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PRN Fish Oil Follow up

By Eye Care Update, What's NewNo Comments

It’s been 3 months now taking PRN’s fish oil.  I believe honesty is the best policy with my patients.  Thus I will not state that the results have been earth shattering, but it has been very positive.  I do feel about a 30% improvement in terms of my dry eyes, which is mostly from staring at the computer all day.  However, I will say that my recent blood work at my annual physical has been much improved without really changing my diet or exercise routine (lack of exercise really).  My eczema has also seen improvements.  Although my initial reason for taking these supplements was improving my dry eyes, I’m quite happy that other things have improved also.  Given the results, I will continue with these supplements as I have seen no negative results from being on PRN DE3 fish oil only positive ones.

New Glaucoma Meds

By Eye Care Update, What's NewNo Comments

It’s been a while since new glaucoma medications have been introduced.  Recently the FDA approved two new glaucoma medications designed to reduce intraocular pressure through different mechanisms.  These new drops are Rhopressa (by Aerie Pharmaceutical)  and Vyzulta (by Bausch and Lomb).    However, at this time, the non-insurance cost can be prohibitive at around 300-400 dollars per bottle per month.  In time, these prices will come down and insurance companies will cover these medications.  If your insurance covers these glaucoma medications, they should be the ones to be on.

Hubble Contact Lenses a Good Value?

By Eye Care Update, What's NewOne Comment

Does Hubble = Trouble for Contact Lens Companies?

Hubble contact lenses are part of the new trend of direct-to-consumer businesses.  Its business model is very much like that of Warby Parker’s or Zenni Optical’s in eye care.  Is Hubble cheaper in price compared to others? Well it sure seems so, but is cheaper always better?  For some people it is, but for many, I think it’s all about the cost to quality ratio.

Now many of you may be thinking, well this post is just an optometrist being sour about not being able to make a contact lens sale.  While this may be true for some eye care practices, it does not apply to our practice because we only want to fit the best contact lenses, not the cheapest.

Comparison Shopping

Let’s look at the comparison here.  Contact lenses are often judged by how much oxygen is able to transmit to the eye.  The higher the DK number, the better.  Here are a few examples

High End 1-Day Lenses:
Alcon Dailies Total One:  140 DK
Acuvue Oasys 1 Day: 103 DK

Mid Level 1-Day Lenses that are popular:
Acuvue 1-Day Moist: 28 DK
Biotrue Dailes: 42 DK

Hubble contact lens:  18 DK


Hubble contact lens DK value of 18 is one of the lowest out there, but then again, it is one of the cheapest in price.  It is, however, not some state-of-the-art lens material like they claim.  In fact, the material they use has been out for a long time and IS definitely passed its prime.   So do yourself a favor, as great as their advertising is about $1 a day for contact lenses, don’t compromise your eye health to save maybe up to a dollar per day, if not just a few cents.  Hubble contact lenses really aren’t that cheap.  For example, $2 dollars a day you can get the high end lenses such as Dailies Total One if you wanted to, and for even less, you could get  BioTrue, Acuvue 1-day Moist, or any other brand name lenses.  The difference is so small, that you could easily make that up by ordering a small instead of a med/large coffee the next time you’re at your favorite coffee shop :-).  Just a thought.



The Effects of Smoking on PRK or LASIK

By Eye Care Update, What's New

Many people are excited about the possibility of not wearing glasses after laser corrective surgery.  However, one thing that is often over looked is the impact of smoking after a procedure called photorefractive keratectomy (PRK) or LASIK.  Smoking can affected the healing process of the cornea, especially in PRK where no flap is created.   In PRK, the top layer must essentially regenerate itself complete.  This is healing process is much longer than LASIK.  With that said, research has shown that people who continue to smoke during the recovery period are at higher risk for corneal haze in both procedures.  Corneal haze could lead to decreased vision or an sub-optimal outcome.  In general, we recommend that every should stop smoking, not just for the eyes but for the body.  If quitting isn’t an option, then at minimum stop a few weeks before the procedure and wait until the cornea completely heals to help obtain the best possible surgical outcome.



Corneal Collagen Cross-linking Approved to Treat Keratoconus in U.S.

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People with keratoconus have a new treatment option. The U.S. Food and Drug Administration (FDA) has approved corneal collagen cross-linking (CXL) for progressive thinning and distortion of the cornea.

The treatment uses a special laser and eye drops to promote “cross-linking,” or strengthening, of collagen fibers in the cornea.

CXL has been in wide use outside the United States for about a decade. Based on three year-long studies, the FDA approved the new treatment for keratoconus and other types of corneal ectasia. Corneal ectasia is the general name for conditions in which the cornea gets thinner and changes shape.

The cornea is the clear front window of the eye where light enters. It helps you see by focusing the light.



By Eye Care UpdateNo Comments

Glaucoma is a sight threatening disease that often goes unnoticed, until it becomes very severe. The worst part of it is, once you lose the vision, you will be unable to recover it even after you start treatment. The best way to monitor for glaucoma is to see your eye doctor on a regular basis. He or she will be able to test you by checking your eye pressure and perform other test to determine the absence or presence of glaucoma. For some people, glaucoma testing may be extensive and may require repeating tests annually. Since glaucoma treatment is indefinite, we as eye care providers want to be certain before starting a patient on drops or recommend surgical intervention.

