Optometric Office June 2018 by First Vision Media Group

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OPTOMETRIC OFFICE PRODUCTS AND TECHNOLOGY FOR YOUR PRACTICE

JUNE 2018

A S T I G M A T I C

SUCCESS from chair

TO WEAR COMING SOON: -2.75D Cylinder for Bausch + Lomb ULTRA® for Astigmatism The only monthly toric lens with a -2.75D Cylinder in your fit set

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OPTOMETRIC OFFICE PRODUCTS AND TECHNOLOGY FOR YOUR PRACTICE

AT-A-GLANCE: PUNCTAL PLUGS

ONE-TO-ONE: HOWARD S. FRIED, OD

JUNE 2018

SEEN AND HEARD AT ARVO 2018

GROW YOUR DISPENSING OF DAILY DISPOSABLES IT STARTS WITH AN HONEST DISCUSSION SUPPLEMENT TO VCPN JUNE 2018

HIGHLIGHT

your expertise

IMPROVE

the practice effciency

ENHANCE the patient experience

Solutions and Technologies Essilor Instruments sets the benchmark in performance and quality. Our goal is to provide the equipment and services that will help you meet your business needs and build a trusting relationship with your patients. Constant innovation from our R&D has created industry-leading equipment in categories including: • Screening • Diagnosis • Refraction • Dispensing • Finishing • Consumables

Let us show you how Essilor Instruments can benefit your practice. 855-393-4647

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essilorinstrumentsusa.com

info@essilorinstrumentsusa.com

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OPTOMETRIC OFFICE EDITORIAL STAFF VP, Editorial John Sailer | JSailer@ FVMG.com Editor-in-Chief Jeffrey Eisenberg | JEisenberg@FVMG.com Editor Cara Aidone Huzinec | CHuzinec@FVMG.com

Table of Contents

Creative Director Megan LaSalla | MLaSalla@FVMG.com

Production and Web Manager Anthony Floreno | AFloreno@FVMG.com Contributing Writer Laurel O’Connor

BUSINESS STAFF President/Publisher Terry Tanker | TTanker@FVMG.com Executive Vice President Shawn Mery | SMery@FVMG.com Vice President, Marketing Debby Corriveau | DCorriveau@FVMG.com

EDITORIAL ADVISORY BOARD Jeffrey Anshel, OD • Sherry Bass, OD • Murray Fingeret, OD • Ed De Gennaro, MEd, ABOM • Deepak Gupta, OD • Alan Homestead, OD • Nikki Iravani, OD • Bill Jones, OD Alan G. Kabat, OD • Kenneth A. Lebow, OD, FAAO • Jerome A. Legerton, OD, MBA Scot Morris, OD • John Schachet, OD • Eric Schmidt, OD • Leo Semes, OD Peter Shaw-McMinn, OD • Joseph Sowka, OD, FAAO Jennifer Stewart, OD • J. James Thimons, OD

INDUSTRY ADVISORY BOARD Dwight Akerman, OD, Alcon Laboratories, Inc., a Novartis Company Steve Baker, EyeFinity • Joseph Boorady,OD, TearScience, Inc. Sally M. Dillehay, OD, Visioneering Technologies, Inc. Dave Hansen, OD, Ophthalmic Consultant • Carla Mack, OD, Alcon Laboratories, Inc. Dave Sattler, Dave Sattler Consulting Michele Andrews, OD, CooperVision, Inc. • Ellen Troyer, Biosyntrx, Inc. Millicent Knight, OD, Johnson & Johnson Vision Care, Inc.

14 | New Product Gallery 16 | Docs Speak Out

FEATURES 8 | Seen And Heard at ARVO 2018

Throughout this magazine, trademark names are used. Instead of placing a trademark or registration symbol at every occurrence, we are using the names editorially only with no intention of infringement of the trademark.

9 | PRODUCT FOCUS: Monaco Combines OCT, Ultra-Widefield Imaging 10 | CONTACT LENSES: Grow Your Dispensing of Daily Disposables

VIEWS

Jeffrey Eisenberg

KNOW WHEN IT’S TIME

TO SPEAK UP

Anyone who knows me can tell you that I’m basically a shy person. I’ve been that way since childhood (though my shyness has diminished a little with age). So, even though my parents and teachers taught me that it’s important to speak up when something is wrong or could be better, I’ve always found that easier said than done. That’s why I offer kudos – lots of it – to anyone who does speak up. For example, it was a small group of optometrists in 1967 who first spoke up about the capabilities of ODs, setting in motion the call for expanded scope-of-practice laws. In recent weeks, a number of people and organizations have spoken up. Among them: • The California Optometric Association, which has warned the public that self-administered “vision tests” conducted online raise significant safety concerns. The COA also sent a letter to the California attorney general stating that one company may be violating an FDA directive by marketing such a test. The American Optometric Association and Transitions Optical also have warned consumers that an online test is no substitute for an in-person comprehensive eye exam. (For more on this, see “Product Buzz,” page 6.) • Texas Attorney General Ken Paxton’s Consumer Protection Division, which stopped 37 distributors and retailers from unlawful contact lens sales. “My office’s contact lens sweep is a reminder to Texans to safeguard

