GlobalCONTACT - 03/2024

ISSN:1386 0194

3

2024 (98)

Technology • The wettability of RGP contact lenses • Spiral-shaped optic

Report • 42nd ESCRS • Achromatopsia

Fitting Background • Presbyopinion • Mini scleral lenses

Business & Marketing • Supply chain security training

Eyepress Fachmedien GmbH Saarner Str. 151 45479 Muelheim a. d. Ruhr Germany

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2/20/24 1:29 PM

26.02.24 09:53

LETTER FROM THE EDITOR

Stay alert Last year, around 8.3% of cyber-attacks were on companies

The most frequent victims of cyber-attacks are in economically

worldwide. The largest share of phishing attacks during the

well-developed countries, particularly the United States and

period of the survey, at around 16.5%, was on global internet

Western Europe, for example Germany and the United Kingdom.

portals*. Attackers use the "human factor" as a gateway for attacks

This is because of the high availability of lucrative targets such

on companies, authorities and other institutions. Especially in

as companies, research institutions and government agencies.

the case of phishing, the human factor is the weakest link in the

Emerging markets are also increasingly affected due to the

security chain. So, cybercriminals try to manipulate people and,

inadequate security measures that are often in place there.

in this way, install malware or gain access to sensitive data.

How to protect yourself against this – and why every single In addition to phishing attacks, infection with malware is the

company should contribute to protecting the global infrastructure

biggest threat for companies and a multitude of new malware

from hackers – is the subject of part 1 of the series on cyber

variants are added every day. These are particularly dangerous

security, starting at page 44.

because they have not yet been identified as malicious programs and are rarely detected. Furthermore, attackers use critical

But that's not all: in this issue, we look at the wettability of RGPs.

vulnerabilities in software products, distributed denial-of-service

Martin Conway and Mark Eddleston draw our attention to the

attacks, in which the attacker floods a server with internet traffic

various factors that need to be considered here.

to prevent users from accessing connected online services and sites. And of course, good old ransomware is also a threat.

One condition that will affect all of us sooner or later is presbyopia.

And even if not everyone can report from their own experience

Everyone knows by now that algorithms are largely responsible

yet (I can now!), the latest facts are interesting. In this issue, Eef

for search results on the world wide web. But did you know that

van der Worp begins by taking a close look at the current state

even comments made on social media are filtered differently

of knowledge on the subject.

depending on the user? Or that up to one in ten random posts, according to some estimates, may come from foreign governments

All this and much more awaits you on the following pages. ■

trying to influence our opinion? *Statista

The increasing digitalization and use of artificial intelligence (AI) offers many advantages for companies and individuals.

SILKE SAGE

However, the networked world also has its downsides, as it offers

Editor-In-Chief

hackers around the world the opportunity to cause chaos and

silke@global-cl.com

interrupt supply chains remotely. AI in particular is increasingly being used by criminals to automate attacks, disguise them and maximize their chances of success.

ONLINE VISIT OUR BRAND NEW WEBSITE WWW.GLOBAL-CL.COM GlobalCONTACT 3-24

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21.11.24 11:21

51th

EFCLIN CONGRESS EXHIBITION

EUROPEAN FEDERATION OF THE

CONTACT LENS AND IOL INDUSTRIES

10TH – 12TH APRIL 2025 LILLESTRØM/OSLO, NORWAY

FINDING TRUE NORTH FOR TOMORROW’S VISION

In the breathtaking north we find close to Oslo together the visions of tomorrow.

The 51th EFCLIN Congress & Exhibition takes place there from 10th – 12th April 2025. For an engaging lecture program, EFCLIN forum and the best trade exhibition in the business, it can’t be beaten.

It’s where the Contact Lens & IOL Industry from Europe, the Far East, North America and beyond come together… will you be there?

SAVE THE DATE MORE INFORMATION WEB www.efclin.com MAIL info@efclin.com PHONE +41 41 372 10 10 FACEBOOK search: EFCLIN X @EFCLIN#efclincongress ADDRESS EFCLIN | Winkelbüel 2 | CH-6043 Adligenswil | Switzerland

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www.efclin.com/congress or e-mail us on info@efclin.com

30.10.24 09:34

CONTENT

ISSN:1386 0194

LETTER FROM THE EDITOR 3

Stay alert Silke Sage

3

INTERNATIONAL NEWS

2024 (98)

6

Technology

All about you

11 All about products

• The wettability of RGP contact lenses • Spiral-shaped optics

12 All about research

Report • 42nd ESCRS • Achromatopsia

38 All about markets

Fitting Background • Presbyopinion • Mini scleral lenses

TECHNOLOGY

Business & Marketing • Supply chain security training

14 The wettability of RGP contact lenses Martin Conway and Mark Eddleston

18 Chemical plastics recycling Eyepress Fachmedien GmbH Saarner Str. 151 45479 Muelheim a. d. Ruhr Germany

20 Spiral-shaped optics INDEX TO ADVERTISERS Title: Contamac, www.contamac.com

MANUFACTURING 22 Time, errors, productivity, & profit: Decisions, decisions! Pt. 2 Erik Larsen

Inside front cover: Bausch + Lomb Inc., www.bausch.com Page 4: Efclin,

REPORT

www.efclin.com 24

Page 7: Acuity Polymers, Inc, www.acuitypolymers.com

Page 9: SCHNEIDER GmbH & Co. KG,

Barcelona in focus: 42nd ESCRS Congress Lena Petzold

26 Achromatopsia on Pingelap Island Silke Sage

www.schneider-om.com Page 17: OPTOCRAFT GmbH, www.optocraft.com

FITTING BACKGROUND

Page 19, 39: Larsen Equipment Design Inc., 28

Presbyopinion: Part I: Definition & mechanism Eef van der Worp

www.larsenequipment.com Page 21: AMETEK Precitech, Inc., 32 www.precitech.com

A dialogue: Mini scleral lenses Uwe Bischoff & Corinna Jonske

Page 37: K & Y Diamond Ltd, 36 www.kydiamond.ca

Red light treatment in myopia management Rebekka Nurkanovic

Page 27, Outside back cover: DAC International, Inc., www.dac-intl.com Page 31: LAMBDA-X S.A.,

VISUAL PERCEPTION

www.lambda-x.com 40

NAMES TO NOTE Bischoff, Uwe Capasso, Domenico Conway, Martin Eddleston, Mark Gharbieh, Nabil Jonske, Corinna Larsen, Erik Lingelbach, Bernd Petzold, Lena van der Worp, Eef

The Ouchi Illusion Bernd Lingelbach

HISTORY

32 42 Pioneers of ophthalmic optics: Heinrich Meibom 50 14 14 44 BUSINESS & MARKETING 32 22 44 Security training in the supply chain – pt. 1 40 24 28 MAGAZINE

48 Yellow Pages 50 Closing words: Domenico Capasso GlobalCONTACT 3-24

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21.11.24 14:51

INTERNATIONAL NEWS

All about you Wöhlk Contactlinsen receives MDR certificate Wöhl k Contact linsen GmbH has received t he MDR

exist on the market in this form a second time?” explains

certificate. The European Medical Device Regulation (MDR;

Dirk Reschat, Head of Quality Management and Regulatory

Regulation 2017/745) has been in force since May 2021,

Affairs at Wöhlk Contactlinsen. “The effort involved in

replacing the two previous European medical device

obtaining this certificate was enormous: we had to expand

directives MDD and AIMDD. The certification was a real

and train our QM department, use external services such as

feat of strength for the medium-sized company: The MDR

toxicological tests in laboratories and meet various technical

requires a full recertification of all existing products (legacy

and administrative requirements. This can only be achieved

products), some of which have been on the market for years,

with a good strategy and an excellent team.”

to ensu re t hat t hey meet t he i ncrea sed reg u lator y

The certification has one major advantage: the contact lens

requirements of this new regulation.

manufacturer from Schönkirchen can now approve new

“The certification process was preceded by a fundamental

products on the market again. “This is particularly important

analysis: Which products could be included in the MDR?

for our company, which has its own material production,

Which contact lenses did Wöhlk have to consolidate with a

research and development facilities,” explains Hiroko Aikawa,

heavy heart for business reasons, even if they were niche

Managing Director of Wöhlk Contactlinsen. “We are proud

products such as the colored Sport Contrast, which did not

and happy to be one of the first companies in our industry to receive this certificate. Our st reng t h ha s a lways been to respond to customer wishes. Our aim is to once again present new and f ur t her developments of individual contact lenses on the market. Our customers can now look forward to new products from Wöhlk in the near future.”

Bausch + Lomb receives FDA approval for full range of vision IOL

93% were completely to moderately satisfied with their vision

Bausch + Lomb Corporation has announced that the U.S. Food

The company says that Envy delivers outstanding performance

and Drug Administration has approved the enVista Envy full

in all lighting conditions thanks to ActivSync Optic intelligent

range of vision intraocular lens (IOL). According to the company,

energy distribution, which optimizes vision in many lighting

the IOL offers a continuous range of vision with excellent

conditions and that the IOL also enables surgeons to treat a

dysphotopsia tolerance on the enVista IOL platform.

wider range of astigmatic patients with more accuracy and

“We’re confident that U.S. surgeons will agree with what their

precision with 0.5D steps (or less) throughout the cylinder range.

Canadian colleagues have already told us: enVista Envy delivers

“I’ve long trusted the enVista platform to deliver excellent outcomes

exceptional outcomes and meets cataract patients’ high

for my cataract patients,” said Alice Epitropoulos, MD, Ophthalmic

expectations, as well as their own,” said Anthony Wallace, Vice

Surgeons & Consultants of Ohio and principal investigator in the

President and General Manager, U.S. Surgical, Bausch + Lomb.

Phase 3 U.S. clinical trial.

A multicenter, randomized and controlled clinical trial evaluating

The new IOLs will be commercially available in the U.S. on a

332 subjects demonstrated excellent long-term outcomes with

limited basis in 2024 and more broadly in 2025. Bausch + Lomb

the enVista Envy IOL in the U.S. On average, 86% of patients

is also in the process of seeking regulatory approvals for the lens

reported little to no bothersomeness for dysphotopsia (glare,

in additional markets.

post-surgery.2

halo, starbursts), showing an impressive tolerance profile overall.1

6

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In a Canadian clinical study evaluating 110 subjects, 94% of

1

Data on file. enVista Envy U.S. Clinical Study.

patients reported little to no difficulty viewing close objects, and

2

Data on file. enVista Envy Canadian Clinical Study.

GlobalCONTACT 3-24

21.11.24 14:54

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21.11.23 15:19

INTERNATIONAL NEWS

Investment company becomes new owner of Hecht

managing partner, is stepping down as managing director. Stefan

Hecht Contactlinsen GmbH from Au near Freiburg, Germany,

Muckenhirn comments: “As commercial director, Bernhard

which has been owner-managed for 46 years, has completed an

Steiert has played a decisive role in shaping the great success of

eight-month process: In future, the manufacturer of custom-made,

Hecht Contactlinsen GmbH over many years with his exceptional

RGP and soft contact lenses will be majority-owned by Novum

management expertise and in-depth industry experience and

Capital, an owner-managed investment company from Frankfurt

has led the company to a high level of profitability. I would like

am Main, Germany. Hecht describes the change of ownership

to thank him wholeheartedly for this and am delighted that he

as “an important prerequisite for continuity, delivery capability,

will remain associated with the company in an advisory capacity.”

innovation and growth beyond the generational change”.

Like Stefan Muckenhirn, the previous managing director Frank

The previous managing partner Stefan Muckenhirn (57) will

Widmer (63) will remain active as managing director. He comments:

retain a minority share in the company founded by his father

“I would also like to thank Bernhard Steiert very much for his

Dieter Muckenhirn in 1978 and will remain managing director.

outstanding and highly competent commitment over many years.

Bernhard Steiert (58), son of an early Hecht shareholder and

The task of the management team remains to continue to be a reliable, innovative partner for optical businesses, practices and clinics that fit individual contact lenses with our staff and our products.”

Beatrice Dreyfus, Partner at Novum Capital, says: “Hecht is a hidden champion that also has great potential in other European countries. We will support the company's growth with business expertise, financial resources, and genuine passion. This will strengthen the home base in Au as well as the subsidiaries in Germany, Switzerland, and Spain.”

Stefan Muckenhirn adds: “I am convinced that in Novum Capital, the management team has found an investment company that is ideally suited to Hecht's potential. We are delighted about this milestone in the company's history and are looking forward to a future full of new opportunities.”

8

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Menicon acquired shares of distributors owned

by Oculus Contact Lens in Southeast Asia

FreshKon brand, which features colored contact lenses, has a

Menicon announced that it acquired 100% of the shares and

2,000 stores.

ownership of three distributors in Southeast Asia from Oculus

Before this acquisition of shares, Menicon expanded its sales in

Pte Ltd., a contact lens manufacturer and distributor headquartered

Southeast Asia through exports and sales agents. The company

in Singapore.

reports that it has achieved establishment of both sales and

Oculus manufactures and distributes contact lenses primarily

production bases in Southeast Asia acquisition of shares and

in Southeast Asia. According to Menicon, particularly, its

expects this to boost growth of the Group in this region.

