The Global Specialty Lens Symposium (GSLS) got off to the races with a fantastic start. Although omicron and COVID-19 certainly presented challenges for holding an in-person event, the meeting was a massive success. Careful planning and an amazing integration of technology allowed specialty lens experts from around the globe to participate. Thank you to all of our attendees, speakers, and, in particular, our meeting sponsors for their commitment to our in-person meeting. Look to Contact Lens Spectrum’s April issue for more in-depth coverage of the event!

One news item of interest at the GSLS was the announcement of our mid-year, GSLS Virtual meeting to be held June 9 to 11, 2022 (https://www.clspectrum.com /gsls-virtual). This will truly be a global meeting with four educational sessions planned with partners from the Asia Optometric Congress (https://asiaoptometriccong ress.com), British Contact Lens Association (https://www. bcla.org.uk), Grupo Manejo de la Miopia Latam (Group Myopia Management LATAM) (https://m.facebook.com/groups/ controldemiopiaLATAM), and our GSLS committee member experts! Stay tuned for more information about this worldwide contact lens virtual meeting that will be a must-see event.
 

Jason J. Nichols, OD, MPH, PhD
 

SynergEyes Launches SynergEyes VS Multifocal Scleral Lens

SynergEyes, Inc. announced the launch of three innovations for the SynergEyes VS scleral lens. SynergEyes VS Multifocal has a front-surface progressive center-distance design, with available adds of +1.00D to +3.50D in 0.50D steps. SynergEyes says that aberration control helps address lens-induced aberrations for consistent power throughout the optical zone; the feature is standard on SynergEyes VS Multifocal lenses and is an option on the Single Vision lenses. The limbal clearance factor (LCF) option broadens the area of limbal clearance and is particularly beneficial for larger horizontal visible iris diameters (HVIDs); it is available in two options—LCF 1: 25-micron change and LCF 2: 50-micron change.

According to the company, SynergEyes VS is an innovative scleral lens with a distinctive bi-tangential periphery and linear landing zones that fits the true shape of the sclera. Designed to accommodate a wide variety of corneal conditions, each parameter may be adjusted independently, without affecting other parameters.

SynergEyes VS has an All-Inclusive Pricing model, which includes the lens’ standard linear landing zones and toric peripheries as well as the aberration control and limbal clearance factor options. Additionally, its 90-Day Guaranteed Fit Program provides unlimited exchanges shipped free of charge (during the 90-day fitting period). There is no need to return opened lenses for credit.
 

Dr. Yehia Hashad to Join B+L as Executive Vice President of Research & Development and Chief Medical Officer

Bausch Health Companies Inc. has announced that Dr. Yehia Hashad will join Bausch + Lomb Corporation (B+L) as executive vice president of Research & Development (R&D) and chief medical officer (CMO) effective Jan. 31, 2022.

For the past 11 years, Dr. Hashad has held various roles at Allergan/AbbVie, including leading Allergan's global clinical development program for its eyecare portfolio. Prior to that, he was with Novartis Pharma AG for five years, where he focused on ophthalmology, and also with T3A Pharma Group for nearly 10 years.
 

Euclid Systems Launches Customer Portal

Euclid Systems Corporation announced the initial launch of MyEuclid, a new interactive, web-based customer portal designed to help drive practice efficiency and optimize Euclid Ortho-K fits.

According to Euclid, fit flexibility, data-driven algorithms for precise curve selection and for optic zone optimization, and expert order verification are among MyEuclid’s key features. Easy topography uploads and real-time order tracking round out the list of attributes made available in this cutting-edge system, according to the company. Euclid says that the interactive platform has an easy-to-use interface that works with Euclid’s simple three-factor fitting and boasts an “advance mode” for additional practitioner modifications.

A full launch of MyEuclid to U.S. customers is planned for March 2022.
 

CAO Releases Position Statement

The Canadian Association of Optometrists (CAO) has released a position statement on myopia management. The statement addresses risks associated with myopia, risk factors for development of myopia, impact of myopic eye disease, and myopia management options. It can be found at https://mcusercontent.com/d2d25e58d1c4457fa118 64bfe/files/a2f43c71-90ba-4334-d289-d4e7412fa800/CAO_Position_Statement_on_Myopia_Management_2022.pdf. The CAO supports the position of the World Council of Optometry and endorses evidence-based myopia management as a standard of care for all at-risk patients.
 

Several Changes Made in Leadership of Allergan Eye Care

AbbVie announced several changes for its Allergan eye care business.

Jag Dosanjh, formerly senior vice president, Medical Therapeutics, has been appointed to a newly created role of president, U.S. Neuroscience and Eye Care. As part of this new role, Mr. Dosanjh will continue to oversee the company’s vision care business.

Ramin Valian, formerly vice president, Glaucoma and Reimbursement, has been named vice president, Eye Care, and will oversee the company’s dry eye/refractive, glaucoma, retina, and over-the-counter (OTC) portfolios. Mr. Valian will continue the company’s focus on identifying new treatments that address unmet needs and new approaches to improve access to its products.