their vision by using only contact lenses prescribed for them by a licensed practitioner,” Paxton said. “We will continue to take appropriate action against retailers and businesses that endanger consumers by selling unlawful lenses. We strongly urge anyone who has found retailers selling lenses without a prescription to contact our office.” • Fifty-four members of Congress, who in a letter to Federal Trade Commission Chairman Joseph J. Simons, urged him to reconsider proposed changes to the Fairness to Contact Lens Consumers Act. The changes, if enacted, would require eyecare practitioners to have patients sign a document that says they received a copy of their contact lens prescriptions and then keep those documents on file for at least three years. “After nearly two years of deliberation,” the members of Congress write, “the plan continues to threaten to impose an unnecessary and burdensome mandate on tens of thousands of small business healthcare practices while also failing to consider strategies aimed at improved enforcement of existing patient health and safety provisions of the FCLCA.” • Hundreds of ECPs across the U.S., who went as part of the Health Care Alliance for Patient Safety and the AOA to Washington to meet with White House officials, members of Congress, Congressional staff and health regulators. They discussed such topics as the proposed FTC rule change, the need to reform the prescription verification process and the importance of quality eye and vision care for veterans. How willing are you to speak up? For example, did you visit Capitol Hill with your colleagues? Have you contacted your representatives? Or, have you contacted your state association or the AOA? That, along with your care, may affect your patients’ eye health as well as the eye health of millions of other individuals. In short: Don’t be like me. Speak up, and don’t be shy.

*** Jeffrey Eisenberg | Editor-In-Chief | JEisenberg@FVMG.com

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A S T I G M A T I C

SUCCESS from chair

TO WEAR COMING SOON: -2.75D Cylinder for Bausch + Lomb ULTRA® for Astigmatism The only monthly toric lens with a -2.75D Cylinder in your fit set

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THINK ABOUT YOUR EYES

ALL EYES ON

SUMMER Summer used to be a wide open calendar—weeks off from school for kids and a general slower pace of life. But in recent years, summers have become packed with events—weddings, summer camps, family vacations, and checking things off the list that were put on hold during busier months of the year. This summer, Think About Your Eyes will capitalize on the summer timeframe to promote annual eye exams for the whole family. Think About Your Eyes’ research shows that patients ages 30 to 39 are most receptive to health messaging and, more specifically, are likely to act on TAYE messaging for both themselves and their family members.

GOING PRO

This month, TAYE will partner with professional athlete and lifestyle expert Laila Ali, daughter of the late Muhammad Ali, to promote the importance of scheduling an annual eye exam while kids are out of school for the summer. Ali will share her own vision correction story of wearing glasses starting at age 11, as well as the experience of parenting a child who needed vision correction starting at age 5. She will appear in TV interviews across the country and will promote annual eye exams to her Facebook audience of more than 4 million people.

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Laurel O’Connor

Laurel O’Connor is the senior communications manager for Think About Your Eyes. Think About Your Eyes currently lists more than 19,000 eye doctors on its online locator and reaches more than 85% of its target audience through a combination of advertising, media relations, and social media promotion. First Vision Media Group is a media partner of Think About Your Eyes

These efforts are coupled with the ongoing advertising campaign: TV ads airing on 41 cable networks, 22 million online video ads, and 230 million online banner ads. These ads are expected to reach 85% of the target audience of patients.

IT’S WORKING

Recent data shows that TAYE’s efforts yielded 3.4 million eye exams in 2017, resulting in industry revenue of $752 million. So, the campaign is working. These results wouldn’t be possible without the support of leading companies in the industry and the 43 optometric state associations that stand behind the campaign. We invite everyone in the eyecare profession to support those who are supporting our industry and helping it grow. Visit ThinkAboutYourEyes.com/Industry-Portal to learn more. O|O

ONE-TO-ONE

Howard S. Fried Earlier this year, DigitalOptometrics LLC, an optical technology company, launched its Tele-Optometry remote comprehensive eye health exam system. The system offers patients comprehensive eye examinations, performed by licensed optometrists at remote locations from the optical exam site. By using live video conferencing between doctor and patient,

Many optical establishments are having a difficult time finding ODs. This could be utilized not necessarily as a standalone, but as a supplement to whatever anyone has for OD coverage. It could be utilized for low-volume offices that don’t want the fixed cost of a doctor every day. It could be utilized for higher-volume locations that want to be able to supplement their existing ODs in their schedules so that they can have extended hours of coverage when the ODs are not present. Private practitioners who want to expand into a second or third practice but could never do so because they couldn’t be in three places at the same time now can be, because they can be the remote doctor for their own practices. Let’s say you have a number of locations, and you only want to use your own doctors. You can do that, or you can use our doctors or a combination of the two. JE: Are doctors also using this if they note suspicious findings and want a consult? Do they use the system to refer a patient for further treatment? HF: Yes. When the exam sites register on the system, they indicate to whom their referrals are going, who their glaucoma specialist is or cornea or retina specialist. They put that information into the system one time at the beginning. Then, if they see something with their patients, there’s a button that they press called the referral button. They might say, “Okay, we need a glaucoma specialist,” or “Increased pressures in the eye.”

an in-person comprehensive eye exam is performed by harnessing current technology. Howard S. Fried, OD, founder and president of DigitalOptometrics, shared some thoughts about telemedicine and optometry. . Jeffrey Eisenberg: Is telemedicine, as with this system, the future of optometry? Howard Fried, OD: Yes, this is definitely the future of optometry. I think the future of optometry is here.

The system would actually go ahead and print out all the patient records, along with a cover letter. The remote optometrist will go ahead and write down some notes for the referring doctor to indicate that the patient has elevated intraocular pressures, and then that cover letter, along with all the patient records, is given to the patient so they can go to that referring doctor. This way, the exam sites control who their patients are going to from a referral standpoint. Ours is a comprehensive eye exam in which there’s an actual live interaction between optometrist and patient. We don’t sell refractive-only solutions. We only sell comprehensive packages. It has to be comprehensive.

