Optometric Office February 2019

OPTOMETRIC OFFICE PRODUCTS AND TECHNOLOGY FOR YOUR PRACTICE

FEBRUARY 2019

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1 Source: Brennan NA: Beyond Flux: Total Corneal Oxygen Consumption as an Index of Corneal Oxygenation During Contact Lens Wear. Optom Vis Sci 2005;82:467–472.

2 Manufacturer reported Dk/t values: clariti® 1 day: 80, 1-DAY ACUVUE® MOIST®: 25.5, DAILIES® AquaComfort PLUS™: 26 3 Difference of the average total chair time between clariti® 1 day and clariti® 1 day multifocal. Data on file. ©2019 CooperVision 7728 01/19

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OPTOMETRIC OFFICE PRODUCTS AND TECHNOLOGY FOR YOUR PRACTICE

FEBRUARY 2019

ONE-TO-ONE:

PATIENT CARE:

INSTRUMENTS:

JOSH ANDERSON, ALCON RETINA FELLOWS INSTITUTE p5

DOCS SPEAK OUT ABOUT OCULAR TRAUMA p14

RETINAL CAMERAS AT-A-GLANCE p15

FITTING THE | ASTIGMATIC PATIENT TODAY’S TORIC LENSES MAKE IT EASIER THAN EVER

p12

SUPPLEMENT TO VCPN FEBRUARY 2019

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OPTOMETRIC OFFICE EDITORIAL STAFF

Table of Contents

10

VP, Editorial John Sailer | JSailer@ FVMG.com Editor Joanne Marchitelli | JMarchitelli@FVMG.com Creative Director Megan LaSalla | MLaSalla@FVMG.com Production and Web Manager Anthony Floreno | AFloreno@FVMG.com Contributing Writers Christopher J. Babin, OD

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 Regional Sales Manager Eric Hagerman | EHagerman@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.

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.

DEPARTMENTS 2 | Welcome 4 | Views

12

5 | One-to-One: Josh Anderson, Alcon Retina Fellows Institute 9 | Think About Your Eyes: Understanding Diabetic Retinopathy 10 | Product Buzz 15 | At-A-Glance: Retinal Cameras 16 | New Product Gallery

16

FEATURES 12 | CONTACT LENSES: Hot Toric!

14 | PATIENT CARE: Docs Speak Out about Ocular Trauma

www.Facebook.com/OptometricOffice www.Twitter.com/OO_Magazine www.Linkedin.com/showcase/Optometric-Office-Magazine

WELCOME

(Back)

John Sailer She’s an accomplished writer, experienced editor and well versed not only in optometry and eyecare but also in healthcare in general along with a host of broad and varied topics.

Optometric Office’s “new” editor is not so new to the magazine or the subject matter we cover. Her face will be familiar to you, but her name has changed to Joanne Marchitelli.

She was editor of Optometric Office for two years from 2015 to 2017 when Jeffrey Eisenberg then took over the helm as Joanne left to pursue other writing/editing endeavors. Now, the tide has turned, Jeff has moved on to follow his own pursuits, and Joanne has returned to lead the magazine’s editorial content once again. We are thrilled to have her back! She’s an accomplished writer, experienced editor and well versed not only in optometry and eyecare but also in healthcare in general along with a host of broad and varied topics.

Not only does Joanne bring the knowledge of the optometric profession that comes from having run the magazine’s editorial content for two years, but she also possesses the editing experience and the writing skills illustrated by her extensive full-time and freelance career.

In addition to having been editor of Optometric Office, Joanne is the former editor of Drug Discovery & Development for which she wrote extensively on FDA approvals and research breakthroughs, reported on health studies, and interviewed scientists and leaders in the pharmaceutical industry.

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As a freelance writer, she has written extensively on a range of health and wellness topics for numerous national magazines and websites. Her blog posts (at JoanneVanZuidam.com) focus on “fitness, family and creating a fabulous home.”

Clearly, Joanne’s editing and writing experience embrace healthcare in general and optometry specifically, including consumer health as well as product and clinical content for clinicians in private practice. She’s covered parenting, pregnancy, college life, fitness, yoga, nutrition, aging, sleep, and of course, eyecare.

If that’s not enough, in addition to having written about it, she’s also translated healthcare into her personal life as a yoga instructor herself, so you know that she’s a centered and well rounded individual.

As you can see from this, Joanne’s first issue of Optometric Office upon her return, she has hit the ground running, conducting our popular One-to-One in-depth interview with an industry trailblazer, surveying a group of eyecare professionals for our Docs Speak Out survey, and continuing our At-A-Glance chart focusing in on the details you need to know about specific products for getting your job done right.

At this time of welcome and anticipation, we’d also like to thank Jeff for spearheading the content of Optometric Office during Joanne’s absence. Following the momentum she set during her first tenure here, Jeff put his stamp on the magazine based on his own many years of experience covering the optometric field for this and other publications.

Now, we welcome (back) Joanne as she continues the tradition of creating the publication that you have become familiar with as a source of in-depth information about the products you need to make your business a success. *** John Sailer | VP Editorial | JSailer@FVMG.com

Patented MediBeads® are why Bruder is the

#1 Doctor Recommended S PON S OR E D CO NTE NT Moist Heat Eye Compress

NOT ALL COMPRESSES ARE CREATED EQUAL No Silica Gel Beads | No Gels | No Grains Approximately 40 million people suffer from chronic dry eye in the United States alone, and many don’t even realize it. As a professional, you are in a unique position to help these patients.

You see the signs and symptoms caused by aging, contact lens use, surgical procedures and other environmental factors. But what can you do to offer immediate, effective relief from dry, irritated eyes? If you’ve heard patients complain that their compress is ineffective, they may not be using the right one.

What to Look for in a Compress Warm compresses are proven to aid in the treatment of meibomian gland dysfunction (MGD), chronic dry eye disease (DED), blepharitis, and maintaining ocular surface health — however, not all compresses are created equal. A key differentiator is the type and quality of heat: it must be moist heat and it must be delivered at the right temperature for the right length of time to be effective.

Unfortunately, most compresses lack the technology required to accomplish this. That’s because ordinary compresses rely on silica gel beads, gel, or grains. The Bruder Compress offers patented MediBeads®, which provide the moist, uniform, extended heat required to effectively liquify oil in the meibomian glands and release the eyes’ natural hydration.

Moist and dry heat are both common superficial heat therapy treatments.

However, moist heat provides deeper tissue penetration at the same temperatures, thoroughly liquifying sebum and providing greater relief from DED, MGD and blepharitis symptoms.

Only the Bruder Moist Heat Eye Compress with MediBeads ® provides clinically proven levels of extended moist heat.

MediBeads® naturally retain moisture that is released when the compress is warmed. It’s no wonder the Bruder Mask is the #1 doctor recommended moist heat eye compress. No compress outperforms the Bruder Mask.

What’s Different About MediBeads® Technology?

Compresses that contain gel, silica gel beads, or grains can dry out and deliver uneven heat, causing hot spots that are dangerous and reduce product performance. MediBeads® provide clean, uniform heat. Their unique, honeycomb molecular structure encourages complete absorption of water molecules and, when microwaved, releases moist heat in a controlled and consistent manner for 8 to 12 minutes.

It’s easily incorporated into their daily routine, increasing compliance and providing quick relief. It is more than a product — it’s a proactive treatment protocol perfect for your practice and your patients.

