Having just completed 16 hours of continuing education courses,
sponsored by the University of Houston College of Optometry, I
thought I might share some of the latest thinking in the eye business.
I won't be elaborating on any specific topic, but rather "throwing"
pearls at you in short paragraphs.
There are some relatively new lasers, the Holmium and Erbicem:
YAG, that are already far along in development and that may challenge
the Excimer laser (the one you already know about) in the always
changing arena we call refractive surgery. Even the new Excimer
lasers use a gentler spot beam, and eye-trackers attempt to improve
accuracy. The more precise the laser and the more "centered"
the beam, the better the end result.
Studies are underway to determine why people abandon their contact
lenses. There are probably six main reasons why people quit their
contacts. I would put them in this order: discomfort, dryness
symptoms, conjunctival injection (red eyes), visual problems,
care and handling inconvenience, and cost factors. Discomfort
includes DRYNESS, burning, scratchiness, and stinging. I see a
clear "winner" here and it appears to be dryness. Any
soft lens wearers out there wanna argue this point? I didn't think
so. In any case, now that research has shown us the problem we
can all hope for a solution.
A few interesting concepts in drug therapy are emerging. For those
of you that remember the "Thalidomide disaster" of the
late 50's and early 60's, this drug is actually making a comeback.
Experimentally, it is being used in HIV and cancer patients as
well as for those with age-related macular degeneration. Thalidomide
retards the growth of new blood vessels (which proved disastrous
in early pregnancy) which may be a GOOD thing for the "wet"
type of macular degeneration. There are also several new dry eye
medications on the market that are rather unique in their formulation.
It has always been preferred to use non-preserved solutions, but
since the newer preservatives dissipate when exposed to light,
there is very little contact on the eye.
One other class of drug that deserves mentioning is the topical
steroid. Steroids are crucial in eye care but there remains a
concern for significant side effects, so anything new with a lowered
risk is a welcome addition. Vexol and Lotemax are two new steroid
drops that "do their thing" and then "get out".
This of course is desired when you want the drop to be effective,
yet you desire minimum side effects. Certainly, this is a step
in the right direction.
Last, but not least, let me discuss EXTENDED WEAR CONTACT LENSES.
Yes, an old topic that has been beaten up pretty good, but there
is reason now to reopen the discussion! Extended Wear, or a system
of wearing contact lenses for several consecutive days or weeks,
will be re-emerging as a viable alternative to glasses, daily
wear contacts, or even refractive surgery. If it becomes possible
to comfortably wear a contact lens for 30 days straight, would
you have an interest? If there were NO deprivation of oxygen to
the eye while wearing EW contacts, would you be interested? If
sleeping in your contacts were as safe as daily wear, would you
do it? You will probably be able to answer these questions first
hand within the next year or two. Research continues to look for
that elusive "perfect" contact lens that everybody wants,
and one of the biggest hurdles has been oxygen. There are contact
lens materials under study that permit almost a "free flow"
of oxygen through its matrix. When this free flow is a reality,
we will have eliminated the biggest obstacle to safe and comfortable
extended wear.