CLT, edited by Jason J. Nichols, OD, MPH, PhD, is a free weekly newsletter for eye care professionals who prescribe contact lenses.
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March 6, 2022

We have covered the Federal Trade Commission’s (FTC) revised contact lens rule extensively ( Now, we have seen the FTC and Department of Justice enforce parts of the rule, particularly as it relates to unauthorized distribution of contact lenses by an online-seller-turned-rogue-prescriber. What is less clear has been the true impact of the revised rule on your contact lens practice. Has it been as burdensome as you thought? Have you experienced anything unanticipated otherwise? Please share your thoughts with us at
Jason Nichols

Jason J. Nichols, OD, MPH, PhD

Johnson & Johnson Vision Care Receives FDA Approval for Acuvue Theravision with Ketotifen

Johnson & Johnson Vision Care, Inc. announced that the U.S. Food and Drug Administration (FDA) has approved Acuvue Theravision with Ketotifen (etafilcon A drug-eluting contact lens with ketotifen). Each lens contains 19mcg ketotifen, an antihistamine. Acuvue Theravision with Ketotifen are daily disposable contact lenses indicated for the prevention of ocular itch due to allergic conjunctivitis and provide vision correction in patients who do not have red eyes, who are suitable for contact lens wear, and who do not have more than 1.00D of astigmatism.

Acuvue Theravision with Ketotifen is current available with select providers in Canada and nationally in Japan. The company has plans to release it in the United States soon.


Altius Now Available to Most Independent ECPs in the United States

Performance Vision Technologies, Inc’s. (PVTI) Performance-Tinted Single-Use Soft Contact Lenses, under the brand name Altius (meaning “Higher” in Latin) were officially launched and are availability to most independent eyecare practitioners (ECPs) in the United States.

Altius incorporates Light Architecture and 360 Degree Total Immersion Technology into a single-use soft contact lens modality to decrease visual distractions, according to PVTI. The company also noted that this design allows athletes and recreationists to perform with maximum visual comfort, clarity, and quickness under wide-ranging environmental conditions.

Altius lenses are designed for patients who may or may not need vision correction and are available in two tints: Altius Amber is engineered for dynamic, reactive sports in a wide range of light conditions; and Altius Grey-Green is engineered for open-air activities on water and land in varying light conditions.

Altius, distributed exclusively by ABB Optical Group, are available in 10-, 30-, and 90-packs. With an 8.7mm base curve and 14.2mm diameter, Altius is available in powers of plano, and –0.50D to –6.00D in 0.25D steps. The company is planning for expansion of lens powers and additional performance tints in the future.


ABB Optical Group Doubles Down on Key Focus Areas

ABB Optical Group has announced that it will be making a series of investments to support best-in-class service and tools for its customers and growth in the three pillars of the business: ABB Contact Lens, ABB Labs, and ABB Business Solutions.

First, ABB said that it has recently made substantial investments to support the foundation of the business, ABB Contact Lens, with improvements to its distribution centers through increased staffing and additional robotic technology.

Second, the company is investing heavily in the build of a new digital e-commerce platform, singularly supporting eyecare professionals and their patients. The forthcoming platform is launching in pilot and is scheduled to launch for all customers this summer.

Finally, ABB has seen success in its investment of ABB Labs and the growth of its ABB Specialty Vision product portfolio. According to the company, there has been strong adoption with customers of its newest business solution portfolio: ABB Verify, an insurance verification tool designed to bring patients back to their practitioner; and ABB Analyze, an independent benchmarking dashboard.

In support of these growth strategies, ABB has also recently completed a refinancing of its debt facilities, which provides enhanced capacity to invest behind these initiatives going forward.


Eye Care Leaders Named as Contact Lens Institute 2022 Visionaries

More than a dozen eyecare community leaders have been named as Contact Lens Institute 2022 Visionaries. The diverse group represents a range of practice settings, research interests, specializations, and educational pursuits, with members based in cities and towns across the United States.

Every Contact Lens Institute Visionary has committed to help raise awareness of contact lens prescribing benefits, as well as encouraging healthy wear and care habits. Selected in part for their ability to connect with professional peers, they will participate in initiatives that promote best practices, tools, data, and clinical and practice management insights through the Contact Lens Institute’s The EASY Way program and See Tomorrow research.

