The prevalence of myopia is increasing rapidly in many parts of the world and has reached epidemic proportions in East Asia and the USA. Because of the ocular morbidity associated with high myopia, axial myopia is now the second leading cause of permanent low vision in East Asia. Moreover, because of the lack of access to optometric services, the WHO reports that uncorrected myopia is one of the leading causes of preventable vision disability worldwide. In this respect, the optometric community is the only profession positioned to address this significant public health concern and consequently we must take the lead in developing new treatment strategies that reduce the impact of myopia on society. Fortunately, over the past decade gold-standard clinical trials have tested many traditional treatment strategies and preliminary trials are testing novel optical treatment strategies. The emerging picture, which will be summarized in this presentation, is that there are a variety of potential optical treatment strategies that will be effective in reducing myopic progression.

Professor Smith received his OD (1972) and PhD (1978) from the University of Houston and subsequently joined the faculty of the UH College of Optometry. During his tenure in the College of Optometry, he has served as the Chair of the Basic Sciences Department and as the Associate Dean for Graduate Studies and Research. Professor Smith currently holds the Greeman-Petty Professorship in Vision Development and is serving as the Dean of the College of Optometry.

Professor Smith’s research interests are focused on the optics of the eye. He received the Glenn Fry Award (1996) and the Prentice Medal (2010) from the American Academy of Optometry for his research on the role of vision in regulating refractive development and eye growth. Professor Smith has published over 150 refereed papers and received 29 years of research funding from the National Institute of Health’s (NIH) National Eye Institute (NEI). He is also an accomplished lecturer, having received teaching awards at the department, college and university level and in 2003 was selected by the Texas Optometric Association as its Educator of the Year.

Professor Smith is an active member of the vision science community. He is a Fellow of the American Academy of Optometry, an ARVO Fellow (inaugural class), a past President of the American Optometric Foundation (2002), a past Member and Chair of NIH NEI’s Central Visual Processing Study Section (1998-2003) and a past member of NIH’s National Advisory Eye Council (2005-2008). Professor Smith currently serves on the Board of Directors of Prevent Blindness Texas, as the Secretary of the Partnership Foundation for Optometric Education, and as the Past-President of the Association of Schools and Colleges of Optometry.
 

There has been much recent interest and excitement about the potential for overnight orthokeratology lens wear to control the progression of myopia in children.  Early positive results from a number of clinical trials have encouraged many eyecare practitioners to recommend orthokeratology lenses to parents who are anxious about their child’s myopia progression.  But are we really there yet?  Are the studies that have been conducted to date sufficiently rigorous to satisfy the risk-benefit test associated with closed-eye contact lens wear over prolonged periods of time.  How do we identify the children who will truly benefit from this therapy?  How long must orthokeratology lenses be worn to maintain control over myopia?  And is there accrual of effect with continuation of therapy?  This paper will attempt to put the current debate on these issues into perspective so that clinicians can approach the application of this exciting new treatment for myopia with a sense of balance and caution.

Professor Helen Swarbrick gained her optometric qualifications at the University of Auckland, New Zealand in 1974.  Following eight years in private optometric practice in New Zealand and England, Professor Swarbrick joined the CCLRU in Sydney, where she worked for 11 years.  In 1995 Professor Swarbrick was appointed to the School of Optometry and Vision Science, UNSW, with responsibility for contact lens education at the School.  

Professor Swarbrick’s current primary research interest is the corneal response to orthokeratology for the correction of refractive errors, and the role of orthokeratology in myopia control.  She has received significant grant funding for this ongoing research from the Australian Government through the ARC Linkage scheme.  She was awarded the Rodger Kame Memorial Award in 2004 in recognition of her efforts, innovation and research in the field of orthokeratology and corneal reshaping.  In October 2011 she received the Alan Bott Memorial Award from the New Zealand Optometric Vision Research Foundation.

Professor Swarbrick is a Fellow of the American Academy of Optometry, and the International Association of Contact Lens Educators, an honorary member of the New Zealand Society of Contact Lens Practitioners and the Korean Ophthalmic Optics Society, and a member of the Cornea and Contact Lens Society of Australia, the Association for Research in Vision and Ophthalmology, and a Council Member of the International Society for Contact Lens Research.  She has published widely in the international scientific literature, and has presented many scientific and continuing education papers at national and international conferences.

We have examined myopia control with several contact lens modalities, including alignment fit gas permeable, corneal reshaping, and soft bifocal lenses. We will review the findings from each of these studies. While gas permeable contact lenses may appear to slow myopia progression, much of the effect is due to less corneal steepening, so the treatment effect is unlikely to be permanent. More importantly, gas permeable contact lenses do not slow myopic eye growth. On the other hand, corneal reshaping contact lenses do appear to slow eye growth, and this effect has been shown in several studies. Recently, we found that soft bifocal contact lenses with a distance center design also slow myopia progression. Combined, the results of these studies may reveal interesting information about what modality may work best for individual myopes.

Jeffrey J. Walline, OD PhD is an Assistant Professor at The Ohio State University College of Optometry. He received his Doctor of Optometry degree from the University of California, Berkeley School of Optometry in 1996. He received a Master’s degree in Physiological Optics in 1998 and a PhD degree in Vision Science at The Ohio State University College of Optometry in 2002.

Dr. Walline has conducted several pediatric contact lens studies, with topics ranging from myopia control to the effects of contact lens wear on children’s self-perceptions. He teaches Vision of Children and Specialty Contact Lenses to third year optometry students, and he is a clinical instructor in the Binocular Vision and Pediatrics Service and the Contact Lens Service at the College of Optometry.

PURPOSE
To investigate if orthokeratology can slow myopic progression in myopic (*ROMIO study: single-masked and randomised) and astigmatic children (**TO-SEE study: single-masked)
METHOD
In the ROMIO study, children of age 6-10 who satisfied the inclusion criteria of the study were randomly assigned to two groups: test group (wearing Menicon Z Night Lens (spherical lens design)), control group (wearing single vision spectacles). In the TO-SEE study, children 6-12 years old were fitted with Menicon Z Night Toric lenses. Axial length (AL) measurements were made with the IOLMaster at baseline/first overnight visit and every six months thereafter for all children by an independent examiner who was masked to the grouping of the children.
RESULTS
Seventy five and 35 children completed the ROMIO study and TO-SEE studies, respectively. Increase in AL in the ortho-k group (ROMIO) was more than 40% slower when compared to the control group (t-tests, p<0.001).
CONCLUSIONS
Myopic and astigmatic children who wore ortho-k lenses showed significantly slower axial length elongation compared to children wearing spectacles after 24 months of lens wear.

(*ROMIO – Retardation Of Myopia In Orthokeratology; **TO-SEE – Toric Orthokeratology – Slowing Eyeball Elongation. Both studies are supported by Collaborative Research Agreements between PolyU and Menicon Co. Ltd., Japan.) Some preliminary results have been presented at APOC, BCLA, NCC, AAO and local meetings between 2009-2012.