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PRODUCT | BUZZ LAUNCHES, PROMOTIONS, MERCHANDISING, EVENTS AND OTHER THINGS TO KEEP YOU IN THE KNOW. COA ISSUES WARNINGS ABOUT ONLINE VISION TESTS

The California Optometric Association has cautioned California consumers that self-administered “vision tests” conducted online come with significant safety concerns and appear to violate federal law. In a letter to the California Attorney General, the COA said Opternative, and its partner, 1-800 Contacts, appear to be violating an October 30, 2017, Food and Drug Administration letter demanding that Opternative cease marketing its online product in violation of the Federal Food, Drug, and Cosmetic Act. The FDA letter said the app requires a premarket submission in order to allow the FDA to evaluate its safety and effectiveness. In a letter to the California Attorney General, COA president Ranjeet S. Bajwa, OD, FAAO, Dipl ABO wrote, “Public health is therefore potentially threatened by a medical device actively marketed to the pub-

lic despite not having gone through the required review and approval processes demanded by the FDA.” The American Optometric Association also has warned that online vision tests are “no substitute for an in-person, comprehensive eye exam by an optometrist or ophthalmologist.” Transitions Optical also has stated that while today’s employees are interested in coverage of online vision tests, there is a tremendous lack of understanding regarding what these tests entail, as well as a great need to educate employees on the importance of not skipping out on their annual, comprehensive appointments. According to the ninth annual Transitions Optical Employee Perceptions of Vision Benefits survey, half of employees not already enrolled in a vision plan said that they would be more likely to enroll if the plan “fully covered online eye exams.” Furthermore, six in 10 employees said they would be more likely to get their eyes checked more often if their employer offered this coverage. But despite this initial interest, the survey also found that most employees do not understand what online vision tests are—with two-thirds saying they are “unfamiliar with online eye exams,” and nearly half saying they are “very unfamiliar” with them. More alarmingly, the research revealed that four in 10 employees believe that “online eye exams that provide glasses or contact lens prescriptions are a

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suitable replacement for in-office eye exams.”

BLANCHARD INTRODUCES CPR PROCESS FOR ONEFIT, ONEFIT MED

Blanchard Contact Lenses has unveiled its latest design option for Onefit and Onefit MED scleral lenses. Control Peripheral Recess, or “CPR,” is a manufacturing process that creates a precise, controlled and reproducible peripheral recess on a lens (notch) to accommodate pingueculas and any other types of growths and shunts. CPR technology is available on all Onefit lens designs (spherical, sym-toric, toric peripheral curve and quadrant specific). A userfriendly CPR Tool, available on the company’s website, simplifies the design and ordering process and provides a visual representation of the lens design. Go to BlanchardLab.com

OPTOMETRIC NETWORK TO MONITOR SYSTEMIC MEDICATION EFFECTS

Vision Source this month plans to launch My Treatment Monitor, a national optometric network to improve patient care outcomes for people living with and taking medications for chronic diseases such as diabetes, multiple sclerosis, hyperlipidemia and Alzheimer’s. Through My Treatment Monitor, Vision Source optometrists will lead the process of monitoring patients taking medications to treat chronic disease that have possible ocular side effects. Optometrists will provide comprehensive medical examinations for patients with a chronic disease diagnosis as a pre-existing condition.

News After a drug to treat chronic disease is prescribed, doctors will ensure their patients are examined to establish that no pre-existing conditions affect the patient’s safety. Vision Source providers will also monitor patients on treatment medications to ensure patient safety continues. Go to VisionSource.com or call 888.558.2020.

FOR THE RECORD:

In “Product Buzz” we described Eyefinity’s new Kiosk application which lets patients securely and efficiently enter their personal information and health history, sign consent forms, and select their pharmacy via Google Maps. The next sentence should have read, “Then, all of this data automatically populates in the EHR.”

MARK YOUR CALENDARS SEPTEMBER 20-23, 2018 The Neuro-Optometric Rehabilitation Association, International (NORA) Clinical Skills Pre-Conference (September 20-21) and 27th annual General Conference (September 21-23), St. Louis. The Clinical Skills program provides 12 hours of continuing education and includes both hands-on and lecture-style presentations about anatomy and physiology in relation to traumatic brain injury rehabilitative care, advanced applications of general and neurooptometric rehabilitation, Lyme disease and nutrition. The NORA General Conference offers up to 14 additional hours of continuing education for optometrists and allied professionals. Go to NORAVisonRehab.com.

The U.S. Food and Drug Administration has approved Bausch + Lomb’s ULTRA family of contact lenses for extended wear of up to six nights and seven days of continuous wear. Avedro, Inc. has secured $25 million in financing led by Lilly Asia Ventures (LAV) with major participation from existing investors OrbiMed Advisors, InterWest Partners and HealthQuest Capital. Avedro plans to invest the funding in product development, clinical studies and commercial efforts. The Cooper Companies, Inc. has promoted Brian Andrews to senior vice president, chief financial officer and treasurer, succeeding Albert White, who is now president and CEO. Paragon Vision Sciences, a part of CooperVision, recently hosted a group of 18 top key opinion leaders and researchers from throughout China in partnership with Essilor China. Lectures covered treatment and management of myopia and fitting and patient management of CRT and specialty contact lenses.

NOVEMBER 6, 2018

EyeInnovate, Los Angeles. Marketing4ECPs, a digital marketing firm, launched this, a one-day marketing education event, in which 12 speakers will discuss different social media platforms, online search secrets, search engine optimization and reputation management through review platforms. The program will also feature talks from representatives from Google and YELP, who will discuss how to “Unlock Eyecare Business Opportunities with the Power of the Internet” and “YELP and the High Intent Consumer,” respectively. EyeInnovate will also feature vendor exhibits. For more information and to register, go to EyeInnovate2018.com.

