Boston XO2® is everything you love about Boston XO® lens material + hyper Dk.
At 141 Dk, Boston XO2® provides even higher oxygen delivery than Boston XO.® Having these two material choices available offers you:
More Flexibility
Accommodates lens designs for common vision conditions, as well as demanding visual needs such as keratoconus and ocular surface disease.
More Peace of Mind
Backed by the exceptional service and support you’d expect from a company that’s been around since 1853.
More Confidence
All our lens materials are precision manufactured by experienced technicians followed by rigorous quality control.
While it features even higher oxygen delivery than Boston XO®, Boston XO2® is still precision manufactured by experienced technicians and undergoes the same rigorous quality control— all backed by exceptional Bausch + Lomb service and support.
Visit www.fit-boston.eu or contact your authorized Boston® Lab.
Visit bostonlensmaterial.com or contact your authorized Boston Lab.
Not a question of choice
Some time ago, an upset reader called our editorial team. We had featured in one of our magazines (for optometrists and opticians) a picture of an eyewear designer who does not wear glasses himself. This was a scandal. The reader said he had always demanded that his employees – whether or not they had poor vision – wear glasses in the practice during working hours. Only to demonstrate the support of their products.
Without intending judgement on this invasion of his employees' personalities, this shows us that for some professionals, the world of vision consists primarily of two lenses and a frame. This is where the music plays, this is where sales are made. Faces without glasses apparently just look too unspectacular, too blank – and to prevent patients from getting any strange ideas, there are only people with spectacles in this world.
Change of scene: At almost every contact lens conference, someone asks people from the industry: Why are so many people wearing glasses here, do they not back their own product? And with a slightly deeper undertone to the middle-aged counterpart, he speculates: Do you not tolerate your own multifocal lenses? Of course, there are also nitpickers here who look at our ophthalmic world with tunnel vision. And yet Otto Wichterle or Joseph Dallos wore glasses all their lives and into old age.
The astute reader knows that the world of ophthalmic optics has many facets. One of these is correction with contact lenses. If you want to be successful here, you have to go one step further
than selling lenses. In addition to a thorough anamnesis of the patient, a thorough inspection of the anterior segment of the eye is also required. This is where an optometrist demonstrates many aspects of his expertise. This also includes continuous training and the purchase of appropriate equipment.
The condition of the tear film has a significant influence on the success or failure of a contact lens fitting and how long they can be worn throughout life. More and more professionals are therefore offering a dry eye practice. Well-equipped contact lens fitters already have the equipment for qualitative and quantitative assessment of the tear film. Further training is a matter of course for them and they already enjoy the trust and loyalty of their patients.
The decision between spectacles and contact lenses is therefore not an "either/or" but a "yes both, please!". There's just one thing that most optometrists agree on: LASIK is out of the question. ■
SILKE SAGE Editor-In-Chief silke@global-cl.com
WHY JOIN EFCLIN?
“It’s the best form of business networking I have ever done”
“If you can’t support your own industry who can you support?”
“Everyone seems to help each other, it’s amazing”
“It’s run by its members, for its members”
“There is always someone you can contact who will have experiences you can benefit from”
“I’d pay the membership just to come to the congress”
“The members all understand each other”
“A great source of information”
“Why wouldn’t you?”