Poor Contact Lens Care Leads To A Whole Lot Of Eye Infections

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If you’ve worn contact lenses, you know how easy it can be to let things slip a little. Maybe you don’t wash and dry the case every day. Or you wear lenses in the shower. Or you try to eke a bit more wear out of a pair.

Well, the Centers for Disease Control and Prevention is on to us, and it has a message: Stop it.

Improper contact lens use is the major risk factor for infections of the cornea, the clear covering of the eye, and those send people to the doctor or emergency room almost 1 million times a year, according to a CDC study published Thursday in Morbidity and Mortality Weekly Report. It’s the first national look at the issue.

“I think we have badly underestimated the frequency of this problem,” says Dr. Thomas Steinemann, a professor of ophthalmology at Case Western Reserve University and a spokesman for the American Academy of Ophthalmology.

He’s surprised by both the number of people who end up with keratitis and the cost of treating it: $175 million a year. Most infections can be treated with antibiotics, but in some cases they can cause permanent eye damage or blindness.

The data sets used couldn’t identify which of those 1 million people were wearing contact lenses. But about 38 million people do wear lenses, which is known to greatly increase the risk of cornea infections. So the CDC focused its message on getting lens wearers to shape up.

“Wearers need to understand that this is a medical device,” Steinemann, a cornea expert, told Shots. “It needs to be treated with respect.”

But he knows we’re fallible. “People cut corners. We’re all busy.” Steinemann estimates that people do the right thing less than 20 percent of the time; other studies have been even more pessimistic.

Good care includes cleaning and disinfecting lenses every day, cleaning the case and changing the solution every day, and washing hands before touching lenses. Also not showering, swimming or otherwise getting lenses near water, which harbors amoebas and fungus and other nasty stuff.

Sleeping in lenses is particularly bad for the cornea, because lenses reduce oxygen flow to the eye. And even well-cared-for lenses need to be thrown out after a few weeks. “They do wear out,” Steinemann says.

Oh, and while you’re at it? “Amazingly, people with contacts don’t even have a backup pair of glasses,” Steinemann says. “If your lens falls on the floor what are you going to do? You’ve got to have a backup plan.”

There you go. Can’t say you weren’t told.


Viral Conjunctivitis Tester

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New Tool for Adenoviral Conjunctivitis

Clinical studies of conjunctivitis with laboratory confirmation indicate that it’s often difficult to differentiate bacterial from viral forms of acute conjunctivitis by relying on signs or symptoms or both.8 In past studies, corneal and external disease specialists’ clinical diagnosis of adenoviral conjunctivitis had laboratory confirmation in only 20-25% of cases. For that reason, this study utilizes a rapid immunoassay applied to conjunctival scrapings (Figure 3) that can be performed in the examining lane and quickly and easily processed by a technician.

Conjunctival scrapings can be processed for adenoviral antigens in approximately 10 minutes using the RPS Adeno Detector Plus immunoassay for in-office detection.

The RPS Adeno Detector Plus is a point-of-care immunoassay that has 93% sensitivity and 96% specificity. It takes approximately 10 minutes to perform. The monoclonal antibodies used in the assay detect all 53 adenoviral serotypes. The device has a self-contained element used for conjunctival scraping and a colorimetric binary readout similar to urine pregnancy tests. This assay is FDA 510(k) cleared, CLIA-waived and commercially available. It has a unique Medicare procedural CPT code, 87809qw, which more than covers the cost of the test kit.

Source –

Novartis Joins With Google to Develop Contact Lens That Monitors Blood Sugar

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LONDON — Google announced on Tuesday a partnership with the European drug maker Novartis to develop a smart contact lens with the potential to monitor the wearer’s blood sugar levels.

The agreement is among recent moves into the health care sector by technology giants including Apple and Samsung as they develop devices and mobile applications to track people’s daily lives.

Novartis said that Alcon, its eye care unit, had struck a deal to license so-called smart lens technology from one of Google’s research divisions. Financial terms were not disclosed.

Why we don’t reuse daily lenses

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Contamination of Daily Disposable Contacts When Re-Used

February 2013 — Do you ever store your daily disposable contacts in their packaging and then use them again the next day? If so, you’re risking an eye infection.

In a study, 20 people wore their daily disposables for one day, then stored them overnight in the original blister pack solution, covered with the original packaging foil.

Contact lens blister-packs

The next morning they used new plastic forceps to transfer the lenses and solution to a new contact lens case, which was submitted to a lab. The participants did this on five occasions within a month.

The lab compared the 200 samples with a control group of new daily disposable contacts and packaging solution.

The lab found that 45.5 percent of the samples had growths in the solution, and 21.5 percent of these had Staphylococci, while 28 percent had gram negative rods. For 95 percent of the participants, at least one pair of contact lenses was contaminated, and for 35 percent, all samples were contaminated.

The study appeared in Optometry and Vision Science, volume 88, issue 12.