 

Pauline Cho is a Professor of the School of Optometry at The Hong Kong Polytechnic University. She obtained her Bachelor of Optometry at the University of New South Wales, Australia and her PhD at the University of Bradford, UK. She obtained her Master in Professional, Vocational and Higher Education at PolyU in 2003.
She is a Fellow of the American Academy of Optometry and a Fellow of the British Contact Lens Association. She has published over 100 papers in contact lens related topics and is currently the Regional Editor (Asia-Pacific) for Contact Lens & Anterior Eye.
Since 2004, Prof. Cho has been involved in organizing and conducting annual vision screenings for ethnic minority children in Guangxi, China.

MCOS* study result (*Myopia Control with Orthokeratology contact lenses in Spain)
PURPOSE: To compare axial length growth between white myopic children wearing orthokeratology contact lenses (OK) and distance single-vision spectacles (SV) over a 2-year period.
METHODS: Subjects 6 to 12 years of age and with myopia -0.75 to -4.00DS and astigmatism ≤1.00DC were prospectively allocated OK or SV correction. Measurements of axial length and anterior chamber depth (Zeiss IOLMaster), corneal topography and cycloplegic refraction were taken at 6-month intervals.
RESULTS: Thirty-one children were fitted with OK and 30 with SV. Following 24-months, axial length increased significantly over time in the OK (by 0.47mm) and SV (by 0.70mm) groups (p<0.0001), but the SV group experienced significantly greater axial elongation in comparison with the OK group (p<0.005). Both groups exhibited a small change in anterior chamber depth over time (p<0.001), which was similar between groups (p=0.12). Significant differences in refraction were found over time, between groups and for the time:group interaction for the spherical (all, p<0.0001), but not cylindrical components (all p>0.05). The OK group experienced significant corneal flattening vs. SV group for the flatter and steeper corneal powers and corneal shape factor (all p<0.0001).        
CONCLUSION: Orthokeratology lens wear reduces axial elongation in comparison to distance single-vision spectacles in children.

 

Jacinto Santodomingo-Rubido graduated in Optics and Optometry from the University Complutense of Madrid, Spain. He then moved to the UK to undertake an MSc followed by a PhD from Bradford and Aston Universities, respectively. His PhD investigated the ocular response to silicone hydrogel contact lenses. After completion of his PhD, he worked in private practice for a year, and then he moved to Japan as he was appointed Global Professional Relation Manager for Menicon Co., Ltd. His current duties with Menicon Co., Ltd include establishing networks with other professionals, to collaborate and coordinate global R&D activities, to participate in international conferences, to provide sales and marketing seminars, to prepare international press releases, and to pioneer new markets. Jacinto returned to Madrid in 2006 while maintaining his post and responsibilities with Menicon Co., Ltd. In 2011, he has been the recipient of the prestigious Irving Fatt Memorial Lecture Award of the British Contact Lens Association. He is a Fellow of the American Academy of Optometry and the British Contact Lens Association, and a member of the International Society of Contact Lens Research. He has presented many papers and posters at national and international conferences and authored around 50 professional papers. He is also an invited reviewer for most of the leading peer-review research journals such as Optometry & Vision Science, Ophthalmic & Physiological Optics, Eye & Contact Lens, Contact Lens & Anterior Eye, Journal of Optometry, British Journal of Ophthalmology and Investigative Ophthalmology. His research interests include myopia, ocular biometry, the cornea and tear film, and different aspects of contact lenses and keratoconus disease.

Anterior eye grading and imaging is essential for the safe contact lens fitting as well as the detection and monitoring of eye disease. Verbal description is relatively crude so pictorial and photographic grading scales were developed to increase grading sensitivity. However, these scales are not generally linear and subjective grading has been shown to be relatively variable. Attempts to semi-quantitate grading in the 1980-90s were superseded by fully objective grading software from the turn of the century. Objective grading has been shown to be highly sensitive, stable to image capture variability and repeatable. At the same time anterior eye imaging technology has been improving. The resolution of imaging chips has increased, compression algorithms improved and the costs decreased, but the optimal illumination and slit-lamp biomicroscope optics must also be optimised. 

Prof James Wolffsohn studied Ophthalmic and Physiological Optics at UMIST, Manchester, UK, achieving a 1st class degree. He qualified to practice Optometry independently following a pre-registration year Moorfield’s Eye Hospital, London. Following this, James completed a PhD on at Cardiff University. He commenced a clinical / research position at the Victorian College of Optometry / University of Melbourne, Australia in 1997. In 2000, he returned to the UK and a position at Aston University, where he was Head of Optometry from 2004-9, being awarded a personal Chair in 2007. He is now Deputy Executive Dean for the School of Life and Health Sciences. James’ research and teaching interests mainly revolve around intraocular lenses, contact lenses, dry eyes, low vision and the measurement of accommodation, having published over 110 peer reviewed academic papers and given numerous international presentations. James is also a past President of the British Contact Lens Association. He has recently published the “Low Vision Manual” with Prof Jonathan Jackson and an Eye Essentials Series book “Imaging”.  http://www.aston.ac.uk/lhs/staff/az-index/wolffjsw/ 

The integrity of the tear film is of particular importance, not only for contact lens wearers, because dry eye syndrome is one of the most common ocular diseases today.
Therefore a qualitative and quantitative assessment of the tear film is the basis for the overall satisfaction of customers as well as for a successful contact lens fitting. Most of current dry eye tests have limitations regarding the invasiveness, the subjective influence of the investigator or the ability to differentiate between symptomatic and asymptomatic patients.
The Non-Invasive-Keratograph Break-Up-Time (NIK-BUT) measurement represents one of the first objective and noninvasive tear film assessment techniques that supplies good classification results. The technique operates on the principle of the projection of the Placido-Disc pattern of the topographer and its reflection from the tear film. As a consequence of a break up the reflections of the disc are being distorted, which is detected by a special software. Thus the method is investigator independent and the integrity of the tear film is not affected by the measurement.
 

Sebastian Marx graduated in 2000 from the OSZ Havelland School of Ophthalmic Optics in Rathenow before he worked in practice. After a study of optometry at the University of Applied Sciences Jena he started to work at the JENVIS Research Institute in Jena. He is coordinating research projects and responsible for the clinical area. Parallel to his work, he is part time educator at the University of Applied Sciences Jena in the field of vision research and member of the German committee of standardisation. Since 2008 he is a fellow of the International Association of Contact lens educators. In 2010 we was awarded together with his research team with the Peter-Abel-Award of the VDCO for the development of new tear film assessment methods.

Meibomian gland dysfunction (MGD) has recently attracted significant interest among researchers and clinicians. MGD is a common clinical condition and a major cause of lipid tear deficiency and evaporative dry eye. Hence, a routine evaluation of the meibomian glands and lipid layer is vital. In a typical clinical setting, lid and lid margin evaluation is often performed using slit lamp biomicroscopy. Although this technique allows visualization of the lids and lid margin, it does not allow viewing of morphological changes to the meibomian glands in the tarsal plate. This talk will provide an overview of MGD the novel techniques to image meibomian glands.