“It’s like having a whole network of experts available at all times”
“It’s our representative body”
“The congress and exhibition is the best there is”
EFCLIN OFFERS TWO TYPES OF MEMBERSHIPS:
Lens Manufacturers, Wholesalers & Distributors pay an Annual Subscription based upon the number of employees in their organization
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FROM THE EDITOR
3 Not a question of choice Silke Sage
INTERNATIONAL NEWS
6 A ll about you
9 A ll about products
10 A ll about research
45 A ll about markets
14 Europe's ophthalmic optics united: Meetings of ECOO and EAOO in Helsinki Daniel Groß
INDEX TO ADVERTISERS
Title: Contamac, www.contamac.com
Inside front cover: Bausch + Lomb Inc., www.bausch.com
26 Irreplaceable? PFAS in contact lenses – Interview with Dr. Roland Fromme Hanna Diewald
MANUFACTURING
32 Time, errors, productivity, & profit: Decisions, decisions! Erik Larsen
FITTING BACKGROUND
34 Dropouts: One-size-fits-most – but-not-all Eef van der Worp
38 7 myths: children and contact lensesn Silke Sage
TECHNOLOGY
42 C ontact Lens Cleaning with electrophoresis technology Alex Yang
HISTORY
32 Joseph Dallos Silke Sage MAGAZINE
4 8 Yellow Pages
50 Closing words: Marion Beeler-Kaupke
All about you
Dr. Ed Bennett to retire as Executive Director of the GP Lens Institute
After nearly 36 years at the helm, Ed Bennett, O.D., M.S.Ed., F.A.A.O., F.S.L.S. will be retiring from serving as both Executive Director and President of the Gas Permeable Lens Institute (GPLI). Originally formed as the RGPLI in 1984, Dr. Bennett took on the role of Executive Director four years after its inception. Dr. Bennett has spearheaded numerous innovative programs and resources throughout his tenure. In 1996, the organization began conducting GP lens fitting workshops at schools and colleges of optometry throughout the United States. In 1999, the first RGPLI (now GPLI) Cornea and Contact Lens Resident Symposium was held. This program has served as a launchpad for many of today’s contact lens leaders and continues to be offered each August. Increasing demand has prompted Dr. Bennett and his GPLI team to launch a second symposium scheduled to take place in Glendale, AZ in October of this year. With the development of the internet, in the year 2000 Dr. Bennett began hosting an online chat, which evolved into today’s popular monthly GPLI webinar series. Under Dr. Bennett’s guidance, the RGPLI was renamed the GPLI in 2003 and in 2019 became a 501(c)(3) nonprofit organization.
In 2021 Dr. Bennett began developing several GPLI volunteer committees. These have grown to include nearly a hundred experts in specialty contact lens care in 15 committees who willingly share their knowledge and experience with the GPLI and its audience.
Dr. Bennett is also Professor Emeritus at the University of Missouri-St. Louis College of Optometry and has earned numerous accolades, including induction to both the National Optometry Hall of Fame and AAO Hall of Fame.
Dr. Bennett plans to step down from his current position by the end of 2024. A search for a new executive director will be
forthcoming soon. He is excited about the future of the GPLI: “Becoming Director of the GPLI has been – by far – the greatest professional decision I have ever made. Having a passion for GP lenses, this has been a 36-year dream come true. It has been my privilege to work with the leadership of the Contact Lens Manufacturers Association (CLMA), an exceptional board of directors, and a prolific and extremely beneficial advisory board. Whereas I am at a time in my life where I truly need to decrease my responsibilities, I’m very excited about the future of the GPLI. With the ongoing leadership and dedication provided by Associate Director, Dr. Tom Quinn, and the numerous talents of our Administrative Director Beth Anderzhon, I intend to work with them to help make for a seamless transition for the new Executive Director.”
Current CLMA President Derrell James best summarizes Dr. Bennett’s impact and accomplishments: "Trying to summarize the impact that Ed has had on our entire industry is like trying to count every grain of sand on all the beaches – it simply cannot be done. Every person he has touched through his life as an educator is what he will be remembered for, but the real work has been behind the scenes. It is through countless hours and meetings with GPLI committees and advisory board, universities, content developers, media, and experts in industry, where Ed has truly made the impact. He has championed the work to provide the best possible partnerships with doctors for decades and does so in an impeccable manner. GPLI's motto is 'First in Education', and we will sorely miss Ed's infectious enthusiasm, drive, and relentless pursuit of excellence. However, the true testament to success is found in the love of his family, friends, and those whose lives he has touched. Like those many grains of sand on the beach, Ed's inestimable contributions confirm his career has been extraordinarily successful.”