New executive director at Optometry Giving Sight

“I’ve had the pleasure of serving with Donna for the last several

Optometry Giving Sight (OGS) is pleased to announce that

years,” says U.S. board chair, Dr. Juan Carlos Aragón. “As a

Donna J. Mikulecky, CPA, has accepted the organization’s

board member, she has been committed to our mission and

executive director position. She replaces retiring executive

a very valued colleague. I look forward to working with her

director Lois Schoenbrun, FAAO, who has served in the role

in her new role.” “She has the skills and experience to lead us

since April 2022. Mikulecky has more than 25 years of

forward,” adds Canada board chair Dr. Susan Cooper. “With

experience leading healthcare organizations, most recently

Donna’s passion, business acumen, and industry knowledge,

as chief operating officer of Vision Source. Until her

OGS will continue to invest in the international development

appointment as executive director, she served as treasurer of

of optometry to provide sustainable primary vision care to

OGS’s U.S. and Canada Boards of Directors.

those in need.”

high brand recognition with strong sales network of more than

GlobalCONTACT 3-24

21.11.24 11:28

INTERNATIONAL NEWS

BostonSight held annual FitAcademy retreat BostonSight held their annual FitAcademy retreat at New

a unique opportunity to collaborate with fellow clinicians,

Eng la nd C ol lege of Optomet r y (N ECO) i n Boston,

strengthening their professional connections as they begin

September 13-14, 2024. This year marked the sixth iteration

their careers.

of the educational retreat for cornea and contact lens

This year, 31 cornea and contact lens residents attended the

residents and fellows at schools and colleges of optometry

event, which included hands-on wet lab training. Thanks

and accredited fellowship sites throughout the United

to funding from BostonSight and support from sponsors,

States and Canada.

students attend FitAcademy for free. “We are incredibly

FitAcademy was held at NECO’s Clinical Training Center,

grateful for our sponsors: NECO, Glaukos Corporation,

where residents learned about scleral lens fitting and

Contamac, and Tangible Science,” said Karen G. Carrasquillo,

assessment, how to manage and co-manage a range of

OD, PhD, FAAO, FSLS, FBCLA, BostonSight’s Senior VP

corneal and ocular surface disorders, including dry eye

of Clinical and Professional Affairs and director of the

disease and keratoconus, managing the scleral lens patient

FitAcademy program. “We have seen their continued support

Beyond the Fit (a staple of FitAcademy programs), and

year after year and are pleased that they, too, see the value

scleral lens application and removal techniques. The

of providing scleral lens education to eye doctors seeking

retreat’s intimate setting also provides residents and fellows

specialization in their careers.”

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06_about_you.indd 9

21.11.24 11:28

INTERNATIONAL NEWS

Founder Dieter Muckenhirn dies at 81: Mourning for a great personality “It is with deep regret that we bid farewell to Dieter Muckenhirn, the founder and visionary head of Hecht, who passed away on November 5, 2024 at the age of 81. With his unique idea of the individual contact lens “Ascon”, he not only founded a company, but also shaped an industry.

He was more than just an entrepreneur; he was a passionate innovator who guided Hecht's fortunes with passion and tireless commitment for decades. His unshakeable belief in the power of ideas and his ability to inspire people made him an indispensable driving force for our company and the entire industry.

His approachability, his ability to listen and his way of leading Dieter Muckenhirn is considered the inventor of the aspherical

the company made him a valued leader and mentor. With

contact lens. Together with partners, he founded Hecht

gratitude and respect, we bid farewell to an exceptional person

Contactlinsen GmbH in 1978. He passed away on November 5.

whose vision and passion will continue to guide us.”

The management and employees of the contact lens manufacturer bid him farewell in an obituary.

The management and employees of Hecht Contactlinsen GmbH

WEBINARS, CONFERENCES & TRADE FAIRS 2024/2025

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06_about_you.indd 10

Nov 23-24

Rome (Italy)

Nov 26

online

Jan 15-18

Las Vegas, NV (USA)

Apr 10-12

Lillestrom, Oslo (Norway)

May 4-8

Salt Lake City, UT (USA),

May 16-18

Ljublijana (Slovenia)

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Jun 20-21

Charlotte, NC (USA)

Oct 8-11

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Oct 1-3

Tokyo (Japan)

Oct 22-25

West Palm Beach, FL (USA)

GlobalCONTACT 3-24

21.11.24 11:28

INTERNATIONAL NEWS Advertisements

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21.11.24 15:39

INTERNATIONAL NEWS

All about research

Bioplastics, healing corneal wounds Washington University in St. Louis reports two studies on purple bacteria that can produce natural polymers.

A University of Waterloo team has developed a contact lens material that could act as a bandage for corneal wounds while releasing drugs in a controlled manner to help the eye heal faster. By Rebekka Nurkanovic

Turning bacteria into bioplastic factories

(PHAs), natural polymers that can be purified to make plastic.

Washington University in St. Louis, USA, reports two studies on

Another study led by research lab supervisor Tahina Ranaivoarisoa

purple bacteria that can produce natural polymers. A study led

showed that genetic engineering could coax a well-studied but

by graduate student Eric Conners found that two relatively obscure

notoriously stubborn species of purple bacteria to dramatically

species of purple bacteria can produce polyhydroxyalkanoates

ramp up its production of PHAs. Conners and Ranaivoarisoa work in the lab of Arpita Bose, an associate professor of biology in Arts & Sciences and corresponding author of the new studies.

“There’s a huge global demand for bioplastics,” Bose said. “They can be produced without adding CO2 to the atmosphere and are completely biodegradable. These two studies show the importance of taking multiple approaches to finding new ways to produce this valuable material.”

Purple bacteria are a special group of aquatic microbes renowned for their adaptability and ability to create useful compounds from simple ingredients. Like green plants and some other bacteria, they can turn carbon dioxide into food using energy

Two studies by WashU biologists shed light on purple bacteria as a potential source of bioplastics. Picture: Joe Angeles / WashU 12

12_Research_News.indd 12

from the sun. But instead of green chlorophyll, they use other pigments to capture sunlight. The bacteria naturally produce GlobalCONTACT 3-24

15.11.24 11:21

INTERNATIONAL NEWS

PHAs and other building blocks of bioplastics to store extra

TIE-1, a well-studied species typically reluctant to produce the

carbon. Under the right conditions, they can keep producing

polymers. Several genetic tweaks helped boost the output of

those polymers indefinitely.

PHA, but one approach was especially successful. Researchers

As the WashU biologists reported in Microbial Biotechnology1,

saw impressive results when they inserted a gene that increased

two little-known species of purple bacteria in the genus

the natural enzyme RuBisCO, the catalyst that helps plants and

Rhodomicrobium showed a remarkable willingness to produce

bacteria capture carbon from air and water. With the help of the

polymers, especially when energized with small amounts of

super-charged enzyme, the usually sluggish bacteria turned into

electricity and nourished with nitrogen. Rhodomicrobium bacteria

relative PHA powerhouses. The researchers are optimistic a

have unusual properties that make them intriguing contenders

similar approach could be possible with other bacteria that might

as natural bioplastic factories. While some species float around

be able to produce even higher levels of bioplastics. Bose plans

cultures as individual cells, this genus forms interconnected

to take a closer look at the quality and possible uses of the polymers

networks that seem especially well-equipped to produce PHA.

produced in her lab.

Other types of bacteria can also produce bioplastic polymers with some help. As reported in Applied and Environmental

1

DOI: 10.1111/1751-7915.14552

Microbiology , the WashU researchers used genetic engineering

2

DOI: 10.1128/aem.01438-24

to coax high levels of PHAs out of Rhodopseudomonas palustris

Source: Washington University in St. Louis

2

Healing eyes with contact lenses A cross-disciplinary team at the University of Waterloo, Canada, has developed a new contact lens material that could act as a bandage for corneal wounds while releasing drugs in a controlled manner to help the eye heal faster.

Typically, corneal abrasion patients spend seven to ten days wearing a clear, oxygen-permeable bandage contact lens, often instilled with eyedrops containing antibiotics. However, the one-time antibiotic application makes it difficult to ensure enough drugs stay on the eye for sustained treatment.

(A) Growth of immortalized HCEC cells on 20% w/v GelMA+ gels, (B) Growth of immortalized HCEC cells on 30% w/v GelMA+ gels. On the 5th day, the cell growth on the respective hydrogels was observed. Picture: University of Waterloo

“It’s a targeted-release drug delivery system that is responsive

called matrix metalloproteinase-9 (MMP-9), which is naturally

to the body,” said Dr. Lyndon Jones, a professor at Waterloo’s

found in the eye.

School of Optometry & Vision Science and director of the Centre

“These enzymes are very special because they’re involved in wound

for Ocular Research & Education (CORE). “The more injured

healing, and when you have a wound, they’re released in greater

you are, the more drug gets delivered, which is unique and

quantity,” Phan said. “If you have a material that can be degraded

potentially a game changer.”

in the presence of this enzyme, and we add a drug to this material,

Jones knew there was a market for a drug-delivering bandage

we can engineer it so it releases the drug in a way that is

contact lens that could simultaneously treat the eye and allow

proportional to the amount of enzymes present at the wound. So,

it to heal. The question was how to develop it.

the bigger the wound, the higher the amount of drug released.”

As the University of Waterloo has several researchers and

The team used bovine lactoferrin as a model wound-healing

entrepreneurs building technology to disrupt the boundaries of

drug and entrapped it in the material. In human cell culture

health, Jones was able to team up with Dr. Susmita Bose (PhD’23),

study, the researchers achieved complete wound healing within

Dr. Chau-Minh Phan (PhD’16) and Dr. Evelyn Yim, an associate

five days using the drug-releasing novel contact lens material.

professor of chemical engineering working on collagen-based

Another benefit of the material is that it only becomes activated

materials. Rounding out the team were Dr. Muhammad Rizwan,

at eye temperatures, providing an inbuilt storage mechanism.

a former postdoctoral fellow, and John Waylon Tse (MASc’18),

The next step is fine-tuning the material, including entrapping

a former graduate student, both with Yim’s lab.

different drugs in it. The scientists believe their material has

Collagen is a protein naturally found in the eye that’s also often

great potential for the eye other body sites, especially large skin

involved in the wound healing process – however, it’s too soft

ulcers. A study outlining the researchers’ work was published

and weak to be a contact lens material. Yim found a way to

in the journal Pharmaceutics.

transform gelatin methacrylate, a collagen derivative, into a biomaterial ten times stronger. One unique property of collagen-

DOI: 10.3390/pharmaceutics16010026

based materials is that they degrade when exposed to an enzyme

Source: University of Waterloo

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TECHNOLOGY

The wettability of RGP contact lenses Providing comfort for the eye In this article, we will examine the role of the polymer chemist, the manufacturing lab, the practitioner and finally the patient, in providing the eye with the most comfortable and wettable GP contact lens possible. By Martin Conway and Mark Eddleston

Rigid gas permeable (RGP) lenses provide good visual acuity as

The role of the polymer chemist

well as being durable. They also are acknowledged to be the

RGP contact lens materials and hydrophobicity

safest form of contact lens¹.

RGP contact lens materials are polymers that are typically

Maintaining adequate wettability can sometimes be a challenge,

manufactured by reacting together several different monomers.

however, due to the hydrophobic nature of some of the monomers

These monomers are carefully selected to impart desirable

utilized in providing oxygen permeability. In this article, we will

properties to contact lenses and to increase the safety and comfort

examine the role of the polymer chemist, the manufacturing

of lens wear for patients.

lab, the practitioner and finally the patient, in providing the eye

All modern RGP materials contain at least one silicone monomer,

with the most comfortable and wettable GP contact lens possible.

primarily added to increase oxygen permeability, and at least one f luorinated monomer, added both to provide deposit

Wettability

resistance and to contribute to oxygen permeability.

Wettability refers to the ability of a liquid to spread and form

Silicone and fluorine monomers are hydrophobic and may

a thin, uniform film on the surface.

confer this characteristic to RGP materials, giving them a low

• Comfort: Adequate wettability ensures that the lens surface

affinity for water, which can lead to poor wettability.

remains moist and thereby prevents discomfort, dry spots,

Low wettability results in liquids beading up on the surface of

and irritation during wear.

lenses, rather than spreading across the surface in an even film,

• Visual acuity: An even tear film across the surface of the lens is essential for clear and stable vision.

• Deposit resistance: A well-wetted lens surface is less likely

leading to friction during blinking. It is therefore important that RGP materials are made more hydrophilic, especially at the lens surface, to enhance comfort.

to attract and trap debris and deposits such as proteins,

Enhancing wettability during manufacture of the polymer

lipids, and other environmental contaminants, which can

Incorporating water miscible monomers such as methacrylic

compromise lens performance.

acid, hydroxyethyl methacrylate (HEMA) and N-vinyl pyrrolidone

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TECHNOLOGY

(NVP) into the lens material’s polymer matrix increases the overall hydrophilicity of the lens, offsetting the hydrophobic nature of the silicone-containing monomers.

Careful balancing of the ratios of silicone monomers, fluorinated monomers, and hydrophilic monomers by material designers, produces a material that is not only permeable to oxygen, but that also wets well.

Fig.1: Various stages of contact angles formed by a liquid drop with the surface of a solid.

To maximize the hydrophilic aspects of the material it is essential that lenses are prepared carefully prior to dispensing, and that lens surfaces are maintained free of deposits and scratches during wear and handling.

When RGP lenses are dispensed to the patient, it is essential that the surface quality of the lens is maintained by the patient to retain its wettability.

Fig.2: Contact angle measurement in laboratory conditions.

The role of the contact lens laboratory Raw material polymers arrive at the contact lens laboratory as pre-formed buttons which, for a corneal lens, are typically 12.7 mm in diameter and 4.7 mm in thickness. The button comprises a polymer which contains a mixture of both hydrophobic and hydrophilic monomers, randomly spread throughout the matrix of the button.

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Fig.3: Contact lens manufacturing.

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TECHNOLOGY

To maximize the hydrophilic aspects of the material it is essential that lenses are prepared carefully prior to dispensing, and that lens surfaces are maintained free of deposits and scratches during wear and handling.

The laboratory machines the button to produce the lens and in doing so will need to secure the button in place during the lathing process. Wax is used to mount the button in place for machining.

