Held annually in Las Vegas, the Global Speciality Lens Symposium 2019 brought together around 1,000 eye care professionals from around the world. It may be easy to get distracted in ‘Sin City’ but the content, pace and social aspects of this meeting meant shows, shopping, and people watching had to wait.
Now in its 13th year and pitched as ‘the premier contact lens event’, the Global Speciality Lens Symposium does not disappoint. The speakers’ list was an international ‘who’s who’ of the contact lens world… Drs Jason Nichols, Patrick J. Caroline, Eef van der Worp, Loretta Szczotka-Flynn, Jeff Walline, Art Epstein, Tom Arnold, Lyndon Jones, Langis Michaud, and Pauline Cho… it was hard not to be a little star struck.
Research on the peripheral power profiles of standard soft contact lenses and how some, more than others, may encourage myopia development was covered
Australia and New Zealand were well represented. Associate Professor of Optometry and Vision Science at Queensland University of Technology, Stephen Vincent, presented on scleral lenses and myopia control. Jagrut Lallu, NZ optometrist, Cornea and Contact Lens Society (NZ) President and former longstanding Orthokeratology Society of Oceania councillor, presented on toric orthokeratology and dry eye. Perth optometrist, and recently elected president of the International Society of Contact Lens Specialists, Damon Ezekiel, received his Fellowship to the Scleral Lens Society at the meeting.
With multiple streams and more than 100 talks to choose from, it was impossible to attend everything and there were hard decisions to be made. However, the conference allowed delegates to follow their passions, learn new information and add new areas of interest to their clinical repertoire.
General sessions included Controversies in contact lenses; a debate on The state of scleral lenses – what we really know, what we need to know; Management of the postsurgical cornea, Myopia control and Corneal cross linking.
Lens care was not forgotten, with Dr Lyndon Jones discussing whether hydrogen peroxide should be our first choice, and an entertaining session with Drs Pauline Cho, David Kading, Eef van der Worp, and others on care and aftercare of specialty lenses.
Myopia control was a hot topic with multiple streamed presentations and two lengthy general sessions delivered by undisputed experts, Drs Patrick Caroline, Pauline Cho, Maria Liu, Eef van der Worp, Langis Michaud, and Stephen Vincent.
The discussions continued during elective sessions with Dr Maria Liu, Founder and Chief of the UC Berkley Myopia Control Clinic, presenting on pharmaceutical intervention; and Dr Pauline Cho covering contact lens and spectacle myopia control, as well as challenging attitudes of parents and patients to myopia control. The need to provide our patients and their parents with evidence based recommendations was emphasised. The strong evidence behind orthokeratology was covered extensively, as were soft lens designs like CooperVision’s MiSight and VTI’s NaturalVue.
Research on the peripheral power profiles of standard soft contact lenses and how some, more than others, may encourage myopia development was covered. The Treehouse Eyes Team – Drs Gary Gerber and Kevin Chan – who’s entire practice is myopia management, presented on their approach to myopia control in practice and their business model.
Dr Jeff Walline covered lifestyle factors and discussed the evidence behind current modalities. He clarified the sometimes misconstrued information about outdoor time, confirming that, “Outdoor time prevents or delays the onset of myopia but does not slow progression”. He also reinforced that children can wear contact lenses and the best choice is determined by parents in discussion with their eye care professional.
Clinicians and manufacturers presented on customisation of scleral lenses, with discussions focussed on perfecting scleral lens fitting and scleral asymmetry. Heavy weights in the scleral lens world, Drs Tom Arnold, Melissa Barnett and others discussed designs, care, compliance and complications. Dr Langis Michaud discussed scleral lens terminology, and Dr Lynette Johns presented to a crowded room on invisible pain syndromes and why scleral lenses don’t always work. The value of using scleral lenses in ‘normal eyes’ was debated.
CUSTOM SOFT LENSES
The case for custom soft lenses to better fit our patients’ eyes, rather than relying on the ‘one size fits all’ approach of mass produced lenses, was discussed. Drs Matt Lampa and Beth Kinoshita covered technical specifics particularly in astigmatism, presbyopia and keratoconic designs.
A general session on soft specialty lenses presented Dr Eef van der Worp’s work from 20151 on the sagittal height differences of frequent replacement silicone hydrogel lenses, the differences in our commercially available products and why, despite similar base curves and diameters, lenses can fit so differently.