Contributed by Tom Quinn to CLMA, O.D. M.S., F.A.A.O., F.S.L.S. & adapted from the publication in Contact Lens Spectrum on 6/9/24
BostonSight launched Beyond the Fit
BostonSight has launched Beyond the Fit, a comprehensive consultation and fitting support program that provides BostonSight Scleral lens practitioners tools for ongoing success.
Obtaining a diagnostic FitKit or scanning the eye for digital lens design is just the beginning of obtaining a successful patient experience. BostonSight Scleral goes ‘Beyond the Fit’ to ensure practitioners feel confident in fitting patients, no
matter their expertise in specialty lenses. Beyond the Fit encompasses multiple programs, allowing practitioners to choose what works with their schedule and needs: Comprehensive Success Team provides access to fitting consultants, lab technicians, and account support coast to coast. First Fit Free gives new practices their first patient fit free when ordered within 30 days of joining the BostonSight Scleral network. With FitAssist vouchers, practitioners earn free lenses for patients in financial need. FitConnect is an
Ed Bennett
online ordering and management platform where practitioners can register patients, design lenses, add customizations, print prescriptions, track orders and manage invoices, which is available 24/7. FitSmart offers educational support, including online seminars and fitting tips, and dine and learn sessions in select regions around the country. FitSmart goes Beyond the Fit to educate on critical troubleshooting strategies that go beyond lens fitting mechanics and address the medical management and co-management of ocular conditions that can be treated with scleral lenses.
CooperVision production site receives honors
CooperVision's state-of-the-art manufacturing facility located in Juana Díaz, Puerto Rico, recently received top honors at the 15th annual Puerto Rico Sustainability Best Practices, Health and Safety Summit. The Puerto Rico Manufacturers Association (PRMA) recognized the site with six prestigious awards for its programs and practices relating to its sustainability and occupational health and safety commitments.
The company was given the Platinum Recycling Award, which is presented to an organization that exemplifies best practice standards in alternate energy and sustainability by achieving greater than 90 percent recycling rates. CooperVision also earned Sustainability Gold for the site’s excellence in reducing the environmental footprint and contributing to sustainable development in Puerto Rico.
The company received an award for its combined heat and power plant (CHP) project, focused on leadership in decarbonization. By capturing and reusing excess heat and avoiding distribution losses, the company’s new natural gas-fueled CHP is significantly more efficient than conventional on-site diesel, natural gas, or propane-powered generators. It also requires less fuel to produce the same amount of energy when compared to traditional generation of power. Additionally, the company was also recognized with three other awards; the Waste in Minimization Award; Honorific Mention: LEED Certification; and the President’s Award, given to companies who exemplify excellence in workplace safety.
Ultra Precision Diamond Tools
Menicons global logistics center has started operation
Menicon has established their global logistics center in Yachiyo City, Chiba Prefecture, Japan, as a contact lens distribution center and commenced full-scale operations on May 7, 2024. The company previously operated four logistics centers in Japan, including three domestic centers in Nagoya, Northern Japan, and Western Japan, and one international center in Komaki. In addition to importing foreign products, the newly established global logistics center, integrating the functions of the Northern
GPLI student membership resource opportunity
The GP Lens Institute is developing a resource for student members as well as cornea and contact lens residents which will provide a list of all awards, travel grants, and scholarships they can apply for and the contact information for the provider. The general information about awards, travel grants, and scholarships will be provided in one panel of a forthcoming brochure which will also include panels on "Why you should consider a cornea and
Japan and Komaki centers, delivers contact lenses to clients and customers all over Japan as well as across the world.
