Optometric Office November 2017 by First Vision Media Group

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OPTOMETRIC OFFICE PRODUCTS AND TECHNOLOGY FOR YOUR PRACTICE

HOW TO MANAGE THE IRRITATION OF BLEPHARITIS

BETTER DIAGNOSTICS AND MORE FEATURES WITH SLIT LAMPS

NOVEMBER 2017

CONTACT LENS SOLUTIONS AT-A-GLANCE

MULTIFOCAL CONTACTS FOR PATIENTS IN THEIR 40S AND BEYOND

SUPPLEMENT TO VCPN NOVEMBER/DECEMBER 2017

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TABLE OF CONTENTS 10

12 | One-to-One: Howard Purcell, Essilor of America 18 | The Optometric Technician 20 | Contact Lens Solutions At-A-Glance

22 | New Product Gallery 24 | Docs Speak Out

FEATURES 14 | Shine a New Light on Slit Lamps 16 | Middle Age Need Not End Contact Lens Wear

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OPTOMETRIC OFFICE EDITORIAL STAFF VP, Editorial John Sailer | JS@VisionCareProducts.com Professional Editor Richard Clompus, OD | RC@OptometricOffice.com Editor-in-Chief Jeffrey Eisenberg | JE@VisionCareProducts.com Assistant Editor Cara Aidone Huzinec | CH@VisionCareProducts.com Vice President, Design Jane Kaplan | JK@VisionCareProducts.com Assistant Art Director Bruce Kenselaar | BK@VisionCareProducts.com Production and Web Manager Anthony Floreno | AF@VisionCareProducts.com Contributing Writers Roberta Beers, CPOT • Jackie Garlich, OD, FAAO • Jenny Kiernsan, OD Sue E. Lowe OD, FCOVD, FAAO • Jennifer Stewart, OD

BUSINESS STAFF Executive Vice President/Publisher Shawn Mery | SM@VisionCareProducts.com President/Associate Publisher Frank Giammanco | FG@VisionCareProducts.com Director of Sales Janet Cunningham | JC@VisionCareProducts.com Vice President, Marketing Debby Corriveau | DC@VisionCareProducts.com Vice President, Operations Sharon O’Hanlon | SO@VisionCareProducts.com

EDITORIAL ADVISORY BOARD

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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.

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CMY

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All-new!

VIEWS

Richard Clompus THE REAL VALUE OF CONTINUING EDUCATION

When I returned from the 96th annual meeting of the American Academy of Optometry in Chicago, I felt completely recharged. The continuing education covered the broad scope of optometry, ranging from behavioral science to primary care to surgery. This was the Academy’s largest meeting ever, with 7,692 registrants. I’d like to share a few of my highlights: Better pharmaceuticals and diagnostic instruments have created the opportunity for improved glaucoma care. Murray Fingeret, OD, FAAO, shared his wisdom about diagnostic technologies that have greater benefits at different stages of the disease.

Let the collective wisdom of our fellow colleagues invigorate and stretch your thinking.

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Michael Cymbor, OD, FAAO, delivered an inspiring lecture about the 10 things he learned from setting up a glaucoma referral center in State College, PA. Never underestimate the work and diligence required to pioneer something new. The practice model works, and I suspect it will be replicated elsewhere. Kelly Malloy, OD, FAAO, and Lorraine Lombardi, PhD, delivered an outstanding lecture on neuroanatomy. Lombardi has taught this subject for nearly 50 years at Salus University Pennsylvania College of Optometry. She made this mind-numbing, difficult content clear enough even for me to understand when I was a student. Optical coherence tomography (OCT) seemed to be everywhere and in almost every lecture. This technology made the “invisible visible.” OCT angiography will do that all over again and will become especially useful for managing patients with diabetes. The list of highlights could go on, but here’s my takeaway: It’s really beneficial for professional development to immerse ourselves in the highest quality CE programs available. Let the collective wisdom of our fellow colleagues invigorate and stretch your thinking. I hope to see you at next year’s meeting in San Antonio, Nov. 7-10, 2018. Richard Clompus, OD, FAAO | Professional Editor | RC@OptometricOffice.com

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VIEWS

Jeffrey Eisenberg

FOR ODS, GIFT GIVING IS YEAR-ROUND

Her sight depends on your confidence. Ocular Response Analyzer® G3 Corneal Hysteresis, a more objective predictor of glaucoma progression. CPT code 92145. Watch the videos at reichert.com/glaucomaconfidence

I’m amazed how each year, even before the children go trickor-treating, stores begin prominently displaying Christmas- and Hannukah-themed merchandise and mentioning upcoming Black Friday deals. Next up is the oncoming blitz of reminders about how many shopping days are left. Without getting too sappy, this seems like a good time to remember that you and your employees already give gifts to your patients and colleagues throughout the year. Here are some items that may appear on your gift list: • Relief of eyestrain and associated symptoms for individuals who work at computers for long hours or spend hours each day looking at their smartphones and tablets. • Better school performance for the child whose binocular vision disorder was mistaken for learning and/or behavioral problems. • Early detection in the patient who didn’t know he had diabetes until you performed a dilated retinal exam. • Replacement glasses or contact lenses for those displaced by this year’s deadly hurricanes and wildfires. • Donations to Optometry Cares—The AOA Foundation and other relief funds to help your colleagues who were affected by these disasters. (Kudos to the ophthalmic industry as well for their financial and material contributions to doctors and patients.) • Advocacy to ensure patients’ access to eyecare and to protect them from illegal and deceptive practices of some online contact lens sellers. The list goes on. And, don’t forget the other gift you can give your patients: education about the importance of eyecare as part of the patient’s overall health, as part of their children’s education, and as a way to prevent blindness from vision-threatening conditions. Whichever holiday you celebrate at this time of the year (or even if you celebrate no holiday), we at First Vision Media Group wish you, your employees and your families peace and happiness in 2018. Jeffrey Eisenberg | Editor-In-Chief | JE@VisionCareProducts.com

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PRODUCT DETAILER

Predicting Glaucoma Progression With Greater Objectivity CORNEAL HYSTERESIS AND ITS ROLE IN GLAUCOMA RISK ASSESSMENT Glaucoma is the second leading cause of irreversible blindness in the world. Although there is no cure for glaucoma, you can slow its progress through treatment. However, predicting the progression of glaucoma can be challenging because there are many risk factors, as identified by the Ocular Hypertension Treatment Study (OHTS). Among them: age, race, cup-to-disc ratio, visual field pattern standard deviation, intraocular pressure (IOP), central corneal thickness (CCT) and family history. 1

“By collecting measurements of corneal hysteresis, clinicians will be able to determine which patients are at higher risk for glaucoma progression.” –Felipe A. Medeiros, MD, PhD San Diego, CA WHAT IS CORNEAL HYSTERESIS? More recently, corneal hysteresis has become of great interest in glaucoma risk assessment. Corneal hysteresis is the cornea’s ability to absorb and dissipate energy. The Ocular Response Analyzer G3 from Reichert, measures corneal hysteresis by calculating the difference between the inward and outward pressure values obtained during the patented dynamic bidirectional applanation process. It is representative of biomechanical properties of the cornea, differing from

thickness or topography, which are geometrical attributes. Research has found that eyes with lower corneal hysteresis measurements have faster rates of visual field loss than those with higher measurements—even with low IOP. 2, 3

PREDICTING GLAUCOMA RISK Glaucoma is a progressive disease, and the rate of progression varies. For example, two glaucoma patients might have very similar risk factors, such as IOP, CCT, and age. The disease may progress rapidly in one patient and slowly in the other. This is a major concern for patients and eyecare practitioners alike. The ability to predict future glaucoma progression is essential for diagnosing the disease and establishing an appropriate treatment strategy.