Online survey conducted by Wakefield Research on behalf of Transitions Optical, Inc. in December 2017 among 1,300 nationally representative U.S. adults, ages 18+, employed full- or part-time, whose employers offer vision benefits. For the purposes of this survey, Generation Z adults are defined as ages 18-19, Millennials (Gen Y) as 20-36, Gen X as 37-52, and Boomers as 53-71.

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PRODUCT BUZZ

SEEN AND HEARD | AT ARVO SUBJECTIVE REFRACTOR COMBINES WAVEFRONT, ARTIFICIAL INTELLIGENCE Training to refract with Vmax Vision’s Voice Activ Subjective Refractor (VASR), which uses wavefront aberrometry and artificial intelligence, may be easier than training to refract using a phoropter but with similar refractive outcomes, a study from Southern College of Optometry suggests. After a masked investigator examined 50 healthy subjects using a standard autorefractor, SCO faculty members did subjective refinement using a standard phoropter. Meanwhile, a second-year optometry student, after two hours of training, did subjective measurements with VASR. There was no statistically significant difference in the mean equivalent sphere measurements between the phoropter and VASR. With VASR, Snellen acuity was better by more than one line in 14% of individuals, worse by more than one line in 3% of subjects, and less than one line of difference in 83% of individuals. Go to VmaxVision.com.

ARMOR STUDY ANALYZES METHICILLIN RESISTANCE

Bausch + Lomb, announced the results from the ninth consecutive year of the multicenter ARMOR (Antibiotic Resistance Monitoring in Ocular MicRoorganisms) surveillance study. In the nine-year trend analysis, researchers reported that resistance in Staphylococcus aureus infections declined from 39% to 14%, while more than half the cases of coagulase-negative staphylococci (CoNS) demonstrated continued methicillin resistance. 8 J un e 2 01 8 | O p to m e tri c O f f i c e .c o m

Further analysis showed decreased resistance among S. aureus to azithromycin (62% to 52%), ciprofloxacin (39% to 16%), tobramycin (24% to 6%), and chloramphenicol (6.6% to 4.4%), and among CoNS to ciprofloxacin (46% to 22%). As in previous years, a high proportion of methicillin-resistant staphylococci demonstrated multidrug resistance (three or more antibiotic classes), although none were vancomycinresistant. Go to Bausch.com.

UV BLOCKER DOUBLES AS ANTIOXIDANT

Norbloc, the ultraviolet blocker in Johnson & Johnson Vision’s ACUVUE Brand Contact Lenses, behaves as an antioxidant and provides a protective effect to a tear component that can be taken into the lens during wear, two studies showed. In one study, researchers compared the antioxidant capacity of Norbloc to 10 known antioxidant compounds using Oxygen Radical Absorbance Capacity (ORAC) and found that the ORAC score was four times higher than vitamin E and was significantly higher than nine out of the 10 antioxidants tested. In a second study, researchers compared silicone hydrogel lenses formulated with and without Norbloc using an experimental lipid model to determine how much a tear film lipid absorbed into the lenses oxidizes. After exposure to different doses of hydrogen peroxide and UV light, lenses that did not contain Norbloc showed statistically higher amounts of oxidative degradants compared to the lenses that did contain Norbloc. Go to JJVision.com.

EXTENDED-RELEASE TRAVAPROST OFFERS EXTENDED IOP CONTROL

Preclinical study results showed that LayerBio’s intracameral extendedrelease formulation of travoprost lowers intraocular pressure to therapeutic levels for longer than six months. LayerBio’s extended-release travoprost formulation is based on its PolyNet technology, a proprietary network polymer-based delivery platform. The platform enables tunable control of drug release from a biocompatible, bio-erodible polymer system with a variety of classes of medications for glaucoma and other ophthalmic indications. Go to LayerBio.com.

CORE CELEBRATES 30 YEARS OF OCULAR RESEARCH

The Centre for Ocular Research & Education (CORE) used ARVO 2018 to celebrate its 30th anniversary. CORE, formerly known as the Centre for Contact Lens Research, was established May 1, 1988, at the University of Waterloo’s School of Optometry & Vision Science. During the next three decades, the organization evolved from a three-person operation into a hub of basic and applied research, collaborating with sponsors, agencies and academia on advanced biosciences, clinical research and education. Now, its approximately 50-person team serves a range of ophthalmic sectors, including medical devices, ocular pharmaceuticals, digital technology and others, with a focus on the anterior segment. Go to CORE.UWaterloo.ca.

PRODUCT FOCUS

MONACO COMBINES OCT, Ultra-Widefield Imaging OP TO S P LC, A PA RT O F N I KON C ORP. , HAS C OMBINED ULT RA-W IDEFIELD IMAG IN G W I TH O P TI CA L CO HE RE N CE TOMOGRAPHY IN T HE NEW LY INT RODUC ED MONACO. The compact desktop imaging device represents the company’s first combined imaging device. Besides OCT, image modalities include optomap color and optomap plus (red and green laser), a color composite view, a green laser view, red laser view, optomap green laser autfluorescence and OCT.

High resolution 200º singlecapture optomap images can be produced in 0.5 seconds and improve pathology detection and management from the macula through the far periphery.

Central pole OCT provides comprehensive multi-modal imaging. Monaco offers 40° OCT views of the retinal structure.