Dr Sruthi Srinivasan is a Research Assistant Professor at the School of Optometry, University of Waterloo, Canada. She is actively involved in various clinical trials conducted at the Centre for Contact Lens Research, University of Waterloo. Sruthi graduated from the Elite School of Optometry, India and obtained her PhD in Vision Science from the University of Waterloo, Canada. After her PhD, Sruthi continued her research on dry eye as a Post -Doctoral Fellow at the Ohio State University, College of Optometry. She has presented at various international conferences and has published several papers in the area of dry eye.  She also serves as a referee for several Ophthalmology & Optometry journals. Sruthi is a Fellow of the American Academy of Optometry, Member of the Association for Research in Vision & Ophthalmology and the Tear Film & Ocular Surface Society.

Current assessment of the anterior eye topography mainly focuses on corneal elevation. The reason for this is the wide availability of relatively inexpensive Placido disk corneal topographers, whose coverage is usually below the central 10 mm corneal diameter. However, the topography of the peripheral cornea as well as the topography of the limbal area is also important, particularly for contact lens design. Some progress in the assessment of a wider area of the eye anterior can be made with fast spectral-domain based optical coherence tomography or by Scheimpflug imaging. The talk will review the problem and provide information on current developments towards techniques for the assessment of the anterior eye topography. 

D. Robert Iskander received the Ph.D. degree in signal processing from Queensland University of Technology (QUT), Brisbane, Australia, in 1997, and the D.Sc. degree (habilitation) in Biocybernetics and Biomedical Engineering from Silesian University of Technology, Gliwice, Poland, in 2010. From 1996 to 2000, he was a Research Fellow at the Signal Processing Research Centre and the Centre for Eye Research, QUT. In 2001, he joined the School of Engineering, Griffith University, as a Senior Lecturer and the Head of the Signal Processing Group. From 2003 to 2009, he was the Principal Research Fellow at the School of Optometry, QUT, where he led the Signal and Image Processing Group within the Contact Lens and Visual Optics Laboratory. Since 2011, he has been as a Professor at the Institute of Biomedical Engineering and Instrumentation, Wroclaw University of Technology, Wroclaw, Poland. He is the author or co-author of more than 70 journal papers and 80 conference publications. He is the holder of 10 international patents. His current research interests include biomedical signal and image processing, visual optics, and optometry and ophthalmic Instrumentation. 

Harry de Vries is product development manager of the Cassini at i-Optics BV, Den Haag (NL). He received his bachelor degree (BSc) in photonics from the TH-Rijswijk in the Netherlands, in 1998. Shortly after that, he moved to Stockholm, Sweden, where he worked for 3 years at ADC-telecommunications being of part of the chin-design group developing innovative tunable laser fiber optics communications. In 2003, he returned to Amsterdam (NL) and received his master degree (MSc) in biomedical physics from the University of Amsterdam (UvA). In 2005, he started working as a product development manager at Topcon Europe Medical BV being mainly responsible for the development of a slitlamp-adapted OCT module, the SL-SCAN-1. This innovative product has been developed in close collaboration with the AMC in Amsterdam. In 2010 he started working at i-Optics BV. His main interests are light-tissue interaction, optical imaging technologies, OCT and ophthalmic instruments.

Is keratoconus (Kc) present in the cornea beyond Fleischer’s Ring? Recent histopathological research at Texas Eye Research and Technology Center (TERTC) reported that regions outside the perimeter of the cone are affected by this corneal pathology. Further study undertaken by TERTC aimed to assess if this may be determined clinically. Kc patients (n=26) and an age and sex matched control group (n=26) had their central and peripheral corneal thickness measured utilizing the Visante OCT and Orbscan instruments. Compared to the control group, the Kc cornea was consistently thinner across the full width. This thickness difference was 12.5% centrally and become progressively less towards the periphery, where the thickness difference was only 6%. This relatively modest thickness difference in the periphery may be the reason that peripheral thinning in Kc has not previously been reported. The present study confirmed our histopathological research that Kc is not a disease confined to the cone region within Fleischer’s Ring, but is rather a pan-corneal condition. This knowledge may influence the management of Kc with contact lenses.

Dr. Jan P.G. Bergmanson received his optometric training (BSc Hons, 1970) and was awarded a PhD (1975) at the City University, London, UK. In addition, he obtained in 1982 a Doctor of Optometry degree from Pennsylvania College of Optometry, in 2007 he was awarded a PhD honoris causa from Kalmar University, Sweden and in 2008 he received a DSc from the City University, London, UK. Currently, Dr. Bergmanson is Professor of Optometry at the University of Houston College of Optometry (UHCO), where he is the founding Director of the Texas Eye Research and Technology Center (TERTC). He has published over 130 scientific articles, 7 chapters and 1 text book, now in its 19th Edition, and he has delivered over 200 invited lectures on subjects of ocular anatomy, pathology and anterior segment therapeutic management, corneal morphological response to contact lens wear, tear and ophthalmic solution effects on the ocular surface, and ocular effects of ultraviolet radiation. Dr. Bergmanson is certified in Texas as a Therapeutic Optometrist and as an Optometric Glaucoma Specialist. He is a Foundation Fellow of the College of Optometry in United Kingdom and a Fellow of the American Academy of Optometry, where he is a clinical Diplomate in the Cornea and Contact Lens Section. He is a council member of the International Society for Contact Lens Research and a lifetime honorary member of the Swedish and Dutch Optometric Associations and the Swedish Contact Lens Association. Dr. Bergmanson is the recipient of the 1998 British Contact Lens Association Gold Medal Award, the 2002 Texas Optometric Association’s Educator of the Year Award, the University of Houston College of Optometry 2003 Cora and J. Davis Armistead Faculty Teaching Award, the 2005 Swedish Optometric Association’s Mark of Honor Award and the American Academy of Optometry Section on Cornea and Contact Lenses Max Schapero Award 2006.

In the past decade advances in technology have led to an expansion of our therapeutic armamentarium for the treatment of keratoconus.  An opportunity to stabilize progressive keratoconus was introduced in 2003 with the development of UVA/riboflavin corneal crosslinking (CXL).  Apart from that, comfort problems of rigid corneal lenses can very often be solved by using the larger diameter contact lenses with scleral support that avoid contact with the cornea and eye lids.  For contact lens intolerant patients the implantation of plastic intracorneal ring segments to improve the shape of keratoconus corneas can provide an alternative.  In the field of corneal transplants, lamellar surgery aiming at selective replacement of diseased tissue is finding a wider application.  
There is, however, a major drawback in this recent (r)evolution in the therapeutic approach of keratoconus: information on CXL is disseminated on the internet without scientific validation and CXL has rapidly become a mainstream treatment in many private ophthalmology practices.  Encouraged by the results of CXL some refractive surgeons have gone further and have tried in recent years to combine corneal excimer laser and other refractive techniques with CXL to correct keratoconus.  Costly surgical solutions for the patient seem to replace contact lens correction as a first line of treatment in refractive surgery practices.  All patients undergoing refractive surgery should be aware of the fact that this is not the standard approach of keratoconus and that the development of nomograms and safety studies are still ongoing.  An updated treatment paradigm will be presented taking into account the need for stabilisation and optic correction of the individual keratoconus patient.