WHAT IS IOPcc? Beyond corneal hysteresis, the Ocular Response Analyzer G3 simultaneously measures IOP. In fact, the instrument’s patented corneal-compensated intraocular pressure (IOPcc) has been shown to be a better indicator of true IOP because it is less influenced by corneal properties. 4

UTILIZING ORA TECHNOLOGY Using the Ocular Response Analyzer G3

in your practice is easy. Its design has no chin rest, so you can quickly position the patient. Plus, Reichert’s patented air pulse ensures maximum patient comfort. A single touch of a button initiates a fully automated alignment and measurement. The screen simultaneously displays IOPcc, corneal hysteresis, Goldmanncorrelated IOP, and waveform score. The waveform score indicates the reliability of each measurement, with a numerical scale of 0-10. If you already have a noncontact tonometer, you can simply replace that device. If you are considering adding the Ocular Response Analyzer G3 to your practice, you can simply put it next to your autorefractor, as it is similar in size and speed and is typically performed before the patient enters the exam lane.

CORNEAL HYSTERESIS AND CPT CPT code 92145 became available in 2015 for the corneal hysteresis measurement provided by the Ocular Response Analyzer. Medicare reimburses at approximately $15.00 bilateral in patients who qualify for the test. Reimbursement may not be available in all states, as Medicare payers operate independent from one another. Private payers set their own rates and payment policies, which may differ significantly from the Medicare published fee schedule. O|O

Learn more about Corneal Hysteresis and Ocular Response Analyzer G3 at www.Reichert.com/ORA. 1. Gordon MO, Beiser JA, Brandt JD, et al. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 2002 Jun;120(6):714-20; discussion 829-30. 2. Medeiros FA, Meira-Freitas D, Lisboa R, et al. Corneal hysteresis as a risk factor for glaucoma progression: a prospective longitudinal study. Ophthalmology. 2013 Aug;120(8):1533-40. 3. De Moraes CV, Hill V, Tello C, et al. Lower corneal hysteresis is associated with more rapid glaucomatous visual field progression. J Glaucoma. 2012 Apr-May;21(4):209-13. 4. Medeiros FA, Weinreb RN. Evaluation of the influence of corneal biomechanical properties on intraocular pressure measurements using the ocular response analyzer. J Glaucoma. 2006 Oct;15(5):364-70.

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Give the gift of vision

GLANCE GIVING YOU A QUICK RUNDOWN ON THE TOP NEWS AND RESEARCH FROM THE PAST MONTH. CONSIDER THIS THE MOST PRODUCTIVE FIVE MINUTES OF YOUR DAY. READY?

this Holiday Season.

Photo Courtesy: Ver Bien - See Better to Learn Better, Location- Mexico.

Jackie Garlich

Let’s review the month in numbers.

One million … The number of SMILE procedures completed worldwide. SMILE, which stands for small incision lenticule extraction, is a minimally invasive alternative to LASIK or PRK for myopes (sorry, hyperopes). It was FDA approved in the U.S. in Sept. 2016.

“I didn’t know what was wrong with me.”– Alyssa

Alyssa struggled in school and at home due to poor vision, until Optometry Giving Sight helped her get a free eye exam and glasses. Today, “Nothing can stop me now!”

Your gift of $100 can help provide this life-changing transformation to 20 more children in need. Please help.

Five hundred … The number of children included in a study about hyperopia and attention. The study, published in Optometry and Vision Science, found that the children with moderate hyperopia were significantly more likely to have poorer scores on attentionrelated tests. Eighty-seven … The number of blood plasma metabolites that were significantly different in patients with AMD as compared to patients without AMD. The new research, from Mass. Eye and Ear, found that of those 87 metabolites, almost half were significantly different across the different stages of AMD. So, theoretically, a blood sample could even tell what stage of AMD a patient is in. More to come. Thirty six … The number of patients included in a recent study comparing the level of ocular inflammation in daily disposable vs. reusable soft contacts. The study, published in Optometry and Vision Science, found more inflammation and greater conjunctival cell metaplasia in reusable contact lens wearers. Ten or less … The typical number of opioid prescriptions written by most OMDs annually, according to a new study in JAMA Ophthalmology. Two … The number of Saks Fifth Avenues that have optical stores. One is even staffed with an OD.

Transforming lives through the gift of vision

proud supporters of

Please donate today at givingsight.org or call 1-888-OGS-GIVE

One … The number of insurance plans Warby Parker will accept. Starting in 2018, Warby Parker will be “in-network” for UnitedHealthcare vision plans. That was easy! Consider yourself informed. See you next year! Jackie Garlich, OD, FAAO | 20/20 Glance | 2020Glance.com

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THINK ABOUT YOUR EYES

Patient Communications: Finding the Balance If we were to add up the amount of correspondence we receive from businesses, both via snail mail and email, I imagine more than half would be unwanted and deleted or tossed upon receipt. As advocates for our patients’ vision (and thus overall) health, we have the challenge of reminding our patients of the importance of caring for their vision, but reminding them in a way that is engaging and informative, not annoying and repetitive.

THROUGHOUT THE YEAR Patient communications should occur throughout the year, not just as a reminder for the annual eye exam. Reminding patients that their vision is part of their everyday life is key. My office uses an automated email system to streamline and manage our patient outreach. When using these systems, it’s important to ensure the communication itself is relevant to the patient’s life. We send birthday emails and New Year’s greetings.

Patient communications should occur throughout the year, not just as a reminder for the annual eye exam.

Sue E. L owe

Sue E. Lowe OD, FCOVD, FAAO, is a member and past president of the Wyoming Optometric Association and among the 18,000 practices 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 (publisher of Optometric Office) supports Think About Your Eyes as a media partner and

We also reach out when a current event is relevant to vision health. For example, the path of totality for the solar eclipse in August covered much of the area where my patients live, so we sent out an email with “eclipse tips” to further remind people of their vision health.

UNIQUE OPPORTUNITY Optometrists have a unique opportunity at the end of the year to remind patients of the importance of an annual eye exam. Many patients have flexible spending funds, which expire at the end of the calendar year. An annual eye exam at which they can purchase new glasses or sunglasses or replenish their supply of contact lenses is a great way to use up lingering funds. A reminder email in November or December can help bring them in.

provides space for this monthly guest editorial.