Glen Curran, formerly vice president, Anterior Segment, will now serve as vice president, Botox (onabotulinumtoxinA) Therapeutic. Most recently, Mr. Curran oversaw the launch of Vuity (pilocarpine HCl ophthalmic solution) 1.25%.
 

IACLE Calls for Entries for 2022 Educator Awards

The International Association of Contact Lens Educators (IACLE) is offering educators worldwide the chance to become IACLE Contact Lens Educator of the Year and to travel to an international meeting providing that COVID-19 restrictions allow. IACLE Contact Lens Educator of the Year will be awarded to three individuals, one from each of IACLE's three global regions: Americas, Asia Pacific, and Europe/Africa–Middle East. These awards recognize and award achievements in contact lens education and are sponsored by CooperVision. The winners will each receive a bursary of up to $3,000 toward the cost of attending an international meeting this year and permission to use the title 2022 IACLE Contact Lens Educator of the Year for their region.

Due to travel restrictions implemented in response to the COVID-19 pandemic, the 2020 and 2021 award recipients have not yet received their awards. The 2020 winners, Professor Renée Reeder (USA), Professor Bariah Mohd Ali (Malaysia) and Jo Underwood (UK), and the 2021 winners, Dr. Johanna Garzón (Colombia), Wei Xu (China), and Dr. Byki Huntjens (UK), will also receive their awards at meetings in 2022 when restrictions allow.

The IACLE Educator Awards are open to all contact lens educators who have been IACLE members for at least three years. Applicants can either nominate themselves or be nominated by another member or by IACLE staff. Educators must demonstrate impact on their institutions and how they inspire their students to become future contact lens practitioners.

In addition, the IACLE Travel Awards are bursaries of up to $3,000, allowing IACLE Educator Members to attend a meeting on a national, regional, or international basis. The IACLE Travel Awards are sponsored by IACLE through the support of IACLE’s sponsors (Alcon, CooperVision, Johnson & Johnson Vision, Bausch + Lomb, Ophtecs, and Euclid). This year, there will be one IACLE Travel Award, and the recipient will attend a national, regional, or international meeting in 2022 when restrictions allow.

2020 Travel Award recipients Dr. Elizabeth Chetty (South Africa) and Associate Professor Nirav Mehta (India) will receive their awards at a national, regional, or international meeting in 2022, providing restrictions allow. Professor Martín Guzmán (Venezuela) received his 2020 Travel Award at the International Congress of Scleral Contacts in Fort Lauderdale, FL, in July 2021.

The deadline for entries for the 2022 Awards is midnight (EST) on Feb 28, 2022. Submit entries at www.iacle.org/awards.
 

Avellino Enters into Distribution Agreement with Keeler to Sell AvaGen

Avellino Lab USA, Inc. and Keeler have entered into an agreement in which Keeler will distribute AvaGen on its U.S. website. According to Avellino, AvaGen is the first genetic test that helps determine a patient’s risk of keratoconus and the presence of transforming growth factor beta-induced (TGFBI) corneal dystrophies. Avellino says that the test allows for more confident management and treatment of patients who have these conditions to protect and preserve patient vision. The test examines 75 keratoconus-related genes and more than 2,000 variants of those genes to develop an actionable genetic risk score for keratoconus, according to the company.
 

 

Which attribute of a soft contact lens do you feel is most important to comfortable contact lens wear?

Click here to vote.

 

Edward Boshnick, OD, Global Vision Rehabilitation Center, Miami

This patient’s uncorrected visual acuity is less than 20/1000 due to a rare form of corneal ectasia known as superior pellucid marginal degeneration. We fit this patient with scleral lenses in both eyes, which provided him with 20/20 vision.

We thank Dr. Boshnick 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 http://www.cltoday.com/upload/upload.aspx to upload your image. Please include a detailed explanation of the photo and your full name, degree or title, and city/state/country.
 

 

The Question That Remains: What Causes Contact Lens-Related Corneal Infections (MK)?

The single most concerning potential complication of contact lens wear is corneal infection or microbial keratitis (MK). If located centrally, there is a potential for permanent vision loss. Much attention and research have been devoted to this problem, and although the risk of vision loss due to MK in contact lens wear is quite low (especially with appropriate lens wear and care behaviors), we surely want to learn how to reduce it even further. A recent paper outlined the authors’ perspective of the mechanisms by which contact lens wear sometimes renders the cornea susceptible to infection.¹

According to the authors, research suggests that the pathogenesis of contact lens-associated MK is complex and multifactorial, likely requiring multiple conspiring factors that compromise the intrinsic resistance of a healthy cornea to infection. They expressed concern that clinical isolates of P. aeruginosa have emerged that are resistant to virtually all currently available antibiotics. Combining that with expected growth in the use of contact lenses in light of the development of advanced contact lenses for biosensing and augmented reality, together with the escalating incidence of myopia, the authors felt that this could portent to an epidemic of vision-threatening corneal infections in the future. However, they also stated that technological advances in genomics, proteomics, metabolomics, and imaging, combined with emerging models of contact lens-associated P. aeruginosa infection, hold promise for solving the problem—and possibly for solving life-threatening infections impacting other tissues.