Green laser autofluorescence minimizes patient exposure to blue light and shows the macula and optic nerve head in detail.

In addition, optomap images and OCT scans, are correlated to facilitate pathology examination, and all the images can be seen in a single, comprehensive view, according to the company.

Three-in-one color depth imaging provides clinical data from the retinal surface through the choroid.

WHERE TO FIND IT Optos 800.854.3039 | OptosNextGen.com

A study on the technology presented at ARVO 2018 evaluated different pathologies using the equipment and comparing it to standalone OCT. Features of drusen, atrophy, pigment epithelial detachment, cystoid macular edema, ellipsoid zone disruption, subretinal drusenoid deposits, nerve fiber layer thinning, vitreo-macular traction, and epiretinal membrane were identified similarly on both devices. Using the ultra-widefield OCT, additional lesions such as drusen and hemorrhages could be observed beyond the OCT scanning field.1 1. Gresores NJ, Singer M, Cairns AM, et al. Evaluation of a combined ultra-wide field SLO with SD OCT. ARVO Abstract 664 -C0222.

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CONTACT LENSES

GROW YOUR DISPENSING | OF DAILY DISPOSABLES

Start with identifying patients, and then have an honest discussion. By J ef f rey Eisenberg The market for daily disposable contact lenses continues to grow. Consider: ABB Optical Group, a distributor of optical products, evaluated sales data from about 11,000 practices it serves across the country. Among the doctors that purchase lenses through ABB Optical, 47% of their contact lens purchases are daily disposables. Also, during the first quarter of 2018, ABB found, same store sales for daily disposable lenses are up 14.6% compared to the same period one year ago. Looking at specific categories, sales of daily disposable toric lenses were up 22.4%, and daily disposable multifocals were up 31.6%. “We look at same stores sales data so we can understand practices and how they are growing,” said Aaron See, vice president of marketing for ABB Optical. This, no doubt, is due to numerous benefits to patients and doctors. “The patients appreciate the numerous benefits of daily disposables, the doctors see better compliance and thus lower rates of contact lens-related disorders, and practice owners gain increased profitability and increased patient retention,” said Steve Rosinski, OD, 10 J un e 2 01 8 | O p to m e tri c O f f i c e .c o m

of Charlotesville, VA. “In my practice, I try to switch every patient to them, as I believe that strongly in their benefits.

Consider the number of companies that introduced new products or expanded the parameters of existing ones:

Where do daily disposables fit in your practice? If you want to grow this area, consider the following steps.

• CooperVision introduced MyDay toric daily disposable contact lenses earlier this year and recently expanded the available parameters.

IDENTIFY THE PATIENTS

Make patients aware that they’re candidates for daily disposable lenses if the required prescription is available. Let this lead to a wider discussion about why you feel a daily disposable is in the patient’s best interests. “I discuss it with all patients who are candidates for daily disposables,” said Mile Brujic, OD, Bowling Green, OH. “Fortunately, in recent years, we have had the advent of a wider range of daily disposable lens options providing more patients the opportunity to wear these technologies.” See agrees. “For a long time, daily disposable spheres have outsold frequent replacement spheres,” he said. “The part that held back daily disposables are torics and multifocals. That’s what’s jolting the whole daily disposable share even higher.”

• Earlier this year, Johnson & Johnson Vision announced expanded parameters for its 1-DAY ACUVUE MOIST Brand Contact Lenses for ASTIGMATISM. These are in addition to daily disposables such as 1-DAY ACUVUE MOIST Brand MULTIFOCAL, ACUVUE OASYS 1-DAY with HydraLuxe Technology for ASTIGMATISM, and ACUVUE OASYS 1-DAY with HydraLuxe Technology for ASTIGMATISM. • Last year, Bausch & Lomb, whose offerings already included Biotrue ONEday and Biotrue ONEday for Presbyopia, introduced Biotrue ONEday for Astigmatism. And, if you were at SECO this year, you might have seen Olympic gymnast Laurie Hernandez, promoting

Alcon’s DAILIES AquaComfort Plus. The line includes DAILIES AquaComfort Plus OneDay Contact Lenses, DAILIES AquaComfort Plus Toric One-Day Contact Lenses and DAILIES AquaComfort Plus Multifocal One-Day Contact Lenses. “I think that all optometrists should make their patients aware that they are candidates for a daily disposable lens if their prescription is available,” Brujic said. “This lends itself to a candid conversation about why the practitioner feels it is the patient’s best option as well.”

EMPHASIZE VALUE, NOT PRICE

But, how can you convince patients to try them, especially if they’re concerned that daily disposables will cost more? “I really stress the overall value to the patient and stress the benefits to them. It is amazing how taking the time to explain why I am prescribing the daily disposables over frequent replacement lenses really resonates with the patient,” Rosinski said.”I do always mention not having to buy solutions and cases. In addition I talk about that fresh lens feeling every single day.” For individuals who are hesitant, Rosinski offers them a trial pack of daily disposable lenses to take home. “Even if they are not going to switch to daily disposable lenses this year it might plant the seed for years down the road,” he said.

Don’t shy away from the question of cost. “I have a very candid conversation about the cost of lenses so that they know what to expect,” Brujic said. “If I was to see any other physicians for a service or product that they are treating me with that would have an out-of-pocket expense, I would hope that they would explain my options and what the cost of the options are. I pay my patients the same level of respect.” When Brujic discusses cost with the patients, he also factors the costs of solutions to care for the lenses as well as any savings available from rebates. “When all of these considerations are taken into account, it mitigates much of the perceived cost differences between daily disposable lenses and other frequent replacement modalities,” he said.

