GlobalCONTACT - 02/2022

ISSN:1386 0194

2

2022 (91)

Fitting Background • Safety in sclerals – Part 2 • Monovision – not just about principles

Manufacturing

TRANSFORMING LIVES From lens materials to industry support, we see the importance of working together to deliver products and expertise that truly transform patients’ lives.

• New technology in blocking systems

History • The ophthalmometer

Full Range of Products

Educational Initiatives

Report • EFCLIN 2022

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LETTER FROM THE EDITOR

Curbed Optimism It all feels almost back to normal: After a two-year break, the

This will also affect our industry. In addition, many companies

EFCLIN Congress and Exhibition was held at the end of April.

have branches and employees in the affected regions on both

Europe's largest trade fair, MIDO, took place at the same time

sides of the border. Here, too, there are still many challenges

with around 22,000 visitors. Only two weeks later, opti Munich

and uncertainties to be resolved.

opened its doors with a good 13,000 visitors and the GSLS, ARVO, BCLA and NCC congresses also took place. Many

Especially in such difficult times, it is good to keep an eye on

international optic and optometry enthusiasts were able to

the positive. For example, that hard times can also lead to great

meet live again. Finally, for the first time since 2019, we are

solidarity, such as the general realization that innocent people

seeing the start of a return to normality – at least it might

need to be helped. The optical industry in general has already

seem that way.

impressively proven that everyone can contribute, and many have already done so.

This emerging optimism unfortunately doesn't feel as good as it could, considering what's going on in the world. War in

In this issue we report on how the EFCLIN Congress went

Europe. As if the Corona pandemic and natural disasters of

in detail and which topics were presented in the lectures. In

recent years hadn't claimed enough victims.

part 2 of our "Safety in Contact Lenses" series by Eef van der Worp, we focus Ortho-K. We also take a look at monovision,

By mid-June 2022, the UN High Commissioner for Refugees

which is often used with a love-hate relationship.

(UNHCR) estimated that around 8 million people had f led Ukraine as a result of the war and due to attacks by the

There are always things to re-evaluate and optimize in the

Russian military in the country, crossing the border into a

manufacturing process. Marco Iovino has written a detailed

neighboring country. This is a catastrophe for the people

article on the blocking process. You will find these and other

who have had to flee, for the families who are now separated

topics in this issue. We hope you find them both interesting

and living in uncertainty, but also for the many people who

and stimulating! ■

have remained in their country despite the threat of danger and, of course, for the relatives on all sides who have lost their loved ones.

SILKE SAGE The economic consequences may seem secondary at first,

Editor-In-Chief

and yet they will affect us all in time. Inflation in Europe is

silke@global-cl.com

rising, and raw materials are becoming scarcer. While oil and gas are becoming much more expensive, raw materials such as nickel, palladium and chrome are already increasingly difficult to obtain.

GlobalCONTACT 2-22

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EUROPEAN FEDERATION OF THE

CONTACT LENS AND IOL INDUSTRIES

WHY WOULD YOU BECOME AN EFCLIN MEMBER It’s the best form of business e one on don everr d e ever ave hav g I have king ki orkin networki

A great source of information all The members understand und un nde ders ders rstta ta each other tan

Why wouldn’t you I’d pay the membership just to come to the congress

It’s run by its members, for its me

mbers

It’s like having a whole

network of experts

available at all times ustry If you can’t support your own ind who h can you support?

There is

always s omeone can contact w you ho will have e xperiience ces you can b ben ene nefi efit fit ffrom fit rom ro

The congress & exhibition is the best there is lp each other,

Everyone seems to he ng iin it’s amaz

e body

entativ It’’s our repres

If you would like to become an EFCLIN Member check out www.efclin.com and click the “Become A Member” link.

info@efclin.com

!AZ.indd 8 1 !AZ.indd 4

+41(0)411279 372 315032 10 10 +44

EFCLIN, EFCLIN WINKELBÜEL 2 CH-6043 ADLIGENSWIL Bishops Stortford, SWITZERLAND CM23 9GZ, UK

Search: EFCLIN

@EFCLIN

20.06.12 17:56 31.05.16 14:33 23.05.22 00:03 13:34 24.06.15

CONTENT

ISSN:1386 0194

LETTER FROM THE EDITOR 3

Curbed Optimism Silke Sage

2

2022 (91)

Fitting Background • Safety in sclerals – Part 2 • Monovision – not just about principles

Manufacturing

INTERNATIONAL NEWS

TRANSFORMING LIVES From lens materials to industry support, we see the importance of working together to deliver products and expertise that truly transform patients’ lives.

• New technology in blocking systems

History • The ophthalmometer

Full Range of Products

Educational Initiatives

6

All about you

8

All about markets

9

All about products

10 All about research

Report • EFCLIN 2022

REPORT 14 EFCLIN 2022 NOW AVAILABLE AT YOUR APP STORE

Silke Sage

01_Titel.indd 1

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INDEX TO ADVERTISERS Title: Contamac, www.contamac.com Inside front cover: Bausch + Lomb Inc., www.bausch.com Page 4: Efclin, www.efclin.com Page 7: Optimec Systems Ltd., www.optimecsystems.com Page 13: K & Y Diamond Ltd, www.kydiamond.ca Page 25: LAMBDA-X S.A., www.lambda-x.com Page 27: Larsen Equipment Design Inc., www.larsenequipment.com Page 31: DAC International, Inc., www.dac-intl.com Page 35: Schneider GmbH & Co. KG, www.schneider-om.com Page 37: AMETEK Precitech, Inc., www.sterlingint.com Page 39: OPTOCRAFT GmbH, www.optocraft.com Page 43: Rotlex, www.rotlex.com Inside back cover: Acuity Polymers, Inc, www.acuitypolymers.com Outside back cover: DAC International, Inc., www.dac-intl.com

NAMES TO NOTE Beilner, Edith 44 Farris Miller, Brandy 40 Fernandez, Jeffrey 40 Iovino, Marco 22 Lauinger, Marco 26 Mach, Lea 26 Rosenfeld, Cordula 44 Roth, Hans-Walter 36 Subramanian, Anand 40 van der Worp, Eef 28, 38 GlobalCONTACT 2-22

05_Content.indd 5

17 Manufacturers’ Forum

MANUFACTURING 22 New technology in blocking systems Marco Iovino

FITTING BACKGROUND 26 Imaging techniques – case study Lea Mach, Marco Lauinger

28 Safety in sclerals – Part 2 Eef van der Worp

32 Monovision – not just about principles Silke Sage

HISTORY 36 The ophthalmometer Hans-Walter Roth

COLUMN 38 Top(t)ics Eef van der Worp

BUSINESS + MARKETING 40 Ergonomic guidelines for hybrid workspaces Brandy Farris Miller, Anand Subramanian, Jeffrey Fernandez

44 Why female values are in demand like never before Cordula Rosenfeld and Edith Beilner

NEWS 48 Yellow Pages 5

24.06.22 09:35

INTERNATIONAL NEWS

All about you Quido A. Cappelli Obituary Quido A. Cappelli passed away on Friday, May 6th at the age of 91. Of course, as you know, Quido was the only two-time President of the CLMA and was a true stabilizing force in this organization as his leadership was outstanding and his honesty and integrity were unquestionable.

After studying Civil Engineering at Georgia Tech University, he became a pioneer and icon in the contact lens manufacturing industry. In addition, he worked closely with his friend and

Quido A. Cappelli (left), September 11, 1930 - May 6, 2022

renown cornea and contact lens researcher, Dr. William "Joe"

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Benjamin - who preceded Quido by six weeks as he passed away

Honor and the Dr. Josef Dallos Award. Another great CLMA leader

on March 24th – on advancements in contact lens standards via

and icon in the profession, Carl Moore, summarized his legacy

a working group for the International Organization for

best: "Quido was one of the early founders of the CLMA and an

Standardization (ISO).

enthusiastic supporter and twice President of the organization. He

No one has been more honored by the CLMA than Quido Cappelli

was always focused on the big picture for the industry. His

including receiving their two highest honors, the CLMA Medal of

contribution is unparalleled." By Ed Bennett, Carl Moore

Innovega Announces Patenting Activity to Broaden Licensing Opportunities

to deliver the respective voice to text to the visual display. The

Innovega Inc. announced the issuance of two US patents and

direction, protects image shifting in smart eyewear as a function

the filing of two international patents that expand their portfolio

of camera position and natural head-tilt and gaze changes for the

to 56 patent cases. The first recently issued US patent, Transparent

diversity of visual tasks undertaken by smart eyewear users.

Projection Screen, protects novel technology for speckle-free

Company co-founder and lead inventor, Dr. Jerome Legerton

augmented and mixed reality displays, while the second issued

shared, "Our portfolio covers a broad scope of patents to protect

US patent, Contact Lens and Method and Systems for Constructing

our smart contact lenses, smart display eyewear, methods of

a Contact Lens, has broad claims for delivery of oxygen to the

personalizing and fitting each of them, multistage contact lens

eye with smart contact lenses containing components having

manufacturing, optical components and artificial intelligence

limited or no oxygen transmissibility.

software that makes the eyewear smart. It’s very meaningful for

The new international filing, display eyewear with auditory

our team to advance this technology to first assist the sensory

enhancement describes a novel system and apparatus to couple

impaired and then to enable consumers to engage in the visual

gaze tracking with directional microphones in extended reality

experiences made possible by this technology. Extended reality

eyewear to assist the hearing impaired in noisy environments and

eyewear is making the metaverse experience possible.”

Haag-Streit launched 4th ‘Slit Lamp Imaging Competition’

Haag-Streit is offering a host of prizes for the first three places.

Haag-Streit UK has announced the launch of the Haag-Streit

2022’ trophy, the winner of the competition will also be

‘Slit Lamp Imaging Competition 2022’. Following very successful

featured in an ophthalmic journal and will receive a Sony

competitions held in 2019, 2020

Alpha 7 IV Kit (28-70 mm, 33 Mpx, Full frame). Second place

and 2021, the ‘Slit Lamp Imaging

will receive a Nikon Z fc Double Zoom Kit (16-50 mm, 20.90

Competition 2022’ gives eyecare

Mpx, APS-C/DX) and third place a Peak Design Everyday

professionals across the globe

Backpack (20L).

an opportunity to showcase their

The competition is open until August 12, 2022. Applicants should

slit lamp imaging skills. Judging

send their images to hsimagingcomp@gmail.com. More information

criteria will include image

on the Haag-Streit ‘Slit Lamp Imaging Competition 2022’, including

quality, technical execution, and

participation terms, rules and regulations can be found online:

disease interest.

https://www.haag-streit.com/imaging-competition.

second international filing, display eyewear with adjustable camera

In addition to receiving the ‘Slit Lamp Imaging Competition

GlobalCONTACT 2-22

24.06.22 09:37

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INTERNATIONAL NEWS

Ohio State University Wexner Medical Center joined PROSE Provider Network

President and CEO. “With the addition of Ohio State

BostonSight announced that they welcomed The Ohio State

central Ohio and beyond. We are excited to welcome Dr.

University Wexner Medical Center as the newest PROSE Provider

Mundy and Dr. Pisano, and the Wexner Medical Center

Network site along with Drs. Chantelle Mundy, OD, and Stephanie

team, to the PROSE Network.”

Pisano, OD. With the addition of Ohio State Wexner Medical

“As a practitioner in the PROSE Provider Network, I’m looking

Center, the BostonSight PROSE Provider Network now includes

forward to offering this customizable device to improve our

19 sites in four countries.

patients’ vision and quality of life,” said Dr. Mundy.

“At BostonSight we continue to expand our network of

“This treatment adds to our ability to provide the highest level

PROSE providers so that more patients can access this

of treatment and care for our patients with ocular surface disease

life-changing treatment,” said Sara Yost, BostonSight

and advanced corneal conditions,” said Dr. Pisano.

Wexner Medical Center, we can help more patients in

Inauguration of the new Trioptics site in Wetzlar On May 20 th, 2022 the new, significantly enlarged Trioptics branch office in Wetzlar, Germany, was officially inaugurated.

Compared to the old building, the new building offers three times as much space and has an appealing, modernly designed showroom as its centerpiece.

The Wetzlar site has already proven itself in recent years as a central location for servicing customers from the DACH region as well as the Netherlands and Belgium, and is now being further expanded as a training center for the region. The showroom with more than 100 m² is used to present the extensive Trioptics portfolio of optical measuring and manufacturing equipment.

Since May 2022, the company has also offered center turning of mounted optical assemblies as prototype production and contract

For the official inauguration, site manager Stefan Best welcomed representatives of the city of Wetzlar, Optence Wetzlar Network, IHK Lahn-Dill, Hessen Trade and Optikzentrum Wetzlar, in addition to the management of Trioptics – represented by Kristin Holzhey (CEO), Stefan Krey (CTO) and Simon Zilian (CSO).

manufacturing for small series in an air-conditioned workshop.