This wax is hydrophobic and is removed from the finished lens, along with any other contaminants. Any microscopic residues left on the surface of the lens may be removed by further treatment in a plasma chamber. The type of plasma treatment used in a normal specialty contact lens laboratory should really be viewed as an additional intensive cleaning step, and though the plasma treatment will also activate the surface of the treated lens and make it more wettable, this effect is temporary and will dissipate within a week.

At the end of the lens’s journey through the laboratory, it will be fully formed, and the surfaces will have been thoroughly cleaned to remove any residual waxes that might inhibit wettability. At this point, the polymer chains at the surface of the finished lens will consist of a mixture of hydrophobic and hydrophilic monomer species that will compete for their effect on the overall wettability of the surface. Although the surface

The polymer manufacturer will have provided recommendations

may appear to be inert, at a molecular level the polymer chains

to the laboratory for each material’s lathing characteristics, and

are capable of reorganization. By soaking the lens in a

these will include speed of rotation and depth of each cutting

conditioning solution before shipping, the laboratory can start

pass of the lathe to avoid the generation of excessive heat on the

a process that will gradually improve the wettability of the lens

finished surface of the finished lens.

surfaces over the following week. The presence of the soaking solution at the surface of the lens will attract hydrophilic components of polymer chains to the surface of the lens and repel hydrophobic species. Over time, this effect will alter the surface characteristics of the lens and will continue for approximately a week after manufacture. The chart (Fig.4) indicates the reductions in wetting angle that take place using four different materials from various manufacturers.

For this reason, it is recommended that lens manufacturers ship lenses to practitioners in a soaking/conditioning solution in order that this process may take place.*

I Fig.4: The contact angle of gas permeable materials over time.

Although it may take up to seven days for the surface to reach optimal performance, the majority of the effect occurs within the first 2-3 days, and this can take place during shipment.

S

M

• • • •

Fig.5: Slit-lamp inspection of the anterior segment of the eye.

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The role of the practitioner It is important that the practitioner insists that GP lenses are shipped from the laboratory in a soaking solution for this surface conditioning process to begin. Although it may take up to seven days for the surface to reach optimal performance,

* It is important to ensure all local regulatory requirements are being complied with when shipping contact lenses in solution.

References: 1 Ophthalmology. 2008 Oct;115(10):1655-62. doi: 10.1016/j.ophtha.2008.04.002.

Epub 2008 Jun 5. The incidence of contact lens-related microbial keratitis in Australia.

the majority of the effect occurs within the first 2-3 days, and this can take place during shipment.

The role of the patient When RGP lenses are dispensed to the patient, it is essential that the surface quality of the lens is maintained by the patient to retain its wettability. The process of conditioning outlined above is reversible. If the lens surface is not cleaned properly after wear, any lipids remaining on the surface will reverse the process described. The hydrophobic nature of lipid at the surface will repel hydrophilic species and attract hydrophobic elements.

This will eventually result in a dry spot on the surface of the lens if allowed to continue. The importance of digital cleaning with an appropriate surfactant cleaner should be stressed at dispensing

Martin Conway has over 40 years’ experience in the contact lens field as a qualified contact lens optician. He is registered with the UK General Optical Council on the Speciality Contact Lens Register. Martin is a fellow of the British Contact Lens Association (FBCLA), and the International Association of Contact Lens Educators (FIACLE). He has served in the professional services role as an educator and clinical adviser on behalf of both Sauflon and CIBA, and now acts as professional services consultant for Contamac.

Martin has lectured extensively in Europe, Asia, Russia, North and South America and the Middle East.

and every aftercare visit.

Should a patient present with wetting issues, then a poor cleaning regimen is likely to be the cause. It is not enough for the practitioner simply to demonstrate cleaning at this stage, as it is likely that the surface has been re-conditioned by the presence of lipids on the surface for some time prior to the visit. The lens needs to be removed, cleaned, and then soaked in an appropriate conditioning solution for at least 48 hours in order that the surface

Mark Eddleston received his PhD from the University of Cambridge in 2012 and has subsequently enjoyed several busy, but rewarding years working as a project leader within the R&D team at Contamac.

can be returned to somewhere near its optimal wettability. n

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TECHNOLOGY

Most drink bottle caps are made of polypropylene. Along with polyethylene they account for 60 percent of all plastic waste. Picture: Shibashish Jaydev / ETH Zurich

Chemical plastics recycling is ready to go New mathematical formula describes entire process Hundreds of millions of tons of plastic waste are generated worldwide every year.

Scientists are working tirelessly on new methods to recycle a large proportion of this waste into high-quality products and thus enable a genuine circular economy.

However, current recycling practices fall short of this goal. Most plastic waste is recycled mechanically: shredded and then melted down. Although this process does result in new plastic products, their quality deteriorates with each recycling step.

is then introduced into the molten plastic. A crucial step involves adding a powdered catalyst containing metals such as ruthenium.

By carefully selecting a suitable catalyst, researchers can increase the efficiency of the chemical reaction, promoting the formation of molecules with specific chain lengths while minimizing byproducts such as methane or propane.

Rotational speed and geometry are key “The molten plastic is a thousand times thicker than honey. The key is how you stir it in the tank to ensure the catalyst powder and hydrogen get mixed right through,” explains Antonio José Martín, a scientist in Pérez-Ramírez’s group. Through experiments and computer simulations, the research team demonstrated that the plastic is best stirred using an impeller with blades parallel to the axis. Compared to a propeller with angled blades or a turbine-shaped stirrer, this results in more even mixing and fewer flow vortices.

An alternative to this is chemical recycling, which avoids loss of

The stirring speed is equally crucial. It must be neither too slow

quality. This method involves breaking down long-chain plastic

nor too fast; the ideal speed is close to 1,000 revolutions per minute.

molecules (polymers) into their fundamental building blocks

The researchers successfully developed a mathematical formula

(monomers), which can be reassembled into new, high-quality

to describe the entire chemical recycling process with all its

plastics, creating a truly sustainable cycle.

parameters. “It’s every chemical engineer’s dream to have a formula like this at hand for their process,” Pérez-Ramírez says.

Fuels from plastic waste

All scientists in the research field can now precisely calculate

As the approach of chemical recycling develops, the initial focus

the effect of the stirrer’s geometry and speed.

is on breaking down these long polymer chains into shorter-chain

With this formula, future experiments can focus on directly

molecules that can be used as liquid fuels, say, or lubricants. This

comparing different catalysts with the influence of mixing under

gives plastic waste a second life as petrol, jet fuel or engine oil.

control. In addition, the principles developed here are central

Scientists at ETH Zurich have now laid down important

for scaling up the technology from the laboratory to large recycling

foundations for developing this process. These enable the global

plants. “But for now, our focus remains on researching better

scientific community to engage in more targeted and effective

catalysts for the chemical recycling of plastics,” Martín says. n

recycling development work.

Researchers in the group led by Javier Pérez-Ramírez, Professor

Source: ETH Zurich

of Catalysis Engineering, investigated how to break down

References: Jaydev, S.D., Martín, A.J., Garcia, D. et al. Assessment of transport phenomena in catalyst effectiveness for chemical polyolefin recycling. Nat Chem Eng 1, 565–575 (2024). https://doi.org/10.1038/s44286-024-00108-3.

polyethylene and polypropylene with hydrogen. Here, too, the first step is to melt the plastic in a steel tank. Gaseous hydrogen 18

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PR-ADVERT

Next level innovation Larsen Equipment Design Introduces the Auto-Transfer Blocking System

The folks at Larsen Equipment Design, Inc. were pleased to

before being laid into the BC. When the diameter of the arbor

introduce the ATB-203 Auto-transfer blocking system at the

determines the amount of wax, no precision metering is needed.”

EFCLIN Congress at Vilamoura Resort (Portugal) in April of

Erik goes on to say, “You can block a 17 mm scleral BC and know

this year. “While most of the industry has our established blocking

the large arbor diameter arbor will have the correct amount of

system in use, we felt it was time to take the industry to the next

wax, then block a 10 mm BC with a corneal arbor with the correct

level in lens blocking technology in keeping with our culture of

amount of wax. That is unprecedented!”

innovation.” Says President and Founder, Erik Larsen. He added

“The new blocking system retains our unique Wax Thickness

“While it is always exiting to create new products and processes,

Control so both corneal and scleral BC’s can be blocked with no

gratification for us is seeing those efforts accepted by industry

mechanical adjustments required (no fiddling by the operator).”

as they have been over the last four decades.”

The new system is housed within a safety shroud in compliance

Larsen displayed the full line of lens fabrication machinery and

with health and safety regulations.

tooling in addition to the new blocking system. We received

“Upon returning with orders for the new system, we undertook

comments like: “We’re happy with our existing system but, Oh!

refining of the design and human/machine interaction. We are

Self-calibration in 15 seconds!?”; “There IS no dispenser? That’s

now “cutting metal” in anticipation of the first deliveries.”

clever.” The wax pool arrangement with no internal moving parts

Larsen Equipment Design is the leading manufacturer of state

greatly reduces maintenance.

of the art contact lens blocking and polishing machines enabling

“We never liked the practice of dropping hot wax into a pristine

labs to reach their highest productivity levels.

base curve. The thermal shock has to have a detrimental effect on the material and thus the optics. Dipping the arbor in hot wax

For more information, please contact Larsen Equipment Design,

enables it to form a perfect shape centered on the arbor, then cool

Inc. at Erik@larsenequipment.com.

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TECHNOLOGY

Researchers have developed a new type of lens that uses a spiral-shaped surface to maintain a clear focus at different distances in varying light conditions. Picture: Laurent Galinier

Spiral-shaped optic Developed for clear focus at different distances French researchers have reported the development of a spiral-shaped optic that maintains clear focus at different distances in varying light conditions. They say that the new lens works much like progressive lenses used for vision correction but without the distortions typically seen with those lenses. It could help advance contact lens technologies,

O

intraocular implants for cataracts and miniaturized imaging systems.

▪U

“Unlike existing multifocal lenses, our lens performs well under

Creating a vortex of light

a wide range of light conditions and maintains multifocality

The inspiration for the spiral lens design came when the paper’s

regardless of the size of the pupil,” said Bertrand Simon from

first author, Laurent Galinier from Spiral SAS in France, was

Photonics, Numerical and Nanosciences Laboratory (LP2N), a

analyzing the optical properties of severe corneal deformations

joint research unit between the Institut d'Optique Graduate

in patients. This led him to conceptualize a lens with a spiral

School, the University of Bordeaux and the CNRS in France.

design that causes light "to spin", like water going down a drain.

“For potential implant users or people with age-related

The researchers explain that this phenomenon, known as an

farsightedness, it could provide consistently clear vision,

optical vortex, creates multiple clear focus points, which allow

potentially revolutionizing ophthalmology.”

the lens to provide clear focus at different distances. “Creating

In Optica, the researchers describe the new lens, which they call

an optical vortex usually requires multiple optical components,”

the spiral diopter. Its spiraling features are arranged in a way

said Galinier. “Our lens, however, incorporates the elements

that creates many separate points of focus which makes it possible

necessary to make an optical vortex directly into its surface.

to see clearly at various distances.

Creating optical vortices is a thriving field of research, but our

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TECHNOLOGY

method simplifies the process, marking a significant advancement

The researchers are now working to better understand the optical

in the field of optics.”

vortices produced by their lens. They also plan to perform

The researchers created the lens by using digital machining to

systematic trials of the lens’ ability to correct vision in people

mold the spiral design with high precision. They then validated

to comprehensively establish its performance and advantages

the lens by using it to image a digital ‘E,’ much like those used

in real-world conditions. In addition, they are exploring the

on an optometrist's light-up board. The authors observed that

possibility of applying the concept to prescription eyeglasses,

the image quality remained satisfactory regardless of the aperture

which could potentially offer users clear vision across multiple

size used. They discovered that the optical vortices could be

distances.

modified by adjusting the topological charge, which is essentially

“This new lens could significantly improve people’s depth of

the number of windings around the optical axis. Volunteers

vision under changing lighting conditions,” said Simon. “Future

using the lenses reported noticeable improvements in visual

developments with this technology might also lead to

acuity at a variety of distances and lighting conditions.

advancements in compact imaging technologies, wearable devices and remote sensing systems for drones or self-driving cars, which

Crossing disciplines

could make them more reliable and efficient.” n

Bringing the new lens to fruition required combining the intuitively crafted design with advanced fabrication techniques through a cross-disciplinary collaboration. “The spiral diopter lens, first conceived by an intuitive inventor, was scientifically

Source: Optica

substantiated through an intensive research collaboration with

References: Laurent Galinier, Philippe Renaud-Goud, Jean Brusau, Lucien Kergadallan, Jean Augereau, and Bertrand Simon, "Spiral diopter: freeform lenses with enhanced multifocal behavior," Optica 11, 238-244 (2024).

optical scientists,” said Simon. “The result was an innovative approach to creating advanced lenses.”