Of course, nothing replaces the conversations we can have with patients while they’re in our offices. Building a solid relationship is important to learn more about their health habits and the impact those habits have on their vision health. Think About Your Eyes ensures that patients are made aware of the importance of an annual eye exam through advertising, social media engagement and the news outlets our patients and potential patients interact with. Overall, it supports our profession. Consider this your end-of-year reminder to support Think About Your Eyes in 2018. O|O

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PRODUCT | BUZZ LAUNCHES, PROMOTIONS, MERCHANDISING, EVENTS AND OTHER THINGS TO KEEP YOU IN THE KNOW.

MATCHING BUYERS AND SELLERS The Practice Management Center (PMC), Vision One Credit Union and VSP Global are teaming up through OptometryMatch.com to connect doctors looking to buy or sell an optometry practice. After doctors register on the secure website, PMC matches them with a buyer, seller or practice that meets the specified criteria and provides support and consultation throughout the practice transition process. Vision One Credit Union will provide capital and financial expertise for pre-qualified optometrists. To register, go to OptometryMatch.com.

RESTASIS RULING The U.S. District Court for the Eastern District of Texas ruled that four asserted patents covering Allergan’s RESTASIS are invalid, paving the way for generic alternatives. Allergan transferred the patents to the Saint Regis Mohawk Tribe and was then granted exclusive licenses. Critics of the move, including four U.S. Senators, say that Allergan transferred the patents, hoping to use the tribe’s sovereign immunity to circumvent the inter partes review and keep its monopoly on RESTASIS. Allergan, whose patent protection for RESTASIS ended in 2014, plans to appeal the court’s ruling. “We have strong arguments for an appeal, and we filed a notice

of appeal with the court,” says Brent Saunders, chairman and CEO of Allergan. “If a generic product enters the market, Allergan is ready to mitigate that impact by growing our base business, reducing costs and deploying our balance sheet. We will also deliver on our capital commitments, including increasing our dividend and paying down debt.” Allergan offers an FAQ document about the court decision on its website. Go to Allergan.com/Investors/Investors-FAQs.

FDA APPLICATIONS FROM B+L Bausch + Lomb, a subsidiary of Valeant Pharmaceuticals, Inc., filed a premarket approval application with the U.S. Food and Drug Administration to approve Bausch + Lomb ULTRA contact lenses for up to seven days of continuous wear. ULTRA contact lenses are made of samfilcon A, have a Dk/t value of 163 and feature MoistureSeal Technology, which helps to maintain 95% of lens moisture for a full 16 hours. In other news, the FDA approved the new drug application submitted by B+L and Nicox S.A. for VYZULTA (latanoprostene bunod 0.024%), a prostaglandin analog for the reduction of intraocular pressure in patients with open-angle glaucoma or ocular hypertension. Go to Valeant.com, Bausch.com or Nicox.com

AOA’S GUEST SPEAKER Aron Ralston captured international headlines in 2003 after a canyoneering accident in Utah left him trapped between two boulders in a remote location for more than five days, ultimately forcing him to sever his own arm with a pocketknife to free himself. Ralston will share his story at the American Optometric Association’s 2018 Optometry’s Meeting, June 20-24, in Denver, during the opening general session event sponsored by Johnson & Johnson Vision. Also, Saturday’s Celebration of Optometry, sponsored by Hoya Vision Care, will feature comedian and TV star Howie Mandel.” Registration and housing are now open. Go to OptometrysMeeting.org.

News

Paragon Vision Sciences has extended its business partnership with Essilor China, the exclusive distributor of Paragon’s CRT contact lenses in China, by another five years. Kala Pharmaceuticals, Inc. submitted an NDA for INVELTYS (KPI-121 1%), a topical twice-a-day product candidate for the treatment of inflammation and pain in patients who have undergone ocular surgery. CovalentCareers, Inc., a Californiabased career development and digital media company, said it will donate 10% of premium eyecare revenue to the Student Optometric Leadership Network, a private-practice optometry club run entirely by optometry students and recent graduates.

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Ask Yourself This Question...

“Why Prescribe?”

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at risk for eye disease. Over time, we have introduced several products that address this need, including Crizal UV and Crizal Prevencia. Today, our newest Eyezen+ 0 design, along with Eyezen+ lens designs 1, 2 and 3, provide sharp, comfortable vision; reduced exposure to harmful blue light; and a complete range of accommodative relief options for every age group.

RC: Essilor acquired Vision Source, North America’s largest independent optometric service alliance, in 2015. What resources has Essilor brought to the alliance to help its members be more successful?

ONE-TO-ONE

Howard Purcell

Howard Purcell, OD, FAAO, joined Essilor of America nearly 10 years ago and was charged with leading the brand sales organization and creating a best-in-class professional relations team. As senior vice president, Customer Development Group, he is now responsible for leading corporate communications efforts, eyecare practitioner and sales training, and industry and professional relations organizations.

Richard Clompus, OD, FAAO: Digital technology continues to change many aspects of our lives, including hours now spent viewing small screens. New refractive technologies combined with custom lens designs permit ECPs to provide a higher level of care for patients. What are the latest optical technologies from Essilor? Howard Purcell, OD, FAAO: In September, we launched Varilux X Series lenses. These lenses feature Xtend Technology, which allows the wearer to see multiple distances through a single point in the lens. In a world in which presbyopes must shift their focus between near and intermediate objects more than ever, those wearers will no longer have to search for “just the right spot” to see at any distance. We also know that patients are being exposed more than ever to harmful blue light from the sun and digital devices. And, since we are living longer, the cumulative effect of harmful blue light puts us more

HP: Our partnership with Vision Source is about creating value for its members. One way we do so is by offering products and programs developed exclusively for them, as well as by providing access to Essilor’s leading product innovations. We have also been able to deliver a series of business tools, services and products that further enhance their patients’ experiences. Examples of this include The Optical Dream and Frame Dream programs. These programs are designed to provide the practitioner with a more efficient process while focusing on key success factors that optimize sales and service. We also heard from Vision Source members that they wanted a world-class marketing program that would define them and reinforce why a patient should choose them for their family’s eyecare. The result is the “My Vision Source Family” multimedia campaign, which includes a television commercial, radio spots, digital advertising and point-of-sale materials for members. RC: Disruptive technology of online refraction and the sale of prescription eyewear is a concern for many ECPs. What is your advice to colleagues providing care to patients in their offices? HP: There really is no question that technology is impacting the optical industry. Patients are more tech savvy and sophisticated, and their demands for an omnichannel offer will require practices to evolve and enhance patient engagement. Technological advances clearly will force change in other areas as well. For example, virtual reality (VR), artificial intelligence (AI) and 3D printing will impact our profession in the near term, each in its own way. What if we could use VR in the exam room to evaluate visual performance in a much more dynamic way? What if we could access data and research results that were published in the last 10 minutes anywhere in the world (AI)? Learning about these technologies and considering the advantages and benefits they can bring to ECPs’ practices and patients will be critical for the short- and longterm success of the industry. O|O

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INSTRUMENTATION

Shine a New Light on Slit Lamps By Jennifer Stewart, OD Today’s slit lamps offer advanced optics, digital images and meibography. Updating optometric exam room equipment usually is not high on an eyecare practitioner’s list, unless it is needed to replace broken equipment or for an additional lane. However, there are many new slit lamps available that provide advanced optics, different filters, enhanced lighting and portable options. Instead of waiting until a replacement is needed, replacing an old slit lamp with a newer option can help with better diagnostics, comfort and optics.

