January 11, 2022
Not all salines are the same!!
Saline is an integral part of contact lens practice, being used regularly by most people who wear contact lenses. Its most common use is as a rinsing agent, either after the contact lenses have been cleaned by a surfactant cleaner or prior to insertion of a contact lens onto the eye. As I have noted in previous blogs, under no circumstances should any type of water be used on contact lenses. Studies continue to show that there is an increased incidence of corneal infections associated with the use of water on contact lenses.
September 9, 2021
Having issues with zoom fatigue and digital eye strain – don’t forget the 20-20-20 rule!
You will recall that last year I wrote how the COVID-19 pandemic has led to a marked increase in the use of digital devices with the result that there has been a dramatic upsurge in the number of people experiencing symptoms of digital eye strain (DES), such that the term ‘zoom fatigue’ has been coined to describe this phenomenon. DES is characterized by visual disturbance and/or ocular discomfort related to the use of digital devices such as smartphones, iPads, computers and laptops.
August 17, 2021
Discontinuation of Silsoft contact lenses
One of the contact lens options we use for the contact lens management of infantile aphakia is the Silsoft lens from Bausch & Lomb. Presently the Silsoft lens is the only silicone elastomer lens on the market and this lens has previously been approved by the Food and Drug Administration in the US for both daily wear and 30-day extended wear for aphakia. The main feature of the silicone elastomer material is its very high oxygen permeability.
May 24, 2021
Regular contact lens after-care is essential
We see many patients in our practice – especially those with keratoconus or those who have undergone corneal graft surgery – for whom contact lenses are the only means of refractive correction. Generally, these patients have an irregular corneal shape so the improvement in vision obtained with spectacles is minimal and hence they are generally dependent on rigid contact lenses (or similar) to achieve levels of vision that allow them to manage with normal activities of daily living.
Hand sanitizer associated corneal burns increasing due to COVID-19
As a result of the COVID-19 pandemic, people around the world are now practicing strict personal hygiene against infection. This includes the regular use of alcohol-based hand sanitizers. A recent paper in the Visual Journal of Emergency Medicine reported on a surge in hand sanitizer associated ocular chemical injury to the marked increase in the use of hand sanitizers over the last year.
March 16, 2021
Rigid contact lenses – the new terminology
Rigid contact lenses are available in many forms. In the past, the classification of rigid lenses was based on differences in total diameter, although the terminology was variable.
February 10, 2021
Vale Professor Barry Cole
This blog is about a great man who left us recently. It is about a great man who was without a doubt the most important and significant person in the development of optometry as a profession over the last 60 years. It is about a great man who always inspired me and undoubtedly had the biggest influence on my career.
Another pair of customised spectacles manufactured using 3-D printing technology
A couple of years ago I wrote a blog about a paper published in Clinical and Experimental Optometry (CXO) that described how customised spectacles were designed and manufactured using three dimensional (3-D) printing technology for a five-year-old girl with Goldenhar syndrome, which is a rare congenital condition characterized by incomplete development of the ear, nose, soft palate (the soft tissue constituting the back of the roof of the mouth), lip and mandible (jawbone).
Recent study suggests that spectacle wearers may be less susceptible to COVID-19
A recent paper in the American Medical Association Journal of Ophthalmology (JAMA Ophthalmology) reported on a cohort study of 276 patients hospitalized with COVID-19 in Suizhou, China. The study showed that the proportion of inpatients with COVID-19 who wore glasses for extended daily periods (greater than 8 hours per day) was smaller (5.8%) than that in the general population (31.5%), suggesting that daily wearers of glasses may be less susceptible to COVID-19.
September 2, 2020
Contact lenses for presbyopia
Presbyopia is a condition where the eye gradually loses the ability to focus at a normal reading distance. It is usually first noticed between the ages of 40 and 50 years when people find that they can no longer focus comfortably on objects closer than at arm’s length. Presbyopia is not a disease and it affects everyone.
July 7, 2020
National Diabetes Week July 12 – July 18
About 7 % of Australians have diabetes. July 12 to July 18 is National Diabetes Week which aims to promote awareness and education about this serious condition which can affect the entire body. Diabetes requires daily self care and – if complications develop – diabetes can have a significant impact on quality of life and can reduce life expectancy. Diabetes is the leading cause of both blindness in working age adults and kidney failure and dialysis.
June 3, 2020
‘Zoom fatigue’ and digital eye strain
Digital eye strain has been an emerging public health concern over the last 10 years with studies showing that over 85% of digital device users experience either ocular or non-ocular symptoms of digital eye strain. This condition is characterized by visual disturbance and/or ocular discomfort related to the use of digital devices such as smartphones, iPads, computers and laptops. Ocular symptoms of digital eye strain include tearing, tired eyes, blurred vision, general fatigue, burning sensation, redness and double vision. Non-ocular symptoms include stiff neck, general fatigue, headache and backache.
