"CONTACTS"

BUILDING YOUR PRACTICE WITH 

=====I.                  Current Status

==========a.    11% of contact lens fits and refits in the ===============US are GPs.(1)

==========b.   Of the breakdown of GP lenses by ===============category (2);

=====                                                            i.     Conventional Spherical: 46%

 =====                                                         ii.     Sclerals: 27%

 =====                                                      iii.     Corneal Reshaping: 11%

======                                                    iv.     Multifocals: 10.5%

=====                                                          v.     Torics: 10.5%

 =====                                                      vi.     Hybrids: 7%

==========c.    Biggest Advancements in GP Lenses in ===============2020 (per survey of the GPLI ===============Advisory Board)

 =====                                                           i.     Introduction of stable, wettable, 200 ===============Dk materials

 =====                                                         ii.     Profilometry/topography-driven scleral ===============designs

=====                                                       iii.     Custom back surface scleral designs ===============(toric haptics, quad-specific)

=====                                                       iv.     New GP disinfection guidelines (3); ===============also available for download from ===============www.gpli.info (under “Resources” and ===============then “Order Printed Materials”)

=====                                                          v.     New orthokeratology lens designs

=====II.                Overnight Orthokeratology

==========a.    Empirical fitting has demonstrated very ===============good (80%)(4) first-fit success

==========b.   Due to the larger diameter, limited ===============movement, low edge clearance ===============design, and overnight wear schedule, ===============adaptation can occur within a few ===============nights.

==========c.    Online certification is straightforward and ===============not difficult

==========d.   The incidence of microbial keratitis is no ===============greater than with conventional ===============extended wear (5)

==========e.    An excellence overview article was ===============recently published by Drs. Mark ===============Bullimore and Leah Johnson.(6)

==========f.      A great consumer resource is the new ===============Myopia Management brochure ===============available from the GPLI.

=====III.             Lens Materials, Coatings, Design, and Fitting

==========a.    Improvements in oxygen permeability, ===============surface wettability, greater flexural ===============resistance, better memory/less ===============warpage, and scratch resistance are ===============characteristic of current materials ===============versus their predecessors.

==========b.   The “New Kid on the Block” is Acuity 200, ===============a 200 Dk material from Acuity ===============Polymers

==========c.    Available for shipment this week is the ===============long-awaited Tangible Boost ===============solution. This is a conditioning ===============solution designed to restore the ===============Tangible Hydra-PEG layer on the ===============lens surface. It is a five-step monthly ===============process to be performed by the ===============patient. It is a prescription only ===============product that can be sold directly by ===============eye care practitioners or via contact ===============lens laboratories. At this time --===============laboratories that can fulfill orders ===============include X-Cel, ABB, AccuLens, AVT, ===============and Valley Contax. 

==========d.   With the advancements in GP lens ===============manufacturing including consistent ===============edges, ultrathin design, and standard ===============peripheral systems, empirical fitting ===============of almost all corneal GP lenses ===============(except fitting of the irregular cornea) ===============is encouraged as patients experience ===============the “Wow” factor with vision upon ===============application. A recent survey found ===============that about 79% of practitioners fit ===============bitoric lenses empirically, followed by ===============multifocals (75%), spherical (69.5%), ===============and corneal reshaping (58%).(2)

=====IV.            Scleral Lenses

==========a.    The SCOPE study has found that 74.2% ===============of scleral fits are to irregular cornea ===============patients, 16.1% to ocular surface ===============disease patients, and 9.7% to healthy ===============eyes (i.e., astigmatism, ===============presbyopia).(7)

==========b.   When the Contact Lens Spectrum ===============readership was recently surveyed as ===============to which contact lens option they fit to ===============irregular cornea patients, the “Go To” ===============lens was sclerals.(2) 52% of ===============respondents fit ≥ 50% of their ===============patients into sclerals followed by 18% ===============for small diameter GPs, 10% for ===============intralimbals, 5% for hybrids, and 4% ===============custom soft.

==========c.    In the September “scleral” issue of ===============Optometry and Vision Science ===============(OVS), Dr. Dan Fuller reported on the ===============safety of scleral lenses.(8) In a ===============sample size of 157, there was a total ===============of 9.6% adverse events with only a ===============few of those being significant ===============complications. It was concluded that ===============overall scleral lens wear is quite safe. ===============In addition to September OVS, both ===============the November, 2020 issue of Eye & ===============Contact Lens and the December, ===============2020 issue of Contact Lens & ===============Anterior Eye were devoted to scleral ===============lens research.