HAAG-STREIT Haag-Streit Diagnostics has offered slit lamps, starting with the BM 900 LED convergent stereoscopic microscope, for nearly 60 years. Today, Haag-Streit offers a wide range of slit lamps, all with LED illumination systems. For example, the BQ 900 LED features a magnification range of 6.3x to 40x, including 10x, 16x and 25x, with high light transmission, high optical quality, and a large field of view. You can add such accessories as the inclined eyepiece adapter, stereo variator and Imaging Module IM900, which enables you to do digital imaging, even under low light conditions. Additional options include: • The BP 900 LED, which features 10x, 16x and 25x magnifications; a bright-

powered LED slit and imaging capabilities. • The BI 900, which has a Kepler microscope, largerdiameter ocular view and The Ultra M5, part of Marco Ophthalmics’ Ultra M series, features single-element LED illumination, integrated background illuminator, default magnifications of 10x and multiple color correction filters. and 16x. Using optional eyepieces, you can extend the magnifications Three magnifications (10x, 16x and 25x) are to 25x and 40x. There is also a yellow baravailable as well as a Galilean-type microrier filter for fluorescein applications. An scope. The joystick is omni-directional, and additional optional imaging set gives exthe SL-D301 has a tower illumination syspanded capabilities. tem with a halogen bulb that houses the slit • The BD 900, which features 10x and mechanism and built-in cobalt blue, red16x magnification, yellow and blue filter free, 13% neutral density and UV cut filters. options, as well as UV and infrared filters. The SL-D301 is digital-ready, meaning that You can swing the AT 900 C/M applanayou can attach the DC-4 Digital Camera for tion tonometer into place as needed, while color images and video clips. the halogen bulb gives up to 300,000 lux. The SL-D301 is the latest addition to • The BA 904, a dual function slit lamp Topcon’s D series of slit lamps. The series that you can use as a portable device or in also features: office. The 10x magnification is standard, • The SL-D2 Digital-Ready Slit Lamp, and there is an option for an additional which can become a high-resolution imag16x magnification. There is a dioptric ing center when you add the DC-4 digital range of +8.00D to -8.00D, a PD range of camera. Three magnification ratios of 10x, 53mm to 95mm and a wide field of view. 16x and 25x are available, and it is avail-

TOPCON Topcon Medical Systems boasts a wide range of ergonomically designed slit lamps and accessories. The SL-D301, released earlier this year, is one option for a comprehensive eye exam.

able as table mount or unit configuration. • The SL-D4 Digital-Ready Slit Lamp, which features traditional magnification ratios of 10x, 16x and 25x, as well as ratios of 6x and 40x for observing the corneal endothelium. This feature gives it a wide range of uses in many settings.

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• The SL-D7 Digital-Ready Slit Lamp, which has an optional Digital Photo Attachment for color or monochrome imaging with video clip capability. When used with the BG-4M background illuminator, you can perform meibography. The magnification ratios available are 6x, 10x, 16x, 25x and 40x. • The SL-D701 LED Slit Lamp with optional digital camera and meibography. LED illumination allows you to observe minute details, such as anterior chamber flare. Five magnifications are available: 6x, 10x, 16x, 25x and 40x options. Also, an optional BG-5 background illuminator allows you to observe the meibomian glands. • The SL-D8Z Digital-Ready Zoom Slit Lamp, which features a 5:1 zoom ratio, a 6.4x to 32.1x magnification ratio, and the option to add the DC-4 digital photo attachment for images and video clips, and the BG-4M background illuminator to perform meibography. Another slit lamp from Topcon, the SL-2G slit lamp, includes LED illumination, an ergonomic design, slit angle rotation from 0° to 180°, and an omnidirectional joystick. A variety of filters, including red-free and blue, are available, as are three magnifications of 10x, 16x and 25x. The opticals are Galilean converging, and a beam splitter can be added, as well as an R-900 or 870 applanation tonometer.

ZEISS ZEISS, a company known for developing the first slit lamp with the Swedish doctor and Nobel laureate Allvar Gullstrand, has a range of slit lamps available for all practice settings. The ZEISS SL 115 is a classic and affordable slit lamp. The instrument features a three-step magnification with ratios of

8x, 12x and 20x; plus 10x super high-eyepoint eyepieces to compensate for +8.00D to -8.00D of ametropia. A variety of filters, including blue, The SL-D701, when used in combination with the optional DC-4 digital (green) red-free and heat attachment and BG-5 background illuminator, allows observation and absorbing, are available. photography of the meibomian glands. The SL 120 offers precision and efficiency for wide-ranging REICHERT applications. It features a five step magniReichert Technologies’ offerings include fication with ratios of 5x to 40x available the Xcel 455 Slit Lamp, a traditional style (depending on the 10x or 12.4x eyepieces). slit lamp with tower illumination and The SL 220 features the popular tower 5 step magnification. The Xcel 455 Slit concept with LED illumination, 22mm Lamp optics incorporate lenses with high stereo base, large field of view, rotatable efficiency, multi-layer optical coatings 14mm slit, and a choice of 3x or 5x magnithat provide bright, even illumination and fication steps. Its optical and mechanical clear image resolution. Xcel 455 uses eyequalities, paired with detail and contrastpieces that are 12.5x magnification. Filters rich images, allow for precise exams. included are red-free, heat absorbing, coThe SL 130 offers the highest applicabalt blue and neutral density. tion versatility. Combined with the VISULINK 532/U and VISULAS 532s from Whether building a new office, adding ZEISS, it performs laser therapy. A wide lanes or upgrading your equipment, there range of accessories and configurations is are many different slit lamps available to available for enhanced performance. fit all settings, needs and budgets. O|O

MARCO OPHTHALMIC Earlier this year, Marco released its Ultra M Series, featuring a single-element LED illumination, a patented integrated background illuminator, and multiple color correction filters. The series also features extended slit aperture and wider field of view, fully incorporated transformer and cabling, and intelligent operator and patient interfaces. Magnification powers are 10x, 16x and 25x for the Ultra M2, and 10x and 16x on the UItraM3, which can go up to 25x with 16x eyepieces. The Ultra M4 and Ultra M5 have magnifications of 6.3x, 10x, 16x, 25x and 40x.

Jennifer L. Stewart, OD, is a partner at Norwalk Eye Care, in Norwalk, CT, and co-founder and chief optometric officer at Performance 20/20, in Stamford, CT. WHERE TO FIND IT: Haag.Streit USA 800.787.5426 | Haag-Streit.com/Haag-Streit-USA Marco 800.874.5274 | Marco.com Reichert Technologies 716.686.4500 | Reichert.com Topcon Medical Systems, Inc. 800.223.1130 | TopconMedical.com Carl Zeiss Meditec, Inc. 800.342.9821 | Meditec.Zeiss.com/USA

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CONTACT LENSES

Middle Age Need Not End Contact Lens Wear By Jenny Kiernan, OD By setting reasonable expectations and meeting the patient’s visual needs, you can keep patients in lenses into their 40s and beyond. When a contact lens patient age 40 or older presents for an annual exam complaining of problems with near vision, dryness or discomfort, do you recommend glasses with progressive addition lenses instead? Do you tell the patient to buy over-the-counter readers? If so, you are missing an opportunity to improve the patient’s visual comfort and satisfaction with contact lenses. Ideally, a discussion about presbyopia should begin before the patient notices difficulties at near. As he or she approaches age 40, you should begin to mention that there are contact lens options to help near vision when it starts to become more difficult. This plants the idea that it is possible to continue to wear contact lenses into middle age and beyond.

