Optometric Physician

Vol. 22, #38   •   Monday, October 4, 2021


Off the Cuff: Regeneron Knocks it Out of the Park with Now Eye See

Growing up before the internet was even imagined, television entertained, educated and opened our eyes to the world. As a kid growing up in the Bronx, I was lucky. New York was a major TV market and we had seven channels to choose from, a lot more than most. Without VHS or DVR for recording programs, deciding which channel and show to watch was a challenge and a decision the entire family had to agree on.

Today, Shannon and I have access to more channels than I can count, especially now that we cut the cable and subscribe to several streaming services. Despite the glut of programming, we often struggle to find programs worth watching. Still, there are a few shows that we do enjoy like reruns of The Big Bang Theory, at least as much as our two puppies will permit. We usually fast forward through the commercials, but the other night we were floored by the Now Eye See commercial by Regeneron.

Not only is the commercial really well done and extremely informative, but the website it links to is absolutely brilliant. A masterpiece of beautifully balanced and artfully presented public health content, NowEyeSee is among the very best, most educational and empowering websites I have ever seen.

I am fortunate to have several friends who work at Regeneron, who have only good things to say about the company. While my clinical interests are a bit eccentric to Eylea, the star of their current retinal portfolio, Regeneron is clearly a place where innovation and good ideas flourish. Their portfolio includes a number of class-leading drugs that are saving and improving lives and a robust pipeline. You may be familiar with their COVID antibody cocktail that has garnered clinical praise and media headlines.

Now Eye See was so well done and such powerful a public health and eye care initiative, I wish I could give Regeneron the Primetime Emmy Award for an Outstanding Commercial. While I can’t do that, I can create and award them the inaugural Optometric Physician Eppy award for this wonderful public health focused programming. Thank you, Regeneron, for helping us educate and better care for our patients, and congratulations on earning the first Eppy!


Arthur B. Epstein, OD, FAAO
Chief Medical Editor

Want to share your perspective?
Write to Dr. Epstein at artepstein@optometricphysician.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.




Standard Automated Perimetry Using Size III and Size V Stimuli in Advanced-stage Glaucoma

In this study, researchers sought to evaluate the extent of further visual field that could be assessed when using stimulus size V in standard automated perimetry compared with size III in advanced stage glaucoma and whether cut-off values could be determined for when to switch from size III to size V. This was a prospective study conducted in a single-center outpatient eye clinic in India (New Delhi). Advanced stage glaucoma was defined as stages 3 to 4. Central static perimetry with the Octopus 900 G program (size III stimulus dynamic strategy) and low vision central program (size V stimulus dynamic strategy) were performed for right and left eyes with both sizes III and V undertaken within one clinic visit.

Researchers recruited 126 patients (170 eyes). Mean patient age at assessment was 55.86 years (SD 15.15). Mean values (SD) for size III vs. size V, respectively, were 6.94 dB (5.58) and 12.98 dB (7.77) for mean sensitivity, 20.02 dB (5.67) and 19.22 dB (7.74) for mean deviation, 5.89 dB (2.29) and 7.69 dB (2.78) for standard loss variance, and 3.32 min (1.07) and 6.40 min (1.43) for test duration. All except mean deviation were significantly different between size III and V tests.

Useful visual field information was obtained with size V stimuli, which allowed continued monitoring of these patients that was not possible with size III. Increased test duration, standard loss variance and mean sensitivity were found with size V, as expected, given that more visual responses were obtained with the increased target size. Researchers suggested that a switch from size III to V may be considered when mean sensitivity reaches 10 dB and/or mean deviation reaches 18 dB.

SOURCE: Sood D, Czanner G, Somerville T, et al. Standard automated perimetry using size III and size V stimuli in advanced stage glaucoma: an observational cross-sectional comparative study. BMJ Open 2021; Sep 28;11(9):e046124.