Site manager Stefan Best emphasizes: "Not only do we perform

jointly configure the devices that are suitable for the individual

equipment demonstrations and training courses in our showroom,

requirements. In order to provide our customers with optimum

but we also offer our customers comprehensive consulting

support, we also offer contract measurements, prototype and

services here. In doing so, it is particularly important to us to

small series production."

Advertisement

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24.06.22 08.06.22 09:37 15:44

INTERNATIONAL NEWS

All about markets Bleak prospects for economic growth The prospects for economic growth in the world's major economies are now much bleaker than they were in December 2021. For Germany, the OECD has revised its growth forecast downward by

Costs of data breaches

2.2

Data breach costs rose from USD 3.86 million to

percentage points to 1.9 percent. In Statista’s selection of

USD 4.24 million

countries, only Russia has been hit harder, with nominal

in 2021, the highest average total cost in the 17-year history of the Cost

GDP expected to fall by 10 percent year-on-year in 2022.

of a Data Breach Report, featuring research by the Ponemon Institute.

Source: Statista Source: IBM

Share of contact lens types Of the 21.7 million wearers in the 34 countries covered in the Euromcontact 2021 market data report,

56% of them use daily disposable, 43.9% weekly/bi-weekly and monthly replacement lenses, and 0.07% conventional soft lenses.

Source: Euromcontact

Contact lens sales increase in Germany Across all sales channels, total contact lens sales in 2021 amounted to 532 million euros vs. 523 million euros in 2020 in Germany. In total, contact lens sales increased by 1.7 percent compared to the previous year.

Source: Industry Report ZVA (Central Association of Opticians and Optometrists, Germany)

Recovery from corona pandemic According to the German industry association Spectaris, German manufacturers of ophthalmic optics and consumer optics were able to recover from the negative effects of the corona pandemic in 2021.

Overall, sales in 2021 increased by 11.4 percent to 4.75 billion euros compared to 2020.

Source: Spectaris

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INTERNATIONAL NEWS

All about products At K&Y Diamond Ltd, it’s all about finding the best solutions for our valued customers Whether it’s manufacturing a special diamond tool used to make scleral lenses (as shown) or helping to solve surface finish issues, out team of dedicated technicians and engineers are always willing to go the extra mile. It’s one reason why we’ve grown into one of the world’s largest manufacturers of single-crystal diamond tools used to make RGP lenses, IOL’S and optical molds. Our diamonds are found in both large and small labs in over 60 countries earning us a reputation for delivering a superior product at a fair price. Consistent growth and service has allowed us to invest in both state-of-the art manufacturing systems and the latest metrology; some of which is found nowhere else.

Let us put our +45 years of experience to work for you! www.kydiamond.ca / kydiamond@kydiamond.ca

Optimum Infinite Receives FDA 510(k) Clearance for Therapeutic Use in Scleral Lenses to Treat Ocular Surface Disorders Contamac has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for the therapeutic use of its Optimum Infinite (180Dk) lens material in scleral contact lenses. Already FDA-cleared for daily wear in spherical, toric, multifocal, and orthokeratology modalities, obtaining expanded 510(k) clearance to include ocular surface disease offers an additional treatment option, with enhanced material characteristics to support the ocular health of such conditions, according to Contamac. Optimum Infinite, Optimum Extra, Optimum Extreme, and Hexa100 lens materials are suitable for therapeutic use in eyes that have ocular surface disease (e.g., ocular Graft-versus-Host disease, Sjögren’s, dry eye syndrome, and filamentary keratitis), limbal stem cell deficiency (e.g., Stevens-Johnson syndrome, chemical radiation, and thermal burns), disorders of the skin (e.g. atopy, ectodermal dysplasia), neurotrophic keratitis (e.g., herpes simplex, herpes zoster, familial dysautonomia), and corneal exposure (e.g., anatomic, paralytic), where the expanded tear reservoir and protection against an adverse environment afforded by a scleral lens might prove beneficial. www.contamac.com / sales@contamac.co.uk

A revolution in the world of diffractive IOLs metrology The metrology of diffractive IOLs is challenging due to multiple factors. Time management is one of the most dominant issues as it takes up to 2 minutes to fully characterize one lens, therefore restricting the production line to its capacity to certify the IOLs. Furthermore, most of the existing metrology instruments imply complexity in use and installation due to the sensitivity of the machines. To drastically reduce the measurement time while improving the convenience and the characterization of the lenses, Lambda-X has tackled those issues and will soon launch the latest generation of Nimo metrology instrument: NIMO TEMPO. Speed, stability, traceability and R&r (Repeatability & reproducibility) are many of the advantages of this newcomer to the ophthalmic market. For several weeks now, beta testers have had the chance to experiment with a new technology, providing them with accurate, reliable data. Efficiency and repeatability are at the center of this new development, allowing the operator to work faster and in a more stable environment. The accompanying software opens the doors to various data analysis as well as new measurements of the contact lens. Interested in an exclusive preview of the NIMO TEMPO during which we will demonstrate the many features and benefits of NIMO TEMPO by characterizing your own IOLs during a live workshop with your team? Visit our website: Ophthalmics.lambda-x.com/nimo-tempo - sales-ophthalmics@lambda-x.com - +32 67 79 40 80.

Inspection of intraocular lenses in production OptiSpheric® IOL PRO 2 offers fully automated IOL measurement. It is completed with WorkStation IOL and integrated SortStation IOL. This workplace is the best choice when it comes to carrying out all the steps upstream and downstream of the measurement in a simple, fast and safe process. It includes loading the sample holders with optimal illumination that makes it easy to ensure the ideal positioning of the lenses. Moreover, the lenses can safely be sorted after the measurement: Test results are automatically transferred to the display and made visible directly at the location of the samples. The fulfillment of the pass/fail criterion is displayed in a red/green color scheme and the reliable assignment of each lens is enabled. www.trioptics.com / sales@trioptics.com GlobalCONTACT 2-22

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INTERNATIONAL NEWS

All about research

Prevention of diabetic retinopathy, monitoring of ocular diseases, AI for eye scan analysis, pupils reveal ‘aphantasia’ A research team has developed a smart contact lens-type wearable device to prevent diabetic retinopathy and treat it in its early stages. Soft contact lenses may soon become a bioinstrumentation tool for unobtrusive monitoring of ocular diseases. Scientists have developed an AI system that can analyze eye scans and identify patients at a high risk of a heart attack. A study found that pupils reveal ‘aphantasia’ – the absence of visual imagination. By Rebekka Nurkanovic

Smart LED contact lenses for treating diabetic retinopathy

Through the study with diabetic animal models, the researchers

A POSTECH research team led by Professor Sei Kwang Hahn and

animals that wore the smart contact lenses for 15 minutes three

Ph.D. candidate Geon-Hui Lee (Department of Materials Science

times a week for a total of eight weeks. In contrast, the animals

and Engineering) in collaboration with Dr. Sangbaie Shin of PHI

that did not wear the lenses showed retinopathic conditions.

BIOMED Co. has recently developed a smart contact lens-type

The safety and effectiveness of the lenses were also confirmed

wearable device to prevent diabetic retinopathy and treat it in its

by the histological analysis of the cornea and retina.

early stages by irradiating 120 µW far red/LED light to the retina.

Professor Sei Kwang Han who led the study, says that it has

Diabetic retinopathy is currently treated by invasive repeated

demonstrated the feasibility of a lens-type wearable device for

therapeutic injections to the eyeball or thousands of small

the applications not only to monitoring oxygen saturation,

burns made with a laser to destroy capillaries near the edges

heart beating rate, and ophthalmologic diseases, but also to

of retina under anesthesia. Both procedures are considered

treating depression, insomnia, neuronal diseases and more.

highly painful for the patient.

Published in Advanced Science, this study was conducted by

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confirmed that the diabetic retinopathy did not appear in

GlobalCONTACT 2-22

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INTERNATIONAL NEWS

the support from the Nano · Material Technology Development Program, Disease Oriented Translational Research, Mid-career Researcher Program, Brain Korea 21 Fostering Outstanding Universities (FOUR) project, and the Korea Medical Device Development Fund of the National Research Foundation of Korea, and by the World Class 300 Project of the Ministry of SMEs and Startups of Korea. DOI: 10.1002/advs.202103254 Sources: Pohang University of Science & Technology (POSTECH)

Soft contact lenses eyed as new solutions to monitor ocular diseases

Purdue Research Foundation Of f ice of Technolog y

A new contact lens technology to help diagnose and monitor

and it is available for licensing.

medical conditions may soon be ready for clinical trials.

"This technology will be greatly beneficial to the painless

A team of researchers from Purdue University worked with

diagnosis or early detection of many ocular diseases including

biomedical, mechanical and chemical engineers, along with

glaucoma" said Chi Hwan Lee, the Leslie A. Geddes assistant

clinicians, to develop the novel technology. The team enabled

professor of biomedical engineering and assistant professor

commercial soft contact lenses to be a bioinstrumentation tool

of mechanical engineering at Purdue who is leading the

for unobtrusive monitoring of clinically important information

development team. "Since the first conceptual invention by

associated with underlying ocular health conditions. The

Leonardo da Vinci, there has been a great desire to utilize

team's work is published in Nature Communications. The

contact lenses for eye-wearable biomedical platforms."

GlobalCONTACT 2-22

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Commercialization helped secure a patent for the technology

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22.06.22 12:01

INTERNATIONAL NEWS

The team has paved a unique way that enables the seamless integration of ultrathin, stretchable biosensors with commercial soft contact lenses via wet adhesive bonding. The biosensors embedded on the soft contact lenses record electrophysiological retinal activity from the corneal surface of human eyes, without the need of topical anesthesia that has been required in current New contact lens technology to help diagnose and monitor medical conditions may soon be ready for clinical trials. The team enabled commercial soft contact lenses to be a bioinstrumentation tool for unobtrusive monitoring of clinically important information associated with underlying ocular health conditions. Photo: Pete Kollbaum

clinical settings for pain management and safety.

"This technology will allow doctors and scientists to better understand spontaneous retinal activity with significantly improved accuracy, reliability, and user comfort," said Pete Kollbaum, the Director of the Borish Center for Ophthalmic Research and an

Sensors or other electronics previously couldn't be used for

associate professor of optometry at Indiana University who is

commercial soft contact lenses because the fabrication

leading clinical trials. DOI : 10.1038/s41467-021-21916-8

technology required a rigid, planar surface incompatible with the soft, curved shape of a contact lens.

Sources: Purdue University

AI can identify heart disease from an eye scan

Professor Alex Frangi supervised the research. He said: “This

Scientists have developed an artificial intelligence system that

technique opens-up the possibility of revolutionizing the screening

can analyze eye scans taken during a routine visit to an optician

of cardiac disease. Retinal scans are comparatively cheap and

or eye clinic and identify patients at a high risk of a heart

routinely used in many optician practices. As a result of automated

attack. Doctors have recognized that changes to the tiny blood

screening, patients who are at high risk of becoming ill could be

vessels in the retina are indicators of

referred for specialist cardiac services. The system could also be

broader vascular disease, including

used to track early signs of heart disease.”

A retinal scan. Photo: Courtesy of UK Biobank

problems with the heart.

The study involved a worldwide collaboration of scientists, engineers

In the research, led by the University

and clinicians from the University of Leeds. The UK Biobank

of Leeds, deep learning techniques

provided data for the study. During the deep learning process, the

were used to train an AI system to

AI system analyzed the retinal scans and cardiac scans from more

automatically read retinal scans and

than 5,000 people. The AI system identified associations between

identify those people who, over the

pathology in the retina and changes in the patient’s heart.

following year, were likely to have a

Once the image patterns were learned, the AI system could

heart attack.

estimate the size and pumping efficiency of the left ventricle, one

Deep learning is a complex series of

of the heart’s four chambers, from retinal scans alone. An enlarged

algorithms that enable computers to identify patterns in data

ventricle is linked with an increased risk of heart disease.

and to make predictions.

With information on the estimated size of the left ventricle and its

Writing in the journal Nature Machine Intelligence, the

pumping efficiency combined with basic demographic data about

researchers report in their paper – Predicting Infarction through

the patient, their age and sex, the AI system could make a prediction

your retinal scans and minimal personal Information – that

about their risk of a heart attack over the subsequent twelve months.

the AI system had an accuracy of between 70% and 80% and

DOI: https://doi.org/10.1038/s42256-021-00427-7

could be used as a second referral mechanism for in-depth cardiovascular examination.

Sources: University of Leeds

Pupils reveal ‘aphantasia’ – the absence of visual imagination

to track their eye movements and pupil sizes. Participants

A study, led by researchers from UNSW Sydney and published

background, which predictably evoked pupillary constriction

in eLife, found that the pupils of people with aphantasia did

in response to bright shapes (comparable to looking up at a

not respond when asked to imagine dark and light objects,

bright sky) and pupillary dilation in response to dark shapes

while those without aphantasia did.