Menicon reports that the global logistics enter has the largest capacity in the company to accommodate future increases in the number of product items and inventories and they will realize a reduction in workload and manpower with operational automation and digitalization to develop a new logistics system suitable for their sales strategy. The location of the new logistics center is expected to further improve domestic service levels in the Kanto area and given its access to Tokyo Port and Narita Airport enables efficient import and export of products. The warehouse work is outsourced to Fukuyama Transporting Co., Ltd. by leasing the Chiba Yachiyo branch of Fukuyama Transporting, which was newly established in September 2023.
contact lens externship", "The benefits of a cornea and contact lens residency", and "Why you should consider contact lens specialty practice". The brochure will provide a link to a specific page on the students/residents tab on www.gpli.info where they can access all of the awards, travel grants and scholarships. If a company does provide any of these benefits, the can provide the specific information to Ed Bennett at ebennett@umsl.edu if they want it to be included in this student member resource.
Bausch + Lomb introduced SiHy dailies for astigmatism in the U.S.
Bausch + Lomb Corporation announced the U.S. introduction of Bausch + Lomb Infuse for astigmatism daily disposable contact lenses. Engineered with a lens material infused with ProBalance Technology and the company’s proprietary OpticAlign design, the contact lens for Astigmatism provides astigmatic patients clear, stable vision, all-day
comfort and minimizes contact lens dryness, according to the company.
The contact lens for astigmatism features a blend of osmoprotectants, electrolytes and moisturizers, essential comfort and eye health ingredients that are released throughout the 16-hour wearing experience. The lens material (kalifilcon A) combines high overall moisture (55%) and high breathability (107 Dk/t) with a low modulus for comfort.
Dr Mark Eddleston receives EFCLIN Award
Dr Mark Eddleston, Project Manager in Contamac's R&D team, received the EFCLIN Award at the 50th Annual Congress in April.
Over 2 years, Mark collaborated with EUROMCONTACT and EFCLIN to compile a dossier advocating for the exemption of Gas Permeable (GP) Contact Lenses from the EU's upcoming PFAS ban. Recognising the critical role of PFAS in lens performance, Mark prepared a peer-reviewed paper, conducted a socioeconomic analysis, and compiled 100+ pages of documentation, showcasing the lack of alternatives and low toxicity of PFAS. With the industry's support, his comprehensive work is anticipated to positively impact the EU's decision.
Contamac is proud of Mark’s dedication and expertise, highlighting his invaluable contributions to the sector and his well-deserved accolade.
All about products
Boston® Materials: A Five-Time Favorite in the EyeVote Readers’ Choice Awards
Boston Materials has once again been honored as the favorite gas permeable lens brand by the EyeVote Readers’ Choice Awards, marking an impressive fifth consecutive year of recognition. This accolade reflects the brand's unwavering commitment to quality and innovation in the eye care industry. The Boston suite of GP lens materials enables eye care providers to address a wide range of visual needs with specialized designs. Boston XO® and Boston XO2® are engineered for high oxygen delivery without compromising on lens performance or surface wetting characteristics. These materials are excellent options for spherical and aspherical lenses used to correct myopia, hyperopia, and irregular corneal conditions like keratoconus.
Discover more about Boston Materials and their award-winning products at www.fit-boston.eu
KY Diamond Launches Comprehensive Customer Portal
KY Diamond proudly announces a new customer portal that will be active by Sept 1 2024 It will provide clients with detailed access to their tool history and data on repairs, measurements (height, radius, rake), and customer-specific information. It will also link to purchase orders, order confirmations, work orders, packing slips, and final invoices, streamlining the documentation process.
“This value-added feature addresses our customers' demand for instant, detailed tool information,” said sales engineer Hugh McAllister
The 2nd phase will be launching by Q1 2025. It will add tool inventory, drawings, spec sheets, and test reports. For more information, visit www.kydiamond.ca or contact our customer service team at: sales@kydiamond.ca
Recently, research teams have presented two different new smart contact lenses that could one day help to measure eye pressure for the early detection of glaucoma. Researchers say hydroquinine could be an effective naturally occurring disinfecting solution for contact lenses and help combat keratitis infections. Researchers in Japan have found a way to convert PFAS into harmless compounds. By Rebekka Nurkanovic
Dual-circuit smart contact lens for glaucoma detection
Scientists reported a prototype “smart” contact lens that measures eye pressure accurately, regardless of temperature in ACS Applied Materials & Interfaces.