SHIP TO PATIENTS

Eyecare practices that ship more than 10% of their soft contact lenses sales directly to patients outpace the national average for dollar growth, according to ABB Optical’s research. By contrast, eyecare practices with little to no direct-to-patient shipping activity underperform the national average. Specifically, the national average for direct-to-patient dollar share was 25%, and the national average for dollar growth in 2017 was 7.2%. Practices with more than 45% direct-

to-patient dollar share grew 8.6% year-over-year, while practices with less than 10% direct-to-patient dollar share only grew at 6.3%. Additional advantages of direct-topatient shipment include freeing up your staff time and word-of-mouth referrals, according to See. Options for direct shipment to patients include LensFerry from EyeCare Prime, a division of CooperVision; YourLens.com from ABB Optical; My CL Reorder from CLX System, and Sightbox. (For more on these, see “Competing for Contact Lens Patients,” June 2017.)

BELIEVE IN THEM One of the most important steps to growing your dispensing of daily disposable lenses is to believe in them yourself. “If we don’t believe in them how are we supposed to explain the benefits to our patients? As a huge believer in daily disposable lenses and their benefits, I would talk to each and every patient about them,” said Rosinski. Keep in mind, that you may require more exam time to do so. But, if you can grow this portion of the practice, “then you are only working smarter and not harder,” Rosinski said. O|O

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AT-A- GLANCE PUNCTAL PLUGS NAME

SIZES

MATERIALS

SPECIFICATIONS

BENEFITS

Beaver Visitec | 866.906.8080 | Beaver-Visitec.com Extend 180 Absorbable Synthetic Implants

0.3 x 2.0mm 0.4 x 2.0mm 0.5 x 2.0mm

polydioxanone

• available in single pack or 10-pack box • provides occlusion for six full months • also available in Extend 180 • indications: post-ocular surgery, Absorbable Synthetic Implant Variety seasonal dry eye, contact lens Pack: two pairs 0.3mm x 2.0mm, five intolerance, dry eye associated with pairs 0.4mm x 2.0mm, three pairs digital eye strain 0.5mm x 2.0mm

Parasol

XS (0.25 to 0.35mm) small (0.35 to 0.65mm) medium (0.65 to 0.85mm) large (0.9mm)

silicone and titanium dioxide

• permanent • available in sterile pre-loaded and bulk, sterile and non-sterile

• easy to insert • simple sizing • guaranteed retention

EagleVision | A Katena Brand | 800.225.1195 | EagleVis.Katena.com Eagle Flexplug

0.4mm 0.5mm 0.6mm 0.7mm 0.8mm 0.9mm

silicone

• two individually packaged sterile plugs with inserter/dilator per twin pack

• tapered shaft. • ribbed interior and exterior shaft, with about 30% more surface area • compresses, elongates and bends at both shaft and rim • super thin rim for reduced corneal contact

EaglePlug

0.4mm, 0.5mm 0.6mm, 0.7mm 0.8mm 0.5 to 0.8mm

silicone

• two individually packaged sterile plugs with inserter/dilator per twin pack

• • • • • • • • • • • •

Plug 1

SuperEagle

SuperFlex

small (0.4 to 0.6mm) soft low-durometer silicone medium (0.6 to 0.8mm) large (0.8mm and larger) 0.3. x 1.1mm, 0.4. x 1.1mm 0.5. x 1.2mm, 0.6. x 1.3mm 0.7. x 1.4mm, 0.8. x 1.5mm 0.9. x 1.7mm, 1.0. x 1.8mm 1.1. x 2.0mm, 1.2. x 2.0mm 1.3. x 2.0mm

• two individually packaged sterile plugs with inserter/dilator per twin pack • two sterile pre-loaded punctal plugs on disposable inserter/dilator

tapered shaft easy insertion reversible flesh-like flow controller dual-lobed design easy insertion technique easily reversible low profile rim tapered shaft pivoting wide-flex nose lowest profile rim custom fit easy insertion

FCI Ophthalmics Inc. | 800-932-4202 | FCI-Ophthalmics.com PVP Perforated Plugs

mini (0.7mm) medium (0.9mm)

medical-grade • sterile silicone with • pre-loaded polyvinylpyrrolidone (PVP) coating

• enhanced drainage • prevent collection of debris on the surface of plugs • indicated for punctal stenosis or partial occlusion

Lacrimedics, Inc. | 800-367-8327 | Lacrimedics.com LacriPro

XS (0.6mm) small (0.7mm) medium (0.8mm) large (0.9mm)

medical-grade silicone

12 J un e 2 01 8 | O p to m e tri c O f f i c e .c o m

• sterile • pre-mounted on an insertion tool

• proven occlusion therapy

NAME

SIZES

MATERIALS

SPECIFICATIONS

BENEFITS

VisiPlug

0.4mm 0.5mm

proprietary polydioxanone polymer

• provides approximately 180 days of occlusion

• no pop-up • no reportable incidences since its introduction in 2003 • FDA approved for use after ocular surgery to prevent complications due to dry eyes and for the treatment of dry eye syndrome and dry eye components of ocular surface diseases

• sterile • pre-loaded • non-sterile bulk

• proprietary shaft design for easy insertion and proper anatomical fit • low profile dome

• sterile • pre-loaded • non-sterile bulk

• hollow nose design provides for easy insertion and retention • two sizes fit most patients for simple sizing

• permanent • dilation tool not needed

• thin rigid 6mm acrylic rod shrinks in length and expands in width to form a gel-like plug