MULTIFOCAL VS. MONOVISION

Once you discuss the patient’s visual needs and set expectations, do you do a trial fit of monovision or multifocal contact lenses? One advantage of multifocal lenses: They keep patients in a more natural binocular state. They also allow for clear vision at a gradual range of distances. When you explain multifocals and monovision, most patients will opt to try multifocals first. Not every patient will be a great candidate for multifocals, however. Patients who require perfection at distance and near are obviously a challenge. Monovision often works better with the exacting nature of these patients’ visual needs. A significant amount of astigmatism also is a problem, as soft multifocal toric lenses are not always successful. Another challenging group to fit with multifocals are emmetropic patients.

Now that the patient has begun to experience problems with near vision, the strategy you try first will depend on several factors. Distance prescription, occupation and personality all play a role. For example, does the patient need perfect distance vision, such as a truck driver might? Is there a greater requirement for comfortable near vision for working at a computer all day? Is the patient easygoing or demanding?

While multifocals are available in emmetropic prescriptions, these patients often will not tolerate the blur at distance required to make them work.

ADDRESS DRY EYES While providing patients with acceptably clear vision may seem like the biggest challenge in fitting presbyopes, studies show that more than half of them discontinue contact lens wear due to dryness and discomfort. Treatment of underlying ocular disease is essential as you begin this process. By treating dry eye aggressively, patients will be comfortable in their lenses for more hours of the day. Fully evaluate the root cause of patients’ dry eye, and treat them with lid hygiene, warm compresses, fish oil supplements and prescription drops, as appropriate.

CooperVision’s clariti 1 day multifocal features WetLoc technology that binds water molecules to the lens surface.

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Also, if you proactively recommend appropriate artificial tears to use with their contact lenses, you can increase patients’ comfort during the trial period. Aging eyes are especially prone to dryness, so fitting patients in comfortable, breathable lenses is important. With advances in silicone hydrogel materials, there’s no reason not to put the patient in a lens that delivers plenty of oxygen to the cornea. A range of silicone hydrogel multifocal contacts are available, so you have healthy lens options to offer all your presbyopic patients.

THE DAILY DISPOSABLE OPTION Some patients may not get enough near correction in any lens to wear contact lenses for a long workday at a computer. While many presbyopic patients are willing to wear glasses with progressive lenses for a nine-to-five job, they long for the ease of contacts in their off hours. Daily disposables are a perfect part-time solution. The ease of care makes them ideal for a hiking trip or an evening out. If you ask former contact lens wearers whether they ever would like to wear contacts again, the answer will often be yes. Part-time wearers are often easier to fit because they have lowered near visual demands. They don’t need perfect near vision, and they’re often happy with just enough add power to glance at their phone or a map. By providing these patients with a few boxes of daily disposables along with their glasses, you’ll increase patient satisfaction and grow your practice.

MISSED OPPORTUNITY Presbyopic contact lens dropouts represent a missed opportunity to provide

DAILIES AquaComfort Plus Multifocal One-Day Contact Lenses feature Precision Profile for clear vision and blink-activated moisture.

patient satisfaction and grow your practice. With new contact lens technology, there are a wide variety of options that can keep patients out of full-time spectacle wear. The key to a straightforward fit with less chair time is managing the patient’s expectations. Fully discuss the tradeoff with each method before the trial lens fit,

and contact lens patients will enjoy wearing lenses for many years. O|O Jenny Kiernan, OD, a graduate of the University of Missouri-St. Louis College of Optometry, specializes in fitting contact lenses at Eye Consultants of Colorado in Conifer, CO.

DAILY DISPOSABLE MULTIFOCAL CONTACT LENSES Alcon | 800.451.3937 | Alcon.com DAILIES AquaComfort Plus Multifocal One-Day Contact Lenses • made of nelfilcon A, 69% water content, Dk of 26 x 10-11 • Precision Profile for clear vision and blink-activated moisture • available in powers of +6.00D to -10.00D with low (to +1.25D), medium (+1.50D to +2.00D) and high (+2.25D to +2.50D) add powers DAILIES TOTAL 1 Multifocal Contact Lenses • delefilcon A, 33% water content, Dk of 140 x 10-11 • water gradient technology for reduced end-of-day dryness • available in powers of +6.00D to -10.00D with low (to +1.25D), medium (+1.50D to +2.00D) and high (+2.25D to +2.50D) add powers

Bausch + Lomb | 800.828.9030 | Bausch.com Biotrue ONEday for Presbyopia • nesofilcon A, 78% water content, 42 Dk/t at -3.00D • Poloxamer 407, a surface active macromer that drives to the surface of the lens to form a dehydration barrier • available in powers of +6.00D to -9.00D (0.25D steps), including plano, and with low (+0.75D to +1.50D) and high (+1.75D to +2.50D) add powers

CooperVision | 800.341.2020 | CooperVision.com clariti 1 day multifocal • somofilcon A, 56%, Dk of 60 x 10-11 • WetLoc technology, which naturally attracts and binds water molecules to the lens surface • available in powers of +5.00D to -6.00D (0.25D) steps and low (up to +2.25D) and high (+2.50D to +3.00D) add powers Proclear 1 day multifocal • omafilcon A, 60% water content, Dk of 21 x 10-11 • PC Technology, which causes water molecules to become part of the lens, creating a natural resistance to dryness • available from +6.00D to -10.00D (0.25D steps, 0.50D steps after -6.00D), and can accommodate add powers to +2.50D

Johnson & Johnson Vision | 800.843.2020 | ACUVUEProfessional.com 1 DAY ACUVUE MOIST Brand MULTIFOCAL • etafilcon A, 58% water content, Dk of 28 • LACREON technology, which permanently embeds a wetting agent in the lens material for improved comfort • available in powers of +6.00D to -9.00D (0.25D steps) and low (+0.75D to +1.25D), medium (+1.50D to +1.75D) and high (+2.00D to +2.50D) add powers

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THE | OPTOMETRIC TECHNICIAN BY ROBERTA BEERS, CPOT LID HYGIENE AND MEDICATIONS CAN HELP MANAGE THE IRRITATING SIGNS AND SYMPTOMS OF BLEPHARITIS. A patient presents with and complains of red, irritated, and itchy eyes. You also notice dandruff-like scales on the eyelashes. Most likely, the patient has blepharitis, which is inflammation and swelling at the edge of the eyelids and eyelashes. Blepharitis commonly occurs when the tiny oil glands of the inner eyelid become inflamed. Symptoms are usually worse in the morning, when patients complain of “crusting” on awakening. Blepharitis can affect people of all ages. It is not contagious and does not cause any permanent damage to eyesight.