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MANUFACTURING

Time, errors, productivity and profit Decisions, decisions! Part 2 This article is a follow-up to the last one in GlobalCONTACT No 97 in which I talked about how the number and types of decisions that a lab tech needs to make affects productivity and rejects caused by wrong decisions. In the article, I alluded to how machines and processes can reduce the number of decisions needed. Here is how you can do this to make your lab more efficient and more profitable. By Erik Larsen

An example is the bladder polishing system. Into to the 90s,

what the lathe turned and the bladder polisher will polish that

pitch and hard polishing tools were utilized to polish spheres.

surface. Again, the current process eliminates many decisions

Special fixtures were utilized to polish torics. This process

on the part of the lab tech. This is because the surface geometry

required either forming the pitch to the lens or picking the

is generated by the lathe and a single bladder tool polishes it;

correct polishing tool to fit the curve. The peripheral curves

the lab tech doesn’t need to choose the polishing tool. The same

had to be formed and polished separately. The bladder polishing

polishing tool can stay on the machine all day.

system eliminated all these tasks, with the proviso that the

The processes I mentioned above are standard operating

curve was turned on an air-bearing lathe. This process has

procedures for most labs around the world. What other advances

become the norm for all back surface geometries including

reduce the reliance on good decisions in the manufacturing

scleral lenses.

process? In answering this question, the production manager

Another example of reducing the number of decisions is

can wander around the lab and look at each task to see what

changing from holding the lens blank directly in the lathe collet

motions the lab tech is making.

to blocking the lens blank. Again, with the pitch polishing (lapping) method, the geometry off the lathe would be

Options for lens blank blocking

“corrected” to a sphere. But with CNC lathes adding toric,

An example is the lens blank blocking procedure. As I mentioned

aspheric, and free-form capability, pitch or hard tool polishing

in the previous article, the center thickness control needs to

is not possible because it will drive the curve to a sphere. If you

be addressed. If the blank thickness needs to be measured, that

turn a base curve (BC) in a deformed state, the resulting curve

can be done for each job, or the bag of lens blanks can be sorted

will not be what you need. Bladder polishing will not correct

upon receipt at the lab, so that blanks with the same thickness

that. So, blocking the lens blank ensures that the BC will yield

can be stored together. A time study will determine which

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MANUFACTURING

approach is faster. If the lens blank is blocked on a hollow arbor, then the center thickness of the BC is directly measured.

3. The cupped arbor is a precision tool, so the lathe collet clamps on it the same every time.

The next step is to block the lens blank to the arbor. There are

4. The face of the lens blank is approximately at the same

several blocking methods in use. This is partly because high

position from the lathe spindle to reduce the probing range

precision is not required at this point in the manufacturing

which saves time.

process. Below are options for corneal lens blanks (12.7 mm diameter).

It should be apparent that I’m talking about transfer blocking

1. Hand blocking using tape or wax and blocking guide or

by the comments I made about lens blank blocking. We did

fixture.

not invent transfer blocking, but in the last few decades we

2. Manual blocking machine.

have championed that process and built machines and tooling

3. Dual purpose auto-blocker.

around it. In summary, the process involves blocking a convex

4. High production lens blank auto-blocker.

arbor to a blocked concave surface. The result is two arbors

Option 1 may be hard to believe, but for low volume it works

with a finished BC between them. This applies to both corneal

fine.

and scleral lens blocking. The goal is to mount an un-strained

Option 2 would utilize an old blocking machine you have in

BC to the convex arbor with high precision in both radial and

storage.

tilt. That means a blocking machine needs to be able to be

One advantage to options 1 and 2 is that you have a separate

aligned in both radial and tilt axes. I’ll leave it to the reader to

workstation next to the lens blank inventory that does not

see if their blocking system has that lab capability. Once the

interfere with the precision transfer blocking station.

BC is transfer-blocked, a separating device removes the first

Option 3 requires the operator to switch the transfer blocker

arbor, then the blocked BC is ready to turn the front surface.

to lens blank blocking several times per shift. This may not seem to be an issue, but the decisions and time delay add up.

Back to decision making: In one type of blocking machine,

Option 4 is for high production up to 3000 lenses per shift.

you need to set up the machine for front blocking (from blank

Again, there would be a separate workstation next to the lens

blocking), set the blocking height for the particular center

blank inventory. Also, having pre-measured lens blanks would

thickness, and set the amount of wax to be dispensed. That is

be good here (if this is your process).

at least three decisions on the part of the technician. In another

Scleral lens blank blocking can be done utilizing the above

of labs utilize the later system.

blocking system those decisions are automatic. The majority options, but some of the industry holds the scleral lens blank directly in the lathe collet against the face of the collet. This

Looking to the future

method can yield good results because the scleral lens blank

Looking to the future holds some interesting possibilities in

is massive enough to withstand the collet force. However, there

the context of decision making. Robots do not make many

are a few problems that can arise with this method.

decisions, the fewer the better. With the advent of machines

1. The face of the lathe collet may not be perfectly square to

and processes that require few decisions, these tasks are an

the bore which may tilt the lens blank. So, the shoulder on

obvious application for robot machine tending. While fully

the lens blank would be against the tilted face of the collet.

automated lens production systems are operating in a few labs

New lathe collets have the bore and face ground at the same

around the world, the norm is a mixture of manually loaded

time, so inherently they are square, but over time and if a

machines and autoloaded lathes. Expect to see more workstations

crash happens, there may be a defect on the face of the collet

with a robot tender in the future. This trend also fits well with

which will tilt the lens blank.

LEAN processes. n

2. The face of the 12.7 mm diameter of the lens blank may not be parallel to the shoulder. This could cause alignment problems in front blocking because blocking machines usually register off the 12.7 mm face of the lens blank.

3. Holding the scleral lens blank directly in the lathe collet means that lathe probing needs to accommodate the different location from the front cut probe position which may be over 10 mm difference. This wastes time.

Another method is to block the scleral lens blank in a cupped holder. The advantages of this method include: 1. Easily done by hand (high precision is not needed).

Erik Larsen graduated from the University of Washington with a Mechanical Engineering degree in 1981 and started Larsen Equipment Design later that year. Erik Larsen has industry awards from CLMA and EFCLIN.

2. No collet force is transferred to the lens blank.

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REPORT

Barcelona in focus – a brief report from the 42nd ESCRS Congress ¡Hola! and welcome to a long weekend packed with the most interesting topics currently occupying ophthalmologists.

We are talking about the 42nd Congress of the European Society of Cataract & Refractive Surgeons – or ESCRS for short.

From September 6 to 10, 2024, the congress invited like-minded people to exchange knowledge at the Fira de Barcelona in Spain. By Lena Petzold

The ESCRS was founded in 1991 to promote education and

bilaterally. Risk factors in this context were male gender and the

research in the field of implant and refractive surgery and to

presence of myopia. How can this be treated? Only a second

advance the study and practice of ophthalmology. The European

operation can improve the dislocation. Option one is repositioning

association now has over 7,000 members from 130 countries. In

of the IOL, whereas the second option is a complete replacement

the following article, we will guide you through the 42nd congress,

of the IOLs. Dr. Vasavada recommends the Yamane technique

which attracted a total of 16,735 participants from 126 countries.

with intrascleral fixation.

“We have strengthened ties with ophthalmological societies around the world, creating a collaborative environment that

The BOSS

benefits everyone.” – Filomena Ribeiro, ESCRS President.

From September 6, the first sustainable, integrative society (BOSS), which was founded this year by ESCRS President

The opening

Filomena Ribeiro, also started. BOSS is designed to give young

The first day of the congress kicked off with the opening ceremony,

ophthalmologists the opportunity to interact with more than

during which the “2024 Ridley Medal Lecture” was given by

40 experts in ophthalmology and discuss professional

Indian ophthalmologist Dr. Abhay Raghukant Vasavada. He

development in the form of speed mentoring sessions. The

discussed the post-operative decentration of IOLs. This is also

mentors are well-known ophthalmologists or decision-makers

known as “dead bag syndrome”. The results of a study by the

at ESCRS. One session offers participants the option of engaging

Iladevi Cataract and IOL Research Centre and Raghudeep Eye

in a one-hour discussion with a total of six mentors, with each

Hospital in India showed that more than 50 percent of the patients

mentor receiving a ten-minute slot. The main topics of these

examined had a decentration of the IOL. This occurred in 75

sessions included, for example, research advances in

percent of the patients more than ten to twenty years after surgery.

ophthalmology, career opportunities and stays abroad. The

In one third of the patients examined, the decentration occurred

work of BOSS continues even after the congress. A year-round

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program has been developed to enable participants to network with each other at future events as well.

History Another networking opportunity with both familiar and new participants was the museum celebrating the 75th anniversary of the first IOL implantation. The IOL in question was performed by the British ophthalmologist Sir Harold Ridley on 29 November 1949. During this exhibition, Ridley's office and operating room were open to visitors, allowing them to immerse themselves in the development of the IOL and the associated implantation process. At the same time, there was an insight into the further development of IOL and cataract surgery up

ESCRS Industrial exhibition.

to possible future innovations. In the adjacent tunnel museum, selected museum pieces were on display. Multimedia presentations were also set up in other sections of the congress

More than 300 exhibitors from the ophthalmologic and optical

halls to provide insights into the day-to-day practice of cataract

industry participated in the ESCRS industrial exhibition, offering

surgery. And not to be forgotten are the escape rooms. One

24 independent symposia, which were attended by a total of

room consisted of various areas, such as an operating table, a

10,000 participants.

gallery of former and current ESCRS chairs, and chests that

Other interesting facts from various industry and research

could be opened by solving puzzles. The aim of the room was

symposia: When performing LASIK on hyperopic patients,

to correctly calculate an intraocular lens to be used with the

attention should be paid not only to the keratometry values, but

help of the ESCRS IOL calculator. The parameters eye length,

also to the epithelial thickness. Artificial intelligence (AI) will

K1 and K2, anterior chamber depth, etc. had to be determined

play an increasingly important role in ophthalmology and will

in the puzzles in order to calculate the IOL to solve the riddle

be used for diagnostics and screening, especially on the retina

of the escape room.

(glaucoma, lesions or diabetic retinopathy). AI can determine

The present

used in patient care, continuing education, and research. Filomena

the patient's gender based on the foveal reflex. AI can also be An insight into current topics was provided by: five main

Ribeiro summed up the congress as follows:

symposia, four research symposia, 393 poster presentations, 80

“Your expertise and insights, presented with clarity and

wet labs and eleven dry labs. In the laboratories, those who

enthusiasm, have enriched scientific discourse and fostered a

wanted to expand their knowledge and skills were able to perform

collaborative environment.”

(virtual) operations on the anterior segment of the eye under the supervision of experts. There was an opportunity to perform

The future

the surgical procedures using a slit lamp or virtual reality glasses.

Next year, the annual winter meeting will take place in Athens,

During the poster presentations, participants had five minutes

Greece, from February 28 to March 2, 2025. Around six months

each to present the results of current studies in a rapid-fire

later, the association invites you to the 43rd ESCRS Congress

session. The topics included, for example, cataracts, surgical

in Copenhagen, Denmark, from September 12 to 16, 2025. n

operation methods or the testing of new IOL developments.

The lecture by Eleonora Bianchi (England) dealt with the development of a contrast sensitivity questionnaire for the classification of existing lens opacities and for the surveyed patients on a waiting list for cataract surgery. The questionnaire was sent by post to 233 patients (divided into age groups, gender and socio-economic status). The costs amounted to around 3 £ (~ 3.60 €) per patient surveyed. However, it should be noted that different lighting conditions lead to different results.

Furthermore, the flexibility of the questionnaire could be exploited by patients, who could artificially lower the results in order to get an appointment for surgery faster. Ultimately, the questionnaire is a practical and cost-effective way of prioritizing

Lena Petzold graduated from high school in 2018 and began her bachelor's degree in ophthalmic optics/optometry at the Ernst Abbe University of Applied Sciences in Jena, which she completed in October 2021. She started the subsequent Master's programme in the same month. In 2022, she had the opportunity to present her bachelor's thesis at the American Academy of Optometry. She has been working part-time at JenVis Research since 2021.

patients on the waiting list for surgery.

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15.11.24 11:29

REPORT

Did you know... ...that there is a small island in the Pacific where a significant percentage of the population lives in a world without colors?

Pingelap, a remote island in Micronesia, is known worldwide as the “Island of the Colorblind”. This description is to be taken literally, as a significant number of the islanders suffer from the rare genetic disorder achromatopsia. This disease leads to total color blindness, meaning that those affected see only gray scales and have no color vision. In addition to color blindness, visual acuity is limited and sensitivity to light is greatly increased, making it considerably more difficult to see in daylight. By Silke Sage bright daylight. Many of them wear widebrimmed hats and sunglasses to protect their light-sensitive eyes. At the same time, however, Sacks emphasizes the remarkable adaptability of the people. They have developed a life that is attuned to their circumstances, and they navigate their environment remarkably well despite their limited vision.

Interestingly, there is no social stigma associated with color blindness on Pingelap. Because so many people are affected, achromatopsia is considered normal there. Unlike in other parts of the world, where such impairments can often have an isolating effect, the community on the small island is an example of how a society can adapt to and integrate genetic Left, Fig. 1: Visual impression of a person with normal vision. Right, Fig. 2: Simulation of achromatopsia: complete color blindness with a glare component from daylight and greatly reduced visual acuity. The view can only be approximated. It is intended to illustrate that this type of visual impairment is more significant than a color vision deficiency such as red-green color deficiency. (Photos: Silke Sage + AI)

peculiarities.

The story of Pingelap also raises important questions about genetic diversity and isolation. Pingelap is an example of the

The story behind the high prevalence of achromatopsia on

so-called founder effect, in which a small number of individuals

Pingelap goes back to a “genetic bottleneck” that occurred

found an isolated population whose genetic traits can be

in the 18th century. In 1775, the island was hit by a devastating

reinforced over generations. This effect can, as in the case of

typhoon that wiped out almost the entire population. Only

Pingelap, lead to the spread of a genetic mutation that rarely

about 20 people survived, and genetic testing showed that

occurs under normal circumstances.

one of them carried a mutation responsible for achromatopsia.