==========d.   It is also very evident that the emergence ===============of scleral lens use has greatly ===============impacted the need for a corneal ===============transplant. In the January, 2021 issue ===============of Cornea, with a sample size of ===============2806 eyes with keratoconus or other ===============ectasia, it was concluded that ===============patients who wore scleral or corneal ===============GP lenses had almost one-fifth the ===============risk of undergoing keratoplasty.(9)

==========e.    There are a number of very good scleral ===============lens resources included 27 archived ===============webinars, and a Scleral Lens ===============Troubleshooting FAQs online mini-===============book (in conjunction with the Scleral ===============Lens Education Society (SLS), the ===============SLS and it’s ongoing workshops and ===============webinars, Eef van der Worp’s “A ===============Guide to Scleral Lens Fitting” ===============(available online from Pacific ===============University), the Scleral Lens Fit ===============Scales (available from the Michigan ===============College of Optometry), the text ===============“Contemporary Scleral Lenses” by ===============Melissa Barnett and Lynette Johns, ===============and a wonderful comprehensive ===============“Scleral Lens Primer” article co-===============authored by four members of the ===============GPLI Advisory Board and available ===============online in the October, 2020 issue of ===============Contact Lens Spectrum.(10)

References:

1.     Nichols JJ, Fisher D. Contact Lenses 2020. Contact Lens Spectrum 2021;36(1):24-29.51.

2.     Bennett ES. GP Annual Report 2020. Contact Lens Spectrum 2020;35(10):28-30,32,34,36,37,59.

3.     Sindt C, Bennett E, Szczotka-Flynn L, Sclafani L, Barnett M. Technical Report: Guidelines for =====Handling of Multipatient Contact lenses in the Clinical Setting. Optometry and Vision Science =====2020;97(8):544-548.

4.     Davis RI, Eiden SB, Bennett ES, et al. Stabilizing myopia by accelerating reshaping technique =====SMART) study three year outcomes and overview. Advances in Ophthalmology & Visual System =====2015;2(3).

5.     Bullimore MA, Jordan LA. The Risk of Microbial Keratitis with Overnight Corneal Reshaping Lenses. =====Optometry and Vision Science 2013;90(9):937-944.

6.     Bullimore MA, Johnson LA. Overnight Orthokeratology. Contact lens and Anterior Eye 2020;43:322-=====332.

7.     Schornack M. The SCOPE Study: An Overview. Contact Lens Spectrum 2017;32(12): 25-28,30,32.

8.     Fuller DG, Wang Y. Safety and Efficacy of Scleral Lenses for Keratoconus. Optometry and Vision =====Science 2020;97(9):741-748.

9.     Ling J, Mian SI, Stein JD, et al. Impact of Scleral Contact Lens Use on the Rate of Corneal =====Transplantation for Keratoconus. Cornea 2021;40(1):39-42.

10. Jedlicka J, Mazza B, Fuller D, Lee K, Bennett E. Scleral Lens Primer. Contact ens Spectrum =====2020;35(10):E1 – E9.

We have just been informed that the changes to the Contact Lens Rule do not have to be implemented until March 31, 2021. Congress has delayed implementation which, therefore, means eye care professionals are not required to provide a signed acknowledgeable prescription release at this time. We want to thank the Health Care Alliance for Patient Safety for their efforts on our behalf.  

Register Here

March 16: Michael Lipson OD, FAAO, FSLS:

April 20: Edward Boshnick OD, FAAO:

May 18: Karen G. Carrasquillo OD, PhD, FAAO, FSLS, FBCLA: 

June 15: Heidi Miller OD, FAAO, FSLS:

July 20: Jeff Walline OD, PhD, FAAO: 

August 17: Stephanie L. Woo OD, FAAO, FSLS:

September 21: Renee Reeder OD, FAAO, FSLS: Custom Soft Lens Update for Healthy and Irregular Cornea Patients

October 19: Jason Jedlicka OD, FAAO, FSLS:

November 16: Greg DeNaeyer OD, FAAO, FSLS: Beyond the Basics: Advanced scleral lens design

December 21: Maria K. Walker OD, MS, FAAO, FSLS: GP Material Update

GPLI Resources Spotlight:

Our popular GPLI Toric and Spherical Lens Calculator should be functioning again by the time this newsletter is out thanks to the heroic efforts of Dr. Todd Zarwell (co-developer of www.eyedock.com) who developed this calculator originally with assistance from Dr. Tom Quinn, rebuilt the calculator which now has a mobile application as well. Several of our other video-based programs were impacted by Adobe’s discontinuation of flash and have either been rebuilt and available on www.gpli.info or will be available soon. 