Accept No Substitutes Keep your patients coming back; offer ® Infused with silver, MediBeads also them a mask that really works. Just repel bacteria to help promote eyelid as you wouldn’t prescribe an ineffechygiene and reduce the risk of infec- tive drug, don’t send patients to the tion. The compress easily withstands pharmacy to select a mask that isn’t Bruder is the only moist heat the rigors of daily use and regular capable of delivering real results. ® washing — MediBeads will not break compress in the world that Whatever treatment strategy you plan down like other compresses. for a patient, it should include the contains patented MediBeads.

The Bruder Mask is an effective dry Bruder Moist Heat Eye Compress — uniform moist heatdoctors – No hot spots. recommended by more than eye treatment that your patient uses • Provides at home, between visits to your office. • Washable any otherand heat compress. reusable - Will not break down in water.

• Anti-bacterial – Like no other mask on the market.

• Flexible two-pod design – Comfortably fits all facial types.

COMPARE COMPRESSES

Bruder Moist Heat Eye Others Recommend the Bruder Moist Accept® No Substitutes.

Compress with MediBeads

Heat Eye Compress to your patients and give them the

Technology

Only the Bruder compress contains Other compresses contain silica exceptional performance, comfort, safety and durability patented MediBeads®. gel beads, gel or grains, which of MediBeads. don’t perform the same way as MediBeads®.

Heat

MediBeads® provide uniform moistOrder heat, online Other materials and release today dry at out order.bruder.com or the most penetrating type of heat. uneven heat, which can hotinformation. email eyes@bruder.com forcause more spots that are dangerous and reduce product performance.

Hygiene

MediBeads® are silver-infused.

Other compresses can harbor Incorporating silver into the bead bacteria that can increase the risk structure ensures pure, clean,VISIT moist US DURING of infection. They also can be more heat with every use, helping toSECO repel IN BOOTH difficult#1828 to keep clean. bacteria and keep eyelids clean.

Design

An ergonomic patent-pending two-pod One-size-fits-all compresses with design comfortably fits all facial types, cumbersome covers can impact fit888-827-8337 bruder.com with no cumbersome cover. and interfere with effective therapy.

Durability

MediBeads® don’t break down with Silica gel beads, gel and grains break repeated use and washing. The entire down with handling and washing. compress can be washed with no impact on efficacy.

Testing

Clinical tests show the Bruder Compress is effective by virtue of its design, its transfer of penetrating moist heat, and its ability to increase compliance.

Other compresses cannot support efficacy with the same degree of rigorous clinical test results.

BROUGHT TO YOU BY www.bruder.com

VIEWS

TO NEW BEGINNINGS

Joanne Marchitelli View everything you do with curiosity because even if it’s something you’ve done before there is always something new to learn.

It’s a new year, with new goals, new opportunities and new beginnings. Well, in my case with my return as editor to Optometric Office, it’s more of a boomerang than a beginning.

But there is always room for novelty and innovation. As a reader of this magazine, you’re familiar with the content and the topics covered but you expect to learn something new after reading an issue. As editor of this magazine, I resolve to present this information in new and exciting ways.

As John Sailer mentioned in his Welcome (Back) column, I am a yogi in addition to being a writer and editor. One of the lessons from my 20-plus year practice that has stayed with me over the years is to cultivate a beginner’s mind. Beginner’s mind is a Zen principle that is often taught in yoga and meditation and one I find to be invaluable in my 20-plus year publishing career.

Simply put, it’s an ability to look at things with fresh eyes so you can find new opportunities and better ways to do the things you are already doing.

To take that approach from yoga practice to an eyecare practice is not, well, a stretch. Just look at new technology as a new opportunity to treat patients. We’ve seen many developments—some would call them disruptors—over the past few years that are changing the industry and how you

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deliver eyecare. On the consumer side, patients are trying on frames virtually, ordering eyewear online and subscribing to contact lens services. Optometrists in private practice are utilizing telemedicine to help diagnosis conditions, iPhones to take refractions and cloud-based software to streamline appointment scheduling, coding and billing. Even the predecessors to these patient management systems were game-changers for a busy optometric office.

Speaking of cloud-based platforms, you may have been curious as to why Marc Beinoff, the chief executive of Salesforce, bought Time magazine a few months back. And you weren’t alone. The business world wondered why the tech CEO was interested in a media company. After all, his career has been firmly rooted in tech—starting with an internship at Apple and landing at software giant Oracle before starting his own company.

In an interview with The New York Times (via text) Beinoff said, “I live with a beginner’s mind. I didn’t realize two weeks ago I was going to buy Time.” He followed that statement by sending a screenshot of a quote from Zen master Shunryu Suzuki: “In the beginner’s mind there are many possibilities, in the expert’s mind there are few.”

In his experience, he said, “My power was that I didn’t really want to do anything but I was open to all possibilities.” In other words, while he didn’t know much about publishing he was interested in its potential.

The takeaway here is to view everything you do from your dayto-day routine to a brand-new experience with curiosity. Even if it’s something you’ve done before there is always something new to learn. Here’s to new beginnings. *** Joanne Marchitelli | Editor | JMarchitelli@FVMG.com

JM: How did it come about?

JA: Resources are limited within most fellows training courses nationwide. Our goal for the Alcon Retina Fellows Institute was to design an experiential surgical training program that would optimize hands-on time with technology and provide an optimum ratio of fellows to faculty, providing best-in-class instruction.

JM: What are the short-term and long-term goals of the program?

JA: We want to continue to partner with the experts in surgical retina to train future leaders. Alcon is committed to the long-term education of surgeons and providing them with world-class technology to assist them in delivering the best possible care for their patients.

JM: How were the 40 participants selected?

ONE-TO-ONE

Josh Anderson

Head, US Surgical Retina, Alcon Josh Anderson, is Head, U.S. Surgical Retina at Alcon Laboratories. He is responsible for leading the U.S. Vitreoretinal Sales and Marketing organizations. He has close to 20 years of experience in the industry across pharmaceutical and medical devices. We asked him about the inaugural program of the Alcon Retina Fellows Institute that took place in November. The annual event, held at The Alcon Experience Center in Fort Worth, aims to provide eyecare professionals with education, hands-on learning and cutting-edge virtual reality technology.

Joanne Marchitelli: What was the inspiration for the Alcon Retina Fellows Institute?

Josh Anderson: As part of our commitment to education of eyecare professionals, we launched the Alcon Retina Fellows Institute to host fellows and facilitate training of future surgeons through many of the best teachers within the retina field.

JA: We encouraged first-year fellows to register for the program at academic institutions through Alcon representatives and via social media.

JM: Will different professionals be invited to attend next year, or will this year’s attendees be able to return next year?

JA: In the spirit of providing the best possible experience for fellows, we are currently evaluating the training needs for 2019. After understanding the needs, we will put together a world-class faculty with recognized leaders to provide first-class training. We will invite those instructors who are leaders in that specific discipline within surgical retina to help teach. We will likely have a combination of returning and new fellows participating in a 2019 Alcon Retina Fellows Institute.

JM: Which types of surgical trainings were held during this year’s program?

JA: Hands-on sessions included: Vit probe surgery, optimizing fluidics, ERM and ILM surgical techniques, techniques for independent surgery, 3D surgical visualization, scrub technician practicum, SiO and PFO management, optimizing 25g and 27g surgery, and ergonomics and OR set up.

JM: Are there specific trainings you would like to see presented in future programs?