April 30, 2020
Further information regarding Contact Lens Wear & COVID-19
A new peer-reviewed paper on safe contact lens wear specific to COVID-19 – authored by five of the world’s most prominent experts in the field of contact lens practice – has been published in the journal Contact Lens & Anterior Eye. The paper titled “The COVID-19 Pandemic: Important Considerations for Contact Lens Practitioners” concludes that no evidence exists for asymptomatic wearers to cease their use of contact lenses and that no evidence exists supporting claims that spectacles protect against COVID-19, among other determinations. A copy of this paper can be accessed here - https://www.lindsayassociates.com.au/media/clnews/1588210840554803007.pdf
Additionally, new guidance was issued this past week by the U.S. Centers for Disease Control and Prevention (CDC) regarding contact lens wear and care amid the COVID-19 pandemic. The clear direction was posted to the CDC’s website (https://www.cdc.gov/contactlenses/protect-your-eyes.html [cdc.gov]) and also supports continued contact lens wear for people who are healthy and practice safe hygiene habits.
Note that as we previously stated on an earlier posting – and consistent with guidance for other types of illness – no contact lens wearer with active COVID-19 should remain wearing their contact lenses.
Stay safe everyone! :)
April 17, 2020
COVID-19 and Contact Lens Wear
Over the past few weeks there has been some misinformation spread about contact lens wear during this pandemic caused by COVID-19. At the present time, there is no evidence to suggest an increased risk of being infected with SARS-CoV-2, the novel coronavirus that causes the disease known as COVID-19, through contact lens wear.
The Cornea and Contact Lens Society of Australia (CCLSA) recently issued a statement on this matter as follows:
“For decades contact lens practitioners have advised thorough, correct hand-washing and strict hygiene practices for contact lens wearers in order to decrease the risk of eye infections. There is however a history of a significant degree of non-compliance with proper hygiene techniques among contact lens wearers, and the general public at large. Now more than ever it is critically important for a contact lens wearer to pay great attention to proper hygiene and for practitioners to strongly reinforce sound practices. Contact lens wear is a safe activity with low rates of infections or other serious complications, despite poor compliance with safe practices.
Contact lenses, solutions and eye drops (where applicable) should be used, worn and replaced as prescribed by your eye care practitioner and according to manufacturer recommendations and expiry dates. Storage case hygiene and care practices should be followed for reusable lenses.
Practitioners have long advised against the wear of contact lenses if a wearer is unwell. This applies in particular to any signs or symptoms of colds and flu, respiratory tract infections, red sore eyes, discharge and so on. Basically, if someone is feeling unwell, they should terminate contact lens wear. For healthy individuals, normal contact lens wear can be maintained.”
April 3, 2020
James Muecke, 2020 Australian of the Year
A few months ago, South Australian ophthalmologist Dr James Muecke AM was named as the Australian of the Year for 2020. Dr Muecke was honoured for his decades of pioneering work in Australia and abroad where his focus remains to fight blindness. Dr Muecke said that while it was humbling to receive such a prestigious award, his work is far from over. He duly notes that there are 285 million people across the globe with vision impairment and blindness, 80% of which is avoidable, and he hopes that his award will help raise awareness of this problem and help to bring the power of sight to more communities across the world.
February 6, 2020
Recently my good friend and colleague Rob Holloway published an excellent paper on the eye condition known as ‘Christmas Eye’, which is an acute toxic corneal inflammation that occurs during the hot, dry summer months in south eastern Australia. This condition usually occurs any time from mid-November until late February, hence the name Christmas Eye.
January 16, 2020
Steve Newman, innovator and genius
In my 35 years working in contact lens practice, I can honestly say that I have not met anyone as brilliant or amazing as my good friend Steve Newman. Originally trained and employed as a cartographer, Steve began his career in contact lenses because of a personal interest in contact lens wear. More precisely, Steve could not understand why no one could develop a toric soft contact lens that would successfully correct his high degree of astigmatism.
Scleral and mini-scleral lenses reduce the need for corneal transplant surgery
You will recall that I discussed these wonderful contact lenses in a previous newsletter a few years ago. They are designed to rest on the scleral (white portion) of the eye (which is fairly regular), and to vault over any corneal irregularities such as those found in keratoconus and post-graft patients.