2022 Visionaries include Nathan Bonilla-Warford, OD, Bright Eyes Family Vision Care; Melanie Denton, OD, Salisbury Eyecare & Eyewear; Darryl Glover, OD, Black EyeCare Perspective; Klaus Ito, OD, University of Virginia Department of Ophthalmology; Essence Johnson, OD, Black EyeCare Perspective; Elise Kramer, OD, Miami Contact Lens Institute; Chris Lievens, OD, MS, Southern College of Optometry; Jennifer Lyerly, OD, TrueVision Eye Care and Defocus Media; Caitlin Morrison, OD, In Focus: Specialty Contact Lens & Vision Solutions; Mark Schaeffer, OD, MyEyeDr; Bridgitte Shen Lee, OD, Vision Optique; Jason Tu, OD, Invision Optometry; and Jennifer Wademan, OD, Bidwell Optometry. Additional bio information can be found at


CooperVision Hosts 2022 Contact Lens and Pediatric Residency Summit

For the fifth consecutive year, CooperVision and its Specialty EyeCare unit held its Contact Lens and Pediatric Residency Summit. The event brought together contact lens and pediatric residents from across the United States and Canada to learn about the latest developments in the company’s broad portfolio of soft and specialty contact lenses, as well as CooperVision’s continued efforts to establish myopia management as the standard of care.

The theme of the three-day program was Act Now, Change Tomorrow, which provided residents with updates surrounding the company’s portfolio of soft and specialty contact lenses. In addition to learning strategies to advance overall patient care, residents participated in hands-on and instrument-driven specialty contact lens fittings.

During the meeting, clinical and research experts across the contact lens, myopia management and irregular cornea categories hosted a series of workshops and breakout sessions on a variety of topics including how to maximize CooperVision’s entire contact lens portfolio, lens options for patients of all ages and conditions, common misconceptions about myopia management, modifications for solving complex scleral lens cases, and how to build a contact lens practice. Discussion leaders included Dr. Leah Johnson of CooperVision Specialty EyeCare, Dr. Maria Liu, Dr. Aaron Neufeld, Dr. Sarah Singh, and Dr. Ashley Wallace-Tucker, as well as several members of CooperVision’s Professional Affairs teams.


Eaglet Eye Releases New Lens Fit Algorithms

Dutch company Eaglet Eye announced the global release of Prime 6.1, the latest Eye Surface Profiler (ESP) software. Eaglet Eye shares that Prime 6.1 has added first lens fit algorithms to six new lens designs and boosted DirectConnect with nine additional labs. The ESP now features 60-plus lens algorithms from more than 25 labs across scleral, ortho-k, hybrid, soft, and corneal GP lens designs. For more information, visit

Heru Appoints Brandon Barber as Chief Marketing Officer

Heru Inc. has announced that veteran tech industry executive, Brandon Barber, has joined the company as chief marketing officer, effective Feb. 14. Mr. Barber brings over two decades of experience in the digital space as an entrepreneur and as an executive in both marketing and operations. According to the company, Mr. Barber will lead Heru’s marketing strategy and accelerate the company’s mission to democratize access to vision care for all through the power of technology.

Ophthalmic Resources Partners Announces SleepTite/SleepRite

Ophthalmic Resources Partners announced the availability of SleepTite/SleepRite for purchase by eyecare practitioners’ (ECPs) offices and their patients. The product can be ordered on the company website,

SleepTite/SleepRite is designed to help patients who have nighttime eyelid closure issues. According to the company, SleepTite/SleepRite keeps the eyelid sealed shut during sleep, allowing it to function normally to protect the cornea and conjunctiva all night long. The company also notes that the product is easy to apply and use and has a porous, latex-free design. It is available for patients who have both regular and sensitive skin types, and it is sold in boxes of 30 pair.

Quick Poll

You have a 4-year-old myope in your exam chair, and both of her parents are also moderate-to-high myopes. The child likes to spend time outdoors. What would be your first line of myopia management?

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Clinical Image
Anthony Mac, OD, MPH, University of the Incarnate Word Rosenberg School of Optometry, San Antonio, TX

image This image shows nasal notching of a scleral lens to avoid contact with a pinguecula.

We thank Dr. Mac for this image and welcome photo submissions from our other readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit to upload your image. Please include a detailed explanation of the photo and your full name, degree or title, and city/state/country.


Tear Supplementation Contact Lenses

Application of artificial tears commonly provide—at best—temporary relief from dry eye symptoms. Polyvinylpyrrolidone (PVP) K-90 is widely used to manage dry eye syndrome (DES). The marketed eyedrop solutions need frequent instillation. A study looked at the ability of a contact lens coated with PVP to release the agent into the tear film.1

In the study, PVP K-90 was loaded and coated to a soft contact lens. The swelling studies suggested improvement in the water uptake (hydration) property of the contact lenses due to the presence of PVP K-90. The optical transparency was within an acceptable range. In animal studies, the coated contact lens showed higher tear volume in comparison to the respective uncoated contact lenses and an eyedrop solution. The study authors noted that this is a novel approach of coating a high amount of PVP K-90 on lenses for sustained release to manage several ocular diseases like dry eye syndrome, conjunctivitis, and other ocular injuries.

