Sulcus Placement of Glaucoma Drainage Device

Ahmed Samir, MD

Eyetube

In this case, 10-0 flanged prolene sutures were used to guide precise placement of an Ahmed valve in the sulcus.

The Promise of Drug-Eluting Contact Lenses

The future looks bright for this technology.

Alex Hynes, OD, FAAO

Modern Optometry

Although not yet commercially available in the United States, and with many prototypes still in preclinical study stages, drug-eluting contact lenses may pave the way for a new era of eye care. This article offers a brief overview of the technology and what lenses are in the pipeline. LENS PROS AND CONS As with all things in life, there are pros and cons to drug-eluting contact lenses. Let’s start with the less positive aspects of this treatment modality. Drawbacks Disadvantages to drug-eluting contact lenses include risk of corneal toxicity with long-term wear and discontinuation of wear due to lens discomfort. There are also fears that unhygienic lens handling may lead to infection.1 Issues remain with lens preparation and storage; for example, the fast and simple soaking method of drug loading is limited by poor sustained medication release. Encouragingly, however, several lenses loaded via more complex methodologies allowing more gradual medication release recently moved into clinical studies.2-5 Given the inherent limitations associated with other methods of ocular drug delivery, the potential of drug-eluting lenses is likely not over-exaggerated.5 Advantages Drug-eluting contact lenses may improve patient compliance compared with topical medication use, which is often limited by forgetfulness and poor hand-eye coordination. In a prospective study of patients with glaucoma, 29% could not administer drops into their eyes.6 Reduced drop instillation ability may result in under- or overdosing, which can lead to side effects or treatment inefficacies if patients don’t follow the correct dispensing interval or quantity.7 Contact lenses may also increase treatment efficacy by enhancing drug bioavailability. The medication is eluted into a post-lens tear layer that is partially shielded from blink-induced tear film turnover. This allows longer residence time on the ocular surface.

Changing the Perception of the Retail Optometrist

It’s time we broaden our perspectives on the possibilities of providing care in this setting.

Harmin Chima, OD, and John Womack, OD

Modern Optometry

Picture a familiar scene in a busy eye care clinic: An optometrist assures a relieved patient they don’t have glaucoma while reviewing their OCT results in the exam lane. The OD swiftly walks to the room next door to begin expressing the meibomian glands of another patient who is undergoing treatment for dry eye disease. Ten minutes and 25 questions about dry eye later, and the optometrist is heading back to the first exam lane to check on an 11-year-old boy who has been in a myopia control treatment program for 6 months. On the way there, a patient in the optical asks whether the red or tortoiseshell frame looks better on her. Add in 10 to 15 comprehensive examinations, several of which also require a contact lens fitting, and what you end up with is a typical day at work for many optometrists. As you were reading the above, were you imagining a retail optometric setting? If not, then you’re not alone—and that’s the purpose of this article—to let our private practice and academic colleagues know that our concept of retail optometry may be outdated. RECOGNIZING OUR PATIENTS’ NEEDS We practice at a franchise group that owns and operates 88 Pearle Vision locations across the country. One of us (JW) serves as the chief medical officer, and the other (HC) as vice president of Professional Services. Our roles come with many responsibilities, one of which, fortunately, is seeing patients so that we can remain clinically relevant.