EyeWitness

Spring 2017

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Notes from Tim An Ounce of Prevention is Worth a Bazillion Pounds of Cure By Tim Koch, FCLSA, COT 4 CLSA EyeWitness Spring 2017 pediatric contact lenses is orthokeratology for children in the prevention of acute, pathological myopia. There is no paucity of data regarding the worldwide myopia epidemic – the dramatic increase in both the prevalence and the severity of myopia globally. The risk of vision loss related to maculopathy is much greater in patients with acute myopia (>-6.00D), and efforts to prevent pathological levels of myopia are under increasing amounts of study. When there are massive numbers of people around the world with increasing levels of myopia, the natural result is a growing number of people with pathological levels of myopia, resulting in a consequential amount of permanent vision loss and blindness. More and more, pediatric practitioners are recognizing the genetic markers, the early warning signs of young children with aggressive myopia (i.e., over -2.00D by age 7), and advising myopia prevention therapies such as orthokeratology, soft multifocals or pharmacological treatments such as low-dose atropine. Keep your eyes and ears tuned to these important contact lens pediatric stories. I promise that they will be a key part of your practice and provide rewards beyond satisfaction. EW O ften, in pediatric contact lens fitting, the issues are not just providing and protecting vision, but preventing serious vision loss and blindness. Infantile aphakia and acute myopia are two prominent conditions in children that require accurate diagnosis and quick intervention on the part of the entire eye care team. It is worth mentioning that I hold in the highest regard those who work with children and contact lenses. It requires persons with big patience and bigger hearts, and it is not surprising to me that the CLSA has significant representation here. I applaud you (but quietly, so as not to disturb any sleeping infants). One of the early and significant products we employed in the management of infantile aphakia are the SilSoft ® and now the SilSoft ® Super from Bausch & Lomb. In September 1984, the SilSoft ® lens (Bausch & Lomb, Rochester, NY) manufactured from a silicone elastomer, was the first lens that reached U.S. Food and Drug Administration (FDA) approval as a 30-day extended-wear lens for aphakia. Developed originally by Dow Corning as part of the early work in contact lens silicone technology in the 70's and early 80s, it would be difficult to estimate the number of children (many who are now adults) that have profoundly better vision than they might have had as a result of the availability of SilSoft ® lenses in the necessary powers of up to +33.00D. As we know, it is vital to provide sufficient post- surgical visual stimulus in infantile aphakia while the visual system is still in the hard-wiring, formative process. I will tip my hat again to Bausch & Lomb because this lens has been kept available on the marketplace more for altruistic, humanitarian reasons than for the lure of large profit in a huge market. There are not big numbers of infantile cataracts. Bausch & Lomb has even developed programs whereby the financially challenged can get the help of these lenses for their newborn children. Thank you, Bausch & Lomb. The big emerging story for Tim Koch, FCLSA, COT, has over 30 years experience in the eyecare industry and is well known as an author, lecturer and specialist in the contact lens field. He has served on the Board of NCLE, on the Board of CLSA and on the Board of Directors of the Contact Lens Manufacturers Association of America.

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