement of certain vitamins and minerals (vitamins C and E, beta-carotene,
zinc, and copper) reduced a patient's risk of advanced age-related macular degeneration
(AMD) by 25%. The advanced AMD participants had a 19% reduction in vision loss.
Those participants without AMD did not benefit from the dietary supplementation.
AREDS cataract portion results showed the same nutrients did not
have significant effects on either the development or progression of age-related
Addressing The Cycle of Failure
By Bob Levoy, O.D.
an effort to improve profitability, have you ever been tempted to skimp on payroll
by hiring fewer employees than needed and/or hiring as cheaply as possible?
Leonard Schlesinger and James Heskett capture the implications of this strategy
in their term "the cycle of failure" ("Breaking the Cycle of Failure in Services,"
Sloan Management Review, Spring, 1991).
The consequences of this strategy include stressed employees who
lack the time and incentive to properly address patient care and/or disgruntled
employees who feel underpaid and unappreciated. The inevitable result is low service
quality and high employee turnover.
In a concurrent cycle, patients become dissatisfied with poor
service, fail to develop loyalty and turnover as rapidly as the staff.
Management justifies the actions, say Mr. Schlesinger and Heskett,
by claiming, "To get good people would cost too much and you can't pass on these
cost increases to customers" or "High turnover is simply an inevitable part of our
business. You've got to learn to live with it."
Part of the problem, say the authors, is failure to measure three
cost variables: the cost of constant recruiting, hiring and training; the lower
productivity of inexperienced new employees; and the time, effort and expense of
constantly attracting new patients.
Also ignored are two revenue variables: future revenue streams
that are lost when unhappy patients leave the practice; and potential income from
prospective patients who are turned-off by negative word of mouth.
Reality check: Employees may stay on the job for a variety
of reasons but if they feel overworked, unappreciated, and resentful about being
exploited financially, they are unlikely to be highly productive or provide good
The 'Net is the Threat
When asked what is the greatest threat to the contact lens segment
of a private practice, nearly 40% of the respondents to an OM Quick Poll replied
"Internet and mail order sellers." Here are the totals based on 245 responses:
Competition from optical retail chains
Contact lens-related legislation
Competition from department stores
Competition from discount superstores
Competition from Internet and mail order sellers
Go to the OM Website
to answer the Quick Poll Question: How man hours do you work?
If you think it's difficult to keep your patients compliant with their eye medicines,
consider that in the recent PRO-SELF study, cancer patients took only about 50%
of their prescribed pain medications.
study in the June 2006 issue of Ophthalmology reports corneal dryness affects the
scan quality of optical coherence tomography (OCT) and measured nerve fiber layer
thickness over a short period of time. The study recommends that patients blink
often or use artificial tears when undergoing OCT imaging.
American Journal of Ophthal-mology (Feb. 2006) found that more gatifloxacin-treated
ulcers healed more completely when compared with those treated with ciprofloxacin.
The conclusion suggests gatifloxacin as first-line monotherapy in bacterial keratitis.
THE SOLUTION TO PATIENT COMPLIANCE WITH CONTACT
Manufacturer Introduces Prototype "Flat"
Contact Lens Package
Contact lens manufacturer ClearLab
says it has seen the future and it's flat. But optometrists ask, will it fly?
The wholly-owned subsidiary of 1-800 CONTACTS, ClearLab, recently
presented AquaSoft Singles, a single-use contact lens package that the company says
will minimize or eliminate many challenges presented by today's contact lens systems
including case contamination, lens inversion, solution compliance issues and left
and right lens identification.
The AquaSoft Singles pack, which measures 1mm thick, compresses
the lens so that it could be carried in a space as narrow as a credit card. The
packaging is color-coded and clearly labeled for left and right. It's package labeling
would include the prescribing doctor's name, thus resembling other prescription
prototype AquaSoft Singles package design.
Once opened, the lens presents with the outside surface face-up
so wearers do not touch the inside of the lens or worry about inversion. The package
could be used with any single-use soft lens. And because the package is designed
for single-use lenses, solutions concerns are eliminated, claims ClearLab.
Optometrists agree that hygiene and compliance are important issues,
as are lens inversion and identification, but the solution to these problems is
not always cut-and-dried. Says Andrew Gurwood, O.D., "Single-use products are a
good concept, however, some folks need rewetting drops or a mid-day break from lens
wear. And if you remove the lenses for any reason, you need a case, which negates
benefits gained from the packaging."
