Article Date: 1/1/2007

Practice pulse
TIPS, TRENDS & NEWS YOU CAN USE

THE PULSE OF EYE CARE TODAY
AAO Conference Demonstrates the Broad Scope of Optometric Research

While the annual press conference of the American Academy of Optometry is a marathon for attendees who listen to 20 presentations, it is a sprint for presenters, who have less than five minutes to explain their respective topics. Held during the Academy's recent annual meeting in Denver, the conference provides a healthy over-view of some of the latest research, products and services that impact eye care. Split evenly between industry presentations and scientific papers, the conference is summarized below.

The latest science

Mark Bullimore, MCOptom., Ph.D., F.A.A.O., presented the results of a study that concluded patients who wore silicone hydrogel contact lenses (Night & Day, CIBA Vision) had no change in refractive error during a three-year period, while hydroxyethyl methacrylate lens wearers experienced a 0.75D myopic progression, or 0.41D when adjusted for age.

In a study of 34 adults who have low vision, Marlee Spafford, O.D., MSc., found that subjects did not seek low vision care because they were unaware of such services (73.5%), they struggled but man-aged without low vision services (68.6%), they were waiting for an eyecare professional's recommendation (41%), or they were resigned to no hope for their situation (32%). Also, 82.4% thought low vision aids threatened their independence. Dr. Spafford called for accessible public education, heightened professional education and an understanding of patient attitudes toward low vision.

Presenting "Effects of visual impairment on driving and pedestrian recognition at night," Joanne M. Wood, Ph.D., explained that the number of night time fatalities can be three to four times greater than fatalities during daylight hours. Among patients who experience reduced vision due to blur or cataracts, the effects of cataracts were greater than blur in night driving situations (even though visual acuity was the same) but much smaller in daylight. The ability to see pedestrians was improved up to 80% when pedestrians wore reflective tape on their moveable joints.

Jane Gwiazda, Ph.D., F.A.A.O., reported in a scientific paper that the proportion of juvenile-onset myopes with two myopic parents is significantly higher than the proportion with one or no myopic parent. However, the proportion of adult-onset myopes does not vary by number of myopic parents. These results suggest that there may be different etiologies for myopia.

Other scientific presentations included:

• "Evaluating the relative risk of microbial keratitis in longer term overnight wear of orthokeratology vs. alignment RGP lenses" By Jennifer Choo, O.D.

• "The impact of soft contact lens (SCL) wear on LASIK surgical outcomes," by Kuang-Mon Tuan, O.D., Ph.D.

• "Toll-Like Receptor 4 (TLR4) and the Pathogenesis of Dry Eye," by Rachel L. Redfern, O.D.,

• "Marker selection for genetic association studies of refractive error" by Robert Wojciechowski, O.D., MSc.

• "The impact of a near task on tear-breakup dynamics," by Meredith Jansen and Monica Bedroya.

From lab to marketplace

Scott Jens, O.D., presented EyeCodeRight ECR v4.0, an electronic health records/practice management software solution that resides on the Internet, allowing practitioners to access the system from any high-speed Internet connection. ECR v4.0 eliminates the cost of networking computer workstations in multiple offices.

Erich Bauman, O.D., introduced the CIBA Vision O2Optix Custom, the first made-to-order silicone hydrogel lens. The lens is available in three diameters and 14 base curves (see additional coverage in "Pulse.")

Michael Edwards, Ph.D., pres-ented Pataday (olopatadine HCI 0.2%, Alcon). In a study of 46

patients during grass/pollen season, one drop per eye of Pataday reduced itching at onset and at 24 hours. Among patients, Dr. Edwards noted that Pataday demonstrated a satisfaction rate of nearly 90%, confirming its comfort and safety profile.

Tim Gels of Eschenbach Optik of America presented the low vision aids SmartView Xtend and the Scribolux portable LED illuminated stand magnifier. The SmartView Xtend is a video magnifier that presents images on a 17-inch or 19-inch monitor. The Scribolux features a large, open viewing area for reading or writing.