Greater lens care compliance observed with patients using hydrogen peroxide
A recent paper in Contact Lens Spectrum by my good friends and colleagues Jill Woods and Lyndon Jones – based on a study done in the Centre for Ocular Research and Education (CORE) at the University of Waterloo in Canada – looked at the difference in lens care compliance between users of hydrogen peroxide and multipurpose solution (MPS) care regimens.
Special Issue on Optical Coherence Tomography in Clinical and Experimental Optometry
Recently my colleagues Bang Bui, Laura Downie and I put together a special issue for the journal Clinical and Experimental Optometry which was devoted entirely to the topic of optical coherence tomography (OCT). This amazing imaging technology – which has only really been in clinical practice for the last decade – has revolutionized the way eye care practitioners detect and manage ocular disease.
New laser treatment helps to reduce the rate of progression of age related macular degeneration (AMD)
April 16, 2019
New laser treatment helps to reduce the rate of progression of age related macular degeneration (AMD)
Age related macular degeneration (AMD) is the leading cause of irreversible vision loss in industrialized nations and costs the Australian economy in excess of $2.5 billion per year. The recent development of the nanosecond laser (2RT, Ellex, Pty Ltd) offers great promise as a treatment that may reduce progression of the disease.
March 12, 2019
Tattoos can lead to serious eye problems
Over the past 50 years there have been at least 15 cases of people diagnosed with tattoo-associated uveitis cited in the medical literature. Uveitis is a general term describing a wide range of inflammatory diseases that produce swelling and redness within the eye, and ultimately destroys ocular tissue. The term ‘uveitis’ is used because the diseases often affect a part of the eye called the uvea.
January 30, 2019
Customised spectacles using 3-D printing technology
An amazing paper published recently in Clinical and Experimental Optometry by Dr Onder Ayyildiz describes how customised spectacles were designed and manufactured in Turkey for a five-year-old girl with Goldenhar syndrome, which is a rare congenital condition characterised by incomplete development of the ear, nose, soft palate (the soft tissue constituting the back of the roof of the mouth), lip and mandible (jawbone).
December 17, 2018
Recent study shows intraocular lenses not the best treatment option for aphakic babies
About four years ago I published a blog discussing the relative merits of contact lenses or intraocular lenses for unilateral aphakic babies. This blog was based on a paper in the Journal of the American Medical Association (JAMA) Ophthalmology which compared the visual outcomes of unilateral aphakic babies optically corrected with contact lenses versus intraocular lenses (IOLs) following unilateral cataract surgery during early infancy. The study also looked at the efficacy and safety of primary IOL implantation for infantile unilateral aphakia.
November 8, 2018
Optometry Giving Sight and World Sight Day
World Sight Day was on October 11 this year. The World Sight Day Challenge is a major, international fundraising campaign. It’s coordinated by Optometry Giving Sight (OGS) as a way to bring the global optometric community together and help end avoidable blindness and vision impairment.
Corneal collagen cross-linking now covered under Medicare
I am pleased to report that many Australians with keratoconus will now benefit from a Medicare rebate for corneal collagen cross-linking (CXL) to help stop or slow down progression of their condition. The Medicare Benefits Schedule (MBS) Item for CXL came into effect on May 1 this year and the rebate amount for the procedure is $1200.
June 8, 2018
Southern Regional Congress in Melbourne: What I learnt
In late May, Andrew, Jillian and I attended the Southern Regional Congress (SRC) in Melbourne. This is the biggest optometric conference in Australia and it is held each year in Melbourne. This year there were over 850 delegates and – as in previous years – they were treated to some excellent lectures from both local and overseas speakers. The conference has a strong clinical aspect with many presentations outlining what is considered best practice for the consulting room, however there were also some very good talks which provided delegates with all the latest developments in ophthalmic research.
May 7, 2018
Update on cataracts
Cataracts are a clouding or opacification of the lens inside the eye. They are generally a result of ageing and long-term exposure to ultraviolet light. Cataracts may also be caused by trauma to the eye and in rare cases they can be present at birth. Note that cataracts simply represent a change in or alteration to the lens material – they are not a growth.
March 27, 2018
Launch of Cataract Kids Australia
About a month ago I had the pleasure of speaking at the launch of Cataract Kids Australia. The event brought together children affected by congenital and infantile cataract, and their families, eye care providers, researchers and other interested parties.
Recent study shows increased risk of melanoma for people with pterygia
Just recently there was a paper published in the British Journal of Ophthalmology by researchers from the Lions Eye Institute (LEI) in Perth which showed that the presence of a pterygium indicates a significantly increased risk of developing a cutaneous melanoma.