(after switching a light off). Next, to test visual imagery – the

To first gauge the pupillary reflex of non-aphantasic people,

mind’s capacity to visualize objects – participants were asked

the researchers sought 42 study participants, self-reported

to simply imagine those same light or dark shapes (with

as having a visual imagination, and fitted them with glasses

their eyes open, for their pupils to be tracked) and subsequently

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were then exposed to bright or dark shapes against a grey

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INTERNATIONAL NEWS

report the ‘vividness’ of that imagery. The researchers found

showed no difference

that even in response to imagined bright and dark shapes,

when imagining light

the participants’ pupils still constricted and dilated

versus dark objects, they

appropriately, a pupillary response that was larger in those

did show a difference

reporting greater imagery vividness.

imagining one versus

Finally, with the link between visual imagery and pupillary

four objects, suggesting

response established, the researchers sought to test the effect

more menta l ef for t ,

in aphantasic individuals. The researchers repeated the study

t hereby negat ing a n

with 18 participants self-reporting aphantasia. Exposing

explanation of non-participation by aphantasic individuals.

participants to bright and dark shapes, the researchers found

Next, the team of researchers plans to investigate how this

that aphantasic individuals exhibited the same pupillary

new method could be scaled up and run online to allow a

response as the general population: constriction to bright,

global, efficient and objective measurement of imagery and

dilation to dark. However, during the study’s second

aphantasia. DOI: 10.7554/eLife.72484

component where participants were asked to visualize those same shapes, the pupillary response of aphantasic individuals

Sources: University of New South Wales

did not significantly differ in response to imagined dark versus imagined bright objects.

To ensure the aphantasic participants were really attempting imagery, the researchers included a further experimental condition, requesting aphantasic individuals to visualize four shapes, instead of one. While the pupils of those with aphantasia

Referenzen: [1] Campigotto A, Leahy S, Zhao G, Campbell RJ, Lai Y. Non-invasive Intraocular pressure monitoring with contact lens. Br J Ophthalmol.

2020 Sep;104(9):1324-1328. doi: 10.1136/bjophthalmol-2018-313714.

Epub 2019 Jul 2. PMID: 31266776.

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REPORT

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5 Photos: Silke Sage

48. EFCLIN Congress The association of contact lens manufacturers met for the first time after a two years This year's EFCLIN Congress, held from April 28-30, 2022, welcomed nearly 300 attendees in Sitges, Barcelona, after a Corona-related two-year hiatus. A large amount of time was given over to regulatory issues (MDR), which continue to preoccupy the entire industry. Innovations in contact lens and IOL design, new technologies in manufacturing and the proper evaluation of software were other important topics discussed in the presentations. There was a great sense of joy at being together again throughout the entire event. By Silke Sage

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14_Efclin.indd 14

After a long break due to Corona, the exhibitors and visitors

Australia. With delegates from all over the world, the 48th

at this year's EFCLIN Congress were very happy to see each

EFCLIN Congress and Exhibition proved once again that it

other again. A relevant and attractive lecture program, a

is “the place to be” when it comes to everything related to

manufacturers' forum and an interesting industry exhibition

contact lenses and IOLs.

attracted 289 visitors from 31 countries to Sitges, southwest

The venue for this year's event was the beach resort of Sitges,

of Barcelona. Over the three days, visitors were able to learn

Spain, which offered plenty of space for business and evening

about materials for contact lenses and intraocular lenses

activities within a setting of the pretty old town, beach bars

(IOLs), manufacturing machinery, measuring equipment,

and a very well-equipped congress hotel.

diamond tools, contact lens and IOL innovations as well as

Already at noon on Thursday, April 28, during the Manufacturers'

service offerings. This meant that the number of visitors

Forum, a topical issue was taken up by the EUROMCONTACT

was almost back to the same level as in the years prior to

Secretary General and put up for discussion. The potentially

the Corona pandemic. The industry is characterized by

problematic use of per- and polyfluorinated alkyl substances

long-standing business relationships, friendships and lively

(PFAS). These are industrial chemicals that are used in numerous

exchanges. Thus, the general mood was very good. “Not to

industrial processes and consumer products because of their

have come would have been a mistake,” said one visitor from

special technical properties.

GlobalCONTACT 2-22

23.06.22 13:17

6

7

8

The Annual General Meeting re-elected Gareth Browne from Contamac as a Board member for another term in office.

The EFCLIN Board from left to right: Dr. William Lee, Martina Clifford, Armin Duddek (President), Marion Beeler-Kaupke (Executive Director), Dr. Johannes Pfund, Alan Bennett and Gareth Browne

9

1. Bausch+Lomb Boston celebrated 50 years of the technology behind Boston gas permeable (GP) lens materials. 2. Carlos Mayoral (Contamac) drew attention to the CLASS Congress in Cartagena, Colombia.

3. Filippo Selden. 4. Alan Bennett. 5. Andy Chryssolor, Kitty and Wim Aalbers (from left). 6. CLMA President Josh Adams, 7. Dr. Randy Kojima.

8. Dr. David Spalton. 9. Pascale Rouhier.

THE LECTURE PROGRAM

results are somewhat sobering. However, hope lies in the

The congress motto “A World of Opportunities 2022” was taken

possibilities of accommodative systems. He showed vividly

up by many of the speakers in the strong and very varied lecture

how far progress has been made in this area: Unfortunately,

program. Three keynote speeches opened the lecture sessions

not so much progress has been made as yet – but with good

on Friday morning. Dr. Diego Lopez Alcón addressed the

approaches things look more promising further into the future.

possibility of multifocal scleral lens designs. As they are often

The contact lens session continued with an illustrative

the first choice for irregular corneas or surface diseases,

presentation on new technologies in blocking systems by Marco

correction for presbyopia is desirable while at the same time

Iovino. He showed the mechanical conditions during the

being an enormous challenge, not only for manufacturers but

blocking process and what impact they can have on a finished

also for scleral lens specialists.

contact lens! Marco Iovino presents his paper in this issue of

Prof. Dr. Andrés Vásquez Qintero addressed the Past, the

GlobalCONTACT starting on page 22.

Present and the Future of smart contact lenses in his presentation.

Dr. Randy Kojima presented a modification of Ortho-K lenses

He highlighted the evolution of the different possibilities in

for myopia control. Among other factors, the optical diameter

this field and gave an exciting outlook into the future in which

plays a crucial role here. He explained very clearly the impact

these lenses will play a role in biomedical diagnostics as well

this can have on design and effectiveness in myopia management.

as being important for entertainment vision.

“Software Validation in the CL Industry” was the title of Filippo

In his presentation, “Accommodating IOLs and the Holy Grail”,

Selden's lecture. He described the concept of Software Validation,

Dr. David Spalton shared with his audience the current

the Regulatory Context, its role in a Lab's own Quality

multifocal possibilities after cataract surgery. Unfortunately,

Management System and how Advance Medical has tackled

these are limited by halos, glare and loss of contrast and the

the subject with its own Software Validation Protocol.

GlobalCONTACT 2-22

14_Efclin.indd 15

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23.06.22 13:17

The final highlight of the event was the congress dinner on Saturday evening. The Congress Hotel provided the festive setting with an aperitif and three-course menu. The current EFCLIN president Armin Duddek and three past presidents did not miss the opportunity to cut a cake for 50 years of EFCLIN. In the IOL session, which was held in parallel, Dr. Gonzalo José Bernabeu Arias discussed the following topic: Multifocal

The traditional golf tournament was held prior to the actual

Intraocular Lenses after more than 10 years of proper use. In

EFCLIN Congress. This year the tournament was won by Marco

his presentation, he conveyed to the audience the importance

Iovino/Medlac Italiy.

of the correct use of these lenses, when they should be used,

On Thursday evening, REM, Optocraft, Larsen LED and Acuity

where they should not be used, why patients in some cases

Polymer sponsored an Open Bar. This event was held in the

are dissatisfied, and how to select the ideal patient for this

hotel bar and was very well received.

kind of implant.

On Friday evening, Bausch+Lomb Boston celebrated their 50th

Dr. Ana Hervás Ontiveros discussed the challenges of

anniversary. The company invited business friends, partners,

toric IOLs in her presentation and provided an update on

colleagues and customers to a trendy restaurant in Sitges directly

this topic.

on the promenade.

In his lecture, Prof. Dr. Gerd Auffarth showed the Optical

Also on Friday evening, Contamac again organized a friendly

Effects of IOL Complications. In addition to normal monofocal

football (soccer) competition for the 4th time, with Contamac

lenses, today there are also the modern EDOF lenses with

playing against customers, business partners and employees.

increased depth of focus as well as diffractive trifocal lenses.

His presentation reviewed each type of lens and its impact on

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14_Efclin.indd 16

WHAT ELSE HAPPENED?

OUTLOOK 2023

optical side effects backed up by illustrative examples.

Mark your calenders: the EFCLIN Board announced that the 2023

Saturday offered the audience a wide-ranging program on

event – the 49th EFCLIN Congress and Exhibition – will be held

MDR and regulatory issues.

in Budapest, Hungary, from April 20-22, 2023. n GlobalCONTACT 2-22

23.06.22 13:17

EUROMCONTACT General Secretary Pascale Rouhier

Erik Smidt and Johannes Pfund

Johannes Pfund, Erik Smidt and EFCLIN President Armin Duddek (from left)

EFCLIN 2022 Manufacturers Forum on PFAS The EFCLIN Manufacturers’ Forum was again the ‘kick off’ of the 2022 EFCLIN conference in Sitges. The topic of the forum was the European situation on PFAS* and the impact on our industry. Following Pascal Rouhiers great presentation in Manufacturers’ Forum three questions were asked and discussed in the format Erik Smidt introduced several years ago. Again, the attendees were divided in discussion groups at several tables. They had to discuss three questions and sort them in order of importance.

How can the industry be of assistance to organizations like

The first step:

Euromcontact in the struggle in Europe to be able to let the European

Advocacy Investigation Definition

Union know the significance of certain polymers in contact lenses?

The second step should be according to the attendees:

Also, it is important to let the authorities know what is happening

Development Chemistry Communication

with the waste in production of contact lenses. The outcome

The wishes of the attendees were:

of the discussions was as follows.

Derogation Tolerance Collaboration Participation

1. The most important way to get help from the industry is to

It was a Manufacturers’ Forum that, above all, raised participants'

collect data and to reduce waste.

2. Creating new materials and processes. Remarkably reduce waste also got into the second place.

3. Reduction or replacement of PFAS in the contact lens material and or get exception.

awareness of what is to come in Europe in terms of all kinds of environmental situations and their impact on our industry. It is clear that EFCLIN, Euromcontact and the industry should put their efforts together in creating a solid and good base to be able to produce contact lenses in a safe and healthy manner with low restrictions of the European Union. Of course, in such a way that

What can organizations as Euromcontact and/or EFCLIN

production has as little impact on the environment as possible. n

do for individual lens manufacturing companies?

1. The organizations should find a path to slow down the transition or at last make it manageable.

2. Continuous updated information is of great importance to the attendees.

3. To help and to provide data to create a closed recycling loop of the material.

In one word: what should be the first, the second and the third step to do?

GlobalCONTACT 2-22

17_Manufacturers Forum.indd 17

*Per- and polyfluorinated alkyl substances (PFAS) are industrial chemicals that are used in numerous industrial processes and consumer products due to their special technical properties. The substance group comprises more than 4700 different compounds.

In the subgroup of perfluoroalkyl substances, the compounds perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) are the best studied. Like many PFAS, these two compounds are also difficult to degrade and are now detectable in the environment, the food chain and in humans.

In September 2020, the European Food Safety Authority (EFSA) published a re-evaluation of the health risks posed by PFAS in food.

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28.06.22 13:08

EFCLIN PR-Advert

SHOWCASE After two long years, the EFCLIN Congress & Exhibition finally took place again from 28th-30 April in sunny Barcelona/Sitges. For all those who could not have been there, we from GlobalCONTACT have created the possibility to show some of the highlights and product presentations and to recall the three exciting days of this event.

CONTAMAC EFCLIN 2022 – A Reunion!

An industry reunion – EFCLIN 2022 Sitges/ Barcelona. It’s what we were all waiting for, and what was anticipated to be a great meeting became true. The congress was buzzing: providing opportunities to see familiar faces once again, meet newcomers in the industry, and connect and share ideas for the future.

Contamac continued to share the success of Optimum Infinite, its balance of properties providing hyper Dk (180 Dk) with a tailored modulus and excellent wettability. The material also recently received 510(k) clearance for therapeutic use in scleral lenses to treat ocular surface disorders.

The MDR continued to be a hot industry topic, and Contamac

Continuing the tradition of the ‘ContaCup’, Contamac customers,

was pleased to share the NAMSA MDR webinar series with the

industry friends and staff gathered to play five-a-side football. After

industry. This was originally delivered in June 2021 and is now

warming up (or brushing off the cobwebs for some), the competitive

available to watch on demand. For more information, visit

spirit came through. Thank you to all those who took part or spectated,

contamac.info/mdr

and special congratulations to Philipp Polonyi who was awarded Best

Finally, Contamac thanks EFCLIN and everyone involved for

Player, Oli Gubler for Best Goal and Garth Barnard for Best Goal Keeper.

delivering another top-class congress - plus, congratulations on

The football tradition was extended to the Contamac booth, where

your 30-year anniversary! We would also like to praise our very

everyone was encouraged to play foosball (table football) for a chance

own Gareth Browne on being re-elected to the board. We look

to win. The lucky winner was Edwin Fierkens of Sub Micron Tooling!

forward to seeing you all again in Budapest 2023!