JA: Alcon will continue to partner with the surgical retina community to understand the current and future needs for their fellows and be able to offer hands-on trainings by bridging gaps in education and experience, to ultimately enhance patient outcomes.

JM: Do you have plans to expand the program in the Alcon Experience Center locations around the world?

JA: We are looking at how to best expand this concept around the world. It will be important to help each region create and execute a program that addresses specific needs in the area.

O p tometr ic O ffic e. c om | February 2019

5

sponsored content

Early

GLAUCOMA INTERVENTION PAUL ZERBINOPOULOS, O.D.

and Why It Matters

As gatekeepers to eyecare, optometrists are often the first line of clinicians to interface with patients for their vision needs. We play a key role in the diagnosis and management of a wide range of ocular conditions, particularly chronic diseases such as glaucoma. At present, there are approximately 3 million people living with glaucoma in the United States.1 A leading cause of irreversible blindness, the course of glaucoma involves progressive and irreparable damage to the optic nerve, even before there is perceived vision loss.2 Early diagnosis and treatment aimed at controlling intraocular pressure (IOP) have been proven to delay glaucoma progression and preserve vision. However, diagnosis is difficult – approximately 50 percent of patients are undiagnosed.3 As optometrists, we are key to addressing this gap, and significant progress has been made to broaden our scope of practice to include glaucoma care. We are involved in multiple facets of the disease, from diagnosis to prescribing and monitoring the effectiveness of pharmacologic treatment options.

The majority of today’s glaucoma therapies were approved for use more than twenty years ago; however, in November 2017, VYZULTA™ (latanoprostene bunod ophthalmic solution), 0.024% was approved for the reduction of IOP in patients with open-angle glaucoma or ocular hypertension.4 Since the most frequently prescribed ophthalmic medication for glaucoma treatment currently is a prostaglandin analog, most providers will be comfortable with VYZULTA. But what makes it novel is that it is the first and only FDA approved nitric oxidereleasing agent with a dual mechanism of action that targets both the trabecular meshwork and uveoscleral pathways at the intracellular level to lower IOP in glaucoma patients.4-6 Once administered, VYZULTA is metabolized into latanoprost and butanediol mononitrate which releases nitric oxide.4 Latanoprost, as demonstrated through years of experience, works on the uveoscleral outflow pathway to increase aqueous outflow, while the nitric oxide moiety of VYZULTA relaxes the trabecular meshwork and aids aqueous outflow through the primary outflow pathway of the eye.4-6 Nitric oxide relaxes the trabecular meshwork by inhibiting Rho kinase and calcium signaling, two major causes of trabecular meshwork contraction.6-12 Every 1 mmHg of IOP reduction yields a 10 percent to 19 percent reduction in progression of visual field loss.13 Additionally, achieving a 20 percent to 30 percent reduction of IOP from baseline or a target IOP of less than 18 mmHg has been proven to slow progression of visual field loss.13 Efficacy

In two Phase 3 clinical studies that compared once-daily VYZULTA to twice-daily timolol 0.5% in 774 patients

with open-angle glaucoma or ocular hypertension, VYZULTA demonstrated up to 9 mmHg mean IOP reduction from baseline (P=0.002) and a 32 percent reduction in mean IOP from baseline at Month 3.14-16 In a Phase 2, dose-ranging study (VYZULTA arm: N=83; Xalatan arm: N=82), VYZULTA achieved a 35 percent mean reduction in mean IOP at day 28 compared to approximately 30 percent for latanoprost 0.005%.17 Additionally, 68 percent of patients treated with VYZULTA achieved a mean diurnal IOP reduction of <18 mmHg compared to only 48 percent of latanoprost 0.005%-treated patients (P=0.05).18 Safety

The safety of VYZULTA was also confirmed in these studies. The most common adverse reaction was conjunctival hyperemia at 6 percent and less than 1 percent of patients discontinued therapy due to ocular adverse reactions.4 Please see Important Safety Information on the next page.

Summary

We should consider VYZULTA as a first-line treatment option for glaucoma because it is a nitric oxide-releasing agent with a dual mechanism of action that works on two outflow pathways.4-6 With early intervention being crucial to preserving vision, VYZULTA’s proven effectiveness, overall safety profile, and once-daily dosing make it a good addition to the glaucoma armamentarium and can enhance our confidence in managing patients afflicted with this disease.

Dr. Zerbinopoulos sees patients at the Rhode Island Eye Institute.

Dr. Zerbinopoulos is a paid advisor and speaker for Bausch + Lomb. This article was sponsored by Bausch + Lomb.

References

1. National Eye Institute. Open-angle Glaucoma Defined. https://nei.nih. gov/eyedata/glaucoma. Accessed November 1, 2018.

2. National Eye Institute. Glaucoma: The ‘silent thief’ begins to tell its secrets. https://nei.nih.gov/news/pressreleases/012114. Accessed November 29, 2018.

3. Glaucoma Research Foundation. Glaucoma Facts and Stats. https:// www.glaucoma.org/glaucoma/glaucoma-facts-and-stats.php. Accessed November 26, 2018.

4. VYZULTA Prescribing Information. Bausch & Lomb Incorporated. 2018.

5. Krauss AH, Impagnatiello F, Toris CB, et al. Ocular hypotensive activity of BOL-303259-X, a nitric oxide donating prostaglandin F2alpha agonist, in preclinical models. Exp Eye Res. 2011;93:250-255.

6. Cavet ME, Vollmer TR,Harrington KL, VanDerMeid K, Richardson ME. Regulation of endothelin-1–induced trabecular meshwork cell contractility by latanoprostene bunod. Invest Ophthalmol Vis Sci. 2015;56(6):4108-4116.

7. Dismuke WM, Mbadugha CC, Ellis DZ. NO-induced regulation of human trabecular meshwork cell volume and aqueous humor outflow facility involve the BKCa ion channel. Am J Physiol Cell Physiol.

2008;294:C1378-C1386.

8. Dismuke WM, Liang J, Overby D, Stamer WD. Concentration-related effects of nitric oxide and endothelin-1 on human trabecular meshwork cell contractility. Exp Eye Res. March 2014;120:28-35.

9. Thoonen R, Sips PY, Bloch KD, Buys ES. Pathophysiology of hypertension in the absence of nitric oxide/cyclic GMP signaling. Curr Hypertens Rep. Feb 2013;15(1):47-58.

10. Buys ES, Potter LR, Pasquale LR, Ksander BR. Regulation of intraocular pressure by soluble and membrane guanylate cyclases and their role in glaucoma. Front Mol Neurosci. 2014;7:38.

11. Schneemann A, Dijkstra BG, van den Berg TJ,et al. Nitric oxide/ guanylate cyclase pathways and flow in anterior segment perfusion.

Graefes Arch Clin Exp Ophthalmol. 2002;240:936-941.

12. Wiederholt M, Sturm A, Lepple-Wienhues A. Relaxation of trabecular meshwork and ciliary muscle by release of nitric oxide. Invest Ophthalmol Vis Sci. 1994;35:2515-2520.

13. VanVeldhuisen, Paul C, et al. The Advanced Glaucoma Intervention Study (AGIS): The Relationship Between Control of Intraocular Pressure and Visual Field Deterioration. Am J Ophthalmol. 2000;130(4): 429-440.