 

 Carina Koppen M.D. is the head of the cornea clinic at the department of Ophthalmology of the University Hospital Antwerp, Belgium.  She is specialised in the medical and surgical treatment of ocular surface and anterior segment disease.  From 2007 onwards she has organised a keratoconus clinic in which all recent treatment options are offered: a dedicated contact lens department and the early application of corneal cross-linking are part of a comprehensive keratoconus treatment.  Keratoconus and cross-linking are the topic of her PhD thesis, which she will bring forward shortly at the Medical Faculty of the Antwerp University.
She is treasurer of the Sobeveco-BSCRS (Société Belge des Verres de Contact – Belgian Society of Cataract and Refractive Surgeons). As the representative of the contactologists in this society, she is responsible for the scientific content of the contactology sessions at the yearly national meeting Ophthalmologica Belgica and at the society’s own annual winter meeting.  In the ECLSO (European Contact Lens Society of Ophthalmologists) she was appointed Belgian National Representative in 2003 and organised the 38th ECLSO Congress in Antwerp in 2007. In that same year she became Vice-President and will be the Secretary-General of this society from 2012 onwards.  As a member of the ESCRS (European Society of Cataract and Refractive Surgeons) and EuCornea she presented several papers on a European level and organised instructive courses on keratoconus and cross-linking for the last three years.
 

Doel: Op het gebied van keratoconus behandeling is steeds meer mogelijk. De basis behandeling blijft echter het aanpassen van brillen en steeds vaker contactlenzen. Niet alleen met contactlenzen is er steeds meer mogelijk, ook de corneal crosslinking (CXL) behandeling voor stabilisatie van progressieve keratoconus krijgt steeds meer bekendheid in de Oogheelkunde. Voor optometristen (met name in de contactlenspraktijk) zijn de inclusiecriteria voor CXL van belang om keratoconus patiënten op tijd te verwijzen.
Methode: Tijdens de presentatie wordt aandacht geschonken en antwoord gegeven op de volgende vragen: Hoe wordt CXL nu toegepast, wat zijn de inclusie criteria voor doorverwijzing door optometristen en wat is er in de literatuur bekend over CXL?
Resultaten: Afhankelijk van de mate van keratoconus en de leeftijd worden patiënten over een bepaalde periode geëvalueerd middels o.a. corneatopografie om eventuele progressie van keratoconus vast te leggen. Internationale afspraken op het gebied van CXL zullen besproken worden.
Conclusie: CXL wordt internationaal toegepast bij progressieve keratoconus, waarbij de mate van progressie gedocumenteerd moet zijn over een bepaalde periode.


Aim: Treatment options for keratoconus are advancing. In the field of contact lenses, more and more options are available, and also the corneal crosslinking (CXL) treatment for stabilisation of progressive keratoconus has gained ground in Ophthalmology. For optometrists (in particular in contact lens settings), knowledge of inclusion criteria for CXL is important in order to inform keratoconus patients on time.
Methods: During the presentation, answers will be given to the following questions: In what way is CXL applied nowadays, what are the inclusion criteria for optometrists in order to refer and what is published in the literature about CXL?
Results: Dependent on the degree of keratoconus and patient age, patients will be monitored during a certain period by corneal topography to document progression. International agreements in the field of CXL will be discussed.
Conclusion: CXL is an internationally accepted treatment for progressive keratoconus; however the progression should be documented during a certain period. 

In 2004, Nienke Soeters received her Optometry Bachelor degree at the Hogeschool Utrecht and started her career at the Diakonessenhuis in Zeist. Four years later she started working as an optometrist at the University Medical Center Utrecht that offered her one year later a new challenge: she is doing scientific research in the area of keratoconus treatment options. Furthermore, she is working as an optometrist / medical contact lens specialist at a private clinic in Zeist (Oogkliniek Heuvelrug).

Tijdens het NCC 2012 zal GfK in diverse sessies marktcijfers en marktfeiten van de contactlens branche en andere branches presenteren en vergelijken. GfK is een groot marktonderzoeksbureau die internationaal voor vele markten gegevens verzamelen. Wij hopen u op deze manier een beeld te geven van de praktijk.

During our NCC 2012 conference GfK, a large market research organization, will present figures and facts on several topics. Not only will they present the actual contact lenses facts and figures, but they also will compare these facts to other branches. We hope to place several trends into perspective by doing this.

 

Na zijn studie Commerciële Economie aan de Hogeschool voor Economische Studies in Amsterdam en zijn studie Beleid, Communicatie, en Organisatie aan de Vrije Universiteit Amsterdam is Niels in 2002 bij GfK aan de slag gegaan. Hij had onder meer een coördinerende rol bij de overgang van veldwerk naar elektronische dataleveringen en is sinds 2006 verantwoordelijk voor het SDA-panel waarin vrijwel alle fabrikanten worden bediend. Daarnaast is hij vanaf eind 2008 betrokken bij de opstart van twee nieuwe markten: Optiek en Horloges. Inmiddels bedient hij voor deze markten zowel de retail- als de industriekant. Voor het optiekvakblad Oculus schrijft hij minimaal 5x per jaar een bijdrage.

Surely the benefits of wearing daily disposables are obvious — aren’t they? Do we really
need to explain to new wearers? When we are passionate about prescribing our chosen
product for the patient, it can be disappointing when our advice is not taken. Sharing our
knowledge of how we decide what is best for the patient is important if we want our advice
to be accepted. This presentation uses daily disposable lenses as the example to review
how to present the most appropriate contact lens of choice for a patient.

Sarah Morgan is an optometrist and staff development consultant, and is passionate about
knowledgable, customer-focused staff. With expertise in effective patient communication,
she has trained hundreds of staff in her interactive seminars for front-line staff, dispensing
opticians, optometrists and industry colleagues. Her second book, ʻThe Complete
Optometric Assistantʼ, is an essential read for gaining a command of everyday knowledge
of optometry or to learn how to discuss eyes and vision in patient-friendly language. At the
University of Manchester she holds the post of Visiting Scientist, and has lectured
extensively at conferences in Europe, North America, Australia and New Zealand. Sarah
is a Fellow of the American Academy of Optometry, is a Fellow, past Council member and
PR officer of the British Contact Lens Association. Her hobbies include playing the piano
and a few other musical instruments, amateur dramatics and stand-up comedy.
CIBA

As we gain greater information about contact lens myopia control, fitting children with contact lenses becomes increasingly important, but many eye care practitioners are still hesitant about fitting children. The aim of this presentation is to alleviate fears that eye care practitioners commonly hold regarding pediatric contact lens wear. Studies have shown that children are capable of understanding the rigors of contact lens care, they require only a little more chair time than teenagers, they benefit as much as teenagers, and their short-terms risks are not greater than teenagers. New evidence will be presented that indicates that there are no long-term ocular health consequences to fitting children with contact lenses at younger ages, in terms of compliance as well as ocular health. The only difference between those fit younger and those fit older was in the amount of myopia; those fit younger were more myopic than those fit older. Were the children fit younger because they were already more myopic, or did they become more myopic after they were fit with contact lenses at a young age? While the current study cannot answer that question, evidence exists to show that contact lenses do not increase myopia progression in children, so it is likely that children were fit at younger ages because they were more myopic. All of this information should make eye care practitioners more comfortable fitting children with contact lenses. 

Jeffrey J. Walline, OD PhD is an Assistant Professor at The Ohio State University College of Optometry. He received his Doctor of Optometry degree from the University of California, Berkeley School of Optometry in 1996. He received a Master’s degree in Physiological Optics in 1998 and a PhD degree in Vision Science at The Ohio State University College of Optometry in 2002.