Lacrivera | 855.857.0518 | Lacrivera.com VeraPlug small (0.4 to 0.6mm) medical-grade silicone medium (0.6 to 0.7mm)

VeraPlug FlexFit

large (0.7 to 0.8mm) XL (0.8 to 1.0mm) XS (0.2 to 0.3mm) small (0.3 to 0.5mm) medium (0.6 to 0.8mm) large (0.9 to 1.0mm)

medical-grade silicone

Medennium | 888.727.6100 | Medennium.com SmartPlug one size hydrophobic acrylic polymer

OASIS Medical Inc. | 844.820.8940 | OasisMedical.com Form Fit one size fits all hydrogel • long-term

Soft Plug Silicone

• gelatinous canalicular plug • no foreign-body sensation removed by irrigation • available in a two-pack or 10-pack dispenser box

• fully hydrates in 10 min. • dilation tool included • pre-loaded on inserter • sterile • long-term • dilation tool included • pre-loaded on inserter • sterile

• softer, more flexible silicone for comfort • available in a two-pack or six-pack dispenser box and in a non-loaded Economy Pack

micro (0.4mm) mini (0.5mm) petite (0.6mm) small (0.7mm) medium (0.8mm) mini (0.5mm) petite (0.6mm) small (0.7mm

silicone

• new pen-style inserter • long-term • dilation tool included • pre-loaded on inserter; sterile

• softer, more flexible silicone • available in a six-pack dispenser box and non-loaded Economy Pack

Soft Plug petite (0.6mm) Flow Control small (0.7mm) medium (0.8mm)

silicone

• long-term • dilation tool included • pre-loaded on inserter • sterile

• softer, more flexible silicone • center channel allows for limited tear flow passage. • available in a two-pack

Soft Plug Collagen

collagen

• short-term • insert with forceps • packaged in foam holder; sterile

• canalicular dissolvable plug • lasts up to two to five days. • available in non-loaded Economy Pack

• short-term (up to three months) • insert with forceps • packaged in foam holder; sterile

• canalicular dissolvable plug lasts up to 90 days • 20-, 40- and variety packs

absorbable polymer • medium-term (up to six months)

• canalicular dissolvable plug lasts up to 180 days • 20-, 40- and variety packs

Soft Plug Silicone (with Pen Inserter)

Soft Plug Extended Duration

(0.2mm) (0.3mm) (0.4mm)

(0.2mm) (0.3mm) (0.4mm) (0.5mm) Soft Plug 0.3mm) Extended (0.4mm) Duration 180 (0.5mm)

• insert with forceps • packaged in foam holder • sterile

O p tometr ic O ffic e. c om | June 2018 13

NEW PRODUCT | GALLERY B+L INTRODUCES CHEWABLE VITAMIN

Bausch + Lomb has introduced PreserVision AREDS 2 Formula Chewable vitamins, designed especially for individuals who have swallowing difficulties, in a mixedberry flavor. A daily dose of one in the morning and one in the evening offers patients 500mg vitamin C, 400IU vitamin E, 80mg zinc, 2mg copper, 10mg lutein and 2mg zeaxanthin. PreserVision AREDS 2 Formula Chewable vitamins are expected to be available for purchase at major retailers this month.

B+L ALSO LAUNCHES LUMIFY

B+L also has launched LUMIFY(brimonidine tartrate 0.025%), an over-the-counter eyedrop for the treatment of eye redness. LUMIFY is an alpha-2-adrenergic receptor agonist that selectively constricts venules but maintains the availability of oxygen to surrounding tissue. It is available at major retailers in 2.5ml and 7.5ml sizes. Eye Therapies, Inc., licensed the solution to B+L or its affiliates. For information, call 800.828.9030, or go to Bausch.com or LumifyEyeDrops.com/Professional.

J&Jâ&#x20AC;&#x2122;S ANDY CHATBOT ANSWERS CONTACT LENS QUESTIONS

Johnson & Johnson Vision has introduced Andy, a virtual assistant chatbot powered by artificial intelligence, to help patients considering contact lenses for the first time or long-term wearers throughout their ACUVUE Brand Contact Lens journey. Andy allows users to get answers to their contact lens-related questions from their computers or mobile devices and provides intuitive coaching to help new wearers develop healthy contact lens habits. Andy can be found by connecting with ACUVUE on the Facebook Messenger app, which is available for free download from the App Store or Google Play store. Call 800.843.2020, or go to JJVision.com.

NEW MASK RELIEVES DRY EYE SYMPTOMS

Heyedrate has released a dry eye mask that is now available on Amazon. The mask serves as a soothing compress for dry eyes, blepharitis, meibomian gland dysfunction, headaches, allergies and sinuses. The patient warms the mask in the microwave for 15 to 20 seconds and then applies the warm compress over closed eyes for 15 to 20 minutes to alleviate discomfort caused by dry eyes, itching, crusts on the eyelids, sensitivity to light, and irritation, to name a few symptoms. Patients also can chill the mask for a minimum of two hours and use it as a cold compress for 15 minutes to relieve sinus headaches and allergies. The mask is washable by hand and can be reused. Go to EyeLoveTheSun.com. 14 J un e 2 01 8 | O p to m e tri c O f f i c e .c o m