14. Medeiros FA, Martin KR, Peace J, et al. Comparison of Latanoprostene Bunod 0.024% and Timolol Maleate 0.5% in Open-Angle Glaucoma or Ocular Hypertension: The LUNAR Study. Am J Ophthalmol.

2016;168:250-259.

15. Weinreb RN, Scassellati Sforzolini B, Vittitow J, Liebmann J. Latanoprostene Bunod 0.024% versus Timolol Maleate 0.5% in Subjects with Open-Angle Glaucoma or Ocular Hypertension: The APOLLO Study. Ophthalmology. 2016;123:965-973.

16. Weinreb RN, Liebmann JM, Martin KR, Kaufman PL, Vittitow JL. Latanoprostene Bunod 0.024% in Subjects With Open-angle Glaucoma or Ocular Hypertension: Pooled Phase 3 Study Findings. J Glaucoma.

2018;27:7-15.

17. Weinreb RN, Ong T, Scassellati Sforzolini B, et al for the VOYAGER study group. A randomised, controlled comparison of latanoprostene bunod and latanoprost 0.005% in the treatment of ocular hypertension and open angle glaucoma: the VOYAGER study. Br J Ophthalmol.

2015;99:738-745.

18. Data on file. Bausch & Lomb Incorporated.

Please see additional Important Safety Information for VYZULTA on the next page. Please see Brief Summary of Prescribing Information for VYZULTA following this advertisement. VYZ.0329.USA.18

VYZULTA DELIVERS A DUAL MECHANISM OF ACTION FOR THE REDUCTION OF IOP IN GLAUCOMA PATIENTS1

ONE MOLECULE. TWO OUTFLOW PATHWAYS. PROVEN IOP REDUCTION 1-3* *

In studies up to 12 months’ duration, the IOP-lowering effect was up to 7.5 to 9.1 mmHg, in patients with an average baseline IOP of 26.7 mmHg

INDICATION

IMPORTANT SAFETY INFORMATION (CONTINUED)

VYZULTA™ (latanoprostene bunod ophthalmic solution), 0.024% is indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

• There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products that were inadvertently contaminated by patients

IMPORTANT SAFETY INFORMATION

• Contact lenses should be removed prior to the administration of VYZULTA and may be reinserted 15 minutes after administration

• Increased pigmentation of the iris and periorbital tissue (eyelid) can occur. Iris pigmentation is likely to be permanent • Gradual changes to eyelashes, including increased length, increased thickness, and number of eyelashes, may occur. These changes are usually reversible upon treatment discontinuation • Use with caution in patients with a history of intraocular inflammation (iritis/uveitis). VYZULTA should generally not be used in patients with active intraocular inflammation • Macular edema, including cystoid macular edema, has been reported during treatment with prostaglandin analogs. Use with caution in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema

• Most common ocular adverse reactions with incidence ≥2% are conjunctival hyperemia (6%), eye irritation (4%), eye pain (3%), and instillation site pain (2%) For more information, please see Brief Summary of Prescribing Information on next page.

References: 1. VYZULTA Prescribing Information. Bausch & Lomb Incorporated. 2017.

2. Weinreb RN, Sforzolini BS, Vittitow J, Liebmann J. Latanoprostene bunod 0.024% versus timolol maleate 0.5% in subjects with open-angle glaucoma or ocular hypertension: the APOLLO study. Ophthalmology. 2016;123(5):965-973.

3. Medeiros FA, Martin KR, Peace J, Sforzolini BS, Vittitow JL, Weinreb RN. Comparison of latanoprostene bunod 0.024% and timolol maleate 0.5% in open-angle glaucoma or ocular hypertension: the LUNAR study. Am J Ophthalmol.

2016;168:250-259.

For more information about VYZULTA and how it works, visit vyzultanow.com

VYZULTA and the V design are trademarks of Bausch & Lomb Incorporated or its affiliates. ©2018 Bausch & Lomb Incorporated. All rights reserved. VYZ.0118.USA.18

BAUSCH & LOMB BRIEF SUMMARY OF PRESCRIBING INFORMATION This Brief Summary does not include all the information needed to use VYZULTA safely and effectively. See full Prescribing Information for VYZULTA.

VYZULTA™ (latanoprostene bunod ophthalmic solution), 0.024%, for topical

ophthalmic use.

Initial U.S. Approval: 2017 1 INDICATIONS AND USAGE VYZULTA™ (latanoprostene bunod ophthalmic solution) 0.024% is indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

4 CONTRAINDICATIONS None 5 WARNINGS AND PRECAUTIONS 5.1 Pigmentation VYZULTA™ (latanoprostene bunod ophthalmic solution), 0.024% may cause changes to pigmented tissues. The most frequently reported changes with prostaglandin analogs have been increased pigmentation of the iris and periorbital tissue (eyelid).

Pigmentation is expected to increase as long as latanoprostene bunod ophthalmic solution is administered. The pigmentation change is due to increased melanin content in the melanocytes rather than to an increase in the number of melanocytes. After discontinuation of VYZULTA, pigmentation of the iris is likely to be permanent, while pigmentation of the periorbital tissue and eyelash changes are likely to be reversible in most patients. Patients who receive prostaglandin analogs, including VYZULTA, should be informed of the possibility of increased pigmentation, including permanent changes.

The long-term effects of increased pigmentation are not known.

Iris color change may not be noticeable for several months to years. Typically, the brown pigmentation around the pupil spreads concentrically towards the periphery of the iris and the entire iris or parts of the iris become more brownish. Neither nevi nor freckles of the iris appear to be affected by treatment. While treatment with VYZULTA™ (latanoprostene bunod ophthalmic solution), 0.024% can be continued in patients who develop noticeably increased iris pigmentation, these patients should be examined regularly [see Patient Counseling Information (17) in full Prescribing Information].

5.2 Eyelash Changes VYZULTA may gradually change eyelashes and vellus hair in the treated eye. These changes include increased length, thickness, and the number of lashes or hairs.

Eyelash changes are usually reversible upon discontinuation of treatment.

5.3 Intraocular Inflammation VYZULTA should be used with caution in patients with a history of intraocular inflammation (iritis/uveitis) and should generally not be used in patients with active intraocular inflammation as it may exacerbate this condition.

5.4 Macular Edema Macular edema, including cystoid macular edema, has been reported during treatment with prostaglandin analogs. VYZULTA should be used with caution in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema.

5.5 Bacterial Keratitis There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface.

5.6 Use with Contact Lens Contact lenses should be removed prior to the administration of VYZULTA because this product contains benzalkonium chloride. Lenses may be reinserted 15 minutes after administration.

6 ADVERSE REACTIONS The following adverse reactions are described in the Warnings and Precautions section: pigmentation (5.1), eyelash changes (5.2), intraocular inflammation (5.3), macular edema (5.4), bacterial keratitis (5.5), use with contact lens (5.6).

6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

VYZULTA was evaluated in 811 patients in 2 controlled clinical trials of up to 12 months duration. The most common ocular adverse reactions observed in patients treated with latanoprostene bunod were: conjunctival hyperemia (6%), eye irritation (4%), eye pain (3%), and instillation site pain (2%). Approximately 0.6% of patients discontinued therapy due to ocular adverse reactions including ocular hyperemia, conjunctival irritation, eye irritation, eye pain, conjunctival edema, vision blurred, punctate keratitis and foreign body sensation.

8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Risk Summary There are no available human data for the use of VYZULTA during pregnancy to inform any drug associated risks.

Latanoprostene bunod has caused miscarriages, abortion, and fetal harm in rabbits.

