In Contact - March 2007
Fear and Loathing
After many failed attempts to visit the USA over the past three decades, I finally made it one fine day in January.
I'd been invited to present at the inaugural Global Keratoconus Conference [GKC] at Bally?s Hotel and Casino in Las Vegas.
Practically all the Americans I've ever met have impressed me as fine, decent and friendly people. I must admit that this is at odds with the propagandised view we are fed via the press and the anti-US brigade. TV soaps and movies don't help either. Was I simply fortunate in having mostly met ?top drawer? individuals and leaders of US optometry?
I was thus pleasantly surprised to find that the majority of people were absolutely fantastic, pleasant and polite.
Even those not seeking a tip.
From the customs and security people at airports through conference attendees, fellow travellers and the man in the street we were treated to levels of friendliness and politeness that most other nations would battle to emulate.
Goodonya Americans.
The GEC was by all accounts well received and I was honoured to take part in the lecture programme. Fellow Australasians Richard Lindsay of SRC fame and Paul Rose contributed positively as panel members. Grant Watters will present a synopsis at the CCLS 50th Anniversary Conference as well as elsewhere in this edition of NZ Optics.
In a nutshell I'd say there was nothing earth shattering nor any breakthrough science or lens options that staunch followers of keratoconus would not already be aware of. However, as with any conference there is always much to learn and things to add to one?s armamentarium and skill base. Getting like minded people together for three days of intensive presentations and panel sessions helps one get the ?big picture? and consider other options.
I'd also add that keratoconus practitioners in Australasia are at the pointy end of lens design and management.
Rose K was well represented at the exhibition level and in the presentations, further cementing its position as probably the most widely prescribed ?recipe? lens in the world. We should soon be benefiting from the availability of Rose K2, Rose K IC [Irregular Cornea] and ACT [Asymmetric Corneal Technology] options in NZ?
Between Paul and Richard O?Brien they certainly keep Hamilton on the map.
It must be that Waikato water eh?
Or just something to do on those foggy winter nights?
Vegas itself is a pretty weird place. On one hand my first experience of Vegas, indeed the USA, was somewhat underwhelming: Like Sun City on steroids. On the other it was mind blowing.
Bally?s was pretty downmarket but fine for a conference while Wynn and The Venetian have a much classier image [and prices too].
There is just so much to see and do.
Highlights included the uber-acceleration of Speed - The Ride at the Sahara and a marvellous ?steak frites? lunch at the French pavement caf?, Mon Ami Gabi. To get more into the gung ho American GI vibe a visit to the Gun Store is a must. Fifty rounds with a full auto M16 gets the adrenalin going as did a few dozen with a .45 Sig-Sauer P220S.
I must say the 5.56mm M16 was a bit wussy compared to the 7.62mm FN I cut my teeth on. After thirty years the smell of gunpowder brought memories rushing back. That FN kicked like a mule, especially when some mate in the army surreptitiously turned the gas recoil to max.
Still into the military macho theme, a helicopter flight in a Eurocopter with the Sundance boys, over Hoover Dam and on to the Grand Canyon, was another treat. I'd certainly love to spend some time on the mighty Colorado River.
A major highlight was the truly amazing Bodies Exhibition and one I would recommend to anyone with a keen interest in anatomy, physiology, bodily systems and organs.
Truly remarkable and a major learning experience.
Essentially cadavers are drained, the water replaced with acetone which is then vaporised in a vacuum and slowly replaced with silicone. Layers are peeled back to reveal the most amazing detail, like you?ve never seen before. They also ?slice and dice? creating ultra thin sections that help MR scanners interpret what they see.
That was day one!
The rest of the time was a mix of checking out the town, attending the odd show, lectures and taking money off the casinos.
Finally we wanted to see how real people lived in Vegas and took a trip into the ?burbs one night to a dinkum pool bar, Club Charleston. We ended up playing pool with the owner and drinking fine Patron tequila. Great Cues, true tables and a vibe ala the Ponsonby Pool Club or like one might find in the UK.
At around 4am the club owner?s father ran us back into town in a Ford F350, 6-litre Diesel Truck. We cruised the strip, listening to his amazing stories.
Taxis had refused to come so ?far? out of town - a mere six miles - as tourists apparently don't stray that far.
Real people. Real tequila. Real pool to US BCA League rules.
Some, who shall remain nameless, didn't make many lectures that day?
My heartfelt thanks to the conference organisers for the invite and to Bausch & Lomb Boston and Rose K International for travel assistance.
Fortunately the classic Vegas clich? ?What goes in Vegas, stays in Vegas? applies and that should keep my mate Watties happy.?
Off the Grid
Finally we got to a part of the real America I've always wanted to experience.
Snowbird Utah is amazing. Although locals bemoaned the ?bad season?, they had a reasonable 154 inches of snow. Our first day was on hard pack pistes and what one would call ?decent powder? in NZ. They didn't.
It seems a bad day at Snowbird is like a reasonable day at ?Concrete Peak?. We were lucky as day two and three provided 10 inches of needed powder: The super dry fluffy stuff that Utah is famous for.
Near white out conditions and zero Fahrenheit [-18?C] with a good 10mph of wind chill [-27?C effectively] and one was certainly in need of good protection. My iPod equipped Oakley ski jacket, heavy duty Kiwi polar fleece, trusty O?Neill snowboarder pants and Long John?s did the trick. Just.
New Grandoe gloves, a fleece neck protector and decent socks kept the extremities ?warm?.