18_Showcase_Efclin.indd 18

24.06.22 07:57

PR-Advert EFCLIN

SHOWCASE ACUITY POLYMERS, INC. Acuity Polymers Inc.

It would take another two years before Acuity 200 was FDA cleared.

It was great to assemble in Sitgés for the 2022 EFCLIN Congress.

Because Acuity 200 is a totally new chemistry, requiring a new

Acuity Polymers was pleased to participate as a Silver level sponsor,

USAN, Acuity Polymers had to conduct an FDA clinical study to

and to co-host the festive Thursday night reception. Acuity’s mission

confirm safety and efficacy. This was the only prospective 510(k)

at the Congress was to showcase its highly vaunted

clinical study of a new GP material in literally decades!

Acuity 200™ Ultra Dk gas permeable material. Following is important information about the unique Acuity 200 material,

Acuity 200 is now one of Acuity’s leading products and its sales are

from its conception to where it is today.

growing exponentially. Many custom lens labs around the world are offering it for scleral lenses and an important number of labs

The concept for the Acuity 200 material came out of a new product

are featuring it for overnight orthokeratology. Practitioners and

brainstorming session focused on creating an innovative material

patients appreciate the inherent wettability of the material which is

that would feature the highest amount of gas permeability while

one of its important characteristics, though it is possible to use

being both “lab friendly” and “patient friendly”. Our priority for

Tangible® Hydra-PEG® with the material as Acuity 200 is licensed

this new material was that it be optimal for scleral lenses (high gas

by Tangible Sciences for use with their coating.

permeability for large diameters ) and overnight orthokeratology (safe overnight wear). Essentially, we were looking to invent a material

With more than four years on the market, in demanding lens

with higher permeability than Menicon Z with many of the strongest

wear applications, Acuity 200 is becoming an important part of

characteristics of hexafocon A (Boston XO, Acuity 100). We were

the practitioners’ toolbox for all kinds of fits. Besides the clinical

aiming to create a new material that would combine the best properties

trial data, Acuity Polymers has conducted all of the essential

for a high performing, world-class specialty lens material that was

biological and physical-mechanical tests required by the most

much needed and long overdue in the market.

demanding regulatory agencies. This data is available to labs to help support their lens product applications. And, Acuity 200

We embarked on this project in early 2017 and had a viable prototype

is available in a broad range of diameters, tints, with and without

12 months later. The development of the material took us in a novel

UV blocker.

new direction to boost the oxygen permeability, resulting in the granting of a patent for the formulation as well as the method of

Acuity Polymers thanks all those who visited our booth at the

producing the polymer.

2022 EFCLIN Congress in Spain. And, for those who could not

Starting in the spring (northern hemisphere) of 2018, we began

attend, we hope we can answer your questions about Acuity 200

shipping small quantities of Acuity 200 to the leading specialty lens

and how it will enhance your product portfolio. Thank you for

manufacturer in New Zealand. The initial feedback was highly

taking the time to learn about Acuity 200 and for further

favorable and re-orders followed. We purposely limited the trial of

information, please visit acuitypolymers.com.

the new product to make sure that any potential issues could be identified and properly addressed, and we needed to figure out how to produce the material in larger production lot quantities before introducing it to others. Scaling up proved to be challenging as we had to develop polymerization chambers different than anything we had worked with before.

During the 2018 EFCLIN Congress in Dubrovnik, we introduced Acuity 200 to the world. There was immediate interest from manufacturers across Europe and beyond, and thus began a very exciting journey and growth phase, both for Acuity 200 and also for Acuity Polymers. In effect, Acuity 200 transformed Acuity Polymers from being a material producer to being a true material innovator, consistent with the mission of the company to be the innovation leader in the custom contact lens market.

18_Showcase_Efclin.indd 19

Kurtis Brown (DAC International), Jonathan Jacobson (Acuity Polymers), Masashi Fujiwara (Ophtecs Europe b.v.)

24.06.22 07:57

EFCLIN PR-Advert

SHOWCASE LARSEN Larsen Equipment Design at EFCLIN 2022

After a two year hiatus, everything came together well for the

The Manufacturers' Forum continues to be, as it has for the past few

exhibition in Sitges, Spain. The compressed air staff was helpful

congresses, an interesting variation on a theme. The topic was about a

and resourceful in making the connection to our stand. The MCI

specific chemical compound present in RGP materials. This material

team and AV staff were very helpful in setting up the commercial

“PFAS” has become a banned substance which our industry will need

presentations. As I mentioned in my commercial presentation,

to address. At first, I didn’t see a direct connection to my company’s use

we have seen huge growth in our business which comes with a

of plastics, but after further consideration, we do make a lot of

huge thank you to our customers

blocking arbors in acetal resin under

and distributors. It is a testament

the trade name Delrin (RTM

to how we address the current

DuPont). With a cursory investigation

needs of the industry and the

this material does not contain PFAS.

longevity of our products.

My thanks to Ms. Pascale Rouhier of Euromcontact for her presentation.

Of the many presentations, I would like to highlight Dr. Iovino’s research

Pam and I would like to personally

into the effects of heat relative to

express our gratitude to everyone

blocking wax shrinkage with the

involved in the planning and

arbor and BC. Readers may recall

execution of the 2022 EFCLIN

that I submitted an article outlining

Congress. Of course, it was great

the possible effects of wax shrinkage

to see everyone again and renew

a few years ago. I have a deep

friendships and create new business

appreciation for Dr. Iovino to take

relationships.

up t his impor tant subject so rigorously. His presentation should

Pam and I feel we were “taken care

be made available on the EFCLIN

of” better than any other event. Of

website for lab managers to review.

special appreciation was Marion

His findings illustrate how to reduce

Beeler’s offer to Pam of a little-

rejects and make the lab run more

k nown elevator to assist her

smoothly and could be included in

mobility.

the Standard Operating Procedures of every lab.

18_Showcase_Efclin.indd 20

See you in Budapest.

24.06.22 07:57

PR-Advert EFCLIN

SHOWCASE BAUSCH + LOMB 50th Anniversary celebration of Boston GP Material at EFCLIN

At the EFCLIN meeting this year, Bausch + Lomb celebrated 50 years of the technology behind Boston® gas permeable (GP) lens materials. Since the technology’s inception in 1972, Boston® materials have transformed into a large product portfolio that can be made into a variety of special designs for demanding visual needs. The materials are also used in authorized lab networks that span more than 35 countries. It was wonderful to see you all again.

18_Showcase_Efclin.indd 21

24.06.22 07:57

MANUFACTURING

New technology in blocking systems Conforming Arbor software Contact lenses produced by turning have undergone enormous progress in terms of surface cutting precision, and then digitization has created the possibility of producing a wide variety of surfaces with the same lathe and with the same tools. A modern laboratory must be open to cutting under licensed lenses designed by others of which it does not know exactly the profile of the back surfaces. By Marco Iovino

Also, new free-form asymmetrical designs become more and

precision and repeatability because if not under control it would

more common in this age. All these conditions put a strain on

introduce distortions that would generate poor optical quality

the production process where the blocking system becomes the

on the surface of final lens. A new arbor conforming system

weak link in the production chain. Since the compounds used

greatly improves the quality of the product regardless of the

for the blocking of the internal surface introduce shrinkage

shape of the lens. A scientific approach was used to evaluate the

during solidification, the control of the thickness in every point

actual benefits by comparing it to the cost of the technology

of the surface becomes essential to achieve optimal levels of

itself.

Talking about the quality of a production process is always complex, and in order to draw reliable conclusions, the right method of evaluation must be used. Lathe cut contact lens manufacturing consists of several processes that have a certain degree of influence on the repeatability and final quality of the lens.

SINCE THE COMPOUNDS USED FOR THE LOCKING OF THE INTERNAL SURFACE INTRODUCE SHRINKAGE DURING SOLIDIFICATION, THE CONTROL OF THE THICKNESS IN EVERY POINT OF THE SURFACE BECOMES ESSENTIAL TO ACHIEVE OPTIMAL LEVELS OF PRECISION AND REPEATABILITY […]

Scientific investigations are necessary in order to establish which production stage has the greatest influence on the quality of the lenses produced.

Basically, there are three main processes in our production:

• Lathe cutting of the surfaces: Modern lathes have an accuracy of more than one micron (1/1000 mm), so differences in final lens power and final optical quality are hardly attributable to this stage.

• Polishing: Modern surfaces cut by modern lathes, have a degree of finish that often requires very short and delicate polishing. In addition, geometric variations induced by polishing are easily detected by checking the surface before and after polishing.

• Blocking: The process of blocking the blank with the concave surface is very delicate and deserves to be studied in depth as it is the least controllable and most variable stage of the entire production process, affecting the optical quality and final power of the contact lenses.

A SCIENTIFIC APPROACH TO ANALYZING THE BLOCKING PROCESS Using the transfer blocking method avoids tension of the collection on the blank, which is why it is the method of choice in our workshops.

This method allows the blank to be clamped onto a flat arbor and then machined into the back surface of the lens. Once the surface has been polished, the blank is fixed to a convex arbor which will allow the outer surface to be machined.

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22_Marco Iovino.indd 22

GlobalCONTACT 2-22

30.06.22 00:44

MANUFACTURING

Transfer blocking The material used for fixing is wax. This material has several special properties that characterize the production process. In general, all substances that are solid at room temperature and liquid at higher temperatures are called 'waxes'. The wax therefore needs to be heated in order to become sticky and thus ensure fixation during solidification. In order to gain a better

Study on heat transfer - polymer graph and temperatures.

understanding of the wax clamping system and its qualityinfluencing characteristics, we studied two related components:

This study confirmed that the flattening of the curvature with respect to the basal curvature at room temperature of the blanks

1. Heat transfer

is different from one polymer to another.

2. Shrinkage

In general, gas-permeable RGP polymers are more sensitive to thermal transfer, whereas hydrophilic soft lens polymers do not undergo strong curvature changes when subjected to heating up to 60° C.

WAX SHRINKAGE The wax undergoes a shrinkage phenomenon when passing from the liquid to the solid state, then during the blocking phase. This phenomenon has an impact on the quality of the Three characteristics of wax.

HEAT TRANSFER As the wax needs heat to become liquid and can be injected

blocking because this shrinkage causes stress on the lens during blocking and these stress will be released upon ­deblocking, so the front surface will change shape in proportion to the degree of shrinkage of the wax used.

onto the surface to be blocked, this heat will be transferred to the parts to be blocked. By heating a polymer block a so called plano-concave blank will result in changes in its shape.

Warming a blank surface will cause an expansion that flattens the curve during blocking.

Diagram of blanks expansion at different temperatures.

Shrinkage and stress demonstration.

We conducted a scientific study to analyze and investigate the true degree of shrinkage from waxes used in contact lens

The result will be an expanded plano-concave blank that will

manufacturing. This study evaluated the linear shrinkage of

have a significant change in the curvature of the concave surface

different commonly used waxes by constructing a cylindrical

resulting in some degree of flattening due to expansion. We

mold of 21 mm diameter with silicone compound, we filled

studied this effect with laboratory tests by heating various

the mold with the wax and measured the diameter of the

blanks of different materials with a cut inner surface and

sample once cooled and solidified at the same condition used

recording the increases in radius base at various temperatures.

during blocking.

GlobalCONTACT 2-22

22_Marco Iovino.indd 23

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30.06.22 00:44

MANUFACTURING

Wax type

DIAM

diam med

Shrinking

%

External

Internal

Tension

Opti-Block

20,99

20,97

0,03

0,10

20,950

20,980

0,030

Brown

20,99

20,84

0,16

0,71

20,800

20,870

0,070

Regular Blue

20,99

20,77

0,23

1,04

20,710

20,820

0,110

White

20,99

20,79

0,21

0,95

20,750

20,820

0,070

Light Blue

20,99

20,75

0,25

1,19

20,650

20,840

0,190

Violet

20,99

20,76

0,23

1,09

20,690

20,830

0,140

Shrinkage graph This study showed that non-water-soluble waxes exhibit lower

Where:

shrinkage values than water-soluble waxes but, nevertheless,

• Front radius blocked is the front radius of the lens after

the maximum linear shrinkage value is 1.19%, so much less

front cut and polishing sitting on the arbor prior to

important than we thought.

deblocking

• Front radius de-blocked is the front radius of the lens after Isolating only these two factors studied, it can therefore be affirmed

deblocking

that heat transfer has the greatest influence on the quality of

This index must be as low as possible (maxi 0.02 mm). If the

blocking, even going as far as 0.10 mm front radius errors, while

BQI is bigger than 0.02 mm, the blocking system has some

wax shrinkage is negligible if the wax thickness remains constant

issue, most possibly the wax temperature is too high or the wax

along the inner surface of the lens and if wax thicknesses greater

type melting point is too high.

than 1.00 mm are not exceeded during blocking.