Dr. Walline has conducted several pediatric contact lens studies, with topics ranging from myopia control to the effects of contact lens wear on children’s self-perceptions. He teaches Vision of Children and Specialty Contact Lenses to third year optometry students, and he is a clinical instructor in the Binocular Vision and Pediatrics Service and the Contact Lens Service at the College of Optometry.
 

PURPOSE: To compare vision-related quality of life benefits between children wearing orthokeratology contact lenses (OK) and distance single-vision spectacles (SV) over a 2-year period.
METHODS: Subjects 6 to 12 years of age and with myopia of -0.75 to -4.00DS and astigmatism ≤1.00DC were prospectively allocated OK or SV correction. The Pediatric Refractive Error Profile was administered at 12- and 24-month intervals to evaluate children’s perceptions in terms of overall vision, near vision, far distance vision, symptoms, appearance, satisfaction, effect on activities, academic performance, handling and peer perceptions. Additionally, parents were asked to rate their child’s method of visual correction and their intention to continue treatment after study completion.  
RESULTS: Thirty-one children were fitted with OK and 30 with SV. Children wearing OK rated overall vision, near vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling and peer perceptions significantly better than children wearing SV (all p<0.05). Near vision and handling were respectively rated better (p<0.001) and similar (p=0.44) in the SV vs. OK. No significant differences were found between 12- and 24-months for any of the subjective ratings assessed (all p>0.05). Significant overall vision*time and peer-perception*time interactions were found (both p≤0.05). Parents of children wearing OK rated visual correction method and intention to continue treatment higher than parents of children wearing SV (p≤0.01).   
CONCLUSION: The improvement in quality of life with OK vs. SV suggests that children should be offered routinely OK as a treatment for refractive error correction.
 

Jacinto Santodomingo-Rubido graduated in Optics and Optometry from the University Complutense of Madrid, Spain. He then moved to the UK to undertake an MSc followed by a PhD from Bradford and Aston Universities, respectively. His PhD investigated the ocular response to silicone hydrogel contact lenses. After completion of his PhD, he worked in private practice for a year, and then he moved to Japan as he was appointed Global Professional Relation Manager for Menicon Co., Ltd. His current duties with Menicon Co., Ltd include establishing networks with other professionals, to collaborate and coordinate global R&D activities, to participate in international conferences, to provide sales and marketing seminars, to prepare international press releases, and to pioneer new markets. Jacinto returned to Madrid in 2006 while maintaining his post and responsibilities with Menicon Co., Ltd. In 2011, he has been the recipient of the prestigious Irving Fatt Memorial Lecture Award of the British Contact Lens Association. He is a Fellow of the American Academy of Optometry and the British Contact Lens Association, and a member of the International Society of Contact Lens Research. He has presented many papers and posters at national and international conferences and authored around 50 professional papers. He is also an invited reviewer for most of the leading peer-review research journals such as Optometry & Vision Science, Ophthalmic & Physiological Optics, Eye & Contact Lens, Contact Lens & Anterior Eye, Journal of Optometry, British Journal of Ophthalmology and Investigative Ophthalmology. His research interests include myopia, ocular biometry, the cornea and tear film, and different aspects of contact lenses and keratoconus disease.

Non-compliance has been a problem which haunted contact lens practitioners. Nearly all contact lens complications can be shown to have developed as a result of the non-compliance. Although there have been significant advances in the contact lens field, serious complication associated with inappropriate use of contact lenses or lens care continues to be a problem. Non-compliance is therefore a problem which is seen as a critical issue in the contact lens field, perhaps more so with the introduction of overnight orthokeratology for children.  This presentation will review some significant research into compliance in contact lens care, and will provide the latest information regarding compliance in contact lens wearers.
 

Pauline Cho is a Professor of the School of Optometry at The Hong Kong Polytechnic University. She obtained her Bachelor of Optometry at the University of New South Wales, Australia and her PhD at the University of Bradford, UK. She obtained her Master in Professional, Vocational and Higher Education at PolyU in 2003.
She is a Fellow of the American Academy of Optometry and a Fellow of the British Contact Lens Association. She has published over 100 papers in contact lens related topics and is currently the Regional Editor (Asia-Pacific) for Contact Lens & Anterior Eye.
Since 2004, Prof. Cho has been involved in organizing and conducting annual vision screenings for ethnic minority children in Guangxi, China.
 

Despite all of the advances in the contact lens field over the years, non-compliance, particularly with respect to contact lens replacement, remains a major concern.  This lecture will review various aspects of non-compliance with contact lens wear and care and present results from several studies evaluating patient compliance with silicone hydrogel lens wear, which have recently been conducted at the Centre for Contact Lens Research to see if our patients are “Still crazy after all these years”. The possible consequences associated with wearing lenses for longer than recommended will be considered and a number of strategies to educate and improve patient compliance will be discussed. 

Kathy Dumbleton graduated from Optometry School at the University of Wales in the United Kingdom. She completed a pre-registration year at Moorfields Eye Hospital in London, England and received an MSc from the University of Waterloo, Canada. Kathy is currently Head of Clinical Logistics at the Centre for Contact Lens Research, University of Waterloo. She is a fellow of the British Contact Lens Association, a diplomate of the Cornea and Contact Lens Section of the American Academy of Optometry, a council member of the International Society for Contact Lens Research and president-elect of the American Optometric Foundation. Her research interests include the ocular response to contact lenses, silicone hydrogel materials, visual performance, compliance and the measurement of ocular discomfort.

Placido based topographers typically measure only the corneal surface but not beyond.  This course will describe how the analysis data can be used to determine the sagittal depth of eye well beyond the cornea.  This method helps us to determine the correct large diameter and scleral lens parameters with a more predictive approach than traditional techniques.
 

Randy Kojima is the Director of Technical Affairs for Precision Technology Services
based in Vancouver, Canada. His primary responsibility is to provide eye care
practitioners with GP and specialty lens fitting support from simple sphere and toric
designs through diseased, post surgical shapes and orthokeratology treatment.
He also serves on faculty at the Pacific University College of Optometry in Forest
Grove, Oregon where he teaches, provides clinical support and does research in
contact lenses and the analysis of corneal and scleral shape.
Randy has published papers on numerous topics and has lectured around the world
on corneal topography and specialty contact lenses. He is a Fellow of the American
Academy of Optometry and a Fellow of the Orthokeratology Academy of America.

Around the world large diameter, scleral contact lenses are emerging as one of the best vision correction options for patients with irregular astigmatism. Throughout this presentation we will describe new insights into the shape of the sclera and how these data have influence the design and fitting of sclera lenses in today’s clinical practice. 

Mr. Caroline serves as an Associate Professor at the Pacific University College of Optometry in Forest Grove Oregon and Assistant Professor of Ophthalmology at the Oregon Health University in Portland Oregon.  He is a Fellow member and Diplomat of the Cornea and Contact Lens Section of the American Academy of Optometry.