Latanoprostene bunod was shown to be abortifacient and teratogenic when administered intravenously (IV) to pregnant rabbits at exposures ≥ 0.28 times the clinical dose.

Doses ≥ 20 μg/kg/day (23 times the clinical dose) produced 100% embryofetal lethality.

Structural abnormalities observed in rabbit fetuses included anomalies of the great vessels and aortic arch vessels, domed head, sternebral and vertebral skeletal anomalies, limb hyperextension and malrotation, abdominal distension and edema. Latanoprostene bunod was not teratogenic in the rat when administered IV at 150 mcg/kg/day (87 times the clinical dose) [see Data].

The background risk of major birth defects and miscarriage for the indicated population is unknown. However, the background risk in the U.S. general population of major birth defects is 2 to 4%, and of miscarriage is 15 to 20%, of clinically recognized pregnancies.

Data Animal Data Embryofetal studies were conducted in pregnant rabbits administered latanoprostene bunod daily by intravenous injection on gestation days 7 through 19, to target the period of organogenesis. The doses administered ranged from 0.24 to 80 mcg/kg/day. Abortion occurred at doses ≥ 0.24 mcg/kg/day latanoprostene bunod (0.28 times the clinical dose, on a body surface area basis, assuming 100% absorption). Embryofetal lethality (resorption) was increased in latanoprostene bunod treatment groups, as evidenced by increases in early resorptions at doses ≥ 0.24 mcg/kg/day and late resorptions at doses ≥ 6 mcg/kg/day (approximately 7 times the clinical dose). No fetuses survived in any rabbit pregnancy at doses of 20 mcg/kg/day (23 times the clinical dose) or greater.

Latanoprostene bunod produced structural abnormalities at doses ≥ 0.24 mcg/kg/day (0.28 times the clinical dose). Malformations included anomalies of sternum, coarctation of the aorta with pulmonary trunk dilation, retroesophageal subclavian artery with absent brachiocephalic artery, domed head, forepaw hyperextension and hindlimb malrotation, abdominal distention/edema, and missing/fused caudal vertebrae.

An embryofetal study was conducted in pregnant rats administered latanoprostene bunod daily by intravenous injection on gestation days 7 through 17, to target the period of organogenesis. The doses administered ranged from 150 to 1500 mcg/kg/day.

Maternal toxicity was produced at 1500 mcg/kg/day (870 times the clinical dose, on a body surface area basis, assuming 100% absorption), as evidenced by reduced maternal weight gain. Embryofetal lethality (resorption and fetal death) and structural anomalies were produced at doses ≥ 300 mcg/kg/day (174 times the clinical dose).

Malformations included anomalies of the sternum, domed head, forepaw hyperextension and hindlimb malrotation, vertebral anomalies and delayed ossification of distal limb bones. A no observed adverse effect level (NOAEL) was established at 150 mcg/kg/day (87 times the clinical dose) in this study.

8.2 Lactation Risk Summary There are no data on the presence of VYZULTA in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered, along with the mother’s clinical need for VYZULTA, and any potential adverse effects on the breastfed infant from VYZULTA. 8.4 Pediatric Use Use in pediatric patients aged 16 years and younger is not recommended because of potential safety concerns related to increased pigmentation following long-term chronic use.

8.5 Geriatric Use No overall clinical differences in safety or effectiveness have been observed between elderly and other adult patients.

13 NONCLINICAL TOXICOLOGY 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility Latanoprostene bunod was not mutagenic in bacteria and did not induce micronuclei formation in the in vivo rat bone marrow micronucleus assay. Chromosomal aberrations were observed in vitro with human lymphocytes in the absence of metabolic activation.

Latanoprostene bunod has not been tested for carcinogenic activity in long-term animal studies. Latanoprost acid is a main metabolite of latanoprostene bunod. Exposure of rats and mice to latanoprost acid, resulting from oral dosing with latanoprost in lifetime rodent bioassays, was not carcinogenic.

Fertility studies have not been conducted with latanoprostene bunod. The potential to impact fertility can be partially characterized by exposure to latanoprost acid, a common metabolite of both latanoprostene bunod and latanoprost. Latanoprost acid has not been found to have any effect on male or female fertility in animal studies.

13.2 Animal Toxicology and/or Pharmacology A 9-month toxicology study administered topical ocular doses of latanoprostene bunod to one eye of cynomolgus monkeys: control (vehicle only), one drop of 0.024% bid, one drop of 0.04% bid and two drops of 0.04% per dose, bid. The systemic exposures are equivalent to 4.2-fold, 7.9-fold, and 13.5-fold the clinical dose, respectively, on a body surface area basis (assuming 100% absorption). Microscopic evaluation of the lungs after 9 months observed pleural/subpleural chronic fibrosis/inflammation in the 0.04% dose male groups, with increasing incidence and severity compared to controls. Lung toxicity was not observed at the 0.024% dose.

Distributed by: Bausch + Lomb, a division of Valeant Pharmaceuticals North America LLC Bridgewater, NJ 08807 USA U.S. Patent Numbers: 6,211,233; 7,273,946; 7,629,345; 7,910,767; 8,058,467.

VYZULTA is a trademark of Bausch & Lomb Incorporated or its affiliates. © Bausch & Lomb Incorporated Based on 9464800 11/2017 VYZ.0055.USA.16 Issued: 11/2017

THINK ABOUT YOUR EYES

UNDERSTANDING

DIABETIC RETINOPATHY

Diabetes is a disease process that affects more than 30 million Americans. Diabetic retinopathy is the leading cause of vision loss in the 25- to 74-year-old population, and this presents a great opportunity to optometrists, not only to provide early detection but also to initiate treatment when indicated.

DIAGNOSING THE DISEASE

Undiagnosed diabetic patients may present to our offices with a wide array of symptoms ranging from asymptomatic to atypical shifts in refractive error to cataract formation to signs of diabetic retinopathy. An atypical shift in refractive error will prompt us to rule out diabetes as the etiology.

Signs of diabetic retinopathy, such as microaneurysms, hemorrhages, cotton wool spots, venous beading, intraretinal microvascular anomalies, macular edema or neovascularization would also prompt us to rule out diabetes.

Once diabetes is diagnosed these patients should receive an annual eye exam to monitor for diabetic retinopathy along with other problems more prevalent in diabetic patients such as cataracts, glaucoma, dry eyes and oculomotor problems.

Diabetic retinopathy is classified into nonproliferative and proliferative with varying stages in each category. Our patients may be asymptomatic until late in the disease process so it is important for us to educate them about the importance of annual exams to allow for early detection and treatment if indicated. Symptoms that may occur include blurred vision, difficulty with night vision, floaters or dark spots in the central vision. This also presents an opportunity for us to discuss the importance of glucose control through diet management, exercise, medication and smoking cessation.

Christopher J. Babin, OD Christopher J. Babin, OD, is a member of Optometric Physicians of Washington and among the 22,000 doctors listed on the Think About Your Eyes online locator. Think About Your Eyes is a nationwide public awareness initiative promoting the importance of an annual eye exam and overall vision health. First Vision Media Group supports Think About Your Eyes as a media partner.

MANAGING THE CONDITION

Diabetes is a disease that lets us interact with the primary care providers and endocrinologists regarding our patientsâ&#x20AC;&#x2122; healthcare. This can help these providers in determining whether diabetes control is adequate and initiate additional treatment when indicated. Diabetes is a disease process that gives optometry the opportunity to be part of the healthcare team for this population.