I first met Dr. Seibel back in the 1980s when he was a 2^nd year optometry student of mine at UMSL. He inquired about whether he could get involved in any contact lens research. By the time he graduated his name was on several publications and his work ethic was (and is) unparalleled. He joined the contact lens specialty practice (Vision Care Consultants) of my St. Louis mentor, Dr. Rex Ghormley. He later bought the practice which was the contact lens practice for the St. Louis Rams and is still the contact lens practice of the St. Louis Blues. He has received numerous honors, none so prestigious as being awarded the 1996 National Young Optometrist of Year by the American Optometric Association. He is a Fellow of the American Academy of Optometry as well as a Diplomate of the Academy’s Cornea, Contact Lens & Refractive Technologies Section. He is a Distinguished Fellow in the National Academies of Practice in Optometry. He has served as Chair of the AOA’s Contact Lens & Cornea Section (CLCS) and is recipient of both the Dr. Rodger Kame Award in 2011 and the Legends award from the CLCS. His student webinar for the GPLI entitled “Finding the Practice of Your Dreams” from April 2020 is “Must See TV” for any student or resident interested in private practice. 

Dr. Ed Boshnick has personified excellence in specialty contact lens fitting for several decades and his knowledge and experience is greatly coveted by the GPLI. He is owner of Global Vision Rehabilitation Center, a specialty contact lens practice in Miami. Florida. He is a graduate of the Southern College of Optometry and served for two years as a Captain in the U.S. Army Medical Service Corp. He is a Fellow of both the American Academy of Optometry and the Scleral Lens Education Society. He serves as an Adjunct professor at the New England College of Optometry and at the Pennsylvania College of Optometry. His areas of interest include: the restoration of vision and comfort lost as a result of refractive eye surgery, keratoconus, corneal transplant surgery, pellucid marginal degeneration, extreme dry eye, corneal dystrophies, corneal trauma, and Stevens-Johnson Syndrome.

One of the most well known and great visionaries in the eye care industry, Dr. Glazier is the founder of “ODs on Facebook”, the eye care industry's largest and most highly engaged eye care organization. Most recently, he has initiated optometry’s first TV show, entitled “The FluoreSCENE”. He is the founder of Shady Grove Eye and Vision Care in Rockville, Maryland. He is a partner and business development executive in Keplr Vision. In 2015 Dr. Glazier was selected as one of the 50 most influential optometrists ever by his peers. In 2017 he was honored as Maryland Optometrist of the year. In 2019 he was awarded a Presidential medal from the New England College of Optometry and also is a member of the board of trustees of the college. He is Inventor on 7 issued patents in computer science and ophthalmology, author of two books and numerous journal articles. He lectures on clinical, practice marketing and myopia control topics.

GO TO . . . .

At the annual advisory meeting held with members from the Association of Optometric Contact Lens Educators at GSLS, the GPLI formally presented the annual “GPLI Practitioner of the Year” award to a very deserving Dr. Jason Jedlicka. In addition, the first “GPLI Educator of the Year” award was presented to Dr. Dan Fuller. Congratulations to Drs. Jedlicka and Fuller!  

1)   GP Lens Management Guide (download only)

2)   Fluorescein Pattern Identification Card

3)   Correcting Presbyopia Tips Card

4)   Contact Lens Clinical Pocket Guide

5)   In-Office Disinfection of Multi-Patient Use Diagnostic Contact Lenses

6)   See with Your Contacts Even When You’re Not Wearing Them (Orthokeratology Patient Brochure which can be downloaded as well)

7)   Look as Young as You Feel (Multifocal Patient Brochure which can be downloaded as well)

8)   Scleral Lenses are Big News (Scleral Consumer Brochure which can be downloaded as well)

9)   Caring for Your GP Lenses (Care and Handling Patient Brochure which can be downloaded as well)

10)   Myopia Management (Myopia Patient Brochure for which the references can be downloaded from this site)

11)  Reading Verification Card (features both passages on one size of varying acuity and different types of print – newspaper, etc. – on the other side)

12) Scleral Lens Care Tips, Application and Removal Card

 https://www.GPLI.info