Drs Lyndon Jones and Karen Walsh, presented on the controversial topic, Sensitive to silicone? Understanding and managing patients who present with an adverse reaction. Despite some in the audience feeling they’d seen reactions to silicone, the presenters discussed how allergy to silicone cannot occur, and what the differentials are.
Renowned dry eye clinician, Dr Art Epstein presented on The effective and practical dry eye practice. Among other things, he discussed utilising 0.01% pure hypochlorous acid in the management of blepharitis and meibomian gland dysfunction. Research, in which he was a co-author, found the solution significantly reduces bacterial load without altering the diversity of bacterial species remaining.2
Art also spoke on the nutrition debate and still sees a strong place for oral omega 3 in dry eye management. While more research is needed, he suggested a ratio of three to one EPA:DHA in a supplement may be ideal.
As a practitioner who uses intense pulsed light for dry eye management, it was interesting to hear the early experiences of US practitioners who have only recently been able to use this technology. They also spoke about how they’re incorporating other new technologies into practice that haven’t made it to us yet.
Presentations discussed all aspects of keratoconus, from early diagnosis and progression to curvature based topography vs elevation based tomography, and anterior segment optical coherence tomography. US and Canadian experiences with corneal cross linking were covered.
PAEDIATRICS AND PRESBYOPES
Our smallest and biggest patients were not forgotten. Presbyopic fitting covered current approaches to soft, rigid, hybrid and scleral lenses. The Brien Holden Vision Institute’s novel extended depth of focus lens was discussed and will be an exciting addition to our options in the coming years.
Dr Jennifer Fogt delivered a brilliant presentation titled Fitting specialty contact lenses in paediatrics: from aphakia to zoster, with clinical and very practical takeaways such as the need to keep an infant’s posture upright to ensure a happy and co-operative patient.
Trade displays at international conferences can be good and bad. Good because the latest and greatest in contact lenses, solutions, equipment and dry eye treatments are all in one place and very professionally displayed, but bad because it can often take a while for some of these products to arrive on our shores.
CooperVision put on a particularly impressive display, with the newly launched CooperVision Speciality Eyecare Division incorporating Paragon Vision Sciences and Blanchard Contact Lenses. The company showcased its existing portfolio of extended range soft contact lenses and MiSight.
Bausch + Lomb launched the new Zen multifocal scleral lens, while in the dry eye realm, Bruder launched its Eyeleve contact lens compress. Two companies discussed the benefits of hypochlorous acid for blepharitis management, only one of which is locally available, being OcuSoft HypoChlor.
Tangible Science launched a new lens cleaning solution to enhance Hydra-PEG coated contact lenses, which will take a while to reach our shores. Synergeyes launched SynergEyes VS scleral lens and SimplifEyes 1 Day with Hydra-PEG, and presented information on their partnership with the Brien Holden Vision Institute and the novel extended depth of focus lens for myopia and presbyopia they’re developing… These too may take time to reach ANZ. But I wanted them now.
Once again, the Global Speciality Lens Symposium delivered on its promise of exceptional education. Three and a half days, with evening events and poster sessions that I haven’t even mentioned, may seem like information overload but the quality of the speakers, the content and the trade show gave us a clear perspective on where contact lens fitting is heading. It also provided a lot of concrete information that can be used to change our practice now.
- Van der worp et al. Sagittal height differences of frequent replacement silicone hydrogel contact lenses. Contact Lens and Anterior Eye 2015; 38(3): 157-162
- Stroman et al. Reduction in bacterial load using hypochlorous acid hygiene solution on ocular skin. Clinical Ophthalmology 2017; 11: 707-714
Adele Jefferies BOptom(Hons) CertOcPharm (Therapeutics) is an optometrist and the national clinical manager with Matthews Eyewear Eyecare Ltd in New Zealand. She has special interests in contact lenses, dry eye and ocular surface disease, myopia control and therapeutics. Ms Jefferies holds positions on the CPD Accreditation Committee and Competence Review Committee for the New Zealand Optometrists and Dispensing Opticians Board, is a councillor for the Cornea & Contact Lens Society (NZ) and a Clinical Masters Student at the University of Auckland. She has been a conference speaker for optometrists and dispensing opticians in Australia and New Zealand, and a pre-market evaluator and advisory panel member for contact lens, contact lens care solutions and dry eye care products for various companies.