Diabetic retinopathy can be a frightening diagnosis, but it provides optometrists an opportunity to build a trusting relationship with patients. This includes education about the importance of annual eye exams to provide for early detection and ongoing monitoring of the signs and symptoms.

Think About Your Eyes (TAYE), the public awareness campaign for the vision industry, also encourages patients to get annual eye exams to better serve the diabetic population. Together with TAYE, we can continue to be advocates for our patientâ&#x20AC;&#x2122;s vision health. O|O

O p tometr ic O ffic e. c om | February 2019

9

PRODUCT | BUZZ LAUNCHES, PROMOTIONS, MERCHANDISING, EVENTS AND OTHER THINGS TO KEEP YOU IN THE KNOW. THE AAO SUPPORTS NEW FEDERAL SAFETY RECOMMENDATIONS

The American Academy of Ophthalmology (AAO) agrees with important patient safety guidelines recommended in a joint report issued by three federal agencies, the U.S. Departments of Health and Human Services, Treasury, and Labor. The report focuses on reforms that deliver system-wide cost savings, with significant attention paid to the delivery of care at the state level.

ESSILOR OF AMERICA PARTNERS WITH TOP VISION EXPERTS

Essilor has partnered with 14 eyecare professionals to form the Myopia Taskforce. Part of the Myopia Initiative in Action (MIA) program, the team plans to establish recommended protocols for myopia management and detection, which will be shared with the optical community later this year.

Essilor announced its plan at its annual sales meeting in January, when it introduced the members of the taskforce: Thomas Aller, OD, FBCLA; David Anderson, OD; Craig Brawley, OD, FAAO; Mark Bullimore, MCOptom, PhD, FAAO; Alan Glazier, OD, FAAO; John Lahr, OD, FAAO; Maria Liu, OD, PhD; Pamela Lowe, OD, FAAO; Moshe Mendelson, OD, FIAO; Pamela Miller, OD, FAAO, JD, FNAP; Yi Pang, MD, OD, PhD, FAAO; Earl Smith, OD, PhD, FAAO; Long Tran, OD, FAAO; David Troilo, PhD. “The rate at which the prevalence of myopia is increasing is staggering,” said Millicent Knight, OD, FAAO,

FAARM, senior vice president of customer development at Essilor of America. “True to our mission of improving lives by improving sight, we are bringing together some of the industry’s top eyecare professionals with diverse areas of myopia interest and expertise to address this problem together through new research and open collaboration.”

Go to EssilorUSA.com

One recommendation that the Academy supports is that states forego scope-of-practice expansion when there are legitimate health and safety concerns. Scope-of-practice regulations ensure that only those professionals with the necessary medical education and clinical training are authorized to perform surgical eye procedures.

Alcon has recently launched AlconScience.com for U.S.- and Canada-based eyecare professionals (ECPs) and academic institutions. The new website consolidates information about Alcon’s scientific, academic, and related activities into one portal. Visitors may download clinically focused publications, submit grant applications for Investigator-Initiated Trials (IITs), apply for independent medical education support and apply for educational equipment donations, among other activities.

“Too often there is a rush to extend surgical privileges to those who lack the years of medical education and clinical training necessary for understanding and safely performing critical procedures,” said Keith D. Carter, MD, FACS, president of the AAO, in a statement. “It is critical, certainly in eyecare, that should our states opt to expand scope of practice, that they eschew any dangerous softening of surgical standards and heed the recommendations in this report by preserving regulations that protect patients seeking surgery and complex medical care of eye disease.”

Go to AlconScience.com.

Go to AAO.org

ALCON LAUNCHES NEW MEDICAL AFFAIRS WEBSITE

10 F e br ua r y 2 0 1 9 | O p to m e tri c O f f i c e .c o m

News Bausch + Lomb has received 510(k) clearance from the FDA for Bausch + Lomb ULTRA Multifocal For Astigmatism contact lenses.

Carl Zeiss Meditec has acquired IanTECH, Inc., a privately held company focused on technology solutions for micro-interventional cataract surgery.

Visioneering Technologies Inc. has appointed Brian D. Lane, CPA, as its chief financial officer.

Alcon has acquired Tear Film Innovations, Inc. Bausch + Lomb has entered into an exclusive agreement with Modulight, Inc., a designer and manufacturer of lasers and optics for personalized medicine, to collaborate and develop a new laser specifically designed for use with Bausch + Lomb’s VISUDYNE (verteporfin for injection) photodynamic therapy (PDT).

Notal Vision, Inc. has announced its first U.S. clinical trial initiated with a homebased, patient-operated, SD-OCT system. The first targeted application of the Notal Home OCT is to monitor exudative (wet) age-related macular degeneration (eAMD) patients between scheduled, standard-of-care examinations by their treating retinal specialist.

Opternative announced its company name changed to Visibly.

Patented MediBeads® are why Bruder is the

ABB OPTICAL GROUP’s specialty lens lab has been approved by Contamac to manufacture gas permeable contact lenses in the Optimum line of GP materials with Tangible Hydra-PEG surfaced coating technology.

#1 Doctor Recommended Moist Heat Eye Compress No Silica Gel Beads | No Gels | No Grains

Clearside Biomedical submitted new drug application for XIPERE for the treatment of macular edema associated with uveitis.

Atia Vision, a Shifamed portfolio company, closed $10 million in Series C financing.

Ophthotech Corporation announced the election of Adrienne L. Graves, PhD, former chief executive officer of Santen Inc., to its board of directors.

CooperVision’s Specialty Eye Care Division has named two eyecare industry veterans to newly established professional services roles.

Elizabeth Lumb, BSc(Hons) MCOptom, FBCLA, has been appointed head of Professional Services, MiSight 1 day, EMEA (Europe, Middle East and Africa) and global brand manager for the lens.

Chi Shing Fan, PD Optom, PhD, has been appointed as professional service and commercial lead, MiSight & Specialty Business, Asia Pacific.

Kala Pharmaceuticals has submitted a new drug application to the FDA for KPI-121 0.25%, a topical product candidate for dry eye disease.

Bruder is the only moist heat compress in the world that contains patented MediBeads.

• Provides uniform moist heat – No hot spots.

• Washable and reusable - Will not break down in water.

• Anti-bacterial – Like no other mask on the market.

• Flexible two-pod design – Comfortably fits all facial types.

Accept No Substitutes. Recommend the Bruder Moist Heat Eye Compress to your patients and give them the exceptional performance, comfort, safety and durability of MediBeads.

Order online today at order.bruder.com or email eyes@bruder.com for more information.

VISIT US DURING SECO IN BOOTH #1828

bruder.com

888-827-8337

O p tometr ic O ffic e. c om | Fe bruary 2019

O p tom

11

CONTACT LENSES

9%

INCREASE

in dollar growth for toric lenses from 2017 to 2018.

HOT TORIC!

Source: ABB Optical

Sales are sizzling for fitting patients with astigmatisms. Here’s how to make them a better fit for your patients—and your practice.

By J o anne M arc hitelli In the past, people with astigmatism were steered toward eyeglasses.

But today, contact lenses also offer easy and effective vision correction.

Patience is required. Just as every person is unique, so is every astigmatism, and one size does not fit all.

Advise your astigmats that they may be trying on a lot of contact lenses, but the time invested will be worth it.