This is just another example of a large number of studies being published recently regarding the use of contact lenses to perform beyond just simple visual correction. In fact, Johnson & Johnson recently received U.S. Food and Drug Administration (FDA) approval for its Acuvue Theravision contact lens with ketotifen (etafilcon A drug-eluting contact lens with ketotifen). Ketotifen is a well-established antihistamine used for the topical treatment of ocular allergy. Delivery of medications, addressing dry eye, addressing allergic eye symptoms, and antimicrobial functions all are being studied and hopefully more will be available to us clinically at some point in the not-too-distant future.

1. Maulvi FA, Patel PJ, Soni PD, et al. Novel Poly(vinylpyrrolidone)-Coated Silicone Contact Lenses to Improve Tear Volume During Lens Wear: In Vitro and In Vivo Studies. ACS Omega. 2020 Jul;5:18148-18154.


Old Versus Young

Dry eye disease (DED) is a debilitating condition occurring in all ages, with increased frequency in older subjects and especially in advanced-age women. An interesting 2022 literature review article aimed to gather insight into the possible differences between dry eye in patients younger than 40 years and those older than 60 years.1 The study reports that younger patients may be exposed to risk factors because of working or recreational activities.

Patients who are under 41 years of age often have severe subjective symptoms and incomplete blinks, with a thin lipid layer, but the number of functioning meibomian glands is elevated and glandular loss is limited. However, in older subjects, glandular loss is a predominant feature along with ocular surface inflammation. These characteristics may be related to the frequent factors producing DED in the elderly, such as systemic inflammatory diseases, glaucoma, and topical or systemic drug use. The pathophysiologic changes of the ocular surface responsible for eye dryness are linked with inflammation and neurosensory abnormalities and may occur with different features in young patients compared with older ones.

The authors of this review suggest that the symptoms observed between patients of different ages may require differentiated treatment strategies for young and older subjects.

1. Barabino S. Is dry eye disease the same in young and old patients? A narrative review of the literature. BMC Ophthalmol. 2022 Feb 22;22:85.


Differentiating Between Contact Lens Warpage and Keratoconus Using OCT Maps of Corneal Mean Curvature and Epithelial Thickness

The purpose of this study was to formulate an Epithelial Modulation index to differentiate between eyes that have contact lens warpage and keratoconus.

Normal eyes and eyes that had either contact lens warpage or keratoconus were scanned by a Fourier-domain optical coherence tomography (OCT) system. Maps of epithelial thickness and anterior surface mean curvature were generated and converted to deviation maps by subtracting the average maps from a healthy population. The Epithelial Modulation index was defined as the covariance between the two types of deviation maps. A logistic regression model was used to classify eyes as non-keratoconus (normal or warpage) or keratoconus (manifest, subclinical, or forme fruste).

The average Epithelial Modulation index value for normal eyes was –0.6µm/m ± 1.0µm/m. Eyes that had keratoconus were characterized by coincident high anterior surface mean curvature and low epithelial thickness, resulting in a high Epithelial Modulation index (manifest: 103.0µm/m ± 82.9µm/m, subclinical: 37.0µm/m ± 23.0µm/m, forme fruste: 7.3µm/m ± 13.2µm/m). The Epithelial Modulation index was closer to normal for eyes that had warpage (–1.9µm/m ± 4.0 µm/m). The classification accuracy of the Epithelial Modulation index during five-fold cross-validation of the logistic regression model was 100% ± 0% for normal eyes and 99.0% ± 2.0% for eyes that had warpage. The accuracy was 100% ± 0%, 100 ± 0%, and 53.1% ± 1.5% for the manifest, subclinical, and forme fruste keratoconus groups, respectively.

The authors concluded that the Epithelial Modulation index is useful in distinguishing eyes that have secondary epithelial modulation (keratoconus) from those that had primary epithelial deformation (contact lens-related warpage).

Pavlatos E, Harkness B, Louie D, Chamberlain W, Huang D, Li Y. Differentiating Between Contact Lens Warpage and Keratoconus Using OCT Maps of Corneal Mean Curvature and Epithelial Thickness. J Refract Surg. 2022 Feb;38(2):112-119.
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