GLOW-IN-THE-DARK CONTACT LENS COULD PREVENT DIABETIC BLINDNESS

California Institute of Technology student Colin Cook and a group of Caltech researchers have developed a glow-in-the-dark contact lens they say may help prevent vision loss in individuals with diabetic retinopathy. The lenses aim to reduce the metabolic demands of the retina, namely the retina’s night-time oxygen demand. To do so, the lens gives the rod cells the faintest amount of light to look at while the wearer sleeps. “If we turn metabolism in the retina down, we should be able to prevent some of the damage that occurs,” Cook said. The illumination is provided by tiny vials filled with tritium, a radioactive form of hydrogen gas that emits electrons, which are then converted into light by a phosphorescent coating. This system ensures a constant light output for the lifetime of the contact lens. The vials are implanted in the lens in a radial pattern, creating a circle that is just big enough to fall outside of the wearer’s view when the pupils are constricted in lighted conditions. In the dark, the pupil expands, and the faint glow from the vials can illuminate the retina. The contact lens design also ensures that the retina receives an appropriate dose of light throughout the night. Early testing shows that rod cell activity is reduced by as much as 90% when worn in the dark. In the next few months, Cook and his fellow researchers plan to start testing the lenses to see if their ability to reduce retinal metabolism will translate into the prevention of diabetic retinopathy. Following those tests, they will seek FDA permits to begin clinical trials. Go to Caltech.edu.

NOVARTIS’ FOCALVIEW APP AIDS RESEARCHERS

Novartis has launch its FocalView app, an ophthalmic digital research platform, to allow researchers to track disease progression by collecting real-time, self-reported data directly from consenting patients. By adapting the design of clinical trials to suit the daily routine of patients, the app may reduce barriers to participation, according to the company. FocalView aims to help patients complete various assessments, gaining feedback on their visual function, including any changes over time. At the same time, the app could provide researchers with a greater volume of real-world, patientreported data, creating more flexible and accessible clinical trial designs. Novartis plans to test FocalView in a prospective, non-interventional study to evaluate the app’s efficacy and usability in assessing visual function. These measurements include visual acuity and contrast sensitivity. Researchers will, in turn, assess ease of use, level of enrollment and the ability to obtain important documentation for future clinical trial research, such as informed consent. In the next phase, the app will be validated against traditional visual testing that takes place within conventional clinical settings. FocalView is now available for download from the App Store in the U.S. Consent to contribute to research data will be required before a user can interact with the tool. Go to Novartis.com.

MAXIMEYES EHR SOFTWARE GIVEN HEALTH IT CERTIFICATION

MaximEyes EHR software (Version 3.0) from First Insight Corporation, has received 2015 Edition Health IT Certification from the Office of the National Coordinator for Health Information Technology (ONC-Health IT). The certification enables clinicians to use the software to meet requirements for value-based care programs from the Centers for Medicare and Medicaid. These include the Merit-Based Incentive Payment System (MIPS), Alternative Payment Models (APMs), and the Medicaid EHR incentive program. MaximEyes EHR was tested and certified through the Drummond Group LLC, an ONC-Authorized Certification Body and has been certified in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. Call 800.920.1940, or go to First-Insight.com/ Resources/Certifications. O p tometr ic O ffic e. c om | June 2018 15

DOCS | SPEAK OUT M o bi l e a p p s

Nowadays, there seems to be a mobile app for just about everything, even eyecare. A number of apps are available to both optometrists and patients. We wanted to know how big a role they play in optometric practice. Many of the doctors who responded don’t use apps or recommend them to patients, but they have a long wish list.

Which apps do you yourself use? (Check all that apply.)

NO 64%

YES 36%

50 40 30

30 20

Which apps do you recommend to your patients? (Check all that apply.)

2% 3%

8% 13% 25% 59%

Do you use or recommend any apps in your practice?

8% 2% 30% 7% 3% 8% 53%

10 0

y S ps dio pia tep Other etr rry Stu ree S y ap om Myap n r sFe t a o n p h l e O T o L use art ix C Parks n’t Sm Opt I do Air

If you could have one app for yourself or your patients that isn’t currently available, what would it be? (Please describe)

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“Blood sugar app monitor.”

“An app to help choose a particular PAL design or brand based on Rx, lifestyle, etc.”

and the FDA, to assure health and safety monitoring for consumers, and one that consolidates all available tools into a standardized and broadly available app that is easy for all ages. This unfortunately cannot happen without federal regulation!”

“An AREDS reminder.”

“Contact lens price search engine.”

“HIPAA-compliant communication.”

“I use all computer-based applications/ websites.”

“An app that explained some common diseases—macular degeneration, cataracts and glaucoma.”

“Slit lamp photos.”

“Fused cross-cylinder calculator.” “More access to my EMR.” “I don’t use any apps at all at any time.” “An app that would describe various treatment options.” “One that is approved by professional associations that develop and defend standard of care protocols for eyecare (American Medical Association, American Optometric Association, etc.) 16 J un e 2 01 8 | O p to m e tri c O f f i c e .c o m

“No interest or time for apps. Don’t use. Don’t recommend. Don’t want to use or recommend.” “Dry eye artificial tear reminder”

“A good medication reminder.” “Pupil measurement app.” “An app for a portal access for their healthcare information.”

“Quick toric crossed cylinder, but I think that is already available.” “More apps for Android. I wish I could access more of them on my Android phone so that I did not have to go to my desktop.”

“Maybe a dry eye app. Patients could monitor symptoms and how many times a day they are using drops. Info could be shared with doctor.”

“Inexpensive seg height and PD measurements.”

“Some sort of diagnostic quick screening for functional visual issues.”

“Reminders for eye exams for diabetic patients.”

“Online formulary check.”

Ask Yourself This Question...

“Why Prescribe?”

OTC Savings Compared to Rx Costs Kills Bacteria on Contact -“0” Eye Irritation Stable 18 Months Opened or Unopened

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6/28/17 11:34 AM 5/23/18 5:38 PM

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