At this stage we spent a lot of time on setting our blocking

• Our research center has developed a simple formula to

system to achieve a BQI that is as low as possible and under

give our blocking system a quality index (BQI=Blocking

0.02 mm. During one test day in production we manufactured

Quality Index)

350+ GP contact lenses and three of them did not pass the final

• BQI= Front radius blocked – front radius de-blocked

Conforming Arbor is based on FocalPoints.

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22_Marco Iovino.indd 24

quality control because the power was not correct. Analyzing

Display of Conforming Arbor.

GlobalCONTACT 2-22

30.06.22 00:44

!AZ.ind

MANUFACTURING

OPTOCRAFT CITO RESULTS

This time, the lenses showed a very high final quality, accurate

SLC EVOLUTION (17.80) BACK TORIC R

Rs

Ab

Sph

Cyl

A

D

9.00

8.00

180

+2.75

-4.50

180

17.80

ARBOUR SPHERIC

CONFORMED ARBOUR

Spheric / dpt:

2,251

2,797

Cylinder / dpt:

-4,128

-4,540

Cylinder angle / °:

2

180

Wave-front PV:

43,0493

40,3866

Wave-front RMS:

7,74724

7,94233

Center prism:

0,109

0,041

powers to 1/100 diopter, but above all, the wavefront value measured with Optocraft Cito was much lower (Rms 0.08 vs Rms 0.14), thus indicating a better optical quality.

CONCLUSIONS The new technology makes it easy to achieve the best quality in the production process of lathe-cut contact lenses. The cost/ benefit ratio remains to be evaluated, which if used for all production could be too high and unsustainable. We therefore recommend using Confirming Arbor only for:

those lenses we discovered that all three had very complicated

• • • •

back surface designs and were blocked with standard mono

The actual cost of plastic lathe cut arbors is about 7-9 Euro each

curve or bicurve arbor tools. Their wax thickness was very

and they could be reused 2-3 times. Therefore, the final price

irregular, in some places thicker than 1.00 mm due to the

will not grow so much if we intend to use the technology on a

difference between back surface and arbor shapes.

"use as needed" basis. n

Large diameter GP lenses (Sclerals) High toric GP Free form asymmetrical GP All third party licensed designs GP lenses

With the help of Advance Medical company we developed a software tool based on FocalPoints called: Confirming Arbor.

This software allows the lab to cut blocking tools conformed to the back surface of the lens to cut, where you can choose to cut symmetrical arbors following the steep meridian of the lens or asymmetrical arbors following the back surface in every meridian. The operator could also choose the wax thickness in the center or the wax thickness in the periphery.

After installing the software, we reconstructed the discarded lenses from the quality control using the new blocking technology by constructing a conformed arbor specifically for each lens.

Dr. Marco Iovino is an ophthalmology assistant and optometrist from Italy who graduated from Second University of Medicine of Napoli. He exclusively fits specialty contact lenses and he is the director of the designs office at Medlac S.r.l. in Avellino Italy. He specializes in process innovation for the contact lens manufacturing, he is the owner of many successful contact lens designs for regular and irregular corneas. He speaks at major optometry and ocularist congresses and manages the contact lens research center of Avellino.

Advertisement

22_Marco !AZ.indd 4Iovino.indd 25

30.06.22 15.06.22 00:44 16:19

FITTING BACKGROUND

Imaging techniques Photo presentation: Students present their findings

Photograph

Lea Mach & Marco Lauinger (HFAK, Cologne, Germany)

What can be seen here?

Papillae examination on the upper eyelid

1

Imaging technique

Slit Lamp (Haag-Streit BQ 900, Koeniz, Schweiz) Photo 1: Diffuse illumination, 10 x magnification Photo 2: Diffuse illumination, blue light and yellow filter,

25 x magnification Photo 3: Diffuse illumination, 25 x magnificatio

Finding

The proband (20 years old, male, no contact lens wearer) does not show any particular signs in the anamnesis, as in the general overview (picture 1) with the slit lamp. Only slight elevations are visible on the caruncle, which suggest papillae on the tarsal conjunctiva.

However, the routine meibography examination during the contact lens training shows severe papillae on the upper eyelid. These can be caused by allergies or bacterial conjunctivitis, for example. Papillae are characterised by a cobblestone-like shape and a centrally located blood vessel.

These central blood vessels of the papillae can be seen particularly well in picture 2. The fluorescein is deposited here in the vessel opening and appears light green. Due to the depression created by the centrally located blood vessel, the shape of these papillae is reminiscent of a donut. For the image acquisition, the upper eyelid of the subject was ectropionated in order to more easily observe abnormalities of the tarsal conjunctiva. Picture 3 shows the size of the papillae. They rise from the eyelid surface and are easily visible by diffuse illumination. This report demonstrates that a complete, uninterrupted examination of the anterior segment of the eye is critical at the outset of contact lens fitting.

2

3

Characteristics

The patient is allergic to his shampoo, which is now being replaced. Closely monitored examinations will follow to document the healing of the papillae.

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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!

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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 27

19.11.21 15:45

FITTING BACKGROUND

Overnight orthokeratology A trilogy on specialty contact lens safety – part 2 A pleonasm: The term ‘overnight orthokeratology’ (ortho-k) can be seen to a large degree as a pleonasm, derived from the ancient Greek word pleonasmós – pleon, or 'to be in excess' – which means a redundancy in linguistic expression. In this case, the ‘overnight’ would be the redundant part, as there is hardly a situation thinkable in which ortho-k lenses are worn during the daytime hours; there is not a need to reshape the cornea for a corrected corneal surface during the sleeping hours. Ortho-k lenses in some parts of the world are called ‘night-lenses’: that is, worn during the night for vision during the day. Originally started as a clever management term, it is now the leading nomenclature to describe ortho-k in a generic way in the Netherlands, for instance, and has even been adopted by professional organizations. The ‘overnight’ part of this modality though, carries most of the weight regarding ‘safety’ issues. So, let’s circle back to the title and assess the special circumstances surrounding this overnight modality. By Eef van der Worp

WITH CONFIDENCE

Comparing the relative risk of MK (not per se leading to

Back to basics regarding contact lens safety: according to a

vision loss) by lens modality, the annualized incidence per

study by Stapleton et al, the incidence of a microbial keratitis

10,000 wearers was determined to be 1.2 (CI 1.1-1.5) for daily

(MK) with loss of visual acuity in daily wear with soft lenses

wear rigid corneal lenses; 1.9 (CI 1.8-2.0) for daily wear soft;

(silicone hydrogels) is 0.00011%. This is more easily interpreted

2.0 (CI 1.7-2.4) for daily disposable; 11.9 (CI 10.0-14.6) for

as a chance of 1.1 per 10,000 patient years. The 95% confidence

silicone hydrogel soft; 19.5 (CI 14.6-29.5) for overnight wear

interval (CI) with these lenses is between 0.9 and 1.4. What

soft; and 25.4 (CI 21.2-31.5) for overnight wear silicone

does this tell us? The interval of confidence basically suggests

hydrogel. No real data regarding overnight rigid lens wear

that if this study were to be repeated 100 times, then the outcome

is available.

in 95% of the cases would be between these values (0.9 and 1.4

From this data, a couple of things become clear: corneal rigid

here). The smaller this range, the more certainty there is

lenses are the gold standard and are by far the safest contact

regarding the outcome numbers.

lens modality out there. Period. The data further clearly shows

1

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FITTING BACKGROUND

MYOPIA MANAGEMENT Ophthalmologists are advising against using this modality in children for myopia control in some parts of the world, for instance in the Netherlands – hence putting an important pillar in myopia management partly ‘off-side’, in football terms, for eye care practitioners. There are a few complicating factors when discussing this topic. The first problem is that large sample sizes are needed to be able to present confirmatory results on the risk of infection. If the incidence of a corneal infection is one in 100,000, then information from hundreds of thousands of lens wearers, ideally under controlled conditions, is needed. This is problematic for specialty lens modalities, including for ortho-k. Chance plays an important role in any numbers that are generated if sample size numbers are smaller.

Another paper by Bullimore et al reported on a retrospective study of the safety of ortho-k. 3 All episodes of infiltrative keratitis from a children's hospital in Moscow were recorded and adjudicated by three ophthalmologists, which resulted in 139 cases of infiltrative keratitis in children, of which 45 were MK (32%). Five of them were overnight ortho-k wearers. The annual incidence thus reported was about 5.0 (CI, 2.1 to 12.4). that daily wear is the safest lens wear modality, occasional

One of the findings of the Bullimore studies is that the group

overnight wear increases the risk, and regular overnight wear

with the biggest risk of MK was not the younger age group

further increases that risk.

(8- 12-year-olds) but rather the 13- to17-year-olds, and the highest risk was in the 18- to 25-year-old group.

In ortho-k the lenses are only worn during the night, and the wearer is lens-free during the day. What are the risks,

It appears, according to experts in the field – although

considering this? Bullimore et al (2013)2 reported a survey

anecdotally and not evidence based – that practices that fit the

involving 1,317 patients (640 adults and 677 children) that

most ortho-k take the care that the modality requires very

resulted in 2,599 patient years of data (1,164 in adults, 1,435

seriously. Informed consents are obtained, for parents and for

in children). Fifty cases of painful red eye were reported, eight

the children, and hygiene and compliance protocols are re-

cases of corneal infiltrates, and two cases of microbial keratitis

confirmed on all follow-up visits, and it is made very clear to

(MK). They reported an incidence, per 10,000 years of wear,

exclude any tap water from the care regimen. Practices that

of 7.7. The confidence interval here was 0.9 to 28. Note that

‘do ortho-k on the side’ may be less ‘on-top-of-things’ and may

the CI here is larger; hence, there is less certainty, or confidence,

not always have the same rigor in their protocols and regulations

that the absolute number of 7.7 is correct, it is roughly

follow up. In some of the larger ortho-k practices, for instance,

somewhere between one and 30. The latter is most probably

patients are told that if they do not return for follow-up care,

the preferred estimate to use toward patients, not the absolute

they are excluded from further lens purchases and eye care in

7.7 number. For children, the MK risk was found to be 13.9

order to show the seriousness of eye and lens assessment. Here

per 10,000 patient-years, again with a large CI of 1.7 to 50.4,

is an important task, for the industry and profession, to work

while for adults the estimated incidence was zero per 10,000

on together.

patient-years (with a CI of zero to 31.7).

BALANCING THINGS OUT

In essence, there is a higher risk of MK with ortho-k, but it’s

To summarize, the risk with overnight ortho-k is increased

not from the lens or the material; ortho-k lenses are not

compared to with daily wear of contact lenses, and certainly

substantially thicker (as is the case with scleral lenses, as

if compared to daily rigid corneal lens wear – but the risk does

described in the previous paper in this GlobalCONTACT

not seem to exceed that of extended wear of soft lenses. Early

trilogy) or made in any different materials (if anything, the Dk

detection and referral are key, as only a small portion of MK

is higher in ortho-k lenses). It is the ‘overnight’ part that is

cases actually lead to permanent vision loss when managed in

different in ortho-k.

an adequate way.

GlobalCONTACT 2-22

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FITTING BACKGROUND

The fact that ortho-k lenses are not worn during the day may

the ladder of importance than in other lens modalities. This is

be a plus in theory. In addition, intact immune systems result

a very important task, for the industry and the ECP alike, to

in normal healthy eyes (as opposed to in patients who require

focus on in the interest of both ocular health and the future of

regular scleral lens or bandage soft lens wear, for instance).

the modality.

Corneas of ortho-k wearers have been reported to show small amounts of corneal staining, which may or may not pose a

In the next ‘episode’ of this trilogy on specialty lens safety, soft

minor increased risk for corneal infection, although in rigid

specialty lens wear will be placed under the magnifying glass.

corneal lens wear – which has the lowest rates of corneal

What are the special considerations for that modality? Stay

infection – corneal staining (especially three- and nine o’clock

tuned. Stay safe. n

staining) is not uncommon either.4 In conclusion, the overnight part of the modality poses the biggest risks, it seems.

Parts of this publication appeared in a Contact Lens Spectrum article (April 2022) that summarized a 2022 Global Specialty Lens Symposium session

HIGH-DK MATERIALS ARE NEEDED FOR ORTHO-K; WITHOUT THEM, NO SAFE ORTHO-K LENS WEAR IS POSSIBLE. BUT APART FROM THAT, IT SEEMS THAT THE BIGGEST RISK FACTORS REGARDING SAFETY ARE LENS CARE AND HYGIENE, FOR WHICH THE EYE CARE PRACTITIONER TOGETHER WITH THE PATIENT COULD PLAY A CRUCIAL ROLE.

devoted to contact lens safety featuring Mark Bullimore, Melissa Barnett, Gloria Chiu and Pauline Cho. References [1] Stapleton F, Keay L, Edwards K, Naduvilath T, Dart JK, Brian G, Holden BA. The incidence of contact lens-related MK in Australia. Ophthalmology.