For scientists, the isolated island is not only a place of special

Due to the island's isolated geographical location and small

interest due to the prevalence of achromatopsia, but also a

population, this mutation spread over generations. Today,

key example for understanding how genetic diseases can

an estimated 5-10% of the island's inhabitants suffer from

develop in small, isolated populations. Research on the island

this disorder, while worldwide it affects only about one in

helps to better understand the mechanisms behind the

30,000 people.

inheritance of genetic disorders and to develop possible

The interesting story of Pingelap and its inhabitants has been

approaches for treatments.

frequently featured in scientific papers and books. One of the

Overall, Pingelap is a fascinating example of the complexity

most well-known contributions comes from neurologist and

of human genetics and how humans adapt to extraordinary

author Oliver Sacks. In his book “The Island of the Colorblind,”

circumstances. In “The Island of the Colorblind,” Oliver Sacks

Sacks describes his trip to Pingelap to learn more about the

not only presents the scientific facts about this island, but also

effects of this unusual genetic disorder. He describes the

a deep understanding of the cultural and human aspects of life

challenges the islanders face, such as their difficulty seeing in

in a world without color. n

26

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GlobalCONTACT 3-24

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PR-ADVERT

CASE STUDY:

Fitting a highly toric and asymmetric ocular surface using current lathe technology BACKGROUND

an 8-meridian toric design was pursued. Sagittal depth was

A 25-year-old female with

reduced by 300 microns and additional haptic adjustments

history of severe aqueous

were made to address areas of edge lift.

deficiency dry eye and filamentary keratitis fol-

LENS DESIGN # 1

lowing numerous ocular

• 18.5mm/2.58 sag/ 8.0 BC/ +3.25 sph/ 8-meridian 1.12mm

reconstruction surgeries

toric (steepest meridian at 7:30)

of benign neoplasm of lacrimal gland and coloboma of lid repair

• VA: 20/40-2, without improvement with over-refraction • Residual compression over the temporal elevated conjunctiva

presented for a PROSE scleral lens consultation. The patient

was evident. Centration of the lens greatly improved. There

complained of ocular discomfort and poor vision, recalcitrant

was adequate and improved corneal clearance, with resolu-

to all prior therapies including periodic amniotic membranes.

tion of the inferior tear prism. Residual inferior temporal

ODsc: 20/150 (PH 20/60) OSsc: 20/30-2 (PH 20/25+2)

edge lift was noted.

since infancy for excision

PLAN

LENS DESIGN #2

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• 18.5mm/2.58 sag/8.0 BC/+3.25 sph/ 8-meridian 1.32mm

a scleral lens. To fit around the temporal conjunctival obstacle,

toric (steepest meridian at 7:30/ custom temporal channel

the diameter of the lens must be either small enough to avoid the anatomical obstacle entirely (and likely necessitating a notch) or be large enough to cover the obstacle. A larger diameter design was pursued to fit over the anatomical obstacle and

(135 – 190^, 250 microns of depth)

• VA: 20/30-1, without improvement with over-refraction • A channel was added to the temporal aspect and the inferior temporal edge was steepened.

allow better coverage of the desiccated ocular surface.

RESULTS TRIAL LENS SELECTION

The patient continued with daily scleral lens wear, with significant

• 18.5mm/2.88 sag/8.0 BC/+0.25 sph/0.35mm bitoric • VA: 20/80+2 • Over-refraction: +3.00 sphere; 20/40-2

improvement in comfort and vision, with resolution of filamentary keratitis. Given the highly toric and asymmetric nature of the ocular surface, necessary lens adjustments could only be achieved with access to advanced high precision FT3 technology provided

The initial trial lens was applied and demonstrated a poor fit.

by our lathe vendor. With appropriate precision lathe technology,

Necessary adjustments to obtain an optimal fit were imple-

the range and customization of fitting is boundless.

mented with utilization of thorough slit lamp evaluation and implementation of PROSE scleral lens customizations.

There was notable compression overlying the temporal elevated conjunctiva with associated inferior temporal edge lift. Mild edge lift was also noted nasally, inferiorly and superiorly.

The apical vault was also over 500 microns and demonstrated inferior decentration as evident by the inferior tear prism.

Two scleral lenses were designed. The highly irregular ocular surface and focal significant inferior

Dr. Bita Asghari, OD, FAAO, FSLS PROSE Provider and Associate Director of Clinical Education

temporal edge lift necessitated at least 1 mm of steepening. To achieve this in this oblique meridian, GlobalCONTACT 3-24

00_PR_DAC.indd 27

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FITTING BACKGROUND

Presbyopinion Part I: Definition & mechanism Everyone has an opinion on presbyopia. But let’s stick to the facts and find out: What is presbyopia exactly? Using an evidencebased approach with information from recently published review papers, this article explores the ins and outs of presbyopia and its correction methods. By Eef van der Worp

28

28_Eef_Article.indd 28

The claimed inventor of bifocal glasses, although there are some

CLEAR

questions regarding the exact nature of that claim, is Benjamin

Back to the mentioned review papers, these were generated by

Franklin – a founding father of the US and one of the architects

the British Contact Lens Association (BCLA). During 2024,

of the Declaration of Independence in 1776. Franklin was a fervent

eight reports in the Contact Lens Evidence-Based Academic

reader and the founder of the first public library in the US; he was

Reports (CLEAR) series focused on presbyopia; in total, more

myopic, and as he got older, like anyone else, he became presbyopic

than 175 pages published in eight ‘chapters,’ if you will, in the

(he passed away at the respectable age of 84). Carrying around

peer-reviewed journal Contact Lens & Anterior Eye. The

two pairs of glasses was a big nuisance to him; he writes in letters

publication is a consensus paper that involved close to 100 experts

to a friend. He asked a local glass grinder to cut the lenses of both

from around the world and numerous references to back up all

glasses in half and mount them both in one frame. He calls these

the information generated. Contact lenses are of course part of

‘double glasses’ in a letter, with a drawing, to the mentioned friend

the series, but the papers certainly are not limited to that; they

in 1785. Besides maybe the first description of bifocal glasses,

cover everything from definition to mechanism to intervention

Franklin was known for a number of interesting quotes, of which

methods besides glasses and contact lenses, such as intraocular

this one seems quite appropriate for the topic of presbyopia: ‘Life’s

lenses, corneal surgical techniques, pharmaceutical solutions,

tragedy is that we get old too soon and wise too late.’

and even scleral technology.

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FITTING BACKGROUND

Interestingly, despite all our recent research and innovations, we don’t fully understand accommodation completely.

A couple of things can be taken from this. Presbyopia is not something that suddenly happens at the age of 45 or thereabout; it is a life-long process that starts at birth pretty much – but only manifests around the age of 45 because we read at a certain distance. In essence, it is related to the length of our arms. This is obviously an anatomical feature, and it at least partly explains the differences in various regions and the (minor, but still) differences between men and women.

Regional differences are quite large. The prevalence of functional presbyopia in 2015 was 24,9% of the entire population – accounting for 1,8 billion people. However, the percentage of people who get a presbyopic correction differs greatly, partly because of income, partly because of near task demands. The CLEAR paper differentiates high-income countries from other regions; in the first, uncorrected presbyopia is close to zero percent, while in parts of the sub-Saharan region, it can be about 90%. So, it is good to keep in mind that presbyopia primarily is One of the first take-home messages is: Presbyopia correction

a near-vision demand condition (with emphasis on ‘demand’).

involves much more than providing ‘just a near add.’ The term

Many risk factors for presbyopia are explored in depth in the

'presbyopia management' is quite appropriate, because if we

papers, including the influence of UV light, nutrition (diet),

want to take our presbyopic patients seriously, we must take a

stress, sleep, etc. on accommodation. Some may have a potential

more holistic approach and consider and inform all options

influence, but at the end of the day there is no strong evidence

available to patients today.

for a clear contribution of any single variable. The number

It also seems appropriate to think in line with ‘myopia management’:

one variable is age, together with vision demands (e.g., reading

with presbyopia too, there is a big task for eye care practitioners

distance).

(ECPs) to inform and provide all types of intervention. Besides that, the potential for our (specialty) lens industry with presbyopia

It’s getting personal

correction is probably at least as big as it is for myopia, although

Just like the theme of the upcoming Global Specialty Lens

the latter gets a lot more attention lately.

Symposium in Las Vegas (US), ‘It’s Getting Personal,’ presbyopia management is also all about getting personal. Presbyopia

‘Tell me and I forget. Teach me and I remember.

Involve me and I learn.’ – Benjamin Franklin

and the CLEAR papers are also prominent on the program of GSLS 2025.

The one and only question we really should ask our presbyopic patients is ‘What do you need?’ And accordingly, we should try to mimic or define the near tasks as ‘real-life’ as possible.

By definition

This means for sure that ECPs should work with a trial frame

Of course, it makes sense to start with determining an accurate

(not the phoropter!) so that patients can hold their near work

definition, which is something the first CLEAR paper does. The

at their desired distance and use real-life reading tasks, such

international consensus is this: 'Presbyopia is defined as occurring

as smartphones, e-readers, sheet music – whatever it is they

when the physiologically normal age-related reduction in the

want/need/desire.

eye’s focusing range reaches a point that, when optimally corrected

One thing ECPs and patients need to understand is that if a

for far vision, the clarity of vision at near is insufficient to satisfy

myope goes from glasses to contact lenses at an early-presbyopia

an individual’s requirements.'

age, this can lead to higher accommodation/convergence

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20.11.24 16:16

FITTING BACKGROUND

changes described here cause a reduction in accommodation … but according to scientists, they cannot 100% predict the total change in accommodation. This is called the ‘presbyopia paradox.’

Additional changes may be found in the alteration of index of refraction of the proteins in the crystalline lens, but this finding has not fully crystallized yet.

Intervention methods In line with myopia management terminology, what are the intervention methods for presbyopia? Apart from glasses and contact lenses, there are corneal inlay techniques, intraocular lens implantation with several lens design options, laser refractive Letter by Benjamin Franklin describing the first ‘double glasses’ or bifocals in 1785 (Image: library of congress USA)

surgery, pharmaceutical solutions and more. Part 2 of this series will focus on all these in the next GlobalCONTACT. The technical aspects will be covered as well as considerations in choosing one

demands – meaning they would need a near correction sooner

option over another. The latter may be as important as the first

or a higher near addition. For hypermetropia, it is the reverse

– as the choice for one technique over another is often a personal

(the near add can be postponed a bit, or lowered, when switching

one. Presbyopia is not an opinion. It is real and can be explained

from glasses to contact lenses).

in an evidence-based manner (and no, exercises do not help and neither does postponing getting a reading device). But the choice

The elderly eye

of management for presbyopia is highly personal, the patient’s

What happens to the eye as we get older? A few things, but they

opinion is crucial, and the choice should be based on a well-

are not in the cornea. The cornea stays relatively stable throughout

informed presentation of all options by the eyecare provider. n

life, which is a good thing as the cornea represents by far the highest optical value of the entire human optical system (the total optical power of the eye is 60D, of which the cornea is responsible for about 40D; for the rest, the crystalline lens is responsible). Astigmatism changes a tad throughout life, but mostly it is crystalline lens-related (not cornea).

So, it’s the crystalline lens that undergoes major changes throughout life and is almost solely responsible for the reduction in accommodation. A common myth in the public, but even in the eyecare world, is that the crystalline lens’ eye muscles degenerate with age and that this process is responsible for the reduction in accommodation. The CLEAR publication is pretty clear about that: it is the lens itself, not the muscles. The lens gets more rigid with age. It consists mostly of proteins; in fact, the crystalline lens has the highest concentration of protein anywhere in the human body (300 mg/ml). And proteins change with age. To make things

References: 1 Wolffsohn JS, Naroo SA, Bullimore MA, Craig JP, Davies LN, Markoulli M, Schnider C, Morgan PB. BCLA CLEAR Presbyopia: Definitions. Cont Lens Anterior Eye. 2024 Aug;47(4):102155.

2 Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye. 2024 Aug;47(4):102185.

3 Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye. 2024 Aug;47(4):102157.

4 Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye. 2024 Aug;47(4):102156. doi: 10.1016/j.clae.2024.102156. Epub 2024 Apr 18. PMID: 38641525.

5 Tm4 Podcast series (Dutch) Presbyopia Management – sponsored by Bausch+Lomb Benelux.

a bit more complex, the crystalline lens can be seen as similar to an onion. Different parts of the lens show different alterations. In general, the lens changes in overall thickness, and the curvatures of the outer surfaces change; there is a steeping of both the anterior and the posterior surface (but not in the same amount; anterior more than posterior, giving the lens a more hyperbolic shape). To finish this part up: the zonulae (the strings attaching the crystalline lens muscle to the lens capsule) also change: their innervation on the lens capsule becomes more anterior with age. This partly causes a ‘shift’ forward of the crystalline lens, which also contributes to the change in optical power (e.g., change in accommodation).

Interestingly, despite all our recent research and innovations, we don’t fully understand accommodation completely. All the 30

28_Eef_Article.indd 30

Eef van der Worp, BOptom, PhD, FAAO, FIACLE, FBCLA, FSLS is an educator and researcher. He received his optometry degree from the Hogeschool van Utrecht in the Netherlands (NL) and has served as a head of the contact lens department at the school for over eight years. He received his PhD from the University of Maastricht (NL) in 2008.

He is a fellow of the AAO, IACLE, BCLA and the SLS. He is currently adjunct Professor at the University of Montreal University College of Optometry (CA) and adjunct assistant Professor at Pacific University College of Optometry (Oregon, USA). He lectures extensively worldwide and is a guest lecturer at a number of Universities in the US and Europe.

GlobalCONTACT 3-24

20.11.24 16:16

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05.11.24 17:47

FITTING BACKGROUND

Mini scleral lenses

Uwe Bischoff, Managing Partner at Müller Welt Kontaktlinsen, Stuttgart, Germany (left) and contact lens specialist at the contact lens institute Corinna Jonske (right)

– when are they beneficial? A dialogue At the last conference of the Association of German Contact Lens Specialists (VDCO) Uwe Bischoff and Corinna Jonske of the Müller Welt contact lens institute in Stuttgart held a critical technical discussion. Read the transcript here to find out what it was about:

Corinna Jonske: We are meeting today to discuss the topic of

because the oxygen supply to the cornea was really limited

mini-scleral lenses and when fitting these contact lenses really

with the materials used at the time and the changes caused

makes sense for us.

to the eye by wearing the lenses were not tolerable. And even though we have better materials available today, a sense of

Uwe Bischoff: Lately, I have often been annoyed by this topic

scepticism remains with me when I see how mini-scleral

and how it is currently positioned in the market ...

lenses are hyped today.

