Download British Contact Lens Association Clinical Conference and Exhibition

INSIGHTS AND BEST PRACTICE
British Contact Lens Association Clinical Conference and Exhibition
Material matters, say researchers at BCLA 2010
Material properties are important attributes of contact lenses that are often neglected at contact lens
meetings. The 2010 BCLA Clinical Conference was an exception as several speakers examined the effects
of these properties on successful lens wear.
Eurolens Research director Dr Philip Morgan and chemist Lenora Copper of the Johnson & Johnson
Vision Care Inc R&D division were among those presenting on this topic. Questions posed included:
• Do material properties matter and, if so, which ones?
• How do they impact clinical performance?
• How should these material properties be measured?
• Why is it difficult to compare material properties data between products?
Dr Morgan said that for contact lenses to be successful they needed to meet five criteria: comfort,
physiological response, vision, usability and market availability. Two of these, physiological response and
comfort, were highly dependent on material properties, including the key parameter of frictional
interaction between lens and lid.
Agreed standards were needed to evaluate properties such as modulus, wettability and coefficient of
friction so that lenses could be compared, said Ms Copper.
Paul Chamberlain, research manager at Eurolens, described a one-year study comparing the
performance of the silicone hydrogel daily disposable 1•DAY ACUVUE® TruEye™ to a control group of
non-lens wearers in a total of 70 subjects who had not previously worn contact lenses. The study found:
• Wearer comfort (captured by SMS) at one month comparable to that of non-wearers and no reduction
in comfort at end of day
• Average ocular comfort over one year equivalent to no lens wear
• Minimal and stable impact on ocular physiology at one year
He concluded that material technology had now enabled us to reach a situation where patient comfort
and physiology were comparable to the natural eye.
CLICK HERE FOR MATERIAL PROPERTIES TO CONSIDER WHEN DECIDING WHICH SILICONE HYDROGEL
LENS TO PRESCRIBE
THE VISION CARE INSTITUTE™ is a trademark of Johnson & Johnson Medical Ltd.
©Johnson & Johnson Medical Ltd 2010
Therapeutic role for practitioners in treating myopia
Contact lenses that not only correct but also treat refractive error could open up a new therapeutic role
for eye care professionals, according to speakers at an ‘Anti-myopia’ session at the BCLA Clinical
Conference.
Professor Brien Holden said that anti-myopia products, targeting both child and adult-onset myopia,
would slow the progression of myopia and reduce the number of people with high myopia and related
eye disease.
Researchers at the Vision CRC and Brien Holden Institute in Sydney, Australia, and at the University of
Auckland, New Zealand, used various approaches to optically manipulate the peripheral retinal image
and change the growth of the eye.
Holden’s group conducted trials of three spectacle lens designs (n=210) and a contact lens (n=85) and
found:
• A myopia-control spectacle lens reduced the rate of myopic progression by 30% over one year in
children aged 6-12 years with history of parental myopia
• An anti-myopia soft contact lens slowed myopic progression by 34% over one year in children aged 714 years compared to standard spectacle lenses, and by 49% when one or more parents was myopic
The DIMENZ (Dual focus inhibition of myopia evaluation in New Zealand) study trialled a dual-focus soft
lens with a central correction zone and concentric treatment zones (n=40) and showed:
• Myopic progression reduced by 37% over 10 months in children aged 11-14 years compared to a
standard single-vision contact lens
• Half of the lens wearers had myopia progression slowed by 50% or more
The effect might eventually be 60-70% for optical devices, or 80% when combined with medication, but
other factors such as outdoor activity were also important.
Professor Earl Smith of the University of Houston said that myopia control lenses needed to be fitted at
an early stage and to very young individuals. ‘In the very near future we’ll be using contact lenses to
guide eye growth,’ he said. Contact lenses had advantages over spectacles for myopia control and could
be worn very successfully by children. Practices needed to start preparing now for seeing more children
and teens in future.
CLICK HERE TO READ MORE ABOUT CHILDREN AND CONTACT LENSES
https://www.thevisioncareinstitute.co.uk/pdf/2204_TVCI_Teens%20and%20Kids%20Article.pdf
CLICK HERE FOR TIPS FOR SUCCESS WHEN FITTING CHILDREN
THE VISION CARE INSTITUTE™ is a trademark of Johnson & Johnson Medical Ltd.