2008 Oct;115(10):1655-62. doi: 10.1016/j.ophtha.2008.04.002. Epub 2008 Jun 5. PMID: 18538404.

[2] Bullimore MA, Sinnott LT, Jones-Jordan LA. The risk of MK with overnight corneal reshaping lenses. Optom Vis Sci. 2013 Sep;90(9):937-44. doi: 10.1097/OPX.0b013e31829cac92. PMID: 23892491.

[3] Bullimore MA, Mirsayafov DS, Khurai AR, Kononov LB, Asatrian SP, Shmakov AN, Richdale K, Gorev VV. Pediatric Microbial Keratitis With Overnight Or tho-k in Rus sia. Eye Contact Lens. 2021 Jul 1;47(7):420-425.

[4] van der Worp E, De Brabander J, Swarbrick H, Nuijts R, Hendrikse F. Corneal desiccation in rigid contact lens wear: 3- and 9-o'clock staining.

Optom Vis Sci. 2003 Apr;80(4):280-90. doi: 10.1097/00006324200304000-00005. PMID: 12692484.

[5] Gifford KL. Childhood and lifetime risk comparison of myopia control with contact lenses. Cont Lens Anterior Eye. 2020 Feb;43(1):26-32.

The unavoidable overnight component of ortho-k and the

doi: 10.1016/j.clae.2019.11.007. Epub 2019 Nov 30. PMID: 31796370.

associated higher risk of an MK need to be balanced against

[6] Bullimore MA, Ritchey ER, Shah S, Leveziel N, Bourne RRA, Flitcroft DI.

the benefits that ortho-k can provide in terms of myopia

The Risks and Benefits of Myopia Control. Ophthalmology. 2021

progression reduction. Work by Gifford et al 5 showed that this

Nov;128(11):1561-1579. doi: 10.1016/j.ophtha.2021.04.032. Epub

balance can be favorable for lens wear if myopic retinal pathology

2021 May 4. PMID: 33961969.

is considered, and a recent paper by Bullimore et al also reported the potential benefits of myopia control to outweigh the risks.6 High-Dk materials are needed for ortho-k; without them, no safe ortho-k lens wear is possible. But apart from that, it seems that the biggest risk factors regarding safety are lens care and hygiene, for which the eye care practitioner together with the patient could play a crucial role. A notable consideration is that when an ortho-k lens is placed on the eye, whatever is ‘trapped’ behind the lens stays behind the lens. There is arguably almost no tear film exchange in ortho-k after the lens is placed on the eye, and the eyelid is closed – so removal of debris and of potential micro-organisms will not take place. This puts lens hygiene, especially upon lens application, on a higher rung of 30

28_Eef_Safety in CL OrthoK.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 2-22

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to any of six independently configurable blocking tables.

“Although more expensive than traditional blockers, I feel that it pays for itself with the reduction of prism related rejects and

Treating blocking like the mission critical process that it is

downtime for setting blockers.”

means looking seriously at the needs of a rapidly evolving industry and providing a robust and flexible solution that

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FITTING BACKGROUND

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FITTING BACKGROUND

Monovision – not just about principles!

While some people only approach the subject of monovision at arm’s length, and would probably prefer to erase it completely from textbooks, people’s heads and in practice – for others monovision is the obvious solution! So let's take a closer look at the topic. By Silke Sage For anyone who performs an eye exam today, besides the

still have an image that is closely associated with growing

standard increments of 0.25 D, increments of 0.12 D are

older. So if the aversion to wearing glasses is high, and the

also available. And in the past few years, it has been possible

desire for perfect vision low, the customer may well be prepared

to be even more precise: not only has it become possible

to forgo full binocular correction.

to perform eye exams within a range of 0.01 D, but also to

The ideal situation is when a contact lens patient becomes

produce t he corresponding spectacle lenses as wel l.

presbyopic and does not even notice it, because the fitter has

Examples of this are the systems from Essilor (AVA) and

already provided him with contact lenses that are optimal for

Rodenstock (BIG). The trend towards wavefront-optimized

him – and this might include monovision.

lenses and the measurement of higher-order aberrations

But many contact lens manufacturers now have better and

of the eye is also progressing. So how does this fit in with

better options in their arsenals for people with presbyopia,

a contact lens fitting method that deliberately avoids

which in turn is pushing monovision further back in daily

binocular full correction? On the one hand, we are trying

practice. Today it is easier to switch to an appropriate multifocal

to squeeze out the last drop of visual acuity during spectacle

design at an early stage than to stay with monovision.

refraction, but we are then giving this away three times over during contact lens fitting?

It's almost like smoothing a road with a rolling pin until it is as flat as a pancake, only to drive over it again afterwards with a tank. But what is the use to a customer of potentially fantastic vision through a spectacle lens, if he simply doesn't want to wear glasses? Some patients already feel restricted by the spectacle frame and simply don't want to wear anything in front of their face – however trendy this might be.

THE PATIENT SHOULD BE WHAT DETERMINES THE APPROACH – NOT PRINCIPLES.

WHAT DOES MY PATIENT REALLY WANT? This is the often fine line between success and failure in contact lens fitting: the needs assessment. If you don't take the trouble to listen carefully here, and get bogged down in textbook examples, you'll get to a point in the fitting process where the frustration of the presbyopia patient becomes palpable. At the end of the day, the motivation of the contact lens wearer has an essential part to play. After all, vision is a dynamic process. Thus, a product should be fitted that the patient is at ease with. The patient should be what determines the approach – not just principles.

The initial situation is also a relevant factor: Has the new member of the presbyopia community worn glasses before, or is he being confronted with them for the first time?

Unfortunately, in the latter case among some people, glasses GlobalCONTACT 2-22

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FITTING BACKGROUND

LET’S LOOK AT THE FITTING OF MONOVISION CONTACT LENSES:

solution for patients who are getting on in years. For an existing contact lens user, it is a fast and easy way of providing

Whereas in the past this correction was used by optometrists

him with a reading aid. Assuming a spontaneous positive

in Europe rather at arm’s length, it still remains widespread

reaction to monovision, a trial prescription is thus the first

in the USA, for example, even though its popularity is steadily

step and may be determinant for the subsequent procedure.

declining. On the other hand, however, it is being increasingly

In the case of higher addition, or a negative reaction to

used by German eyecare professionals as an appropriate

monovision, the patient should be fitted with multifocal or bifocal contact lenses.

As mentioned earlier, many patients do not need (or want) 100% full vision correction for incipient or advanced presbyopia. Here a thorough needs assessment is critical to success. The fitter first needs to select the appropriate candidates. For an optometrist whose day-to-day work is not primarily to do with fitting contact

THE FINE LINE BETWEEN ­SUCCESS AND FAILURE: NEEDS ASSESSMENT

lenses, further selection should take place at the start, so that it does not remain with the initial prescription; rather success should be judged over several years. Patients with dry-eye symptoms, very high correction values, anisometropia or corneal anomalies should be referred to a very experienced fitter.

Monovision correction has established itself as a reliable method for clients with low to moderate additions of approx. 0.75 to 1.25 D, with a clear distinction between their dominant and non-dominant eyes. The dominant eye is then fitted with full correction for distance, and the non-dominant eye corrected for near sight. The adjustment of the dominant eye for distance is important so as not to impair spatial awareness or motor

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FITTING BACKGROUND

Most patients are happy with their results in everyday life.

SO HOW DOES THIS FIT IN WITH A CONTACT LENS FITTING METHOD THAT DELIBERATELY AVOIDS BINOCULAR FULL CORRECTION?

About 80% of the daytime can be managed successfully without any additional visual aid. Only for prolonged reading, reading in a dim light or reading small print are reading glasses still needed. Some people may also need glasses when driving at night on longer journeys.

ADDITION 2.00. AND THEN WHAT? But what happens next? After a patient has initially been fitted with monovision or multifocal contact lenses, with advancing years and the inevitable need for additional correction, the fitter will be presented with new challenges. These are not so easy to overcome.

In the past, the industry has come up with new products, but

skills. Furthermore, specific aspects of the different visual

a real breakthrough especially for high addition has not been

defects need to be taken into account.

among them. Customized soft lenses, RGPs as well as hybrid

Some contact lens wearers, who are used to having excellent

systems all look promising. A tandem solution of a bifocal hard

distance vision, when fully corrected may be reluctant to give

lens built into a "pocket" of a more comfortable soft lens has

up some of it in favor of improved near sight. This is often true

also been discussed. Besides this, there are also many offers in

of people with myopia. Whereas people with hyperopia are

the form of training courses and seminars from the industry

glad to benefit from any improvement in their near sight.

for their particular current contact lens types. n

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HISTORY

The ophthalmometer From the Roth collection After the discovery of the refractive phenomena of a glass sphere, medieval physics and anatomy puzzled over how images were formed in the spherical human eye. Later, when the laws of refraction and especially the magnifying properties of a convex lens became known, it was assumed that the spherically curved cornea and eye lens were responsible for the formation of retinal images. However, it was not until the invention of the obscura camera or the photographic camera equipped with a magnifying lens that the formation of images in the eye could be finally explained. By Hans-Walter Roth

BEFORE THE SUCCESSFUL CONSTRUCTION OF THE OPHTHALMOMETER, THE CURVATURE OF THE ANTERIOR CORNEAL SURFACE COULD ONLY BE ESTIMATED WITH THE KERATOMETER OR PLACIDO DISC.

36

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While the optical properties of the crystalline lens inside the

known to be 1.33, the refractive power in all sections could

eye, also known as the "lens cristallinea", were known early

be calculated directly.

on, the light-refracting relationships of the cornea remained

The instrument in use today, usually referred to as an

unsolved for a long time and it took until the 19th century to

ophthalmometer, astigmatometer, or more accurately as a

fully answer all questions. Today it is known that the lens,

keratometer, essentially dates back to the work of Helmholtz

viewed in isolation in air, is a concave lens with light-scattering

in 1851, who had already invented the ophthalmoscope in 1850,

properties. For this discovery, it was necessary to accurately

making it possible to examine the back of the eye in living

record the inner as well as outer curvature of the cornea in

subjects. Before t he successf u l const r uct ion of t he

all its sections. This required the development of a measuring

ophthalmometer, the curvature of the anterior corneal surface

device with which not only the radii of curvature of the corneal

could only be estimated with the keratometer or placido disc.

anterior surface but also of its posterior surface could be

Now it was possible to measure the so-called corneal radii at

determined. Since the refractive index of the cornea was

any point. Javal in Paris, Gullstrand in Stockholm and Schiötz GlobalCONTACT 2-22

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HISTORY

in Oslo improved the technique, which remains the basis for

axial position. This device, made with high precision, is an

optical measurement of the eye until today. Gullstrand received

example of the craftsmanship of the century before last. Despite

the Nobel Prize for Medicine in 1911 for this work.

its age of over one hundred years, it is still fully serviceable.

OPHTHALMOMETER FROM AROUND 1900

Such historical ophthalmometers were irreplaceable especially in the manufacture and fitting of the contact lens. They also

The device shown here is an ophthalmometer from around

proved their worth in the diagnosis of keratoconus or in the

1900. It consists of a cast-iron three-legged frame on which a

fitting of an injured eye with scarring astigmatism.

classic telescope is mounted and focused to a distance of about

Even after such a long time, it still works with amazing

10 cm. To the right and left of this are two light sources that

precision and is in no way inferior to modern, laser-controlled

can be moved around the central axis and with which a

devices. It is the gift of a colleague for the collection and

measurement figure can be projected onto the cornea. The basic

comes, lovingly cared for over the years, from his grandfather's

principle is the mirroring of test images projected onto the

ophthalmological practice. n

cornea. In the beginning, this was done by lighting with a gas flame, although it is not known whether many eyelashes fell victim in the process. The device shown was subsequently electrified and an electric cable wrapped in green cotton suggests that this was already done at the beginning of the last century.

Dr. Hans-Walter Roth Institut für Wissenschaftliche Kontaktoptik Ulm E-mail: institut.roth.ulm@t-online.de

The measurement is uncomplicated. At the beginning, the two test images are projected onto the center of the cornea, focused and brought to concurrence by varying the projection angles or rotating the axes. The astigmatism and the values for the corneal radii are calculated from the determined angles or the

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COLUMN

Photo: Frank Sonnenberg

Top(t)ics An aberration Contact lens optics is one of the most interesting but increasingly one of the most controversial areas of optometric education. In many European countries, the profession of optometry stemmed from optical schools and optics education, which gradually (or not so gradually sometimes) transitioned into health care-related tasks and responsibilities. The professional body in Europe is called ‘European Academy of Optometry and Optics’, which held its annual meeting recently in Dublin from May 12-15. In the United States, it is a bit different: optometry as a profession originated more than a century ago, and the national association is simply called ‘the American Academy of Optometry’. By Eef van der Worp

OF HIGHER IMPORTANCE Optics used to be an integral part of the education system for the profession. But in the US certainly, and more now in Europe, we see that education on optics is increasingly reduced. There

unlimited, but only if we understand the optics side of things, including that of higher-order aberrations.