Harvard Sylvan, O.D., provided a preview of CooperVision's Biomed-ics EP (emerging presbyope) contact lens, which provides up to +1.50D add. This multifocal two-week replacement lens will be available in the first quarter of 2007. Dr. Sylvan, director of professional relations for CooperVision, noted that the lens can fill a large niche: about 2.4 million adults become presbyopic each year, he said.

Robert Sambursky, M.D., dis-cussed Rapid Pathogen Screening's RPS Adeno Detector, an in-office test that can determine the cause of conjunctivitis (viral, bacterial, allergenic or chemical) within 10 minutes.

Dan Mannen, O.D., board chair of VSP, announced that the VSP Vision Loans program will be expand-ed to include an Associate Salary Program. The program will provide loans for VSP network optometrists to use toward the salaries of new optometric associates. Dr. Mannen explained that since 2003, VSP has issued $13 million as part of the Vision Loans program.

In the "Contact Lens in Pediatrics (CLIP) Study" of children (ages 8 to 12) and teenagers (ages 13 to 17), Jeffrey J. Walline, O.D., Ph.D., found that "children as young as eight years old are as capable as teenagers at wearing and caring for soft contact lenses." He recommends that both age groups "be presented with the option of contact lens wear when vision correction is required."

The study of 169 children who wore silicone hydrogel contact lenses concluded that both kids and teens perceive an improvement in quality of life. The study did not find any significant differences in contact lens fitting times between children and teens.

Troy Smith of Cynacon/Ocusoft announced Ocusoft Lid Scrub Plus Extra Strength for severe cases of blepharitis. Ocusoft Lid Scrub re-moves oil, debris and desquamated skin from the eyelids. It is available in pre-moistened pads, a foam and a solution, which can be applied with a damp, warm washcloth or cotton swab.

Joseph Vehige, O.D., Allergan, presented "The benefits of compatible solutes in the treatment of dry eye." Dr. Vehige explains that as tear film evaporates and tear production decreases, tear film can become more hyperosmotic, presenting conditions conducive for dry eye. Dr. Vehige ex-plained that numerous tissues and organs protect their cells from hypertonicity with compatible solutes.

The research presented by Allergan concludes that compatible solutes can also protect corneal cells from the physiological stress of exposure to hyperosmotic conditions. The protection reduces pro-inflammatory changes in the cells in vitro and demonstrates the potential benefit of compatible solutes in artificial tear formulations.

Recalls from Alcon and AMO

Alcon announced a voluntary recall of Systane Free Liquid Gel lubricant eye drops distributed in the United States, including Puerto Rico. This recall was in response to 11 consumer reports citing the presence of foreign material that the company identified as mold.

The company received no reports of fungal infections, and according to Alcon, the development of an infection is "unlikely" because of the characteristics of the mold.

The mold is related to formulation of the eye drops, not the manufacturing processes, said Alcon. The recall does not affect the original formulation of Systane lubricant eye drops and Systane unit dose.

The drops can be identified by the words "Free" and "LIQUID GEL" on the product box or bottle.

Those in possession of Systane Free Liquid Gel should immediately discontinue use and call (866) 608-3936, or visit www.systane.com for instructions. Alcon will replace any purchased bottles of Systane Free LIQUID GEL with its original formulation of Systane lubricant eye drops.

Complete lots recalled

Advanced Medical Optics (AMO) announced a nationwide, voluntary recall of certain lots of its 12 oz. Complete MoisturePLUS multipurpose contact lens care solution and Active Packs. Three lots sold in Ja-pan, traced to a manufacturing plant in China, were found to have bacterial contamination, which compromised sterility. AMO is recalling 18 lots distributed in the United States that were manufactured on the same production lines during the same production period. AMO has not received any reports of adverse health events associated with the recalled product lots in the United States. The company said it believes that the likelihood of solution users experiencing an adverse reaction is low.

The recall does not include 4 oz. and 16 oz. bottles or professional samples. The recall includes approximately 183,000 units, or less than 1% of COMPLETE MoisturePLUS contact lens products distributed in the United States on an annual basis.