The “error” in the trial and error is usually in stability. Today’s advanced lens designs help minimize rotation to provide that stability. Here are the latest “off-the-shelf” options.

ALCON

DAILIES AquaComfort Plus Toric contact lenses offer a daily disposable for astigmats. The lens features BlinkActivated Moisture Technology for wettability and tear film stability. Its Precision Curve Lens Design provides visual acuity, and the lenses’ dual thin zones utilize blinking pressure of the lids to maintain rotational stability.

Available in +4.00D to -6.00D (0.25D steps) and -6.50D to -8.00D (.50D

steps) with -0.75D, -1.25D and -1.75D add powers. Axis is 10/20/70/80/90/10 0/110/160/170/180.

AIR OPTIX for Astigmatism provides patients with a monthly lens replacement option. The lens is available in powers of +6.00D to -6.00D (0.25D steps) or -6.50D to -10.00D (0.50D steps) with -0.75D, -1,25D, -1.75D and -2.25D add powers; and axis is full circle in 10° steps. Alcon’s SmartShield Technology smooths and protects the lens to retain moisture and resist deposits, and its unique, Precision Balance 8|4 lens design is engineered to work with the eye’s blinking mechanism to stabilize the lens.

BAUSCH + LOMB

Bausch + Lomb ULTRA for Astigmatism is a monthly lens approved for daily and extended wear for up to seven days. The lens features MoistureSeal Technology that helps maintain 95% of lens moisture for a full 16 hours. Its OpticAlign Design provides stability, has an ori-

12 F e b r ua r y 20 1 9 | O p to m e tri c O f f i c e .c o m

entation mark to aid insertion and features spherical aberration control optimized in both axes to help reduce halos and glare. It is indicated for myopia or hyperopia with astigmatism up to 5.00D. It is available in +6.00D to -6.00D in 0.25D steps; -6.50D to -12.00D in 0.50D steps with cylinder powers -0.75D, -1.25D, -1.75D, -2.25D and -2.75D and Axis 10° to 180° in 10°. Bausch + Lomb ULTRA Multifocal for Astigmatism will be available mid-2019.

“Always begin exams by exploring why the patient may not be wearing lenses or how they feel in their current lenses, using their response as a way to inform them of new options.”

—Mile Brujic, OD Biotrue ONEday for Astigmatism is a daily disposable. Its patented dehydration barrier allows the lens to maintain nearly 100% of its moisture for 16 hours. It has a peri-ballast design, a tapered edge to limit lid interaction and, like the ULTRA, has spherical aberration control to

help reduce halos and glare. Available in +4.00D to -6.00D in 0.25D steps -6.50D to -9.00D in 0.5D steps with cylinder powers -0.75D, -1.25D, -1.75D (and additional parameters in a -2.25D cylinder), and a 0 to 180° axis.

COOPERVISION

Biofinity toric is a silicone hydrogel lens that can be worn as a daily wear lens or up to seven days in a row with a monthly replacement. Its Optimized Toric Lens Geometry is designed to reduce lens movement when blinking and provide more comfort. Its uniform horizontal ISO thickness and wide ballast quickly orient the lens. Aquaform Technology provides wettability and breathability with no additives. It is available in the following powers: +8.00D to -10.00D (0.50D steps after +/-6.00D) and +10.00D to +8.50D (0.50D steps) with cylinder powers -0.75D, -1.25D, -1.75D, -2.25D; and +10.00D to -10.00D (0.50D steps after +/- 6.00D) with cylinder powers -2.75D, -3.25D, -3.75D, -4.25D, -4.75D, -5.25D and -5.75D. “It’s so easy to fit patients with this lens. It has great stability, and I would encourage all practitioners to try fitting this lens.” – Rebecca Nally, OD The MyDay toric offers the same lens design features as Biofinity and pairs it with Smart Silicone for a comfortable daily disposable lens. Smart Silicone chemistry transports oxygen so efficiently that it requires less raw silicon (only 4.4% content), leaving more space for hydrophilic material.

Available in plano to -10.00D (0.50D steps after -6.00D) and +0.50D to +6.00D (0.50D steps) with cylinder powers -0.75D, -1.25D, -1.75D and -2.25D.

Another silicone hydrogel lens from CooperVision with a wide parameter range (1,590 power combinations) is the clariti 1 day toric. It allows 100% corneal oxygen consumption.

The daily replacement schedule, lens material and UVA/UVB protection provide healthier lens.

JOHNSON & JOHNSON VISION

Johnson & Johnson Vision’s ACUVUE Brand Contact Lenses for ASTIGMATISM offer a portfolio of toric lenses with common features in a variety of modalities. All of ACUVUE’s toric lenses feature proprietary BLINK-STABILIZED Design, which utilizes four stabilization zones within the lens that work naturally with the eyelids and harness the power of the blink to help keep the lens in the correct position during head tilts, blinks and eye movements.

It is the only brand to offer UV blocking across its entire product line for astigmatism.

“DO (or don’t be scared/hesitant to) fit the same amount of cylinder in contacts as you would give the patient in their spectacle prescription (with the correct vertex distance, of course!)” —Charissa Lee, OD. The two-week ACUVUE OASYS for ASTIGMATISM has the widest range of stock parameters, covering nearly 99% of spherical and astigmatic eyes, including -2.75D in-stock availability. Its HYDRACLEAR PLUS Technology and EYEINSPIRED Design help maintain a stable tear film and provide comfortable and clear vision all day long. The lens offers around-the-clock coverage in +4.00D to -6.00D (0.25D steps), -6.50D to -9.00D (0.50D steps) and

+4.25D to +6.00D (0.50D steps) and cylinders -0.75D, -1.25D, -1.75D, -2.25D and -2.75D. A non-coated silicone hydrogel formulation, ACUVUE VITA for ASTIGMATISM with HydraMax, is balanced to help maximize and maintain hydration throughout the lens, resulting in a full month of comfort for patients. It offers coverage for nearly 96% of spherical and astigmatic eyes: +4.00D to -6.00D (0.25D steps) and -6.50D to -9.00D (0.50D steps) and cylinders -0.75D, -1.25D, -1.75D and -2.25D. ACUVUE’s portfolio of daily disposable contact lenses also offer a wide parameter coverage, covering nearly 96% of spherical and astigmatic eyes.

ACUVUE OASYS 1-Day with HydraLuxe Technology is a daily disposable lens for patients who demand high performance and want a daily that keeps up with their busy life.

1-Day ACUVUE MOIST for ASTIGMATISM is a great lens for those looking to move into a daily.

Featuring the proprietary LACREON technology, the lens is embedded with a wetting agent for all-day moisture.

Both of these lenses are available in +4.00D to -6.00D (0.25D steps) and -6.50D to -9.00D (0.50D steps) and cylinders -0.75D, -1.25D, -1.75D and -2.25D. O|O

WHERE TO FIND IT Alcon Laboratories 800.451.3937 | Alcon.com Bausch + Lomb 800.828.9030 | Bausch.com CooperVision, Inc. 800.341.2020 | CooperVision.com Johnson & Johnson Vision Care, Inc. 800.843.2020 | JnJVisionPro.com

O p tometr ic O ffic e. c om | February 2019

13

PATIENT CARE

DOCS | SPEAK OUT Ocu la r T r a u m a

Many eye injuries happen to adults on the job, however, nearly half (44%) happen in the home, according to the American Academy of Ophthalmology. In our “Docs Speak Out” survey this month, we asked optometrists about the ocular trauma injuries they commonly see in their practice, how often, where they happen and who they happen to.