CORNEAL & SCLERAL LENS OPTICS

is logic behind this: it completely makes sense that for an

Corneal rigid lenses have always provided excellent vision. It

optometric professional to take on all of the responsibilities to

is almost ironic to see that the good old rigid lens corrects and

ensure healthy eye care, a more-than-substantial portion of

provides vision that would qualify as ‘higher-order-aberration’-

the education should be devoted to anatomy of the eye, ocular

corrected lenses. About 90% of all corneal aberrations are

physiology, eye disease and pharmacology. With most education

corrected automatically (the rest is lost because of the difference

programs being only four years maximum in length, something

in index of refraction between the lens material, the tear film

needs to give. And indeed, curriculum changes typically are

and the cornea). In fact, if you perform aberrometry with and

made at the expense of optics and the more technical parts of

without a rigid lens on the eye and subtract these two maps

the education program.

(like in an orthokeratology topography map), you will get the higher-order aberration profile map of the tear film behind the

This prompted Pete Kollbaum, a US optometrist who is surely an

lens. Pretty cool.

exception to the rule, to write a column in softspecialedition.com

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38_Eef_Columne.indd 38

newsletter titled: Higher Order Aberrations – of Higher

Scleral lenses do the same, as they are rigid too, but an excellent

Importance. He urges the profession and the industry to not

paper by Vincent and Fadel pointed out that the ‘thin lens’

forget about contact lens optics in higher education and to

optics of rigid lenses on the eye simply cannot be applied when

invest in education in this field. He mentions the huge challenges,

it comes to scleral lenses. Indeed, there is still a discrepancy,

but also the great possibilities, when we incorporate and apply

as many in the industry may tell you that the optical performance

better optics to the different lens modalities. The sky is almost

of scleral lenses – especially if there is more vault – will not be

K a

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Se Sp

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the same as that of corneal rigid lenses. Some patients simply

optometrist. But we cannot expect that from most of the

continue to prefer the latter. It’s all in the contact lens optics.

graduates coming out of optometry school today. If optics education is overshadowed by other important topics, it may

CUSTOMIZING SOFT

be a task of the industry to step in and to keep educating young

Of all the specialty lenses, soft customized lenses may have the

professionals to remain up-to-speed with all of the cool things

biggest potential in our field. First, we must better understand

that contact lens optics can bring to them, to the profession,

standard soft lens fitting. Work by Graeme Young et al confirmed

and to their patients. n

that soft lenses need to be fitted ‘somewhat steeper’ than the ocular surface to gain the desired ‘grip’ on the eye. In our

Hughes et al. Higher order aberrations, refractive error development and

terminology, we call this the delta-sag: the difference between

myopia control: a review. Clin Exp Optom. January 2020

the sagittal height of the ocular surface over a given area and

Kollbaum. Higher Order Aberrations – of Higher Importance. softspecialedition.

the contact lens sagittal height so that the lens can bend or

com. Spring 2022

deflect to do so. This shows that any given soft lens on the eye needs to bend or flex to successfully fit the eye. By how much exactly is still up for debate. And in current lens wearers, this value varies by quite a bit. This also means that the deflection

Van der Worp . Variation in sag values in daily disposable, reusable and toric soft contact lenses in the journal. Contact Lens and Anterior Eye. December 2021 Vincent SJ, Fadel D. Optical considerations for scleral contact lenses: A

in some lenses may be 100 microns, while in others it could be

review. Cont Lens Anterior Eye. 2019 Dec;42(6):598-613

several hundred microns. What does that do to the optics of a

Young G, Hall L, Sulley A, Osborn-Lorenz K, Wolffsohn J. Inter-relationship of soft

lens? We don’t know. In a standard -3.00D spherical lens design,

contact lens diameter, base curve radius, and fit. Optom Vis Sci 2017;94:458–65

it probably will not generate more than a 0.25D change. But in more complex lens designs – e.g., toric, multifocal and myopiacontrol – this could prove to be more than trivial. Understanding this, and then applying that to soft lenses – taking the individual and general characteristics regarding age and pupil size into account – could potentially have a huge impact on myopia management outcomes in kids and also could improve multifocal soft lens fitting for presbyopia.

DEDICATION IN EDUCATION This all means that we need to dedicate adequate time and energy to optics education. I am personally happy that I was first trained as an optician, followed by an education as

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.

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08.06.22 14:43 16:04 23.06.22

BUSINESS

Ergonomic guidelines for hybrid workspaces Ensuring productivity and safety The disruption to office work has been unparalleled in the last few years due to the impacts of COVID-19.

As the world moves towards opening the office doors to allow employees to return to an office-based setting, new variants continue to emerge (WHO and ILO, 2021). With so many unknowns, and a desire to allow a return to in-office work, businesses are considering their return-to-work strategies.

By Brandy Farris Miller, Anand Subramanian and Jeffrey Fernandez

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One trend that emerged from the required remote work brought

effective to be completed within the traditional office space

on by COVID-19 is that businesses understand that much

and what tasks are most effectively worked outside of the

productive work can take place without physically being in the

traditional work environment (such as home office or remote

office. The time spend commuting to and from the workplace

work) as shown in figure 1.

can either be used to contribute to work productively or can

The hybrid workplace could be a mix to varying degrees of an

be spent doing things that improve the quality of life.

employee working from the office, working from home, a

The concept of “great resignation” has also ensured that

conference room, or any other location; with two extremes of

businesses can no longer compel their staff to be in the physical

the spectrum being 100% in-office and 100% working from

office full time. Technological advancements have permeated

home. Traditionally, office ergonomics has focused on one end

all aspects of life and have provided businesses with the concept

of the spectrum (i.e., 100% in-office). In our previous discussion

of working effectively and efficiently at the office, home, or any

(Ergonomics recommendations for remote work, see

other remote location. This flexibility has continued to shape

GlobalCONTACT 02/2020), we reviewed the use of ergonomic

the concept of a “hybrid workplace”.

principles for the temporary 100% working from home setup.

The seamless integration of a physical workplace with the

Here, we aim to address the role of ergonomics in addressing

remote workplace will ensure that employees can be productive.

the challenges of returning to the office in a hybrid setup, where

This includes determining when and what tasks are most

office presence is less than full time.

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THE REQUIREMENTS OF TASKS, AS IT RELATES TO TIME IN THE OFFICE CAN BE DIVIDED INTO THREE GENERAL CATEGORIES: RETURN TO OFFICE FULL TIME; RETURN TO OFFICE ONLY FOR SIGNIFICANT MEETINGS; AND RETURN TO OFFICE PARTIAL. Fig. 1: Evaluating where tasks are most efefective to be completed is important – in-office or remote.

WHAT WILL A RETURN TO THE OFFICE LOOK LIKE?

Compared to the traditional office environment, where every

Increasingly, organizations are looking at periodic attendance

individual had a desk space that was theirs, this “meeting only”

in the traditional office. For some organizations and job tasks,

employee will, likely, not have an office and primarily be working

this will be ensuring department coverage on-site every day

in conference rooms during their time on-site, in the office.

of the week, while for others, it may include meeting onsite for collaborative work that is most effectively performed in person.

There are distinct considerations for this type of work primarily

This reduced census of employees on-site and the related

in conference rooms. This includes paying attention to the

opportunity to reduce the real estate related to office work can

traditional ergonomics risk factors such as duration and body

produce positive results when implemented with a comprehensive

posture (Putz-Anderson, 1988).

plan. Among the considerations are what type of tasks will be

The assumption previously was that people working in conference

performed and where will people be working.

rooms are there for a short duration (from one to a few hours)

WHAT TASKS WILL BE PERFORMED?

and that they may be primarily taking handwritten notes.

Moving forward, these assumptions do not continue to hold

The goal in ergonomics is to fit the tasks performed to the

true. Conference rooms used for long meetings (half-day, full

capabilities of the human while adhering to the acronym

day, or multi-day) should include the following additions:

‘N-E-W’ (Neutral posture – Elbow/Eye height – Work Area)

• laptop peripherals such as external mice, keyboards

(Fernandez & Marley, 2013) to guide workstation setup. Looking at the tasks performed may give clues as to the type of in-office accommodations that are necessary. The requirements of tasks, as it relates to time in the office can be divided into three general

and monitors

• fully adjustable chairs that accommodate a range of users • footrests for use while seated at the common conference room table

categories: return to office full time; return to office only for

• Many tables are set at a standard height that requires users

significant meetings; and return to office partial (ranging from

of average height or smaller to raise their chair in order to

a few days a week to a few days a month).

work at elbow height, thus putting additional strain on the underside of the thigh, and allowing for posture variation

1. Return to the office full time

through regular breaks or allowing participants to stand

When tasks require the presence of the same individual regularly

along a conference room wall.

in the office (i.e., customer-facing, or other service type employees), many organizations provide this individual with

3. Return to office – partial

a dedicated workspace. This would be similar to the pre-

This partial return to the office presents challenges and opportunities

pandemic work environment. This allows the workspace that

in how to efficiently accommodate hybrid employees in offices

will be used daily to be configured once for a single individual.

when they may only be on site a few days a week or a few days a month. The problem of effectively accommodating the ergonomic

2. Return to the office for significant meetings

needs of more people with fewer real estate resources can be solved

On the other end of the spectrum of employees who will be

by repurposing and effectively applying industrial engineering

returning to the office environment, there will be individuals

and ergonomics concepts to arrive at possible solutions. These

who mainly return to the office environment for meetings.

concepts include fully flexible workspaces and A-B-C workspaces.

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workspace. In order for this concept to be successful two activities should be conducted: (I) a map of the entire work area, cataloging the dimensions, features, and adjustability for the workstations, seats, and peripherals, and (II) measurements (e.g., elbow height for work surface height) of employees so that they can be categorized and educated as to which pod is most appropriate.

With this information in mind, the space can be arranged so that desks accommodating smaller, medium, and tall individuals can be placed throughout the work environment. One Fig. 2: A sample spatial arrangement of workspace by A-B-C categories.

organization implanted such a strategy and set some desks so that the work surface were 25 in (63-64 cm), 27 in (68-69 cm)

DIFFERENT WORKSPACE CONCEPTS

and 29 in (72-73 cm) (figure 2).

The working population was then educated as to which

Concept A

workstation height would be most appropriate for their body

Fully flexible workspaces refers to providing a workstation

size. In addition to different work surface heights, similar

solution that accommodates the majority of individuals that

considerations as mentioned above will also be necessary,

could possibly work at a location. In many instances,

including:

organizations would need to invest additional initial capital in furniture (such as adjustable height desks or desktop units).

I. A-B-C worksurfaces

Fully flexible workspaces provide maximum accommodation for all employees and do not require extensive scheduling or

II. fully adjustable seating

reservation requirements. Individual employees have the

• footrests may need to be provided for those that are

capability of selecting and utilizing any workstation at any

smaller and cannot work at the minimum adjustable

point in time. Fully flexible workstations should be equipped

workstation height

with some basic items such as: III alternate seating for those who need it

• adjustable height work surfaces • alternate seating for those who need it a. larger or taller individuals may need access seats that will accommodate their size

• larger individuals may need access seats that will accommodate their size

• smaller individuals may need seats with short seat pan depth at their workstations

b. smaller or shorter individuals may need access to seats that fit them better

• appropriate peripherals such as a. external monitor(s) b. docking station

IV. appropriate peripherals such as

• external monitor(s) • docking station • external keyboard/mouse

c. external keyboard/mouse As organizations begin to navigate a return to the office, Concept B

considerations related to the type of tasks that are being

A-B-C workspaces is a way of grouping workstations based on

performed by in-office employees can drive decisions related

features or parameters so that individuals can select the type

to the design of conference rooms, fully flexible workspaces,

of workstation that is appropriate for them and their work

or A-B-C workspaces. There are many more considerations

needs (e.g., A- medium workstation size; B- small workstation

for full, effective implementation of a hybrid work environment

size; C- tall workstation size). A single sharing area would have

related to changes in the manner employees work, frequencies

a mix of these groups of work pods and based on availability

of breaks, social connection and distancing, and transition

or any other method an individual employee can select for a

of employees from temporary home work to permanent

given time window. The percentage of As, Bs, and Cs can be

home work. It is important for individuals who have a history

determined during the planning stages to accommodate the

of related injuries (such as musculoskeletal disorders) and

maximum population.

other disorders to seek the assistance of a certified professional ergonomist. With planning, consideration, and training,

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The concept of A-B-C workspaces allows for the use of existing

employees can continue to work productivity and safely in

furniture to accommodate people that may not need a dedicated

the hybrid work environment.