Lot numbers are located on the top of the product box and on the side of the product bottle. The re-called product lots include:

• COMPLETE MoisturePLUS Active Pack package lot numbers ZB03087 (bottled lot numbers in kits ZB03085, ZB02845), ZB03724 ( ZB03713, ZB03506), ZB03734 (ZB03506, ZB03713), ZB03735 (ZB03510, ZB03713), ZB03736 (ZB03510, ZB03713), ZB03739 (ZB03510, ZB03737)

• COMPLETE MoisturePlus package lot numbers ZB02710 (bottled lot number in kit ZB02709), ZB02714 (ZB02713), ZB02718 (ZB02717), ZB02722 (ZB02721)

• Complete MoisturePLUS 2 x 12 oz. package lot numbers ZB02746 (bottled lot number in kit ZB02745), ZB02750 (ZB02749), ZB02771 (ZB02770), ZB02792 ( ZB02791), ZB02796 (ZB02795), ZB02800 (ZB02799), ZB02804 (ZB02803), ZB03535 (ZB03534)

Those who believe they are in possession of the recalled product should discontinue use immediately and call (877) 884-7779 Monday through Friday between 8a.m. and 5p.m. Eastern Standard Time, or visit amo-inc.com for instructions.

MADE-TO-ORDER SILICONE HYDROGELS
CIBA Vision Customizes O2Optix

CIBA Vision has introduced the O2OPTIX Custom contact lens, a silicone hydrogel lens that is available in a total of three diameters and 14 base curves. The daily-wear, quarterly replacement lenses can be produced in a greater number of configurations through a patented technology, InnoLathe, which manufactures the lens based on an individual patient's lens design.

As custom lenses require high-precision lathing that is difficult to achieve with silicone, CIBA Vision developed a new silicone hydrogel material, sifilcon A, to be used with the new manufacturing process. O2OPTIX custom are available for patients who have high myopia, high hyperopia, large and small corneas, steep and flat corneas and aphakia.

The Dk/t of the lens is 117. It is available in sphere powers of +20.00D to -20.00D in 0.25D steps and in diameters of 13.2 [base curves (mm) of 7.4, 7.7, 8.0, 8.3] 14.0 [base curves of 7.8, 8.1, 8.4, 8.7, 9.0] and 14.8 [8.0, 8.3, 8.6, 8.9, 9.2].

CIBA Vision offers a "Perfect Fit Guarantee" where upon receiving patient measurements, it will ship two single lenses within 10 working days. These lenses are used for the first on-eye evaluation. If a change is necessary, the O2OPTIX are exchanged until the patient is satisfied. When the optom-etrist arrives at a final prescription, the O.D. orders a four-pack of lenses for each eye.

For more information, visit O2OPTIXcustom.com.

O.D. NOTEBOOK

■ CE deadline clarification: In the November OM CE ("Strategic Skill Builders), the deadline for submission, listed on page 57, should read September 15, 2007, not September 15, 2006. We apologize for any confusion.

Henna Inam has been appointed president of CIBA Vision's America's Region. Ms. Inam has been with CIBA's parent company, Novartis, for nine years, most recently as general manager, Mexico for Gerber.

CIBA Vision has established a new Customer Development Group. Karen Gough, previously president, Americas region, has been appointed chief customer officer to lead the group in meeting the needs of an increasing and diverse global customer base, including optometrists. Richard Weisbarth, O.D., joins the team as vice president, global head of professional development and partners. Manny Rodriguez will serve as vice president and global head, key customer programs, and Marcus Swalwell has been appointed vice president and global head of sales force effectiveness and customer excellence.

Advanced Medical Optics (AMO) and Tracey Technologies announced AMO's world-wide, non-exclusive license to Tracey Technologies' ray tracing wavefront technology. This replaces a prior agreement between Tracey Technologies and AMO's predecessor, VISX.

Bausch & Lomb has purchased Alimera Sciences' OTC allergy franchise, including Alaway (ketotifen fumarate ophthalmic solution 0.025%), a multiple action eye antihistamine, which is indicated for use up to 12 hours.

Transitions Optical has introduced a new brochure in the "What to Expect" series. The "Adult Eyes" brochure, available in English, French and Spanish, provides information and statistics on types of vision problems that come at different stages of adulthood.



Optometric Management, Issue: January 2007