SEVERAL TYPES Everyone has some bacteria on their skin. Some people, however, have more bacteria at the base of their eyelashes that looks like dandruff flakes, or they have problems with oil glands in their eyelids that can also lead to blepharitis. There are several types of blepharitis. The two most common are anterior and posterior blepharitis. Individuals who have anterior blepharitis may complain of burning, excessive tearing, red eyelids, puffy eyelids, red eyes, lash loss and foreign-body sensation. They may complain of light sensitivity and crusting of the lids, and they may have a history of chalazion or hordeolum. Posterior blepharitis, which affects the inner edge of the eyelid, can be caused by irregular oil production by the glands of the eyelids. This creates a good environment for bacterial growth that may also result in other skin conditions, such as acne rosacea and dandruff.

DIAGNOSIS Blepharitis is diagnosed when the patient

presents for a comprehensive eye examination. During the history, the patient may report a gritty, burning sensation in the eyes, excessive tearing, red and swollen eyelids, dry eyes or crusting eyelids. Some patients might Blepharitis causes inflammation at the edge of the eyelids only experience minor irand eyelashes. This patient also has a chalazion, which is ritation or itching, while caused by a blockage of an oil gland. others may experience • Antibiotic ointments. The doctor may more severe signs and symptoms, such prescribe erythromycin or bacitracin ointas blurry vision or missing or misdirected ment. Instruct the patient remove crusteyelashes. Blepharitis may cause inflaming and debris with a warm washcloth or mation to other eye tissue, particularly to lid scrub and then use a cotton swab or a the cornea. clean fingertip to apply the ointment. The optometrist will do an external ex• Antibiotic-steroid combinations. amination of the eye, including lid strucCombination agents, such as sulfacetature, skin texture and eyelash appearance. mide and prednisolone, may help deThe doctor also will evaluate the lid marcrease inflammation and quickly diminish gins and the quantity and quality of tears, symptoms of blepharitis for the shortchecking for any abnormalities. term. Long-term use is not recommended.

TREATMENT Although some cases of blepharitis may require a more complex treatment plan, the key to treating most types of blepharitis is keeping the lids clean and free of crusts. Treatment options include: • Warm compresses. Instruct the patient to wet a clean washcloth with warm water, wring it out and place it over closed eyes for five minutes to loosen the crusts. This should be followed by gentle scrubbing of the eyes with a mixture of water and baby shampoo. • Eyelid scrubs. A number of commercial products are available to help with lid hygiene. (To learn about more eyelid scrubs, see “Put It on a Lid,” June 2017.)

SELF-CARE Blepharitis seldom disappears completely, as there is no cure. Even with successful treatment a relapse may occur. Patient self-care plays a major role in the management of blepharitis. Individuals with blepharitis must understand the importance of keeping their eyelids, skin and hair clean. Making this a routine procedure will keep the blepharitis under control. It is always a good practice for the technician to reiterate the instructions the doctor gave the patient. O|O Roberta Beers, CPOT, is an optometric assistant in Erie, PA.

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The most comprehensive GP lens care system available.

Menicon LacriPure Rinsing and insertion saline solution.

Indicated for use with soft, hybrid and rigid gas permeable lenses, LacriPure is a sterile, non-preserved saline which provides an alternative to tap water rinsing. Packaged in a 5ml unit-dose vial, LacriPure has been cleared as a scleral lens insertion solution and provides the patient with exceptional sterility.

Menicon LacriPure joins Menicon Unique pHÂŽ multi-purpose solution and Menicon PROGENT protein remover to complete the industryâ&#x20AC;&#x2122;s most comprehensive GP lens care system.

800-636-4266 | meniconamerica.com | information@menicon.com

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AT-A- GLANCE

CONTACT LENS CLEANING SOLUTIONS SOLUTION

INDICATION

TYPE

CARE REGIMEN

BENEFITS

Johnson & Johnson Vision | 877.266.4543 | JNJVC.com Blink RevitaLens

Multi-Purpose Disinfecting solution

Soft (hydrophilic) contact lenses, including silicone hydrogel

Place three or more drops of solution on lens surface. Rub lens for two to four seconds. Turn the lens over and repeat. Rinse each side of the lens for five seconds with solution. Allow lenses to soak for a minimum of six hours for disinfection, cleaning, protein removal and conditioning.

• Disinfects like a peroxide with the simplicity and comfort of an advanced multi-purpose solution • Broad-spectrum disinfection against FDA/ISO standard-panel microorganisms, comparable to peroxide systems • Greater than 99.9% kill-rate against both forms of Acanthamoeba • Dual disinfection • Conditions lenses for increased wearing comfort • Provides 16+ hour end-of-day comfort

COMPLETE

Multi-Purpose Easy Rub solution

Soft (hydrophilic) contact lenses, including silicone hydrogel

Place three drops or more of solution on one side of the lens surface. Rub lenses gently from the center to the edges for at least 10 seconds. Turn lens over and repeat. Rinse each side of the lens for five seconds with fresh solution, place in lens case and fill with solution. Allow lenses to soak for a minimum of six hours for disinfection, cleaning and protein removal.

• Gentle on epithelial cells •9 9.99% effective against standard FDA panel microorganisms when used as directed •C ontains four beneficial electrolytes to promote a healthy lens-wearing experience

Alcon Laboratories | 800.451.3937 | Alcon.com CLEAR CARE PLUS with HydraGlyde Moisture Matrix

3% hydrogen peroxide solution

Silicone hydrogel, soft and RGP lenses

Lenses must be placed in a specially designed lens case with a built-in neutralizing disc. After placing lenses in lens cups, rinse with solution and store for at least six hours to allow neutralization of the peroxide.

•C onvenient and highly effective hydrogen peroxide system for biocompatible deep cleaning and disinfection •T riple action cleaning – deep cleans, loosens dirt and enhances protein removal • Preservative-free

OPTI-FREE PureMoist

Multi-Purpose solution

Silicone hydrogel and soft lenses

Wet lenses with solution and rub for 20 seconds. Rinse each side of the lens for 10 seconds with a steady stream of the solution, and store them in a lens case filled with the solution for at least six hours.

•C ontains HydraGlyde Moisture Matrix for comfort and to help keep moisture on the lenses •T he POLYQUAD and ALDOX dual-disinfectant system reduces harmful microorganisms •R educes lipid deposition and removes protein deposits for fresh, clean lenses

Bausch + Lomb | 800.828.9030 | Bausch.com/ECP Biotrue

Multi-Purpose solution

Silicone hydrogel and soft lenses

Place at least three drops of solution on each side of lens surface and gently rub for 20 seconds. Thoroughly rinse each side of the lens for five seconds, then place in case and fill with fresh Biotrue solution. Soak at least four hours.

•C ontains a lubricant found naturally in eyes to provide up to 20 hours of moisture •M atches the pH of healthy tears • Keeps certain beneficial tear proteins active

renu Advanced Formula

Multi-Purpose solution

Silicone hydrogel and soft contact lenses

Place three drops of solution on each side of the lens surface and gently rub for 20 seconds. Thoroughly rinse each side of the lens for five seconds, then place cleaned contact lens in the lens case and fill with solution. Soak at least four hours.