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References [1] World Health Organization (WHO) and International Labour Organization (ILO), 2021. Preventing and mitigating COVID-19 at work. Policy Brief. Retrieved 2 Feb 2022 from www.who.int/publications/i/ item/WHO-2019-nCoV-workplace-actions-policy-brief-2021-1.

[2] Fernandez, J.E. and Marley, R. J. (2013). Applied Occupational Ergonomics: A Textbook, Fourth Edition. Society for Industrial and Systems Engineering Press, 2013.

[3] Putz-Anderson, V. (1988). Cumulative Trauma Disorders: A

Brandy Farris Miller (bmiller@apexergonomics.com) is a principal at Apex Ergonomics. She holds a Ph.D. in business organization and management and master's degree in industrial engineering with an emphasis in applied occupational ergonomics. She is a certified professional ergonomist, certified Six-Sigma Black Belt, an OSHA authorized 10/30 hour general industry outreach trainer. For more information visit: apexergonomics.com/

manual for musculoskeletal disease of the upper limbs. Taylor and Francis, London and New York.

Anand Subramanian (anands@jfa-inc.com) is a principal at JFAssociates Inc.. He holds a Ph.D. and masters degree in industrial engineering from the University of Cincinnati, Ohio, is a certified Six-Sigma Black Belt, a certified professional ergonomist, an associate safety professional, and an OSHA-30 certified professional. For more information visit jfa-inc.com

Jeffrey Fernandez (jf@jfa-inc.com) is the managing principal at JFAssociates Inc..

He holds a Ph.D. in industrial engineering from Texas Tech University, is a registered professional engineer and a certified professional ergonomist. For more information visit jfa-inc.com

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09.03.22 12:49 14:17 22.06.22

BUSINESS

Why female values are in demand like never before And how to realize their full potential "The future is female" is the core statement of one of the Dalai Lama's recent books. He talks about the fact that in today's world, companies need female values more than ever; values such as empathy, integrative power and benevolence.

We are also experiencing this epochal cultural change in companies and the ever-increasing striving of people for meaning and lived values in the world of work. Proven leadership instruments are increasingly losing their effect and it is not only the younger generation that is making changed demands on leadership. By Cordula Rosenfeld and Edith Beilner 44

44_WomenInPower.indd 44

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BUSINESS

evaluation prevents a creative tension and mutual appreciation from developing between the two poles. For this to happen, we need a way of dealing with female and male qualities on an equal footing, which is so urgently needed to shape our future.

Qualities attributed to the masculine pole are goal and result orientation, competition, focused thinking and linear approach – skills that enable conquering, growing and rational understanding. These have been strongly demanded and encouraged in the corporate world for decades.

Feminine qualities, on the other hand, relate more to creating One of these demands, in our view, is a still unspoken yet

living relational spaces with all the aspects that go with them.

clearly perceptible “yearning for more humanity”. Against this

They enable connection, protection and peaceful coexistence.

background, the demands on leadership and managers are

In the corporate environment, these competencies often come

changing more and more in favour of female leadership

under the heading of “soft skills”.

strengths.

While these soft skills were often mildly ridiculed as “soft facts”,

MASCULINE AND FEMININE QUALITIES NEED EYE LEVEL

today they are becoming the new “hard facts” and are crucial, for example, to inspire committed employees for the company in the future, to create a

We do not define feminine as the sole quality

healthy working environment and to use the

of women. Both women and men carry

opportunities of diversity and networking.

qualities that are attributed to the female

Women in particular are good at making

as well as the male pole. However, time

even critical issues easy to discuss by

and again we notice how competition

actively involving employees. They

takes place between the two poles. Socially – but also originally in each individual. This GlobalCONTACT 2-22

44_WomenInPower.indd 45

understand feelings as competent impulses for action and give concerns or fears appropriate 45

22.06.22 12:51

BUSINESS

space in everyday work. In this way, they create a sustainable

primal feminine competencies or take them for granted as well.

relationship in which each employee feels that his or her

It is time to liberate female competences from their shadowy

personality is recognized. This enables the development of

existence! This requires women who stand by their feminine

potential, increases satisfaction, promotes self-motivation and

values and take responsibility for them. In this way, an attitude

thus also contributes to the health of the individual.

of increased self-respect and autonomy can emerge in addition

Increasingly, we are seeing hierarchical structures being

to their orientation towards relationships.

dissolved in favor of networked cooperation. The call for “agility”

From generation to generation, a victim consciousness has

is becoming louder in order to meet complex challenges and

been passed down among women, which still has a paralyzing

the demands on leadership are changing drastically.

effect. But being in the role of creator and victim at the same

This leads to the following consequence: in a corporate

time is mutually exclusive! In order to mobilize their creative

environment in which the ability to organize oneself, to take

forces, women have to make themselves visible. They have to

initiative and personal responsibility, where networked, cross-

take responsibility for this – no one can take this first step away

divisional cooperation at eye level determine success or failure,

from them.

female qualities are becoming a must-have!

TAKING RESPONSIBILITY FOR FEMALE COMPETENCES

What do I stand for?

In order to master challenges with joy every day and to generally

At the same time, as business coaches in companies, we notice

experience one's own work as meaningful, one needs clarity

again and again: Many women are excellently qualified and yet shy

about one's personal sense of meaning, one's own answer to

away from drawing attention to themselves and their achievements.

the question “what for”. Formulating this “what for” in a strong

Particularly in management positions, the female pole is usually

sentence can act like a compass that is powerfully oriented

still underrepresented. Yet, especially in these times of high pressure

towards strengths, competences and courageous progress.

to change, female competences are so urgently needed as a powerful

Those who clearly establish their own values and commit to

complement to effectively master complex chal­lenges.

them have a compass in their hands that provides orientation,

To overcome shyness and courageously draw attention to

especially in challenging times.

yourself, we have the following tips.

The following questions can support you in this:

HOW FEMALE LEADERSHIP GETS GOING Three keys as a source of power for the very personal leadership mission:

• Which five values guide my actions?

• Which concrete behaviors embody these values for me?

• What do I want to pay more attention to in my behavior in order to live these values?

Identify the personal mission in the female leadership role For women, the first step is to take responsibility for their very

Exposing hindering thinking styles and transforming them

own female competencies and to respectfully acknowledge

into powerful motivating factors

them. For decades, these skills have been ridiculed or taken

Women are often united by a strong desire for perfection and

for granted, and many women are unaware of the value of these

a high demand on themselves, especially in positions of responsibility. Most of the time, these behaviors have developed in the past and have become a kind of automatism.

In addition, it is often taken for granted that one has to look after the well-being of others, so that one's own limits are hardly perceived and it is even more difficult to stand up for them. In this way, however, women gain less recognition than they would like – on the contrary, they appear contourless and increasingly invisible.

Such ways of thinking and behaving can hinder further development, like inner blockades, and slow down or even completely undermine one's own work.

46

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Source: fauxels / Pexels

What is needed here is loving attention and recognition of how much strength and resources can be released when these old ways of thinking are appropriately transformed. Only when women consciously take responsibility for transforming their inner barriers can they realign themselves for the future. As long as they choose to be victims of circumstance, they GlobalCONTACT 2-22

22.06.22 12:51

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BUSINESS

incessantly roll out the carpet of past experiences, walking on

has unbalanced our world. Instead of condemning and

the aspects of the past without ever moving forward and having

devaluing this state of affairs, it is now more a matter of

new experiences.

recognizing that this one-sided orientation has lost its raison

This is why it is so important for women to get to the bottom

d'être. Now men and women are challenged to grow beyond

of these unconscious and obstructive behavioral strategies and

it together.

transform them into new powerful action.

We need a healthy balance of growth and preservation, of competition and harmony, of autonomy and relationship

The following questions can give you a clue:

building, of direction and depth.

• What typical behavioral patterns am I very familiar with?

• What skills have I developed from them? What do I succeed

Above all, it is about connecting male and female competences

at particularly well as a result?

• What is not possible because of this behavior? What does this behavior pattern prevent?

WOMEN NEED FEMALE POWER SPACES

at eye level and building bridges.

In the first step, we could recognize and appreciate the different competences of the other gender.

In the second step, we are convinced that if women take on even more responsibility at important interfaces in companies, society and politics, different perspectives and decisions will

In earlier times, women spent a lot of time together – across

come about, which our world urgently needs in order to regain

generations they lovingly supported each other and learned

its balance.

from the exchange of experiences. Women who share in a circle among their peers on a deep, trusting level strengthen their

In this process, men and women must act hand in hand and

power. They inspire each other, look out for each other, increase

at eye level! n

their wisdom, nourish and strengthen each other.

Even though we live in different social structures today, women could create such circles in which they strengthen each other and grow together.

A helpful way to start could be to open such a circle with the question: “What did I do particularly well this week?” or “What am I particularly proud of this week?”

“Where did I set a goal for myself and realize that I had beaten my pattern?”

MALE-FEMALE AS AN INSPIRING FORCE FIELD FOR THE FUTURE For centuries, the world of work has been built on typically male values according to the higher-faster-further principle.

The focus on competition, rivalry and maximizing profits GlobalCONTACT 2-22

44_WomenInPower.indd 47

Cordula Rosenfeld, Edith Beilner.

With more than 20 years of leadership and business experience, Edith Beilner and Cordula Rosenfeld accompany leaders and teams in change processes and help people in challenging situations to grow concretely and together into the new.

Their work with teams in large organizations has inspired them to accompany women in particular to go their own way authentically and confidently.

They are explicitly concerned with bringing female qualities more strongly into the company so that these can be effectively combined with male competences at eye level.

47

22.06.22 12:51

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BostonMaterials Materials Group Boston Group Bausch + Lomb Bausch + Lomb Wintergasse 32 69469 Weinheim Wintergasse 32 Germany

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One Module per Year 510€ - 660€ please contact marie@global-cl.com

69469 Weinheim Phone:Germany +49 6201 17869 T +49 6201 17869 tanja.malkus@bausch.com susanne.krostitz@bausch.com F +49 6201 62184 www.fit-boston.eu

tanja.malkus@bausch.com Contact Lens Material www.fit-boston.com

Contamac LTD Carlton House, Shire Hill Saffron Walden Essex CB11 3AU United Kingdom Phone: +44 1799 514800 sales@contamac.co.uk www.contamac.com

Contact Lens Material

®

Contact ProductsFor: For: ContactLens LensHandling Handling Products Firm Lenses, Soft FirmLenses, Lenses Scleral Lenses, Hybrid Lenses, Ortho K Lenses

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CONGRESS Available in Europe Josefstrasse 53 from: EXHIBITION Prolens AG CH-8005 Zürich Josefstrasse 53 Switzerland CH-8005 Zürich Switzerland Phone: +41 44 272 78 18 +41 44 272 78 18

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

Manufactured by DMV Corporation Zanesville, Ohio USA Zanesville, Ohio USA www.dmvcorp.com www.dmvcorp.com

Contact Lens Accessories

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

LAMBDA-X S.A. Avenue Robert Schuman 102 B-1400 Nivelles Belgium

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

Phone: +32 67 79 40 80 Fax: +32 67 55 27 91

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

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

info@lambda-x.com www.lambda-x.com

erik@larsenequipment.com www.larsenequipment.com

mikef@misupco.com mikef@misupco.com www.misupco.com

Instruments

Machinery and Tools

S Y S T

E M

USA

Phone: +1 651 353 8632

www.misupco.com

Blocking Wax

S

Optimec Systems Limited Unit B3, The Haysfield Spring Lane North Malvern, WR14 1GF United Kingdom

OPTOCRAFT GmbH Am Weichselgarten 7 D-91058 Erlangen Germany

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

Phone: +44 1684 607006

Phone: +49 9131 691500 Fax: +49 9131 691511

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

www.optimecsystems.com info@optimecsystems.com

sales@optocraft.de www.optocraft.de

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

35112 Fronhausen

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

Instruments

Instruments

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

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

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

www.sterlingint.com

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Eyepress Fachmedien GmbH Saarner Str. 151 D-45479 Mülheim an der Ruhr Phone: +49(0)208-306683-00 Fax: +49(0)208-306683-99 www.global-cl.com info@global-cl.com

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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 EDITOR-IN-CHIEF Dipl.-Ing (FH) Silke Sage E-mail: silke@global-cl.com EDITOR Britta Laupichler E-mail: britta@mafo-optics.com TRANSLATIONS John Saniter, Bopfingen, Germany EDITORIAL BOARD Wim Aalbers, Erik Larsen, Eef van der Worp PRODUCTION & LAYOUT Efstathios Efthimiadis, Pascal Bruns DISTRIBUTION PressUp GmbH, Postbox 70 13 11, D-22013 Hamburg Tel.: +49-40-386666-308, Fax: +49-40-386666-299 MEDIA CONSULTANT Constanze Classen Tel.: +49-208-306683-20 Fax: +49-208-306683-99 E-mail: constanze@global-cl.com 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 ADVERTISEMENT RATES Price list No. 11, valid from January 01, 2022 Publication Schedule 3 issues 2022: March, July, November

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