Corinna Jonske: What do you mean? We fit mini-scleral lenses

Corinna Jonske: You mean that because many fitters are too

almost every day. Have you suddenly lost your conviction?

careless with the modality “mini-scleral”, because you hear about it everywhere, and it is advertised as “easy” and without

Uwe Bischoff: That's not the point. Of course, I'm happy

problems? Are you worried that some people don't realize the

about every patient that we can help significantly by fitting

effects?

these lenses. But I also belong to the generation that experienced the “extinction” of scleral lenses in the 1990s.

Uwe Bischoff: That's right, and actually even more than that:

These lenses disappeared from the market for good reasons,

at every contact lens conference, mini scleral lenses are one of

32

32_Minisklerallinsen_Bischof.indd 32

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21.11.24 12:12

FITTING BACKGROUND

Fig. 1: When fitting mini scleral lenses, it is not only the size that matters, but also the sagittal height.

Alternative Names Corneal Corneoscleral

Corneal-Limbal Semi-scleral Limbal

Fig. 3: Epithelial vesicles on a previously damaged cornea, occurring under the scleral lens, are tolerated and observed by the ophthalmologist.

Diameter

Bearing

Tear Reservoir

8.0 to 12.5 mm

All lens bearing on the cornea

No tear reservoir

12.5 to 15.0 mm

Lenses share bearing on the cornea and the sclera

Limited tear reservoir capacity

15.0 to 25.0 mm (Full) Scleral

Mini-scleral Haptic

15.0 to 18.0 mm Large-scleral

All lens bearing is on the sclera

18.0 to 25.0 mm

Somewhat limited tear reservoir capacity Almost unlimited tear reservoir capacity

Fig. 2: Definition of mini scleral lenses for bridging fitting. Source: Scleral lens guide, Eef van der Worp

the main topics, and the trade press also mainly covers the

Corinna Jonske: I see what you mean, if you haven't tried all

possibilities offered by scleral lenses. Almost every manufacturer

the corneal RGP contact lens options before resorting to a

now has its own product, and optometrists are led to believe

scleral lens.

that fitting them is easy and can be done at the push of a button in some cases. But what happens then? If a contact lens fitter

Uwe Bischoff: Right! Our clear strategy is to only fit scleral lenses

has little or no experience with GP contact lenses, will changes

when all corneal options have been exhausted. As a rule, only those

to the cornea caused by scleral lenses always be detected early

customers who have no viable alternative wear mini scleral lenses.

and correctly on the slit lamp? What does he do when difficulties

If there are changes or difficulties, then at least we know that we

arise? Does he then have the know-how and experience to

have already tried everything else that might have been healthier.

assess the situation correctly?

Corinna Jonske: Even with clear indications such as keratoconus, Corinna Jonske: That's right, but we all don't have that many

after keratoplasty, etc., we always try to find a corneal lens

years of experience with these lenses yet. Even in practice, we

before resorting to a scleral lens. Because we know that this

occasionally see phenomena with these lenses that we didn't

usually works for decades!

know about with corneal treatments. Just think of the epithelial vesicles that we have already seen under scleral lenses in severely

Uwe Bischoff: For the practitioner and the patient, mini-scleral

damaged corneas, or the phosphate deposits that appear in

lenses initially offer many advantages that are quickly visible

some people. We always have to approach these cases cautiously

and noticeable: there is hardly any familiarization time, they

and consult with the treating ophthalmologist.

can quickly be worn all day, and the adaptation by bridging the entire surface is initially stress-free and easy. No wonder

Uwe Bischoff: The question is: how often are such changes also

that many practitioners may no longer take the supposed detour

triggered in healthy eyes that would not necessarily have to

via the corneal contact lens, even if it would actually be better

wear scleral lenses?

and healthier for the eye.

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FITTING BACKGROUND

Fig. 4: Phosphate deposits in the cornea under scleral lenses, often in connection with vitamin D intake, cause not yet verified.

Fig. 5: Severe deep-seated keratoconus.

Fig. 6: Tilted keratoplasty with pronounced step.

Recently, we had a special case: we provided a customer with a lens after leukemia and severe graft-versus-host disease. We

Fig. 7: Extensive pterygium.

had to perform the fitting completely in the dark because the man was so blinded by the open and scarred cornea that he experienced severe pain in normal daylight. Under such conditions, you need much more time for the fitting, let alone for teaching how to handle the lenses.

Corinna Jonske: It took four training sessions before the customer was able to put in the lenses with the help of his wife.

This is almost impossible to calculate and can hardly be reflected in the bill with a German health insurance company.

Uwe Bischoff: It is also worth taking a look at physiology: What is the situation of the eyes after 20-30 years of wearing these lenses? We don't know that yet.

Fig. 8: Advanced keratoconjunctivitis sicca.

Corinna Jonske: Especially when I think of keratoplasties, we see neovascularization and changes to the cornea much more

a situation. This requires perfect mastery of the slit lamp,

often, which we did not know from corneal care in this form.

experience and further training.

I am concerned that a keratoplasty under scleral lenses could decompensate earlier than if such a patient had a corneal

Corinna Jonske: And especially with follow-up care, you

treatment, which would mean an earlier re-keratoplasty, which

occasionally face completely different challenges when a lens

one would actually like to avoid!

that has worked perfectly so far is reordered with the same specifications and then no longer wets. In this case, it is also

Uwe Bischoff: Exactly, and that's why it's important that

helpful to have experience with reworking and to be able to

experienced specialists deal with these lenses and can recognize

remove manufacturing residues (block wax) from the lens

changes early on and, if necessary, find solutions to avoid such

surfaces by polishing, for example.

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FITTING BACKGROUND

Fig. 11: Conjunctival flap; the loose conjunctiva is pulled under the scleral lens, impairing oxygen supply.

Fig. 12: Midday fogging; the tear film under the scleral lens becomes cloudy, impairing vision.

Fig. 9: Comparison of two 20-year-old keratoplasties, both treated with a corneal lens. This shows the difference in aging depending on the quality of the transplant, regardless of the lens worn.

contact lens variants and not simply dismissing corneal care as “antiquated”. It is still fully justified and should not be forgotten in all this hype!

Uwe Bischoff: My conclusion: Whenever the conditions in the eye do not allow the use of corneal solutions, we can fit scleral lenses meaningfully and then we can really help many people with these lenses without having to worry in the long term about perhaps making the wrong decision regarding the health of the eye.

Corinna Jonske: An additional comment on this: compliance plays a ver y impor ta nt role in t he success of t hese adjustments. In addition to being informed about the recommended maximum wearing time, the customer must

Fig. 10: Significant blanching when blood flow is interrupted by the vessels.

This is not acceptable!

also receive instruction in how to care for the lenses. In this context, the sensitivity of the filling solution is extremely important. We recommend mechanical cleaning, disinfection with a hydrogen peroxide system and a saline

Uwe Bischoff: In general, it is also very helpful to know the

solution without any additives such as buffers or similar

geometric structure of the lenses used well and to be able to

as the filling solution (under no circumstances the saline

optimize comfort by making targeted modifications when

solution from the bottle!), and these solutions are not that

fitting them.

easy to find on the market.

Corinna Jonske: My advice: anyone who wants to get started

Uwe Bischoff: Even though it is a challenge, with this concept

with the topic of mini-scleral lenses should definitely get training

we have now been able to help a great many people with mini-

from the manufacturer or ideally even do an internship at a

scleral lenses not only to better vision but also to a completely

specialist institute where many such contact lenses are fitted.

new quality of life, and that even makes up for the annoyance

This also shows the importance of trying out all the other

I mentioned at the beginning of this article. n

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FITTING BACKGROUND

Red light treatment in myopia management First results and outlook A question mark would have been a good fit after our headline, because in recent years, low-level red light treatment has received attention in connection with myopia management. However, in addition to success stories, there are also warnings about this form of treatment. We have looked at the studies. By Rebekka Nurkanovic

Several studies on myopia management using low-level red light

that red light therapy is an effective measure for myopia

(LLRL) have already been published in China. In April 2023,

prevention, with good user acceptance and a reduction in myopia

for example, JAMA Network Open presented the results of a

in children with pre-myopia of up to 54.1% within twelve months

12-month, school-based, randomized, parallel-group clinical

when comparing the group without interruption of treatment

trial conducted between April 2021 and August 2022 in ten

with the control group.1

primary schools in Shanghai, China. The study aimed to evaluate the efficacy and safety of a repeated LLRL intervention for the

In January 2024, an optometry researcher at the University of

prevention of myopia in children with pre-myopia. The study

Houston, USA, warned against the use of LLRL therapy. Lisa

included 278 children with pre-myopia (spherical equivalent

Ostrin, a professor at the UH College of Optometry, reported

refractive error of -0.50 to 0.50 dpt in the more myopic eye) and

in the journal The College of Optometrists that measurements

at least one parent with ≤-3.00 dpt, in grades 1 to 4.

in her laboratory indicate that clinicians should reconsider use until safety standards can be confirmed and it is ensured that

The children were randomly assigned to two groups. The children

the retina cannot suffer photochemical and thermal damage.

in the intervention group received three-minute red light therapy twice a day, five days a week. The children in the control group

The researcher explains that thermal eye injury from a laser can

continued their usual activities. At the final examination, a

occur at any wavelength if the temperature change of the retina

distinction was made in the intervention group between children

is more than 10°C, which leads to protein denaturing. In the

who had an interruption of treatment due to the COVID 19

case of thermal damage, the size of the injured area is usually

pandemic and those who did not. The data of the more myopic

smaller than the beam diameter, and the resulting scotomas

eyes were analyzed. The authors report that their results show

(weakening in part of the visual field) are permanent. The study

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FITTING BACKGROUND

was published in Ophthalmic & Physiological Optics (OPO)2.

of laser equipment – part 1: classification of systems and

The publication of this study was followed by an objection from

requirements) provide guidance. For example, DIN EN 60825-1

a company whose product was mentioned in the article but was

states that laser class 3R has a wavelength between 302.5 nm

not among the devices tested. The company felt that its device

and 700 µm and an output of 1 to 5 milliwatts. According to the

was misrepresented and criticized the application of ANSI

DIN standard, Class 3R laser radiation is potentially dangerous

(American National Standards Institute) regulations in the study.

to the eye and special protective measures must be taken during

The objection and the researchers' response to it were also

operation, including the wearing of protective goggles, the

published in OPO.3+4

appointment of a laser protection officer and the reporting of the use of this equipment.

At the EAH Jena (Germany), where clinical studies on the topic

Until further study results are available, it is up to the user to

of red light in myopia management are in progress, a class 3R

carry out a thorough risk/benefit assessment. n

laser power was confirmed for a commercially available device during the measurement. Josefine Dolata, lecturer in the SciTec faculty, faculty of ophthalmic optics/optometry/ophthalmic technology/vision science, as well as a doctoral candidate at the

Source:

TU Ilmenau and the EAH Jena, explained to GlobalCONTACT

JAMA Network Open; University of Houston 1 DOI: 10.1001/jamanetworkopen.2023.9612 2 DOI: 10.1111/opo.13272 3+4 DOI: 10.1111/opo.13295; DOI: 10.1111/opo.13296

that the Occupational Safety and Health Ordinance on artificial optical radiation OSTRV/2006 and the DIN EN 60825-1 (safety

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36_Low_Level_Red_light.indd 37

21.11.24 12:09

INTERNATIONAL NEWS

All about markets Ophthalmic devices market According to forecasts, the global market for ophthalmic devices could reach a volume of USD 55.47 billion by 2029. One reason for this expected market growth is that the prevalence of eye diseases is increasing as the global

Gen Z worries about water

population ages and the demand for ophthalmic devices is rising accordingly.

A web survey conducted in August 2024 reveals that worries about climate are present in Gen Z’s future outlooks, with the

Source: Statista

results showing that 36% percent of Gen Z worry at least somewhat that they will need to move from where they currently live due to climate change and its impacts on water.

Source: The Walton Family Foundation and Gallup

Global growth The International Monetary Fund’s October 2024 World Economic Outlook summary states that global growth is expected to remain stable yet underwhelming and that five years from now, global growth should reach 3.1%, a performance that is described as mediocre compared with the pre-pandemic average.

Source: IMF

71%

Items sold on Amazon 71% of the products that wholesalers and retailers sell on Amazon are produced in China, according to a survey conducted by Jungle Scout and published by the ECDB.

38

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GlobalCONTACT 3-24

20.11.24 16:35

PR-Advert

Larsen Equipment In 2004, Keith Parker and I opened Advanced Vision Technologies (AVT). At that time, the economy was going through a very bad recession and as a result, it was impossible for a new business starting up to get a loan. We immediately reached out to Erik and Pam at Larsen Equipment to get refurbished equipment to use in our Laboratory. As AVT’s business grew, we invested in many different pieces of new equipment from Larsen Equipment and this helped us grow into one of the Premiere Labs in the United States. Our success is due in part to Erik and his Team with their state-of-the-art equipment and maintenance of their products. AVT is forever grateful for Larsen Equipment’s support of AVT. It is great to know AVT is working with Industry leaders with the Larsen Equipment and their Team!