He is a Council member of the International Society for Contact Lens Research as well as a member of the International Association of Contact Lens Educators and the American Association of Optometric Educators.  For the past fifteen years Patrick has served as a contributing editor for the Contact Lens Spectrum and is on the editorial board for Contact Lens and Anterior Eye Journal.
 

Scleral contact lenses (ScCl) offer a number of advantages over gas permeable corneal contact lenses. The biggest benefit is the fact that the ScCl is designed to vault over the cornea; an important design feature in post-surgical corneas, in particular transplant patients. ScCls provide optimal vision without bearing on the junction between host and donor tissues. Recently, TERTC researchers reported that areas of the cornea beyond the Fleisher ring are also affected by keratoconus and, thus, it makes good clinical sense to utilize ScCl to eliminate the challenge of a contact lens bearing on the compromised cornea. This presentation, consisting of video recorded cases from our clinic, will illustrate the application of scleral contact lens designs on complex, compromised corneas and how complications may be avoided or averted by design changes. Helpful clinical pearls in ScCl patient management will be offered.
 

Dr. Jan P.G. Bergmanson received his optometric training (BSc Hons, 1970) and was awarded a PhD (1975) at the City University, London, UK. In addition, he obtained in 1982 a Doctor of Optometry degree from Pennsylvania College of Optometry, in 2007 he was awarded a PhD honoris causa from Kalmar University, Sweden and in 2008 he received a DSc from the City University, London, UK. Currently, Dr. Bergmanson is Professor of Optometry at the University of Houston College of Optometry (UHCO), where he is the founding Director of the Texas Eye Research and Technology Center (TERTC). He has published over 130 scientific articles, 7 chapters and 1 text book, now in its 19th Edition, and he has delivered over 200 invited lectures on subjects of ocular anatomy, pathology and anterior segment therapeutic management, corneal morphological response to contact lens wear, tear and ophthalmic solution effects on the ocular surface, and ocular effects of ultraviolet radiation. Dr. Bergmanson is certified in Texas as a Therapeutic Optometrist and as an Optometric Glaucoma Specialist. He is a Foundation Fellow of the College of Optometry in United Kingdom and a Fellow of the American Academy of Optometry, where he is a clinical Diplomate in the Cornea and Contact Lens Section. He is a council member of the International Society for Contact Lens Research and a lifetime honorary member of the Swedish and Dutch Optometric Associations and the Swedish Contact Lens Association. Dr. Bergmanson is the recipient of the 1998 British Contact Lens Association Gold Medal Award, the 2002 Texas Optometric Association’s Educator of the Year Award, the University of Houston College of Optometry 2003 Cora and J. Davis Armistead Faculty Teaching Award, the 2005 Swedish Optometric Association’s Mark of Honor Award and the American Academy of Optometry Section on Cornea and Contact Lenses Max Schapero Award 2006.

Sinds de introductie van Scleralenzen in 1988 door  Fick en Muller hebben scleralenzen een enorme ontwikkeling doorgemaakt.  Zo kwamen er passets, zuurstofdoorlatende materialen en niet-rotatiesymmetrische scleralenzen (met een binnentorisch scleradeel). Door deze ontwikkelingen zijn de toepassingsmogelijkheden van scleralenzen in belangrijke mate uitgebreid en kunnen ze met succes worden toegepast bij diverse indicaties.
Uit recente studies blijkt dat de vorm van de sclera vaker een tangentiale  (rechte) dan een convexe (gekromde) vorm heeft zoals altijd werd aangenomen. Tijd om de bestaande en nieuwe ontwikkelingen en innovaties van scleralenzen onder de loep te nemen.
Op basis van de nieuwe informatie over de scleravorm  zijn nieuwe scleralensontwerpen ontwikkeld met een tangentiaal scleradeel. De tussentijdse klinische bevindingen van de nieuwe scleralensontwerpen worden geëvalueerd. Er zal worden aangetoond dat deze een eenvoudige en doeltreffende aanpassing met een goed resultaat voor zowel de passing als voor de lensdrager bieden.

The clinical application of scleral lenses began with the work of Fick and Muller in the 1880s. Since then developments as preformed fitting techniques,  high-oxygen permeable materials and non-rotational scleral lens designs have considerably extended the use of scleral lenses. Scleral lenses are indicated for several ocular disorders and can often be fitted successfully when corneal and hydrogel contact lenses fail.
Recent studies show that the shape of the anterior sclera appears to be tangential (rather than convex) in shape. Time to evaluate the developments and innovations of scleral lenses!
As a result of the new insights of the scleral shape new scleral lens designs have been developed. The preliminary clinical results of the new designs will be evaluated.  


 

Simone Visser volgde de opleiding optometrie aan de Hogeschool van Utrecht. Zij heeft o.a. stage gelopen in het Moorfields Eye Hospital in Londen en aan de Universiteit van Houston.
Sinds 1996 is zij werkzaam bij Visser Contactlenzen Praktijk. Vanaf 2005 maakt zij onderdeel uit van de directie. Ze houdt zich voornamelijk bezig met het vakinhoudelijke beleid en het aanpassen van scleralenzen.
Daarnaast heeft zij in 2004 haar Mastersgraad behaald aan de City University London.
De onderzoeken die zij deed naar de indicaties en klinische prestaties van scleralenzen resulteerden in diverse nationale en internationale publicaties.


Simone Visser graduated in Optometry from the School of Optometry in Utrecht, the Netherlands. She subsequently completed a practical internship at the Contact Lens Department of Moorfields Eye Hospital in London, UK. She obtained her Masters Degree at City University in London, UKin 2004.
After spending a Semester at the University of Houston, USA with a Scholarship for Optometry she joined The Visser Contact Lens Practice, working at several (university) hospitals in the Netherlands, where she continued to specialise in medical contact lens fitting. She subsequently joined the scleral lens fitting and development team of the practice. Simone is primarily focussed on fitting scleral lenses with various corneal disorders, as well as clinical trials involving contact lenses, contact lens care products and scleral lenses. She published and gave presentations widely on scleral lenses.

 

¹José Manuel González-Méijome (presenting author)
²Jaume Pauné
¹António Queirós Pereira
¹Daniela Lopes-Ferreira
¹Helena Neves
¹Miguel F. Ribeiro

¹Clinical & Experimental Optometry Research Lab. Center of Physics, University of Minho, Braga (Portugal)
²Clinica Teknon, Barcelona (Spain)

PURPOSE:  The purpose of this presentation is to report the changes induced in peripheral refraction with different commercially available and custom made soft and rigid gas permeable lenses for daily wear in myopic patients.
METHODS:  Peripheral refraction was measured along the horizontal meridian up to 35º of eccentricity in the nasal and temporal retinal area in 5º steps using an open-field auto-refractometer. Different studies carried out in myopic patients are summarized including 14 patients wearing multifocal dominant design (center-distance) lenses and 50 patients wearing custom designed rigid or soft contact lenses. Effectiveness was measured as the capability of a given solution to provide a significant myopic increase in the peripheral relative refractive error (RPRE) and the proportion of patients in a given cohort achieving such a change.  
RESULTS:  All treatments were able to create significant degrees of RPRE. The region in the peripheral visual field where such changes were achieved was different with different types of solutions, depending on the location of the myopization area and the amount of power addition. Custom made soft and rigid lenses increased the myopic RPRE irrespective of the baseline axial myopia, with RGP designs being more effective. Multifocal dominant-design lenses changed the RPRE according to their peripheral add power but not as a linear function of that; low add power lenses (<2-3 D of add) are no effective, while the higher add powers (>3 D) did not provide significant advantages over medium-high adds.
CONCLUSIONS:  Today is possible to change the RPRE across the visual field using commercially available and custom-made contact lens solutions. Different types and designs of contact lenses are promising solutions for arresting the progression of myopia having the advantage of being well tolerated, and remaining quite stable and centered with the optics of the eye during changes in direction of sighting.
 

