In Contact - October 2007

ICU @ ICLC

The 12th ICLC at Sea World was by all accounts a successful meeting.
My debate against Nathan Efron, countering his ?demise of RGPs by 2010? went off well with raucous laughter and 69% audience support in favour of RGPs. Full credit to Nathan for stepping up and debating controversial issues against four tough opponents.
Nathan tells me he's been invited to speak in NZ in 2009. Maybe we can do a final debate on the RGP issue then?
My other presentations were well received. I've also been invited to speak at a few other meetings in Australia, India, Asia and the UK. The only pity is that I cannot make it to all of them.
A broad spectrum of issues was covered at the meeting. Greg Nel and Anita Dransfield review it in more detail elsewhere in this edition of NZ Optics.
Once again studies dealing with microbial contamination of contact lenses, cases and accessories further confirms my ever strengthening opinion that we should simply get rid of the major cause viz. reusable soft lenses, cases and solutions.
Dailies Rock.
Okay?
I figure if the industry gets its act together then the millions - if not billions wasted on solution and lens studies, FDA trials, staining, cases, infections, complications, packaging, shipping and marketing ? can simply be invested in single use daily disposables.
These days we can probably correct most of the bell curve with single use lenses. With a little expansion of ranges we could cover most.
We can expect high Dk dailies in the ?near? future.
It's time.
We could safely and effectively cover the ?out of range? extreme prescriptions, refractive surgery complications and irregular corneas with RGPs and the new, emerging lathe-cut custom silicone hydrogels.
Until something better comes along.
No more excuses. No more delays.
Just do it!

Expats

It was great to see a bunch of old mates and expat ?SAffas?, who made up a significant proportion of delegates. There were five of my final year classmates in attendance as well as two former lecturers.
Des Fonn, now head of the CCLR at Waterloo, Canada was one of them. He was awarded the Ken Bell Medal for his contribution to CL research. Des was one of the strong positive influences on my passion for contact lenses. Full credit.
Another was Allan Burrow, now practising in Coff?s Harbour NSW. We were involved in computerisation of optometric practises ? way back in the early ?80s when a 5MB HDD was as big as you got, 640K RAM was a lot and a 1MB RAM card was as long as my arm. Today we talk 200GB as entry level for a HDD. You can now buy a desktop version for around $200.
2GB of RAM is now near standard and we have low cost 4GB USB memory sticks that are smaller than a cigarette lighter.
Of my class mates present at ICLC, two of them, both resident in Oz, Malcolm Kofsky and Bernard Starfield were my co-researchers in a study comparing neovascularisation with high and low water content contact lenses for which we won a B&L award for outstanding achievement. Des was our supervisor.
Small world eh?
Its great to see that after all these years we still come from the four corners to present and attend meetings like this.
Rock on!

Sunny Skies?

After Sea World we headed off to Noosa to experience the legendary blue skies, sun, prawns, sea and surf?
We were welcomed by rain that would make an Auckland winter tame in comparison. It lasted four days. Two weeks prior they'd experienced 800mm of rain in two days; a one in a hundred year occurrence.
Australia, a large desert with a narrow green rim, always needs water and frankly I didn't mind the rain too much. All I wanted was a few days of R&R, after a frantic few months. We had a great time with family and friends living in and around Noosa. When the sun finally appeared my ?Auckland skin? took a trashing. I looked like one of my ancestral pomegranates after just a few hours and no doubt sped up the development of a few melanomas?.not to mention accelerated coronary artery plaques from all the fine food?
C?est la vie?

Nothing Changes?

I was recently looking through some boxes of old books for a photographic text for my daughter who is studying photography and loving it. Like father like daughter. Nice.
By pure chance I came across a December 1989 edition of The South African Optometrist journal. I wrote my first In Contact column, nearly twenty years ago, in S Afr Optom and later served on the editorial board.
What struck me when I read that ?89 South African version of In Contact, was that the main issues I covered then were all amazingly still just as topical today. As you can see - in the accompanying scan of that edition - the opening paragraphs dealt with CPD and optometric and ophthalmological relations. Refractive surgery, oxygen, the endothelium and diffractive optics were on the agenda then as they are these days!
The next item dealt with Extended Wear and its complications, particularly Infiltrative Keratitis. As recent research and experience has shown we are still concerned with the same issues and hardly an edition of a journal goes by without something on corneal inflammatory events [CIEs]. Even more coincidental was another paper from the now defunct International Contact Lens Clinic [ICLC] journal. This one, by the legendary Dick Hill, dealt with the complexity of contact lens solutions and their problems. His question, ?Will they ever get it right? could hardly be more topical today!
RGP EW was also discussed. I can thankfully say that today we do a lot better with this modality. In the past few weeks I've seen two of my few EW RGP wearers. Both admitted to only removing their Saks Custom Tetracurve Boston XO lenses ?about every three months?. Their corneas showed almost no staining and their tarsal conjunctivae were in good shape.
I also discussed the beneficial, synergistic relationship that exists [and must flourish] between research and clinical practice.
Just when I thought this was all much too d?j? vu, I came across the closing paper referenced in that edition. It dealt with a just published [1989] article detailing VLK, a condition I have oft discussed in articles and lectures. Here?s the weird part. That very paper, by Grohe and Lebow, was again featured - almost eighteen years later - in an article titled VLK in Veteran GP Lens Wearers in the recent August 2007 edition of Contact lens Spectrum.
Apart from some small talk about a forthcoming Contact Lens Conference I closed with the following comment; ?There are no all-encompassing new developments that can be regarded as a panacea for all these problems?.
Nothing?s changed!

Sport?

Rugby world cup is now in full swing. Not too many surprises thus far but nice to see Argentina keep up the Southern Hemisphere mojo and take out the French in the opening game. Lots more to come. I hope we see an All Black and Boks final. I loved the Boks zeroing of cup holder Poms.
In fierce Formula One, Imola and Spa were destined to be good races and we are now at the sharp end of the F1 GP World Championship. The $100 million fines being thrown around add intrigue, as does the competition between team mates? world champ Alonso and upstart Hamilton.
Elsewhere in Europe the lippy EU spanked Microsoft for threefiftysevenmilliondollars.
It's Big Business?

For more information or any comments email Alan at incontact@optom.co.nz.