•F ormula combines three disinfectants and two surfactants to provide excellent cleaning and disinfection, as well as all-day comfort •C linically proven ingredient ensures excellent protein removal

FOR AN EXPANDED LIST OF LENS CLEANING SOLUTIONS, GO TO OPTOMETRICOFFICE.COM

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Advertorial

HIGH PATIENT AND ECP PREFERENCE FOR

AIR OPTIX PLUS HYDRAGLYDE CONTACT LENSES ®

Melissa Barnett, OD, FAAO, FSLS Sacramento, California

The daily lives of contact lens wearers are full of obstacles to comfortable lens wear, including dry or smoky air, digital device use and long days of lens wear. These obstacles have their impact: in a recent survey, 2/3 of contact lens wearers said they experience dryness/discomfort with their current lenses.1 At my practice, my goal is to provide contact lenses with improved technologies that promote patient comfort, healthy eyes and contact lens compliance. Studies show that monthly replacement lenses promote better replacement compliance than 2-week lenses. 2,3 Patients and ECPs agree that AIR OPTIX® plus HydraGlyde® monthly replacement contact lenses provide a positive wearing experience.1 I recently participated in a survey of contact lens satisfaction in habitual wearers of 2-week or monthly replacement contact lenses (N = 229). We surveyed our patients about their habitual brand, and then about AIR OPTIX® plus HydraGlyde ® contact lenses after a 1-month trial.1 Patients used CLEAR CARE® PLUS Cleaning and Disinfecting Solution or OPTI-FREE® PureMoist ® Multi-Purpose Disinfecting Solution for daily lens care. Both of these lens care products feature HydraGlyde® Moisture Matrix. At the end of the trial period, patients surveyed expressed strong satisfaction with AIR OPTIX® plus HydraGlyde® contact lenses: more than 9 out of 10 patients surveyed agreed these lenses felt comfortable upon insertion each day,1 and four times as many agreed (vs disagreed) that AIR OPTIX® plus HydraGlyde® lenses felt comfortable through the end of the day.1 Finally, four times more patients surveyed preferred AIR OPTIX® plus HydraGlyde® contact lenses (plus daily HydraGlyde ® lens care), over their previous lenses, after wearing them for 1 month.1 Among the eye care professionals who participated in the survey (N = 20), three out of four agreed** that AIR OPTIX® plus HydraGlyde ® contact lenses will be the preferred monthly replacement lens in their practices. The same ratio also agreed† they would proactively recommend their 2-week and monthly replacement wearers switch to AIR OPTIX® plus HydraGlyde® contact lenses.1 The outstanding experience reported by patients and eye care professionals is supported by a combination of two proprietary technologies. SmartShield ® Technology is the permanent surface treatment used in all AIR OPTIX ® brand lenses. SmartShield® Technology is an ultra-thin permanent protective shield that is bonded to the outer surface of the lens, minimizing

the amount of exposed silicone. 4 This proprietary surface treatment helps the lens resist lipid deposits,5-7 supports tear film stability,7,8 and helps maintain outstanding wettability. 9,10 HydraGlyde® Moisture Matrix is a proprietary wetting agent that creates an envelope of long-lasting lens surface moisture.10 Recent studies demonstrate the wettabilit y of AIR OPTIX® plus HydraGlyde® contact lenses. In one, Placido rings were projected onto surfaces of several lenses.11 A wet surface reflects a stable image of the rings, but as the surface dries, the reflections become distorted. Directly out of pack, AIR OPTIX® plus HydraGlyde ® contact lenses showed more stable reflections at 2 minutes than several competitors (P<0.01), demonstrating excellent lens surface moisture retention. In another study, time to lens surface moisture breakup (the time it takes for the first “spot” of dryness to appear on the lens) was measured after soaking lenses in PBS solution for 16 hours.12 The time to lens surface moisture breakup of AIR OPTIX® plus HydraGlyde® contact lenses was longest (19 seconds), indicating lasting lens surface moisture. (Figure) Mean time to lens surface moisture breakup (seconds)

Dr. Melissa Barnett was compensated by Alcon for her authorship of this advertorial.

= time akup etention e r b r er Long moisture r e t a gre *

25 20 15 10 5 0

Biofinity^

ACUVUE^ ACUVUE^ AIR OPTIX® Bausch & Lomb AIR OPTIX® OASYS^ VITA^ AQUA ULTRA^ plus HydraGlyde® Figure: AIR OPTIX® plus HydraGlyde® Contact Lenses Provide Long-Lasting Lens Surface Moisture Retention After 16 Hours of Simulated Wear12 Mean time to lens surface moisture breakup after 16-hour soak in phosphate-buffered saline solution. Ten lenses per brand were analyzed. *P<0.05 vs AIR OPTIX® plus HydraGlyde® contact lenses. ^Trademarks are the property of their respective owners.

Recommend lens care solutions with HydraGlyde® —CLEAR CARE® PLUS with HydraGlyde® or OPTI-FREE® PureMoist® — as the per fect combination with AIR OPTIX® plus HydraGlyde®contact lenses to keep outstanding comfort going all month long,1 so your patients can see, look and feel their best!

Based on ECPs who “agreed” or “somewhat agreed” with the statement: “AIR OPTIX® plus HydraGlyde® contact lenses will be the preferred monthly replacement lenses in my practice.” Based on ECPs who “agreed” or “somewhat agreed” with the statement: “I plan to proactively recommend to my 2-week and monthly contact lens wearers that they switch to AIR OPTIX® plus Hydraglyde® contact lenses.” ^ Trademarks are the property of their respective owners. Important information for AIR OPTIX® plus HydraGlyde® (lotrafilcon B) contact lenses: For daily wear or extended wear up to 6 nights for near/far-sightedness, presbyopia and/or astigmatism. Risk of serious eye problems (i.e., corneal ulcer) is greater for extended wear. In rare cases, loss of vision may result. Side effects like discomfort, mild burning or stinging may occur. ** †

References 1. Based on a survey of 229 previous monthly or 2-week replacement contact lens wearers and 20 eye care practitioners; Alcon data on file, 2017. 2. Dumbleton K et al. Compliance with lens replacement and the interval between eye examinations. Optom Vis Sci. 2013;90:351-358. 3. Guthrie S et al. Financial Implications of Patient Compliance. Contact Lens Spectrum. December 2014;29:42-45. 4. Rex J, Perry S, Lemp J, Maissa C. Concentrations of silicon at the surface of silicone hydrogel contact lenses. Invest Ophthalmol Vis Sci. 2015;56(7):6099. 5. Nash W, Gabriel M. Ex vivo analysis of cholesterol deposition for commercially available silicone hydrogel contact lenses using a fluorometric enzymatic assay. Eye Contact Lens. 2014;40(5):277282. 6. Nash W, Gabriel M, Mowrey-Mckee M. A comparison of various silicone hydrogel lenses; lipid and protein deposition as a result of daily wear. Optom Vis Sci. 2010;87:E-abstract 105110. 7. Alcon data on file, 2017. 8. Guillon M, Maissa C, Wong S, Patel K, Lemp J. Tear film dynamics over silicone hydrogel contact lenses with different lipid deposition profiles. Optom Vis Sci. 2014;91: E-abstract 145196. 9. In vitro and ex vivo measurement of contact angles on unworn spherical lenses; significance demonstrated at the 0.05 level; Alcon data on file, 2009. 10. Lemp J, Muya L, Driver-Scott A, Alvord L. A comparison of two methods for assessing wetting substantivity. Poster presented at Global Specialty Lens Symposium; January 21-24, 2016. Las Vegas, NV. 11. Marx S, Sickenberger W. Wettability of different silicone hydrogel lens materials and blister solutions measured using non-invasive keratographic drying up time (NIK-DUT). Optom Vis Sci. 2016;93:E-abstract 165113. 12. Tucker R, Lemp J, Guillon M. In vitro and on eye wettability of lotrafilcon B lenses packaged with a substantive wetting agent. Invest Ophthalmol Vis Sci. 2017;58:ARVO E-Abstract 3070 Our passion is to help See product instructions for complete wear, care and safety information. your patients see, look and feel their best. Sponsored by © 2017 Novartis 08/17 US-AOH-17-E-2057