In the body of the paper, the authors covered topics such as how intact healthy corneas intrinsically resist infection, the role of blinking and the tear film, corneal epithelium barrier function, specifics regarding P. aeruginosa, and the various impacts of contact lens wear and lens care issues, among others. The paper concludes with a detailed discussion of what factors associated with contact lens wear trigger infection susceptibility. They specifically state that while silicone hydrogel lenses did solve some less serious problems associated with soft lens wear, they did not reduce the infection rate and introduced some new problems while also increasing inflammatory complications.

The topic of contact lens-related MK is obviously a very complex one. While we thought that we had found the holy grail with the development of hyper-Dk materials, soon we realized that this was not the case. So much has been learned about this topic over the past decades, but so much still needs to be discovered. All of this being said, contact lens wear, when associated with appropriate lens wear and care habits, is amazingly safe and effective. We need to be the bastions of this message as we provide care to our patients.

1. Fleiszig SMJ, Kroken AR, Nieto V, et al. Contact lens-related corneal infection: Intrinsic resistance and its compromise. Prog Retin Eye Res. 2020 May;76:100804.
 

 

The Transitive Property of Demodex and Dry Eye

As eyecare professionals, we generally accept that blepharitis is a factor in ocular surface disease (OSD) and in dry eye disease (DED) and that Demodex is a precipitator of blepharitis. So, if A = B and B = C, then A = C. Can we therefore say that the presence of Demodex is a trigger for dry eye development?

Let's look at a study to determine whether ocular Demodex colonization results in differences in Schirmer test scores and Ocular Surface Disease Index (OSDI) questionnaire values in individuals who have diagnosed for the first time.

In this study, participants included 88 ophthalmology clinic adults aged 40 to 68 years who were reporting for routine ophthalmological examination. Participants were diagnosed with DED for the first time and did not have any chronic disease. All patients completed the OSDI. Schirmer testing was performed, and then two eyelashes were taken from the inferior eyelids. The samples were evaluated by a parasitologist experienced with Demodex.

One hundred sixty-eight eyes of 84 patients were included in the study. The average Schirmer test score was 2.1 ± 0.5, the OSDI questionnaire score was 61.82 ± 10.95, and the mean age was 55.36 ± 8.74 years in patients who had Demodex colonization (n = 30), whereas the average Schirmer test score was 6.6 ± 0.9, the OSDI questionnaire score was 40.96 ± 12.73, and the mean age was 49.12 ± 6.87 years in patients who did not have Demodex colonization (n = 58). The authors observed that dry eye patients who had Demodex colonization had a higher mean age, higher mean OSDI score, and lower average Schirmer test score compared with those who did not have Demodex. The significant relationship between lower Schirmer test score and higher OSDI rates and occurrence of Demodex infestation continued after adjusting for mean age values.

In this study, Demodex quantity was increased in older-aged patients, but the significant relationship between lower Schirmer test scores and higher OSDI rates and Demodex infestation persisted even after controlling the mean age values. Supporting these findings with large-numbered and randomized-controlled studies will help in clarifying the association of the Demodex infestation with etiopathogenesis of dry eye.

Although this is not a particularly well-powered study and used methods that I question, I would continue to support that the evaluation for Demodex is an important part of your patient OSD/DED profile.

1. Ayyildiz T, Sezgin FM. The Effect of Ocular Demodex Colonization on Schirmer test and OSDI Scores in Newly Diagnosed Dry Eye Patients. Eye Contact Lens. 2020 Jan;46 Suppl 1:S39-S41.
 

 

Light and Myopia: From Epidemiological Studies to Neurobiological Mechanisms

Myopia is far beyond its inconvenience and represents a true, highly prevalent, sight-threatening ocular condition, especially in Asia. Without adequate interventions, the current epidemic of myopia is projected to affect 50% of the world’s population by 2050, becoming the leading cause of irreversible blindness. Although blurred vision—the predominant symptom of myopia—can be improved by contact lenses, glasses, or refractive surgery, corrected myopia (particularly high myopia) still carries the risk of secondary blinding complications such as glaucoma, myopic maculopathy, and retinal detachment, which prompts the need for prevention.

Epidemiological studies have reported an association between outdoor time and myopia prevention in children. The protective effect of time spent outdoors could be due to the unique characteristics (intensity, spectral distribution, temporal pattern, etc.) of sunlight that are lacking in artificial lighting. Concomitantly, studies in animal models have highlighted the efficacy of light and its components in delaying or even stopping the development of myopia and have endeavoured to elucidate possible mechanisms involved in this process. In this narrative review, the authors summarize the current knowledge concerning light modulation of ocular growth and refractive error development based on studies in human and animal models, summarize potential neurobiological mechanisms involved in the effects of light on ocular growth and emmetropization, and highlight a potential pathway for the translational development of noninvasive light-therapy strategies for myopia prevention in children.

Muralidharan AR, Lança C, Biswas S, et al. Light and myopia: from epidemiological studies to neurobiological mechanisms. Ther Adv Ophthalmol. 2021 Dec 19;13:25158414211059246.