Changes in Corneal and Anterior Chamber Indices Due to Methamphetamine Abuse

Considering the significant relationship between methamphetamine abuse and some anterior segment indices, methamphetamine abuse should be considered in differential diagnosis especially in the case of angle-closure glaucoma. In this cross-sectional study, the participants were (crystal) meth addicts living in Zahedan. The participants were transported to the examination site to undergo imaging and optometric tests to investigate the effect of inhaled methamphetamine (meth) and crystal methamphetamine (crystal meth) on the quantitative indices of the cornea and anterior chamber using the Pentacam (Oculus) and anterior-segment optical coherence tomography. Imaging was then conducted to evaluate corneal and anterior chamber quantitative indices.

A total of 42 (crystal) meth addicts and 42 healthy subjects with matching age and gender were examined. Out of 42 subjects in the case group, 6 were female and 36 were male (mean age: 35.7 ± 8.6 years). The mean dose of drug used was 0.0074 ± 0.0034 g, and the mean duration of drug use was 6.9 ± 2.6 years (5 to 12 years). Based on the images of both devices, corneal curvature was significantly steeper in both meridians of anterior and posterior surfaces compared to the control group (p=0.01). Among the anterior chamber parameters, the anterior chamber depth and volume were lower in the cases than the controls (p<0.01). However, the lens rise was higher in addicts than controls (p=0.01).

Investigators reported that quantitative changes in corneal and anterior segment indices including dilated pupils, shallower anterior chamber depth and higher lens rise in addicted cases compared to the control group may precipitate the risk of closed-angle in these individuals.

SOURCE: Mahjoob M, Heydarian S. Changes in corneal and anterior chamber indices due to methamphetamine abuse. Clin Exp Optom. 2021; Sep 30. [Epub ahead of print].


Patient Experience and Satisfaction with Immediate Sequential and Delayed Sequential Bilateral Cataract Surgery

Researchers evaluated bilaterally pseudophakic patients who received immediate or delayed sequential bilateral cataract surgery (ISBCS and DSBCS) to determine patient experience, particularly related to the loss of opportunity to modify the surgical plan for the second eye. 1,818 ISBCS and 1,818 DSBCS patients who actively used the electronic patient portal were randomly selected and sent a survey link. The survey inquired about reasons for choosing ISBCS or DSBCS, concerns about surgery, and whether the loss of opportunity to modify the surgical plan for the second eye affected the patient's decision to undergo immediate sequential bilateral cataract surgery.

Participation was 18% among ISBCS patients and 17% among DSBCS patients. Of the ISBCS patients, 96% would choose ISBCS again while 80% of DSBCS patients would choose DSBCS again (p<.0001). Convenience was the leading reason patients chose ISBCS (65%), whereas surgeon recommendation was the primary reason patients chose DSBCS (68%). Sixteen percent of ISBCS and 38% of DSCBS patients reported that the possibility of modifying the surgical plan to reduce the need for corrective lenses in the second eye was an important consideration (p<.0001).

In comparison to DSBCS patients, ISBCS patients were more likely to choose ISBCS again and to recommend ISBCS to a family member or friend. The option to modify the surgical plan for the second eye to reduce need for glasses or contact lenses was not an important consideration for a majority of either group.

SOURCE: Carolan JA, Amsden LB, Lin A, et al. Patient experience and satisfaction with immediate sequential and delayed sequential bilateral cataract surgery. Am J Ophthalmol. 2021; Sep 25. [Epub ahead of print].





Industry News

B+L Announces Positive Topline Results from Second Phase III Trial of NOV03

Bausch + Lomb announced statistically significant topline data from the second Phase III (MOJAVE) trial evaluating the investigational drug NOV03 (perfluorohexyloctane) as a first-in-class eye drop with a novel mechanism of action to treat the signs and symptoms of dry eye disease associated with Meibomian gland dysfunction. The MOJAVE trial met both primary sign and symptom endpoints:
• Change from baseline in total corneal fluorescein staining (tCFS) achieved statistical significance at day 57, using the National Eye Institute scale, compared to control [p<0.001].
• Change from baseline in dryness score achieved statistical significance at day 57, as rated on a visual analogue scale ranging from 0 to 100 (0=no dryness; 100=maximum dryness), compared to control [p<0.001].
• The MOJAVE trial also met all of its secondary endpoints. Read more.