José Manuel Gonzalez-Meijome, OD, FIACLE, PhD, is an Associate Professor at Universidade do Minho, (Braga, Portugal) and has been involved in optometry and contact lens teaching and research activities for the last ten years. In 2007 presented his PhD Thesis on deterioration of contact lens biomaterials using different techniques. He is currently conducting research in different aspects of contact lens fitting and material properties as well as refractive surgery, quality of vision and refractive error development, working in collaboration with international partners in Spain, UK and USA. He is Adjunct Dean of the Physics Department, Director of Masters Degree Program in Advanced Optometry, Member of the Scientific Council at the School of Sciences, Associate Editor in Chief of the Journal of Optometry, Chairman of the International Conference of Optometry-CIOCV and coordinator of the Clinical & Experimental Optometry Research Lab (CEORLab).

He is an active member of the Spanish Optometry Network funded by the Spanish Ministry of Science and Innovation, Fellow of the International Association of Contact Lens Educators (IACLE), member of the Spanish College of Optometrists, Portuguese Optometrist’s Association (APLO), member of the Association for Research in Vision and Ophthalmology (ARVO), founding member of the European Academy of Optometry and Optics (EAOO) and elected member of the International Society for Contact Lens Research (ISCLR).

He has authored over 70 papers in scientific journals with refereeing indexed in ISI Web of Science and Pubmed and other 30 in publications without refereeing. Has also been presenting to national and international meetings and has authored 15 book chapters in the fields of optometry, cornea, contact lenses, intraocular pressure, biomaterials, refractive surgery and ophthalmology. Gonzalez-Meijome has also been author of a monograph on Pachometry and applications in 1999, has edited and co-authored a book on Contact Lens Practice in 2005, and is co-author of a book on Overnight Orthokeratology published 2006.

González-Méijome collaborates intensively with several foreign universities and research centers and is consultant for several national and international companies including the leading companies of the contact lens industry World-wide. During the last 10 years has attracted to the University of Minho over 0.5 million Euro in investment from public and private companies including several funded research projects.

Gonzalez-Meijome is also frequently requested as referee from 8 international journals in the field of Optometry, Optics, Biomaterials and Ophthalmology. He is also Associate Editor-in-Chief of the Journal of Optometry, the Peer-reviewed Journal of the Spanish Council of Optometrists indexed in SCOPUS and Pubmed Catalog.
 

Most of the measurements we make of the human eye are conducted in primary (horizontal) gaze looking to a far distance. But there are a range of factors that dynamically influence the optics of the eye during everyday visual tasks (eg. downward gaze and accommodation). This lecture will examine the role of dynamic changes in the corneal surface, the crystalline lens and the axial length of the eye using a range of sophisticated biometric techniques. The nature of these changes in the optics of the eye will be related to normal clinical measurements and to possible stimuli to refractive error development. 

 Michael Collins is a Professor in the School of Optometry at the Queensland University of Technology, Brisbane, Australia. He originally trained as an optometrist, graduating in 1977. He has since completed a Masters degree in visual psychophysics and a PhD in visual optics. He teaches the contact lens program to undergraduates at QUT. His research interests include the visual optics of the eye, myopia and contact lenses. He has numerous publications and has lectured widely. He is the director of the Contact Lens and Visual Optics research laboratory, a fellow of the Contact Lens Society of Australia and a fellow of the American Academy of Optometry.

Purpose:    To determine the critical soft contact lens fit evaluation parameters and how these relate to toric lens fitting.
Methods:    Ten subjects (aged 28.1 ± 7.4 years) wore ten different modern soft contact lenses (including daily disposable and monthly modalities and HEMA and silicone-hydrogel materials). Video was captured of blink (from central and up-gaze), excursion lag (up, down, right and left gaze) and push-up movement, centration and coverage. The contact lenses were marked centrally with surgical pen to enhance video movement detection by image analysis to quantify contact lens displacement and speed.
Results:     Lens centration was on average close to the corneal centre. Movement on blink was significantly smaller (p<0.001) in up-gaze (0.15 ± 0.20mm) than in primary-gaze (0.22 ± 0.14mm). Lag was greatest in down-gaze and least in up-gaze (0.70 ± 0.36mm vs 0.21 ± 0.27mm, p<0.001). Push-up test recovery speed was 1.32 ± 0.73mm/s, ranging from no movement to 6.0mm/s. Overall lens movement was determined best by assessing horizontal lag, movement on blink in up-gaze and push-up recovery speed, accounting for 91% of the variance. Steeper lens base-curves did not have a significant effect on lens fit characteristics. Contact lens material did influence lens fit characteristics, particularly silicone-hydrogels which generally had lower centration (F=2.67, p<0.05) and a faster push-up speed of recovery (F=3.34, p<0.05) than HEMA lenses.
Conclusion:    Lag on up and down gaze, and movement on blink in primary gaze generally provide little extra information on overall lens movement compared to horizontal lag, movement on blink in up gaze and push-up recovery speed. They can therefore be excluded from a simplified recording scheme. A simplified and comprehensive soft contact lens fit recording system could consist of a cross-hairs indicating the centre of the cornea; a circle to indicate the lens centration; a mark on the relevant position of the circle to indicate any limbal incursion; a grade below for movement with blink in up-gaze, a grade to the side for horizontal lag and a grade above for the assessed push-up recovery speed. Only after lens centration and movement has been shown to be sufficient, the toric marking misorientation should be ascertained and compensated for in the axis of the final prescription fitted.   
 

Prof James Wolffsohn studied Ophthalmic and Physiological Optics at UMIST, Manchester, UK, achieving a 1st class degree. He qualified to practice Optometry independently following a pre-registration year Moorfield’s Eye Hospital, London. Following this, James completed a PhD on at Cardiff University. He commenced a clinical / research position at the Victorian College of Optometry / University of Melbourne, Australia in 1997. In 2000, he returned to the UK and a position at Aston University, where he was Head of Optometry from 2004-9, being awarded a personal Chair in 2007. He is now Deputy Executive Dean for the School of Life and Health Sciences. James’ research and teaching interests mainly revolve around intraocular lenses, contact lenses, dry eyes, low vision and the measurement of accommodation, having published over 110 peer reviewed academic papers and given numerous international presentations. James is also a past President of the British Contact Lens Association. He has recently published the “Low Vision Manual” with Prof Jonathan Jackson and an Eye Essentials Series book “Imaging”.  http://www.aston.ac.uk/lhs/staff/az-index/wolffjsw/

Contact lens wear can induce ocular symptoms that are remarkably similar to that reported by patients with various dry eye conditions, and these symptoms affect almost 40% of contact lens wearers resulting in contact lens drop-out. While contact lenses are considered a contributing factor in dry eye disease, many believe the diagnosis and management scheme should be different for contact lens-related dry eye. It is important that the practitioners understand the various factors that play a role in inducing contact lens-related dry eye. Understanding these factors would assist practitioners in managing these patients effectively, which would help in preventing contact lens dropouts. There is considerable interest in the contact lens research community in determining the impact of contact lens materials, rewetting agents and care solutions on contact lens-related dry eye and this talk will focus on the various factors that are associated with contact lens-related dry eye.
 