I've also finally succumbed and purchased a skid-lid in the form of a Giro Bad Lieutenant helmet. I guess one has to protect what?s left?
Ganz cool.
It kept the cold out too.
It's been a while since I had icicles on my moustache. The last time I can remember -24?C was in our self-converted Leyland Sherpa camper van during a big freeze at Breuil-Cervinia in the Italian Dolomites in 1984. Our 20 litre water bottle and dishwashing liquid froze. In the van. The doors froze shut as did our boots to the floor inside?
From the top funivia at Cervinia one can access the Monta Rosa plateaux and from there Zermatt [with passport] and the highest ski lift in the world at around 4000m.
Snowbird is a lot like that with three areas all easily accessible. From our comfy lodge we had a five minute walk to the tram [cable car] or high speed quad chair, the former to 11,000ft. From there one can descend to another side of the mountain or take a 600 ft tunnel through it, from the top of the quad. This side, Mineral Basin, is normally rated as blue and green runs with a few blacks while the Snowbird side is in the main black or double black diamond. In these conditions however only expert skiers were advised to venture there and frostbite warnings were prominent.
We managed and thus transferred to a third valley, Alta, a resort with milder runs and no snowboarders. It was easier in the limited visibility conditions.
It was however so cold that a member of our ski party had to ski down to a handy ski shop for fleece glove inserts and chemical heating pads to ward off the dreaded frostbite.
Steep and testing. Hard work in fact, especially in new powder, near white out conditions and subfreezing temperatures. My legs were still stiff two days later.
What a great experience.
Snowbird is definitely a place we can recommend.
Nordica rental boots [into which I inserted my custom foot pads] surprised me with their relative comfort. Better than my super tight and less than comfy old Lange race-style boots. My ?demo? rental skis were a ?top rated? Volkl AC3 set of all mountain carvers. They handled the varied conditions well but were in need of a decent waxing. They were a bit ?grippy? in the very cold snow and we did a fair bit of ?pushing? on relatively flat declines. It didn't help that I'd hit a submerged rock, flown out of my bindings and banged my right arm, the day before. Judging by the condition of the bases I'd say others had graunched plenty of rocks before me. The rental guy assured me the pair I had were in relatively good nick?
Check out snow.tv
We wrapped up our trip with a final night out to one of America?s top rated restaurants, Shallow Shaft.
Caviar coated Trout Cakes and rare, grilled Bison - that made the fillet mignon seem tough by comparison, was marvellous. This was rounded with a fine bottle of Belle Glos, Clark and Telephone Vineyard, Pinot Noir from Santa Barbara. It had the nose and taste that one, if blindfolded and of Kiwi persuasion, could easily have labelled as a top drawer Central Otago Pinot.
The service and food quality was tops: Better than many a meal I've had at top eateries in Africa, Asia, Europe, Oceania and the US.
A fantastic trip.
What's New?
Normal supplies of Cooper?s long awaited Biofinity are finally available. Miraflow is promised by the end of the first quarter.
It's taken a year.
We may benefit from new hyper-Dk RGP materials and at least one new contact lens player in the NZ market. Look out for range extensions in some popular disposable brands.
OPTI-FREE RepleniSH is on the market as is Systane [at last].
SteriLid is another great addition to the already effective TheraTears range.
What we really can live without this year, are lens or solution recalls.
If we have any I think I?ll puke.
A very much customised range of plasma-treated, latheable, Sifilcon A based O2 OPTIX Custom will be a major development. All going well we should, later this year, have access to a power range of +20.00D to -20.00D, in three diameters, with Base Curves ranging from 7.4 to 9.2.
Modulus could be an issue at extremes of Rx? It should however physiologically be whole lot better than similarly bulky high Rx HEMA!
I made predictions of such customised disposables in one of my ?blue sky? talks at Berlin in 2000. It hasn't taken too long to get there.
Fantastic and a brave move.
No doubt a logistical nightmare, but goodonya CIBA for trying and delivering what we want.
Now for a Daily version?
With aberration control? Please.
Novel Research
Take a look at In Vitro Assessment of Medical Device Toxicity: Interactions of Benzalkonium Chloride With Silicone-Containing and p-HEMA-Containing Hydrogel Contact Lens Materials as it appears in Eye & Contact Lens: Science & Clinical Practice. 33(1):26-37, January 2007 by Dracopoulos, Dixon, Jones, Sivak and Bantseev.
It opens a whole new can of worms regarding toxicity and alludes to potential chemical ?leachates? from contact lens polymers. No doubt Lyndon Jones will be giving us first hand information on this at the 50th Anniversary CCLS Conference in Queenstown, 8th to 11th March, just a few days after this column goes live. If you haven?t registered you still have a few days left. Judging by the calibre of speakers and topics it should be a beneficial meeting.
As far as societies of this type go, a 50th anniversary is no mean feat. It seems only the Contact Lens Society of America exceeds this with their 52nd Anniversary coming up.
A damn good effort.
Full credit to the founding members who had the foresight and to all the good people whose voluntary efforts have helped keep the CCLS a healthy, functioning society, this past half century.
I also note that as predicted, the Andrasko staining grid shows that Clear Care [US version of AOSEPT PLUS], has the lowest staining incidence with all materials tested so far. Biofinity is now being evaluated, as is Proclear.
I think we're going to see a lot more on all this, as evinced by the aforementioned papers, before we actually get to the bottom of it all and attain resolution.
Box on
For more information or any comments email Alan at incontact@optom.co.nz.