November 20, 2017
Children and soft contact lenses
A couple of months ago, my friend and colleague Mark Bullimore published an excellent paper in Optometry and Vision Science in which he critically analysed how safe it was to fit children with soft contact lenses. Since about the turn of the century there has been less reluctance shown to fit children with contact lenses.
October 5, 2017
We are now approaching the warmer time of the year, and – as we all know – overexposure to UV radiation can cause eye damage, such as swelling of the cornea and the conjunctiva (the ‘white’ of your eye), cataract development and other kinds of problems including pterygium (tissue growth which can encroach on your cornea) and skin cancer around the eyes.
September 15, 2017
16th International Cornea & Contact Lens Conference
Recently I attended the 16th International Cornea & Contact Lens Conference (ICCLC) in Sydney. This is the biennial conference of the Cornea and Contact Lens Society of Australia (CCLSA) and it is without a doubt the biggest contact lens conference held in Australia. This year there were over 320 optometrists in attendance.
August 14, 2017
Our specialist colleagues
A little while back, one of our corneal transplant patients unfortunately suffered a rupture to their corneal graft due to an accidental poke in the eye from his two year old boy. Naturally this occurred on a Sunday night. Our patient was immediately taken to the Royal Victorian Eye and Ear Hospital (RVEEH) where the ophthalmologist on duty advised him that the corneal graft would need to be resutured.
May 30, 2017
I was an invited speaker at the recent Southern Regional Congress (SRC) in Melbourne. This is the biggest optometric conference in Australia and it is held each year in Melbourne. This year there were over 800 delegates and as is the norm they were treated to some excellent lectures from both local and overseas speakers.
May 3, 2017
Age-related macular degeneration
In late May – May 21 to May 27 – there will be Macular Degeneration Awareness Week which is organized by the Macular Disease Foundation Australia (who do a tremendous job in promoting awareness and educating the public about this serious group of eye diseases). Hence, it seems only appropriate that I write about this important topic and for this I have called on the services of a guest blogger, namely my wife Professor Erica Fletcher.
March 27, 2017
Rigid contact lenses – what’s in a name?
Rigid contact lenses are available in many forms. The classification of rigid lenses is usually based on differences in total diameter, although the terminology can vary. I favour the rigid lens nomenclature whereby corneal lenses have a diameter of 7.0 to 12.0 mm, corneal-scleral lenses have a diameter of 12.0 to 15.0 mm, mini-scleral lenses have a diameter of 15.0 to 18.0 mm and scleral lenses have a diameter of 18.0 to 25.0 mm.
March 7, 2017
Contact lenses and the internet
A few years ago, internet purchase of disposable contact lenses was identified as a major risk factor for contact lens-related infection in an Australian study published in a major ophthalmic journal.
February 14, 2017
Contact lens conference in Las Vegas
My colleague Andrew Huhtanen recently attended the Global Specialty Lens Symposium (GSLS) in Las Vegas. This is now probably the biggest contact lens meeting in the world and – as the name implies – there is an emphasis throughout the meeting on the contact lens management of conditions such as keratoconus, post-graft, high myopia, astigmatism and paediatric aphakia.
January 16, 2017
Off to school
It is an exciting time when a child heads off to school for the first time. Like thousands of other children, our youngest girl Hanna is commencing school this year and in a couple of weeks my wife and I will be walking her to school where she will meet her new Prep teacher and all her classmates.
October 14, 2016
BCLA - Digital eye strain
Last month I attended the British Contact Lens Association (BCLA) Asia conference which was held in Hong Kong (in conjunction with the Hong Kong Cornea and Contact Lens Society). It was an excellent meeting with over 200 delegates from all over the world in attendance and various topics were covered including myopia control, orthokeratology, scleral lenses, dry eye and paediatric contact lens fitting. One of the best and most interesting seminars at the conference was a presentation given by Peter Kollbaum from the USA on the topic of ‘digital eye strain’.
August 11, 2016
Daily disposables – the way of the future
Disposable soft contact lenses were launched onto the Australian contact lens market in 1989. Interestingly, for a few years before the introduction of disposable lenses several companies had operated frequent replacement schemes, with the interval between lens replacements generally being three or six months. These frequent replacement programs were not that successful and it was only with the introduction of disposable lenses – and the subsequent shorter interval between lens replacements – that the concept of ‘frequent lens replacement’ was truly embraced by contact lens patients.
July 26, 2016
The great outdoors and myopia
Last month there was an excellent article in Contact Lens Spectrum by David Berntsen in which the author summarized the recent studies that have demonstrated the protective effect of outdoor time against the onset of myopia.