Alan N. Glazier, O.D., agrees that single-use lenses address solution
compliance, but "a lens with fancy packaging would have to deliver more in terms
of comfort or oxygen permeability to really make an inroad into the one-day market."
Miller, O.D., says that her practice's solution to the compliance issue is education
and appropriate follow-up. "We see our contact lens patients every six months,"
she says. "We ask basic questions concerning such areas as replacement, age of case,
solutions [and] length of wear."
She admits however, that all practices may not be as steadfast
in their approach to contact lenses. "In all fairness, I am fully aware that many
offices do things differently than we do," she says.
ClearLab is convinced the packaging will score a big hit with
con-sumers. Once patients experience the benefits of AquaSoft Singles, "we expect
they will never want to return to the old days of lens mix-ups, fishing for lenses
in a bowl, checking for inversion and cleaning with chemicals," says Graham Mullins,
president and managing director of ClearLab.
While ClearLab holds patents in the United States and Japan for
the AquaSoft singles pack, the product exists today only as a prototype. 1-800 CEO
Jonathan Coon says that the company "needs a partner" to move forward and would
consider a licensing agreement or a strategic or financial partnership. "We'd prefer
the option that would allow AquaSoft to come to market most quickly," Mr. Coon says.
ClearLab expects the product to come to market in no more than two years.
Ernest Bowling, O.D., notes that many eyecare professionals would
have trouble recommending a product from 1-800 CONTACTS, a fact that Mr. Coon acknowledges
could limit ClearLab's growth potential. As a solution, he says, the company is
"evaluating a potential separation of ClearLab from 1-800 CONTACTS."
In our August issue ("Pulse," p. 14), we reported
that 1Day Acuvue Moist and 1Day Acuvue are the only daily disposable
contact lenses with UV blocking. Actually, CooperVision offers two daily disposables
with UV blocking: Biomedics 1-Day and ClearSight 1-Day. We apologize for the error.
Optometrist Akio Kanai will recieve the United Nations 2006 Nansen
Refugee Award for outstanding service to the cause of refugees. Dr. Kanai is active
in both the World Council of Optometry and the World Optometry Foundation.
Optos recently formed a Primary Eye Care Advisory Council that includes David
Nelson, O.D., Madison, Wis.; William Jones, O.D., F.A.A.O., Albuquerque,
N.M.; Jerome Sherman, O.D., F.A.A.O., New York; Tom Lewis, O.D., Philadelphia;
Gregg Ossip, O.D., Indianapolis; and Donald Digby, M.D., Greensboro,
Transitions Optical has joined Carl Zeiss Vision for a multi-city tour to teach
eyecare professionals about premium products and healthy sight, while earning ABO
or COPE credits. The cosponsored tour will continue through October. For information,
call Transitions Optical at (800) 848-1506 or register online at
Vision Service Plan (VSP) announced President Rob Lynch's official transition
to chief executive officer of the nationwide eyecare benefit company. Lynch was
selected in late 2005 to succeed outgoing CEO Roger J. Valine.
The Association of Regulatory Boards of Optometry (www.arbo.org) OE Tracker Web
site now includes online continuing education certificates with unique serial numbers
to guarantee authenticity. In addition, the Web site offers the ability to print
a certificate online for any CE event that reported attendance to OE Tracker.
John Ingriselli has been appointed the new manager of customer service and
applications for Gerber Coburn. Mr. Ingriselli's career at Gerber Coburn began in
Transitions Optical named Brett Craig to the new position of chief operating
officer, where he will provide global leadership and direction to Transitions Optical's
commercial, marketing and operations organizations. Prior to joining Transitions,
Mr. Craig held sales and sales/marketing management positions with PPG's industrial
The Vision Council of America (VCA) and AARP have partnered to educate adults about
the importance of regular vision care. The partnership will feature a public service
advertisement (PSA) campaign about the need for regular eye exams for those over
age 40. It will proclaim, "an eye doctor can see things you can't."
A new Web site, Doctorpricing.com, free to consumers and providers, will allow users
to compare prices of healthcare services. The site claims it has a database of
over 700,000 physicians and it will create "transparency" in pricing.