Dr Lakshman Subbaraman is the Head of Biological Sciences at the Centre of Contact Lens Research, School of Optometry, University of Waterloo. He has authored several peer-reviewed & professional articles and 3 book chapters in the area of contact lens deposition and contact lens related-dry eye. He has presented in numerous conferences in several countries including Canada, USA, UK, Greece, Portugal, India and Australia. He also serves as a referee for several Ophthalmology & Optometry journals. He is a two-time recipient of the American Optometric Foundation’s prestigious William Ezell Fellowship. Dr Subbaraman is a Fellow of the American Academy of Optometry and a Member of the Association for Research in Vision & Ophthalmology.

Dry eye syndrome is one of the most frequently encountered ocular conditions by both Optometrists and Ophthalmologists.  Dry eye is a common source of discomfort that can seriously affect a patient’s quality of life. There are many subjective and objective methods to assess dry eye. Technological advancements in instrumentation and analytical methods over the past 10 years have resulted in a better understanding of the pathogenesis of this condition. This talk will focus on the modern-day techniques available for the assessment of dry eye.

Dr Sruthi Srinivasan is a Research Assistant Professor at the School of Optometry, University of Waterloo, Canada. She is actively involved in various clinical trials conducted at the Centre for Contact Lens Research, University of Waterloo. Sruthi graduated from the Elite School of Optometry, India and obtained her PhD in Vision Science from the University of Waterloo, Canada. After her PhD, Sruthi continued her research on dry eye as a Post -Doctoral Fellow at the Ohio State University, College of Optometry. She has presented at various international conferences and has published several papers in the area of dry eye.  She also serves as a referee for several Ophthalmology & Optometry journals. Sruthi is a Fellow of the American Academy of Optometry, Member of the Association for Research in Vision & Ophthalmology and the Tear Film & Ocular Surface Society.

 Carolina M.E. Kunnen^1,2,3, Eric B. Papas^1,2,3, Percy Lazon de la Jara<sup>1,2

1</sup>Brien Holden Vision Institute, Sydney, NSW, Australia; ²School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia; ³Vision CRC, Sydney, NSW, Australia


Background
There are about 2 billion people with refractive error in the world. Of these, approximately 125 million wear contact lenses (CL). About 30% to 50% of those contact lens wearers report comfort problems as dry eye symptoms. Dry eye symptoms can result in contact lens intolerance and discontinuation of contact lens wear. Every year about 12.5 million people stop wearing contact lenses because of ocular discomfort and dryness symptoms. Abnormal function of meibomian glands has been investigated as a possible cause of dry eye in CL wearers. To understand this potential cause of dry eye pathology it is essential to indentify the complete lipidome of the human tears and meibum.
Aim
To compare the lipidome of human tear and meibum.

Methods
Tears and meibum secretion were collected from six non CL wearers aged between 20 and 35 years on 3 consecutive days at approximately the same times throughout the day. The choice of either left or right eye was randomized and the same for each participant throughout the study.
Up to 10 µl of tears were collected and meibum secretion was expressed by using the Meibomian Gland Forceps and the Korb Meibomian Evaluator. The meibum was collected by scraping with a metal spatula along the eyelid margin.
The lipidome of the tears and meibum was analysed via Mass Spectrometry. Components assessed include: cholesteryl ester, wax ester, triacylglyceride, OAHFA, glycerophospholipids and sphingolipids.  

Results
Results of the pilot study comparing patient-matched tear and meibum samples demonstrate that although the diversity between patients is large, apart from the phospholipid component, matched tears and meibum have similar lipid profiles. In addition, the difference between the day-to-day lipid profiles in a single patient is found to be minor. Phospholipids found in tears were at a much higher level than those in meibum, suggesting an additional source of phospholipids may be contributing to tears.
 

Carolina is a PhD student at the University of New South Wales in Australia. Her research project is supervised by Associate Professor Eric Papas and Dr Percy Lazon de la Jara. Carolina’s research investigates dry eye symptoms in relation to meibomian gland dysfunction (MGD).
Carolina studied Optometry at the Hogeschool Utrecht and graduated in 2003 followed by Orthoptics which she finished in 2005. In 2008 – 2009 she completed the Bachelor course in Orthoptics.  
After her studies Carolina worked as an Optometrist and Orthoptist at Lens Utrecht, Arnhem and Deventer and other clinical settings for several years.
In addition to her studies, she is the chairperson of a non-government organisation, The Optical Foundation. In 2007 she developed a program based in Ghana, West Africa, for the Foundation; this program provided eye screening and care for Ghanaian children and gives optometry students from the University of Cape Coast an opportunity to gain practical work experience. During her work in Ghana in 2007 she trained and supervised students involved in the program.

 

High speed videokeratoscopy (HSV) and lateral shearing interferometry (LSI) are two powerful noninvasive methods of tear film surface quality (TFSQ) assessment. Recently, the techniques have been used to evaluate the effect of soft contact lens type on TFSQ. The talk will summarise recent developments in the effort to discriminate contact lens type/material in vivo on eye. 

D. Robert Iskander received the Ph.D. degree in signal processing from Queensland University of Technology (QUT), Brisbane, Australia, in 1997, and the D.Sc. degree (habilitation) in Biocybernetics and Biomedical Engineering from Silesian University of Technology, Gliwice, Poland, in 2010. From 1996 to 2000, he was a Research Fellow at the Signal Processing Research Centre and the Centre for Eye Research, QUT. In 2001, he joined the School of Engineering, Griffith University, as a Senior Lecturer and the Head of the Signal Processing Group. From 2003 to 2009, he was the Principal Research Fellow at the School of Optometry, QUT, where he led the Signal and Image Processing Group within the Contact Lens and Visual Optics Laboratory. Since 2011, he has been as a Professor at the Institute of Biomedical Engineering and Instrumentation, Wroclaw University of Technology, Wroclaw, Poland. He is the author or co-author of more than 70 journal papers and 80 conference publications. He is the holder of 10 international patents. His current research interests include biomedical signal and image processing, visual optics, and optometry and ophthalmic Instrumentation.
 

This presentation will briefly cover differences between the contact lens markets across Europe and how these variations might arise. Are these differences due to the practitioner, the patient or some other factor? The prevalence of Internet supply will be considered what this means to the contact lens practitioner and industry more generally. 

De combinatie van academisch onderzoek en toepassingen in de “praktijk”

• Voorzitter van het RFID platform Nederland
• Voorzitter van de Stichting Certificering Thuiswinkel Waarborg
• Lid van het examencollge van het NIMA, Nederlands Instituut voor Marketing en
•  lid van de adviesraad van diverse bedrijven.