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NEW PRODUCT | GALLERY HYDROPHILIC LENS COATING FOR IMPROVED COMFORT Custom contact lens manufacturer Valley Contax now offers Tangible Hydra-PEG hydrophilic coating as an option to all of its lenses manufactured in Contamac Optimum materials. This polyethylene glycol coating, applied to the lens at the final stage of manufacturing, has a 90% water content. It is designed to increase lens comfort and relieve dry eyes by improving wettability, increasing lens surface water retention and lubricity, and minimizing deposits and lens fogging. Tangible Hydra-PEG, which is permanently bonded to the surface of the lens, is ultra-thin (less than 50nm), so it does not alter lens geometry, mass or Dk/t. It also does not inhibit oxygen permeability or light transmission. Call 800.547.8815, or visit ValleyContax.com.

CATALOG FOR PLANNING OFFICE SPACE Eye Designs, LLC, manufacturer of custom ophthalmic environments and optical display systems, released its 17/18 Complete Guide, a full-line catalog that describes the company’s services, collections and merchandising systems, and offers project-specific information to walk eyecare practitioners through the process of planning a new environment. This year’s catalog also offers more information on IRIS (Intelligent Retail Integrated Solutions) and technology-based Experience Centers that integrate social media and the web into brick-and-mortar stores. Eye Designs also added two new furniture lines, Celine and Strata, as well as several accessories to its line of merchandising solutions, including frame risers, frame trays and messaging blocks. Call 800.346.8890, or email Info@EyeDesigns.com.

EYE GEL FOR THOSE BAGS AND LINES MediNiche, Inc. now offers a new version of OcuDerma, an eye gel that contains advanced technology peptides to decrease capillary permeability, improve lymphatic circulation, and improve firmness and elasticity. The result: a diminished appearance of under-eye bags and puffiness. OcuDerma also combines extracts, locust bean and hyaluronate to make the skin around the eyes feel tighter and look firmer, help lift the upper eyelid and reduce the appearance of “crow’s feet.” What it doesn’t contain: fragrances, artificial dyes, parabens, sensitizers or pore-clogging agents. MediNiche also updated the OcuDerma packaging to include an airless pump bottle and a “Sani-Dose” pump dispenser to reduce the risk of contamination from repeatedly dipping fingers into jars. As part of the introduction, a display offer featuring discounts, free goods and free shipping is available to new customers. Call 888.325.2395, or go to MediNiche.com/OcuDermaOffer.html.

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Think About Your Eyes

Because Life is Worth Seeing! Motivate the American public to get an annual comprehensive eye exam: that is our one

mission at Think About Your Eyes (TAYE) - and now we are now able to do that more effectively. Through the support of our Leadership Partners, the 40 state optometric associations who have signed up every active member, and the individual practices who have purchased a listing on the TAYE locator, TAYE has developed and launched two new television ads and two new radio ads during 2017, all of which celebrate how the gift of sight enhances everyday experiences as well as lifeâ&#x20AC;&#x2122;s important moments.

Thanks to our partners for their continued support. We look forward to 2018, with more people seeing the new campaign. We invite every optical company and eye care provider to join us in growing exams today, and educating the next generation of patients for tomorrow!

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DOCS | SPEAK OUT GROWING YOUR PRACTICE IN 2018 Planning for and implementing change is always important to improve the care your office provides. This issue’s “Docs Speak Out” survey explores the changes optometrists expect to implement in their offices for 2018.

Do you plan to offer a credit card service to your patients to help them finance expenses not covered by medical or vision insurance?

How do you plan to change the physical layout of your office? (Check all that apply.)

NO YES 8%

13%

16%

68%

s e y t ffic e at the sar nge ren iffen ign dispen cha ed se oootag n s d a o e e a n d r nn inc uare focatio ve to ocatio re ptical pla o sq me l mo fice l sa of

15% 8%

already offer this financial service

77%

What instrument(s) do you plan to add or update in your office? (Check all that apply.)

27% 24% 18% 21% 5% 31%

m rt er stem ds mian gra lan cha aph y n g meibo) tino cuity ogr era s a e i r m m eat GD tro a to cam eibo ce ital tr (M elec dig ren t lamp ge m ce to ease e h i s a i sl m l co devand di to i ica gl ice opt v e d

IF YOU COULD IMPLEMENT ONE THING TO IMPROVE YOUR PRACTICE IN 2018, WHAT WOULD THAT BE? “Online ability for patients to complete and download forms and information.” “Marketing more.” “Improve our company culture by clearly defining it, implementing processes to fulfill it, training associates to use it and changing associates as they either embrace or reject it.” “Figure out how to smoothly handle rechecks from online glasses and big box optical purchases. We waste a lot of time doing this and don’t seem to convert the patients to purchasing from us.” “Decrease the number of insurance plans accepted.”

“Better staff training for more professional presentation to patients.” “Going to telemedicine so that the office can see patients from other states or patients that have been with our office so that we can maintain the continuity of care. Not able to do it currently due to the different restrictions from various state boards of optometry.” “Affordable but efficient slit lamp imaging.” “Currently in the process of implementing electronic health records.” “Add another optometrist.”

“Dry eye center.” “Improve flow and movement of patients by redesigning current space.” “I wish I knew the answer to this! I hope to continue to implement increased medical billing and increase our higher-end optical sales.” “Begin to use social media to promote the practice.” “Better hours and less wait time.” “Improving the software we use.” “Create an automated digital imaging system for patient check-in.”

24 N o v e mb e r 2 0 1 7 | O p to m e tri c O f f i c e .c o m

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optometric-office-mrk-2877.pdf

10/26/17

10:55 AM

CONVERSATIONS

CMY

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For work, play and everyday

An annual supply of contacts and eyeglasses for any occasion… It’s easy to help your patients get all the eyewear options they want — right from your practice. Simply introduce promotional financing options* available with the CareCredit healthcare credit card. Call for more information and enroll at no cost today^.

866.853.8432

www.carecredit.com

visioninfo@carecredit.com

* Subject to credit approval. Minimum monthly payments required. See carecredit.com for details. ^ Subject to change.

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