Among ocular trauma patients, what percentage has suffered from:

blunt trauma

42%

% 42other

What age group is most susceptible to eye injuries?

100 80 60 40

3%

radiation

chemical agents

10 per month

89%

98 per year

%

13

How many ocular trauma patients do you see per week in your practice? 3

20 0

-0-

-0-

ages 0-3

ages 3-9

11% ages 10-18

ages 18 and older

What are the most common eye injuries you’ve treated in your practice? Can you share any extraordinary cases you’ve seen?

“Metallic foreign body and corneal abrasions are the most common. Two strangest incidents were a tick (alive) attached to bulbar conjunctiva and a spider (deceased) under upper lid of another patient.”

“Scratched in the eye with yard debris while doing yard work.”

“Nail gun, chemicals, cleaning fluids, glue (from false eyelashes), a fist.”

“Most common, with often poor outcomes, are the use of bungee cords or other elastic property (heavy key chain) that release back unexpectedly for blunt or lacerating results.”

“Sports—mostly basketball. Also, babies’

fingers into parents’ eyes, fist to eye, chemical splash, welders with slag and mechanics with rust. These are common.”

“Corneal/conjunctival foreign bodies are the most common. We also see globe laceration, orbital fractures.”

“Foreign bodies from grinder injuries.

Walking into objects like trees or cabinet doors. Using hydrogen peroxide cleaner improperly.”

“Our most common injury is small metallic corneal foreign bodies.”

“Welding mishaps are most common.”

“Foreign body lodged in cornea from workplace safety mishap.”

“Most common are corneal abrasions

14 F e b r ua r y 20 1 9 | O p to m e tri c O f f i c e .c o m

following a sports incident or the occasional Nerf gun.”

“Foreign bodies due to not wearing safety glasses.”

“Puncture wound while hunting.”

“Sports-related blunt trauma.”

“We are open Saturdays so we do a lot of metal foreign body removals.”

“We see a lot of metallic foreign bodies from both workplace and home. Also, a good amount of eyes being poked by a branch, another person, or even a pet.”

“Corneal or conjunctival foreign body/ corneal abrasion.”

AT-A- GLANCE

RETINAL CAMERAS COMPANY

TYPE

SOFTWARE

Canon | 800.970.7227 | USA.Canon.com CR-2 AF Non-Mydriatic • DICOM

• JPEG • TIFF • PNG • XML

RESOLUTION/ MAGNIFICATION

BENEFITS

20.2 Megapixels/2x digital via • Autofundus, autoexposure, autofocus, and autoshoot with ultra high-res medical-grade manual override Canon EOS

• RGB filter modes offer increased scrutiny of suspect tissues • Anterior mode and stereo capability with internal target positioning

Carl Zeiss Meditec | 925.557.4100 | Meditec.Zeiss.com CLARUS 500

True Color, HD Ultrawidefield

• DICOM • JPG • TIFF • JPEG2000 • PNG

7.3 µm

• Allows clinicians to visualize subtle changes in pathology over time • In addition to true color imaging, it also captures highresolution fundus autofluorescence (FAF) images–FAF-Blue and FAF-Green–and Infrared (IR) and external eye images • Designed to create a more comfortable, satisfying patient experience that provides images free of obstructions, such as lids and lashes, and requires fewer recaptures

Marco | 800.874.5274 | Marco.com

AFC-330

Non-Mydriatic

• NAVIS-EX 12 Megapixels Database • Complete review, compare & measure capabilities • EMR interface

• Built-in Camera & Computer • Auto-Alignment in X-Y-Z • Auto-Tracking • Auto-Focus • Auto-Capture

Optos | 800.854.3039 | Optos.com | info@Optos.com

Monaco

Non-Mydriatic • OptosAdvance optomap color: 20 µm optomap plus, af: 14 µm • OptosCloud

• DICOM compatible

• • • • •

The only ultra-widefield device with integrated OTC Auto-montage captures up to 200° of the retina Stereo imaging for optic disc and retinal evaluation Exposure time is less than 0.4 second UWF with OCT saves time, space and minimizes patient movement • Color, AF, and OCT images are shown in a single, comprehensive view • 5 OCT scan types

Topcon | 201.599.5100 | TopconMedical.com

TRC-NW400

Non-Mydriatic

• IMAGEnet 5 • EZ Capture

5 Megapixels

• Fully automated operation and automatic transfer from eye to eye • 10-in. touch-screen monitor for instrument control and image display • Anterior segment photography

For a longer listing of retinal cameras, go to OptometricOffice.com. O|O O p tometr ic O ffic e. c om | February 2019

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NEW PRODUCT | GALLERY COBURN TECHNOLOGIES INTRODUCES NEW PORTABLE SLIT LAMP

Coburn Technologies has introduced a brand new portable slit lamp—the SK-LS-1B. With its hand-held operation, users are able to examine patients who don’t have the ability or cannot sit comfortably at a traditional slit lamp.

Lightweight and portable, it comes in a custom case making it easy to carry and store. Key features include one-hand operation, increased slit angle with a maximum illumination angle of 60° to help practitioners get a better slit view of the cornea, strong LED illumination, long-term operation with AA batteries, and iPhone adaptability. Go to CoburnTechnologies.com.

TRANSITIONS RELEASES SNAPCHAT VIRTUAL TRY-ON

Transitions Optical has partnered with Snapchat to create a virtual try-on experience. Using the filter, patients and eyecare professionals can try on different frame styles with Transitions Light Intelligent Lenses and experience them in a variety of indoor and outdoor situations. Users can find the Transitions Snapchat Lens by downloading Snapchat and scanning the custom Transitions Snapcode. The lens will load automatically and switch into “selfie” mode. Users just tap on the screen to try custom Transitions Snapchat Lenses in different environments. More information and in-office resources are available for eyecare professionals.

Go to TransitionsPRO.com/Snapchat

NEW VISOPOCKET FOLDING MAGNIFIER FROM ESCHENBACH

The VisoPOCKET folding magnifier features an ultra-thin lens, 2.5x (6D) magnification and a built-in leather case. It has a large 2.9 in. x 1.9 in. diffractive aspheric lens for a wide field of view. A cut-out tab on the corner of the case allows the lens to be pulled out quickly and folded back in when not needed. The VisoPOCKET’s compact design and light weight make it easy to carry in a pocket or purse for quick viewing tasks such as reading menus, maps, bills, prescriptions and more. Available in black, brown, and bordeaux, the VisoPOCKET comes with a countertop display for showcasing in an office.

Go to Eschenbach.com 16 F e br ua r y 2 0 1 9 | O p to m e tri c O f f i c e .c o m

Your Donations at

Photo Credit Brien Holden Vision Institute

Work

Your donations will help support more programs like the first ever School of Optometry in Haiti. After almost 5 years in planning, the school has welcomed 17 new students to the Bachelor of Vision Science program.

Pierre Christopher (pictured) was delighted to commence his 5-year degree in November 2017.

The creation of locally trained optometrists will be a huge benefit for the 70% of the population who currently have little or no access to eye care services. Within 10 years, there will be at least 80 new locally educated eye care professionals who will be providing eye care to more than 360,000 Haitians per year.

A regular donation to Optometry Giving Sight will help transform even more lives.

To learn more or to donate today please visit: givingsight.org or call 1-888- 647-4483

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