Janine Bungo, Vice President

QUALITY MANAGER: RANDY MINGOY

PRESIDENT: KEITH PARKER

I have known Erik Larsen since 1992. Since then I have used

I have had the pleasure of working with Erik since the beginning

just about every piece of equipment his company has built. My

of Larsen Equipment. The first piece of equipment, a 6 spindle

experience with Erik and the Larsen team has been one of great

horizontal arm polisher revolutionized our production of GP

appreciation as they have always helped me in my needs of

contact lenses. Through the years, I watched his business grow

fully understanding equipment used to manufacture quality

as he and his team listened to our Industry needs and developed

contact lenses. Erik has also been able to engineer any part

now numerous products not only simplifying many tasks of

needed for me even it was a custom part.

manufacturing but improving the consistency of quality in

Erik (Larsen Equipment) has been and still is a pioneer in the

our finished products. Innovation has been an ongoing

contact lens and optical industry, and I am thankful to him

experience of our Company only made possible through the

for his support over the years.

innovation of necessary equipment developed and made Randy Mingoy

available by the Larsen team.

Quality Manager

Larsen Equipment is a family owned business hosting a team

Advanced Vision Technologies

of willing Staff all having the attitude of serving their

DIRECTOR OF OPERATIONS: JORDAN GOBEL

Customer’s needs. As a Customer, we are made to feel like we have a friend in the business helping us develop a more

There can be a lot of moving parts when it comes to managing

efficient process allowing our Company to deliver better

operations, so it is key to have reliable precision equipment

products for our Customers.

that assists in overall efficiency. Larsen Equipment delivers just

Our success of AVT simply could not have been possible without

that! I have been utilizing Larsen manufacturing equipment

the help, assistance and dedication of Larsen Equipment. I

for over 15+ years and have yet to run into an issue they could

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not resolve. I am a satisfied owner of bladder polishers, edge

and his very capable Staff.

roller’s and auto-blockers etc. Each one of these units greatly

Keith Parker

assists in the reduction of rejects and manufacturing waste.

President

Their ability to customize and retrofit specific tools certainly sets them apart from the competition. Larsen stands behind their equipment with a knowledgeable staff that provides exceptional service. Simply put, we are a better laboratory because of our relationship with the folks at Larsen.

Jordan Gobel Director of Operations/Consultant Advanced Vision Technologies GlobalCONTACT 3-24

PR_Larsen.indd 25

969 S. Kipling Parkway, Lakewood, CO 80226 Phone: 303-384-1111 888-393-5374 Fax: 303-384-1124 www.AVTLENS.com 39

26.03.24 13:33

VISUAL PERCEPTION

Fig 1: Ouchi illusion

The Ouchi Illusion From the series “Visual Perception” It is a book of “Designs for Artists and Craftsmen” that was published as early as 1977 under the title “Japanese Optical and Geometrical Art”. When the designer and artist Hajime Ouchi visited the psychologist Dr. Walter Ehrenstein jr.* (1950-2009) in 1986, he brought him his book as a gift. Walter Ehrenstein leafed through it and in the 746 patterns he saw on page 75 (Fig. 2) at the top left, an incredible picture: the inner circle seemed to move within the outer circle! By Bernd Lingelbach

Before this incident, no one had ever noticed this apparent

largely stable despite small eye movements. This is not the

movement in the pattern, not even Hajime Ouchi. Walter

case with central vision. If, as in figure 1, there is already a

Ehrenstein also had an explanation ready. The inner and outer

separation of center and periphery in the image itself, then

circles are separated by the different directions of the “tiles”

the inner part can also be separated from the outer part in

for the perception.

perception. The inner circle takes on a life of its own and

The peripheral and central visual fields are “processed”

follows the eye movements. This leads to the apparent

differently by the neurons. The peripheral visual field remains

movements of the inner circle.

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VISUAL PERCEPTION

Fig 2: Ouchi's book contains 746 patterns in this and similar styles. On page 75, right page, top left, Walter Ehrenstein discovers the apparent movement of the inner circle.

Fig 3: Akiyoshi Kitaoka emphasizes the separation of the periphery and the center in this version. The inner circle seems to float in front of the outer level.

Walter Ehrenstein knew immediately: he should publish the

Spine-Drift Illusion by Akiyoshi Kitaoka

effect as soon as possible. It turned out differently.**

Akiyoshi does not seem to have been completely satisfied with the result of figure 3. He experimented further and then carried

Akiyoshi Kitaoka's version of the Ouchi illusion.

out a consistent separation of center and periphery in the picture.

The optical illusion “Rotating Snakes” made Akiyoshi Kitaoka

For this he used his “spines”, which he had also used to explain

world-famous more than 20 years ago. But he is also known

other phenomena. In figure 4 the inner square seems to be

for creating a stronger version of almost every illusion.

detached from the periphery. Even if you try to concentrate on

In figure 3, the well-known researcher of optical illusions

keeping it fixed, it will make small movements. Basically, we

strengthens the separation of the periphery and the center by

“see” our spontaneous eye movements. n

adding a red ring and a shadow. Both are slightly offset to the side. This also creates an enormous sense of space. The inner circle seems to float above the periphery.

Dr. Bernd Lingelbach was a professor at Aalen University in the Ophthalmic Optics degree programme. He was and is regularly present at international conferences with his own contributions.

Lingelbach's barn in Leinroden is known far beyond the borders of Germany. Many examples of visual perception and a large collection of various items illustrating optical phenomena can be found here.There have been a whole series of television programmes about the barn.

Fig 4: Spine-Drift Illusion by Akiyoshi Kitaoka. The inner square seems to “float”. Depending on the distance, it may even appear that the outer square moves a little.

GlobalCONTACT 3-24

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References: * Walter Ehrenstein Jr., hereinafter referred to as Walter E., is the son of the psychologist Walter Ehrenstein (1899 - 1961), the discoverer of the “Ehrenstein Pattern”. ** The pattern became known worldwide in 1986 as the “Ouchi-Spillmann Illusion.” It was only in 2016, seven years after the death of Walter Ehrenstein Jr., that Spillmann mentioned that Walter Ehrenstein had given him access to the book (https://journals. sagepub.com/doi/pdf/10.1177/0301006616637433 ).

41

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HISTORY

Heinrich Meibom. (Picture in frame: Herzog August Bibliothek Wolfenbüttel: Portr. II 3479a) 42

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HISTORY

Pioneers of ophthalmic optics Heinrich Meibom Anyone who deals with contact lenses today or is increasingly concerned with the topic of dry eyes cannot avoid his name: Heinrich Meibom. He was an important German scientist and physician of the 17th century who is best known for his discovery of Meibomian Glands, which are named after him. These small glands, which ends are located at the rim of the eyelids, play an important role in the health of the eye, particularly in the production of the lipid part of the tear film. By Silke Sage

First a few key facts: Heinrich Meibom, born on June 29, 1638 in Lübeck, Germany and died on March 26, 1700 in Helmstedt, came from an academic family. His grandfather, also a Heinrich Meibom (the Elder), was a professor of history and poetry, and his father was a well-known historian. Meibom initially received private tuition, but then studied medicine at the University of Helmstedt and later also in the Netherlands in Groningen and Leiden. In 1663, he received his doctorate in France at the University of Angers. Meibom undertook numerous educational trips throughout Europe, including to Italy, France and England.

Broad scientific sphere of activity After his return to Germany, Meibom began his academic career at the University of Helmstedt, where he worked as a professor of medicine. His scientific interests were initially wide-ranging.

His ability to combine these different disciplines contributed significantly to his scientific success.

The meibomian glands, clearly recognisable here as light-coloured structures in the upper and lower eyelid. Picture: Dr. Stefan Bandlitz / HFAK

of the University of Helmstedt. In 1678, he also became professor His work, particularly on the of history and poetry. He held these positions until his death in anatomy of the eye, and the 1700. Meibom's involvement in the academic world and his contributions to medicine and science made him an influential scientific significance of his figure of his time. His marriage to Anna Sophia produced seven His son Brandanus Meibom (1678-1740) became findings have endured to this day. children. professor of pathology, semiotics, botany and medicine.

The "discovery" of Meibom's glands took place in 1666, when

Meibom's legacy

Meibom carried out detailed studies on the anatomy of the eye.

His work, particularly on the anatomy of the eye, and the scientific

He first described these glands in his work "De vasis palpebrarum

significance of his findings have endured to this day. Every

novis epistola", in which he detailed the structure and function

optometrist is familiar with the meibomian glands (also known

of these previously unknown glands. The Meibomian glands are

as the tarsal glands) and they are assessed in particular when

small sebaceous glands at the rim of the eyelids that produce an

dealing with the tear film and contact lenses. The condition of

oily secretion that prevents the tear fluid from evaporating too

the gland function has a decisive influence on modern contact

quickly. The secretion also lubricates the rim of the eyelids, which

lens fitting and on the quality of the tear film. Both underproduction

prevents the tear fluid from "overflowing" beyond the rim of the

and overproduction of the meibomian glands can cause difficulties.

eyelid. Meibom's discovery was a significant contribution to

Overproduction leads to deposits and a greasy film on the contact

ophthalmology and is still appreciated in medical circles today.

lens surface. Underproduction can lead to dry eye symptoms.

In the same year, he also discovered the "blind hole of the tongue"

Meibom's life and work provide an inspiring example of the

(Foramen Meibomii). In addition to his medical research, Meibom

power of curiosity and scientific discovery that still resonates in

was also active in academic administration and served as rector

the medical community today. n

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BUSINESS & MARKETING

Security training in the supply chain Cyber security series | Part 1 In an increasingly interconnected global economy, companies must recognize the critical importance of protecting their data and knowledge. The supply chain is a vital component of our economic infrastructure, and its security directly impacts our national security, economic stability, and competitive edge. Everyone must take responsibility and do their part. In part 1 of this serial about cyber security you will find a high-level overview of why it is important to protect yourself and, in turn, protect the entire chain. By Nabil Gharbieh

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BUSINESS & MARKETING

The Vision Council came to me to create this cybersecurity series as a result of increasing requests from their members and a very direct call out by the United States Trade Representative (USTR) in their “Four Year Review of China Tech Transfer Section 301,” released in May of this year.

Specifically, in the report, the USTR stated: “U.S. companies should prioritize cyber defenses, invest in the necessary infrastructure and services, and take appropriate actions to remediate vulnerabilities and prioritize strengthening cyber defenses. Greater transparency by U.S. companies on the extent, type, and investment in cyber defense would permit market investors to support U.S. companies taking appropriate steps to protect their technology, IP, trade secrets, and confidential business information from China’s cyber espionage.”

Essentially, the government is advising industry to work together and prioritize cyber security. The Vision Council’s Government Regulatory Affairs team flagged this immediately, and saw an opportunity to educate the vision industry on steps that they can take to protect their businesses and work together to fortify the industry.

A collective approach to business intelligence security Pardon the cliché, but we are stronger together. Just as a chain is only as strong as its weakest link, the security of our supply chains depends on each company's ability to protect their data.

Working together ensures that vulnerabilities are addressed collectively, reducing the risk of breaches.

By collaborating, companies can share insights on emerging threats, effective security practices, and successful mitigation strategies.

A coordinated approach to security incidents allows for faster and more effective responses, minimizing the impact of breaches.

The protection of all is therefore based on three pillars: 1. Collective defense 2. Shared knowledge and best practices 3. Unified response to threats

Fig. 1

Examples of technology incidents in the supply chain: Target

make purchases. For weeks, every card swiped at Target was

During the holiday season of 2013, shoppers were filling Target

silently recorded by the hackers.

stores while a significant data breach was unfolding behind the

The attackers were a group of skilled cybercriminals operating

scenes. One that would impact millions and changed how we

out of Eastern Europe, primarily from Russia and Ukraine. They

think about cybersecurity.

were known for their expertise in exploiting weaknesses in large

A small subcontractor named Fazio Mechanical Services handled

organizations and had carried out similar attacks before.

refrigeration, heating, and air conditioning for Target.

The breach was detected by FireEye, a security firm monitoring

Unfortunately, their security defenses were not as strong as they

Target's network. They saw the malware and sent alerts, but these

needed to be. Hackers saw an opportunity and sent a phishing

warnings were not acted on quickly enough. It was not until the

email to Fazio, tricking an employee into downloading malware.

U.S. Department of Justice alerted Target that the company took

This malware opened the door for the hackers to access Fazio’s

significant steps to stop the breach.

network. But they did not stop there. They used the credentials

The fallout was severe. Over 40 million credit and debit card

they found to break into Target’s main network. Once inside,

numbers were stolen, along with personal information from 70

they placed more malware on Target’s point-of-sale systems − the

million customers. Target faced lawsuits, huge financial losses,

very machines that read our credit and debit cards when we

and a tarnished reputation. They had to spend millions on legal

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BUSINESS & MARKETING

fees and security upgrades. This breach highlighted the

Practical IT steps for securing the supply chain

importance of strong cybersecurity measures and the risks posed

With a few important but effective steps, the vast majority of

by third-party vendors.

attacks can be avoided. The following rules provide clarity and offer a simple guideline that every company can follow.

Lessons learned So, what can we learn from this?

Third-party risk management: It is crucial to ensure that any company you work with has strong security practices. Regular

1. Conduct regular security audits Regularly assess the security posture of your systems and those of your supply chain partners. Periodically hire independent auditors.

2. Implement Multi-Factor Authentication (MFA)

audits and strict security requirements for vendors can help

Enhance security by requiring multiple forms of verification

prevent similar breaches.

before granting access to your systems. Let a risk registry

Phishing awareness: The breach started with a simple phishing

highlight your weak points.

email. Educating employees about the dangers of phishing and

3. Use end-to-end encryption

how to spot suspicious emails is essential.

Protect data in transit and at rest with robust encryption

Prompt response to alerts: When security alerts are ignored or

methods.

delayed, it gives hackers more time to cause damage. Having a robust incident response plan and acting on alerts promptly can limit the impact of breaches.

Network segmentation: By segmenting networks, companies

4. Monitor network traffic Employ advanced monitoring tools to detect unusual activity and potential breaches in real-time.

5. Patch management

can prevent attackers from moving freely within the system.

Ensure all software and systems are up-to-date with the latest

This means even if one part is compromised, the rest remains

security patches to close known vulnerabilities.

secure.