June 21, 2016
Hydrogen Peroxide – the Forgotten Cleaning System
Hydrogen peroxide was introduced as a contact lens maintenance system in the mid 1980s. At this time, it was seen as a major breakthrough in contact lens cleaning and disinfection, as previously patients had been required to use heat disinfection (which usually led to signification contact lens degradation and deposition) or chemical systems that incorporated preservatives such as thiomersal or chlorhexidine (which often led to adverse reactions from the eyes).
June 2, 2016
When I was an optometry student at the University of Melbourne, one of my great memories is the outstanding clinical teaching I received when I started to see patients for the first time.
March 29, 2016
Annual Cornea Society and Eye Bank Meeting
My colleague Andew Huhtanen and I recently attended the 33rd Annual Cornea Society and Eye Bank Meeting which was held here in Melbourne. Once again, the top corneal specialists from here and New Zealand were in attendance.
January 19, 2016
New registry for corneal collagen cross-linking
Our experience over the last 10 years with the corneal collagen cross-linking treatment (CXL) of keratoconus shows that this procedure is both safe and effective in halting the progression of the keratoconus. We also know that the earlier this procedure is offered, the more likely it is to retard keratoconus progression.
July 24, 2015
The ‘patching’ you do without a patch!
Amblyopia (or ‘lazy eye’) is a common visual disorder that affects about 4% of people. The most common causes are strabismus (where the child has a large squint or ‘turned eye’) and anisometropia (where there is a large difference in the refractive error between the two eyes).
May 25, 2015
I have just returned from the 15th International Cornea & Contact Lens Congress which was held last weekend on the Gold Coast. This is the biggest contact lens meeting in Australia and it is put on every two years by the Cornea & Contact Lens Society of Australia.
Presbyopia is a condition where the eye gradually loses the ability to focus at a normal reading distance. It is usually first noticed between the ages of 40 and 50 years when people find that they can no longer focus comfortably on objects closer than at arm’s length. Presbyopia is not a disease and it affects everyone. Presbyopia is usually corrected by reading glasses (which will make near objects clear but distant objects blurry) or multifocal glasses (which incorporate progressive lenses that provide clear vision at both distance and near).
There was good news recently in the contact lens market with Alcon releasing their Air Optix Colors contact lenses. These excellent lenses involve a unique 3-in-1 colour technology that can enhance any eye colour for a wonderful cosmetic result.
January 27, 2015
Global Specialty Lens Symposium (GSLS) in Las Vegas
I have just been to the Global Specialty Lens Symposium (GSLS) in Las Vegas. The GSLS is one of the biggest annual contact lens meetings and this year there were over 800 attendees from all around the world.
December 16, 2014
Recently – in both Australia and the UK – there has been an increased incidence of corneal infections associated with the use of water on contact lenses. These infections are caused by Acanthamoeba, a parasite commonly found in tap and other sources of water.Recently – in both Australia and the UK – there has been an increased incidence of corneal infections associated with the use of water on contact lenses. These infections are caused by Acanthamoeba, a parasite commonly found in tap and other sources of water.
October 28, 2014
I have just returned from doing some volunteer work in Hanoi, where I was teaching contact lens fitting at the Vietnam National Institute of Ophthalmology. This is the major eye hospital in Hanoi and it generally serves about 2000 patients a day.
September 19, 2014
Myopia control is an exciting area with recent studies providing good evidence that it may be possible to minimize or even stop the progression of myopia (short sightedness). Presently there are various modalities of myopia control which have been clinically shown to reduce the rate of myopia progression and these include orthokeratology (Ortho K)
August 13, 2014
Dry eye is a common problem for both soft and rigid contact lens wearers. A recent study estimated that over 10% of patients have symptomatic and treatable dry eye. Contact lens discomfort is often associated with – or due to – a dry eye condition.
June 30, 2014
In a very exciting development in contact lens practice, the first silicone hydrogel colour contact lenses have recently been launched in the USA.
Four of my optometric colleagues were awarded the OAM (Medal of the Order of Australia) in the recent Queen’s Birthday Honours – Ms Jane Duffy, Mr Peter Lewis, Mr Peter Stewart and Mrs Susan Walton.
Our most recent newsletter – which has just been posted on our website – features a summary of a paper that was published earlier this year in the Journal of the American Medical Association (JAMA) Ophthalmology. The paper showed there was no significant difference between the visual acuity of children who underwent primary intraocular lens (IOL) implantation and those who were fitted with contact lenses.
January 20, 2014
An issue we face at this practice is non-compliance in contact lens wear. All contact lens wearing patients exhibit some degree of non-compliance with regard to contact lens wear and maintenance, even though most patients consider themselves to be complying with guidelines for lens wear and care that have been outlined to them by their contact lens specialist.