©Johnson & Johnson Medical Ltd 2010
Hands up to hygiene!
In-practice hygiene was another key theme at BCLA 2010, with a special session on controlling infection
chaired by Roger Buckley, Professor of Ocular Medicine at Anglia Ruskin University in Cambridge.
Jane Veys, education director at THE VISION CARE INSITUTE™, explained that hand hygiene was the
single most effective way to help prevent the spread of infection. Yet hand-washing compliance could be
variable even among health care professionals.
From September 2009 to March 2010, data were collected from more than 200 UK eye care
practitioners attending eye health-related courses at THE VISION CARE INSITUTE™ on how well they
rated their own hygiene practice. The practitioners then used UV disclosing gel to demonstrate the
effectiveness of their hand-washing technique, after which they re-evaluated their ratings. Results
showed:
• A significant shift in self-rating scores once awareness of correct hand hygiene had been raised
• 69% rated themselves excellent or very good initially compared to 25% post demonstration
The data support the need for more engagement and ongoing education on the importance of effective
hand washing.
CLICK HERE FOR THE VISION CARE INSTITUTE™ PRACTICE POSTER PROMOTING HAND HYGIENE
NOMGD: a new clinical entity in dry eye
Meibomian gland dysfunction (MGD) may be the leading cause of dry eye syndrome and impacts the
health and well being of millions of people. But to date there has been no global consensus on its
definition, classification, diagnosis or therapy.
The BCLA’s 2010 Clinical Conference hosted an international workshop on MGD, initiated by the Tear
Film and Ocular Surface Society and involving 50 leading authorities from around the world, which
defined MGD for the first time. The BCLA Medal Address from US researcher Dr Donald Korb, who
named and described the condition, also provided some useful insights for clinicians.
Dr Korb said that the most frequent form of MGD was an obstruction of the glands without any obvious
inflammation or signs, ‘non-obvious obstructive MGD’ or NOMGD, which he described as analogous to
dental plaque. Just as daily cleaning kept teeth clear of plaque, meibomian glands needed to be cleared,
he argued. Among options for optimising gland function were:
• Wet, warm compresses, ideally for 15 minutes at 45ºC, applying upward pressure on the lower lid
• Lid massage and digital expression of meibum
• A new device (Lipiflow) in development that heated the glands from inside the lids and applied
pressure to the outer lid
• Lid scrubs and therapeutic preparations
THE VISION CARE INSTITUTE™ is a trademark of Johnson & Johnson Medical Ltd.
©Johnson & Johnson Medical Ltd 2010
Incomplete blinking had been implicated in lid wiper epitheliopathy, another condition first identified by
Korb, which he described as a lubrication problem between the marginal conjunctiva of the upper lid
and the ocular or contact lens surface.
CLICK HERE FOR MORE ON THE IMPORTANCE OF BLINKING TO EYE HEALTH
UV danger in the UK? U bet!
The damaging effects of ultraviolet (UV) radiation on the eye and skin may be well recognised but
researchers at Johnson & Johnson Vision Care and Kanazawa Medical University in Japan continue to
discover some surprising findings on the relative risks of environmental UV exposure.
The latest study, presented by Dr Cristina Schnider at the BCLA Clinical Conference, looked at the impact
of factors such as latitude and environs on UV exposure to the head, eyes and face. A mannequin system
with 12 UV-A/B sensors (embedded in cheeks, chin, neck, forehead, crown of head and eyes) was used
to collect UV intensity relative to solar angle at locations in Japan and Iceland, as follows:
• Okinawa (beach, lat 26.2N, July)
• Kanazawa (roof, lat 36.6N, July and Nov)
• Reykjavik (roof, lat 64.1N, Aug)
Although ambient-UV was highest in Okinawa, ocular exposure was significantly higher in Reykjavik in
the face-to-sun condition, due to persistently lower angles of the sun in the sky throughout the day.
The researchers concluded that people dwelling in northern latitudes are likely to receive more total
radiation to their eyes than those in more southerly latitudes due to the increased time the sun spends
below solar angles of about 40º. Major re-education may be needed to protect the eyes from damaging
effects of UV, they say.
CLICK HERE FOR THE LATEST FINDINGS ON UV AND THE EYE
THE VISION CARE INSTITUTE™ is a trademark of Johnson & Johnson Medical Ltd.
©Johnson & Johnson Medical Ltd 2010