J&J Vision Appoints Dr. Jong as Global Professional Education Lead, Myopia

Dr. Monica Jong was appointed as Global Professional Education Lead, Myopia at Johnson & Johnson Vision. Dr. Jong co-founded and led the International Myopia Institute, setting up and collaborating with a global advisory board of ophthalmology and optometry thought leaders, and bringing together commercial representatives of the vision care sector to strategically build awareness of myopia.

Eaglet Eye Releases Software


Eaglet Eye announced the global release of Prime, the latest Eye Surface Profiler (ESP) software, which now includes a dedicated module for fitting and tracking Ortho-K, allowing the practitioner to easily see and record the refractive changes induced. Included with Prime is an algorithm specifically designed for Paragon’s CRT lens, a popular Ortho-K design. In addition, several new features have been added to make specialty lens fitting faster and easier, including ZoneControl in which the fitter has the ability to specify apical and mid-peripheral zone clearances for increased precision. Learn more about the company.

MacuLogix Establishes $25,000 Endowment for AMD Advocacy at the PCO at Salus University


MacuLogix has established a $25,000 MacuLogix AMD Advocacy endowed award at PCO/Salus University to be presented annually to a graduating optometrist demonstrating outstanding dedication to managing patients with age-related macular degeneration. PCO/Salus was selected for this award to honor two of its graduates for their commitment to AMD diagnosis: Dr. Glenn Corbin of Wyomissing Optometric Center and Dr. Gary Kirman of Kirman Eye. As the first commercial customers of MacuLogix, Drs. Corbin and Kirman have been utilizing dark adaptation testing in their practices since 2014, starting with the original AdaptDx automated dark adaptometer. In 2020, they also became the first optometrists to use the AdaptDx Pro head-mounted dark adaptometer.

Allergan Launches Site for Presbyopia Information


According to a recent survey commissioned by Allergan, an AbbVie company, of 1,000 adults ages 40 to 55 reporting near vision issues:
• 65% reported they weren’t prepared to have their eyesight worsen as they got older
• A quarter reported they were in denial that their near vision was getting worse.
• Eighty-four percent reported it was more frustrating to have blurry near vision when reading than having a video call freeze.
• Over half with reading glasses (51%) admitted they lose or misplace them at least once a week; more than a quarter (26%) said they lose them daily.
• Half of survey respondents admitted they decreased or gave up on a hobby because they could no longer see well up close. As a result, Allergan launched BlurryNearVision.com, offering information on presbyopia. Visit the site.

ScienceBased Health Welcomes New Members to Advisory Panel


ScienceBased Health (SBH) announced the addition of Melissa Barnett, OD, FAAO; and Selina McGee, OD, FAAO, to its Optometry Clinical Advisory Panel. Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center. Specializing in dry eye disease and specialty contact lenses, Dr. Barnett is currently serving on the Tear Film & Ocular Surface Society: A Lifestyle Epidemic Ocular Surface Disease Workshop. Selina McGee, OD, FAAO, is the founder and owner of BeSpoke Vision, a boutique-style eyecare practice that specializes in dry eye disease, specialty contact lenses and aesthetics. She is the vice president of the Intrepid Eye Society, the past president of the Oklahoma Association of Optometric Physicians and a SECO Trustee.

Prevent Blindness Declares October as Contact Lens Safety Month


Prevent Blindness declared October as Contact Lens Safety Month, and is strongly urging the public to consult an eyecare professional before purchasing or using contact lenses. Learn more.

IDOC Launches Turnkey Practice Management Services


IDOC launched a full suite of turnkey practice management services designed to help independent ODs reduce the time spent on business tasks and focus their efforts on patient care and other pursuits. Learn about IDOC.









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