6. Relationships

Continuous monitoring and detection: Regularly updating

Manage them! Be picky!

security tools and ensuring they work effectively can help detect

Create or use existing third-party risk management cycle

threats early. Continuous monitoring is key to staying ahead of

relationships with your employees!

cyber threats.

Cybersecurity training for employees Vendor and supply chain risks

At least once a year every company should conduct a security

There are many risks to vendors and the supply chain when it

refresher for the entire team. Part 2 of The Vision Council serial

comes to the security of our operations, data, devices, and

of cyber security presentations can be implemented as a required

business partners. Hardware, software, networks, data or service

training for your team, eliminating the need to organize or hire

providers are all potential entry gates for hackers. Talking about

a separate company to conduct one.

hardware, servers, A/Cs, appliances or machines for example

And do not forget: your security is as strong as your weakest

can become a target. Regarding software, those responsible

link and your weakest link tends to be coworkers. Ask yourself:

should be able to answer the following questions: Who owns it?

how confident are you with your coworker’s security knowledge?

Who owns the data? Who is protecting it? Who has access? The

Especially four aspects are crucial to make your team fit for

network can be hosted in-house, by third-parties or the data is

cyber security:

stored on the cloud. In the last case, be aware that everything is

Phishing Awareness: Train employees to recognize and report

everywhere all at once. These risks can generally be categorized

phishing attempts, which are common vectors for cyber-attacks.

at a high level as follows:

Incident response training: Develop and drill incident response

Compromised devices: For example, copiers can be hacked.

plans to ensure quick and effective action in the event of an incident.

Cloud solutions: Services like Office 365, Dropbox, and other

Data handling & privacy: Educate staff on best practices for

solutions you might not even realize are within your reach can

handling sensitive data and complying with data protection

pose risks.

regulations

Incident investigation: I often encounter security scares with

Third-party risks: Train employees to assess and manage risks

clients, and my first job is to determine whether the issue is on

associated with third-party vendors and partners.

our end or the vendor’s. This is why someone in the organization

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44_Cyber Security.indd 46

must vet all companies you do business with, as those not in IT

If you do not have internal guidance, the government provides

might not ask all the necessary questions regarding IT security.

well-drawn-out guidelines on cybersecurity for businesses.

Vendor engagement: It is challenging when, every other day, I

These guidelines are widely adopted by government agencies

hear, “Oh, I am talking to this salesperson about software we

and larger companies.

may buy.” You do not know how much we just love to hear those

Here are some of the main ones if your IT team does not cover

words on the security side of things.

security: U.S. Cybersecurity and Infrastructure Security Agency GlobalCONTACT 3-24

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BUSINESS & MARKETING

Fig.2: Risk management life cycle

(CISA), Information Sharing and Analysis Centers (ISACs),

Outlook

Professional Cybersecurity Organizations like ISACA and ISC2

This article should provide a good basis for raising awareness

and the National Institute of Standards and Technology (NIST).

on good cyber security strategies and the importance of protecting

Recently NIST has released the 'Risk Management Framework

your supply chain. In the second part of the series, I will focus

(RMF) Small Enterprise Quick Start Guide,' which I highly

on employees. The article will teach employees how to be more

recommend for small businesses seeking a comprehensive,

vigilant when working with computers and “all of the things”.

flexible, risk-based approach to managing information security

In part 3 of this article series, we will discuss essential policies

and privacy risk.

and procedures, such as business continuity plans and backup

When choosing software or a third-party vendor, make sure to

plans, that you need to establish and review annually. n

include the IT team so they can help assess IT risks. Here is a third-party risk management life cycle (Fig. 2) that you can copy.

This topic was first addressed in a lecture, presented by The Vision Council

While it is not an official version, as those are more detailed, this is a good starting point.

Issues can arise when you do not manage this effectively. For example, employees might use services like Dropbox or bring in vendors to discuss software without IT assessing how it will integrate with existing systems. I have had instances where an employee created a Google Drive or Dropbox account, then left the company, and nobody could access the account because nobody had the password.

This also becomes a problem as you continue to move towards AI. AI quality depends on the data it receives, so the experience you get is influenced by the data you input. The more tools you have scattered across different platforms, the more you will need to integrate them with add-ons, increasing security vulnerabilities.

Therefore, it is crucial to get a handle on it.

GlobalCONTACT 3-24

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Nabil Gharbieh is an IT-expert and currently leads The Vision Council´s webinar series about cyber security strategies. As an Information Technology Advisor at Dataprise, Nabil provides quality management services to clients across various industries and sectors. With over 17 years of experience in IT, he has developed expertise in program management, technical account management, customer success, sales, and technology advisory. Nabil is certified in Microsoft Technologies, AI, Health Care IT Security, ITIL, Google Cloud, and Apple/ Mac Integration.

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Acuity Polymers Inc. 1667 Lake Avenue Building 59, Suite 303 Rochester, New York 14615 USA Phone: +1 585-458-8409

6390 Rose Lane, Carpinteria, CA 93013 USA dac-intl.com

info@acuitypolymers.com www.acuitypolymers.com

Contact Lens Material

“Diamonds for all purposes” APEX DIAMOND PRODUCTS LIMITED Unit 10, Bartleet Road, Washford Industrial Estate, Redditch,Worcestershire B98 0DQ United Kingdom Phone: +44(0)1527 529011 sales@apexdiamond.co.uk www.apexdiamond.co.uk

Diamond Tools

SALES Chris Pantle +1 805 745 1610 cpantle@dac-intl.com Kurtis Brown +1 805 745 1628 kbrown@dac-intl.com

Machinery & Tools

Boston Materials Group Bausch + Lomb Eschelbacher Str. 16 69242 Mühlhausen Germany

Contamac LTD Carlton House, Shire Hill Saffron Walden Essex CB11 3AU United Kingdom

Phone: +49 6222 5718308

Phone: +44 1799 514800

tanja.malkus@bausch.com susanne.krostitz@bausch.com www.fit-boston.eu

sales@contamac.co.uk www.contamac.com

Contact Lens Material

One Module per Year 550€ - 715€ please contact sabine@global-cl.com

EUROPEAN FEDERATION OF THE

CONTACT LENS AND IOL INDUSTRIES

EFCLIN Winkelbüel 2 CH 6043 Adligenswil Switzerland

K & Y Diamond Ltd. 1801 Boul Saint Regis Dollard-des-Ormeaux (Quebec) Canada H9B 2M9

Phone: +41 41 372 10 10 Fax: +41 41 372 06 83

Phone: +1 514 676 0640 Fax: +1 514 676 0645

www.efclin.com info@efclin.com

sales@kydiamond.ca www.kydiamond.ca

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Contact Lens Material

Diamond Tools GlobalCONTACT 3-24

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MISUPCOTM Larsen Equipment Design 1117 N.W. 52nd Street Seattle, WA 98107 USA

MisupcoTM Inc. MisupcoTM Inc. 1378 Osceola Avenue Saint Paul, MN 55105 USA

SCHNEIDER GmbH & Co. KG Biegenstrasse 8 –12 35112 Fronhausen SCHNEIDER GmbH & Co. KG Biegenstrasse Germany 8 –12

Phone: +1 206 789 5121 Fax: +1 206 789 7756

Phone: +1 651 353 8632 Fax: +1 651 698 0719

Phone: +49Germany (64 26) 96 96-0 Fax:Phone: +49 (64 96 96-100 +4926) (64 26) 96 96-0

erik@larsenequipment.com www.larsenequipment.com

Machinery and Tools

Phone: +1 702 951-8696 www.misupco.com mikef@misupco.com

contactmisupco@gmail.com www.misupco.com

Blocking Wax & Contact Lens Polish

35112 Fronhausen

Fax: +49 (64 26) 96 96-100

info@schneider-om.com info@schneider-om.com www.schneider-om.com www.schneider-om.com

Machinery and Tools RZ_Yellow_Pages_60x80_4C.indd 1

Sterling Ultra Precision Division of AMETEK Precitech Inc. 8600 Somerset Drive, Largo Florida, 33773 USA Phone: +1 727 538 6110 fadi.achkouti@ametek.com

V-Optics SAS 2, rue du travail 67400 Illkirch-Graffenstaden France

Eyepress Fachmedien GmbH Saarner Str. 151 D-45479 Mülheim an der Ruhr

Phone: +33 (0) 3 67 10 28 60

Phone: +49(0)208-306683-00 Fax: +49(0)208-306683-99

info@v-optics.fr www.v-optics.fr

www.global-cl.com info@global-cl.com

Europe: +49 98 3797 8238 andreas.kuchler@ametek.com www.sterlingint.com

Machinery & Tools

23.06.2020 12:37:08

Instruments

Media Service

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GLOBAL CONTACT The Website and the Magazine: The complete communication system for the contact lens industry. The magazine, 2,500 copies, is distributed to contact lens laboratories, wholesalers and other organizations active in the contact lens and IOL industry.

The website www.global-cl.com is free for all industry related professionals PUBLISHERS ADDRESS Eyepress Fachmedien GmbH Saarner Str. 151, D-45479 Mülheim a. d. Ruhr Tel.: +49-208-306683-00 Fax: +49-208-306683-99 Website: www.global-cl.com E-mail: info@global-cl.com CEO Petros Sioutis E-mail: p.sioutis@eyepress.de PUBLISHER Silke Sage, Efstathios Efthimiadis, Petros Sioutis

Name: Domenico Capasso Position: Business Development Manager Organisation: Menicon Italy, Soleko SpA

EDITOR-IN-CHIEF Dipl.-Ing (FH) Silke Sage E-mail: silke@global-cl.com TRANSLATIONS John Saniter, Bopfingen, Germany EDITORIAL BOARD Wim Aalbers, Erik Larsen, Eef van der Worp PRODUCTION & LAYOUT Efstathios Efthimiadis, Pascal Bruns

If I didn’t do this job, then… I’d be a simultaneous translator at the United Nations.

DISTRIBUTION PressUp GmbH, Postbox 70 13 11, D-22013 Hamburg Tel.: +49-40-386666-308, Fax: +49-40-386666-299

The best thing about this job is… Mixing Italian and Japanese culture.

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In this job it is not difficult to… Go off at tangents to resolve unforeseen issues.

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The last time I was disappointed with my job was… When I realised that there is still so much to learn.

ADVERTISING AGENT GREAT CHINA Beijing FOCUS Optics Culture Commnication Co. Ltd. Room 319, Building 2, Nr. 1, Northbank 1292, Nr. 15 Jianguo Eastroad, Beijing 100024 (Chaoyang), P.R. China Mrs. Jian Wang Tel.: +86-10-8537-6529 Email: jennywang_focus@126.com Skype: jennywang611

The most insane thing about my job is… The ability to interact with clients in all four corners of the globe.

I was surprised that… Time passes so quickly!

For me talking with customers is… The opportunity to cement longstanding relationships and plant seeds for new long-term connections.

I can see why a conference is going to be successful by… The palpable buzz of anticipation which can be seen and heard around the venue.

When I think about those who work with me, I am happy that… I have such an effective support network to help me resolve different issues.

A day is perfect when… There is sun, sea and music.

I cannot live without… My wife Mary Jane, the love of my life.

If I had superpowers I would… Experience a few laps of pure exhilaration hurtling around the Isle of Man TT circuit.

On my bedside table there is… My alarm clock, my smart phone and headphones.

My greatest wish is… That my family is safe and happy.

ADVERTISEMENT RATES Price list No. 13, valid from January 01, 2024 Publication Schedule 3 issues 2024: April, July, November SUBSCRIPTION COSTS PER YEAR European Union 80,00 € (plus VAT for German companies), Overseas Seamail 90,00 €, Overseas Airmail 110,00 €, United States Seamail 95,00 €, United States Airmail 125,00 €, Single issue 20,00 € (plus mailing costs) The Publisher requires three months written notice on cancellation. Subscribers please note that proof of notice may be required.

BANK DETAILS Bank account: Sparkasse Aachen IBAN: DE21 3905 0000 1073 3925 06 SWIFT: AACS DE 33XXX PRODUCTION & PRINT Kollin Mediengesellschaft mbh, Neudrossenfeld The publisher takes no responsibility for unsolicited manuscripts. Please note also that photographs submitted for use in GlobalCONTACT cannot be returned. The publisher's written permission is required for any reproduction, translation or recording of material published in GlobalCONTACT, including extracts of such material. Permission will normally be given, subject to the usual acknowledgement. Copies made of published items must be limited in number and for personal use only.

PHOTO CREDITS Page 12: apinan, 14: LightFieldStudios, 22: Brian A Jackson, 28: dolgachov, 34: Fotograf /stock.adobe.com /unsplash.com /istockphoto.com

Members of

In my next life I'll… Try to improve on the above.

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20.11.24 17:04

VISIT THE NEW WEBSITE YOUR TRUSTED SOURCE IN OPHTHALMIC OPTICS Why Choose GlobalCONTACT Global Insight: Stay ahead with our worldwide perspective on industry dynamics and emerging trends.

Expert Analysis: Benefit from in-depth analyses, exclusive interviews, and thought-provoking articles.

Innovation Spotlight: Explore cutting-edge technologies shaping the future of vision care.

Community Hub: Join a global network of professionals passionate about advancing the Contact Lens and IOL industry.

VISIT US ONLINE NOW: WWW.GLOBAL-CL.COM Webseite_2023.indd 2

10.04.24 00:21

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30.10.24 15:49

2023-3 V3 updated .indd 1

Chris Pantle +1 805 745 1610 cpantle@dac-intl.com Kurtis Brown +1 805 745 1628 kbrown@dac-intl.com

For High Efficiency IOL Haptic Milling

Horizontal DAC Mill With Optional Autoloader

From Vertical To HORIZONTAL

Changing PERSPECTIVES

29.10.23 11:03 PM