A slight increase in intraocular pressure (IOP) is usually not noticed by those affected and is only detected by an ophthalmologist. Increased IOP can lead to glaucoma, a group of eye diseases in which the optic nerve is damaged and visual impairment can result.
Researchers have been testing ways to detect tiny fluctuations in pressure continuously and more comfortably, such as contact lenses that transmit signals to receptor glasses. However, changing temperatures can throw off the lenses’ measurements. Dengbao Xiao and coworkers wanted to develop a contact lens
that accurately measures and wirelessly transmits real-time signals about eye pressure across a wide range of temperatures. First, Xiao and the team designed two miniature spiral circuits, each with a unique natural vibration pattern that would change when stretched by minute amounts, such as with changes to an eye’s pressure and diameter. To create pressure-detecting contact lenses, the researchers sandwiched these tiny circuits between layers of polydimethylsiloxane, a typical contact lens material. Then they wirelessly read the embedded circuits’ vibration patterns by holding a coil near the lens that was connected to a computer. The transmitted signals were unaffected by tests meant to mimic eye movement, extended exposure to moisture (to simulate damp conditions in the eye), and daily wear and tear. In laboratory tests, the researchers placed the new lenses on three individual pig eye specimens while controlling the ocular
pressures and temperatures. The contact lenses monitored and wirelessly transmitted pressure data from 50 to 122 degrees F. When pressures were calculated from the signal of only one circuit in the lens, the results deviated up to 87% from the true values. However, when information from both circuits was used, the pressure readings differed by only 7% from the true value because the combination removed temperature-related errors. The researchers say that their dual-circuit “smart” lens design has potential to be used for accurate early detection and monitoring of glaucoma, even in a wide range of temperatures.
DOI 10.1021/acsami.4c02289
Source: American Chemical Society
Smart contact lens for glaucoma detection with electrically passive sensor
Academics from the United Kingdom and Turkey have developed a contact lens which can detect changes in eye pressure which signal possible glaucoma.
The new contact lenses contain micro-sensors which monitor changes in IOP over a period of several hours, sending the data collected
This “smart” contact lens could someday help measure eye pressure and send wireless signals to enable early detection of glaucoma. Image: Adapted from ACS Applied Materials & Interfaces 2024, DOI: 10.1021/acsami.4c02289
wirelessly so it can be analyzed by an ophthalmologist and a diagnosis can be given. The research has been carried out by Professor Hamdi Torun, of Northumbria University; and Professors Günhan Dündar and Arda D. Yalcinkaya, of Boğaziçi University, in Istanbul, and has been published in Contact Lens and Anterior Eye, the official Journal of the British Contact Lens Association. Their paper sets out the findings from their initial pilot study of six participants.
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Having determined that the technology works successfully, they now plan to carry out a further study with a larger group of participants, which will take place over the next year. The lenses will then be made commercially available through their spin-off company GlakoLens.
Previous contact lenses for IOP measurement have used an electrically active silicon chip, which results in a thicker, less
Organic compound could prevent contact lens eye infections
Microbial keratitis is one of the most serious potential complications for contact lens wearers. It’s an infection of the cornea that is caused by bacteria; the most common being Pseudomonas aeruginosa. A new study suggests a naturally-occurring material is an effective disinfectant for contact lenses. Hydroquinine, an organic compound found in the bark of some trees, is known to have bacterial killing activity against Pseudomonas aeruginosa and several other clinically important germs.
comfortable and less flexible lens. The GlakoLens contact lenses use an electrically passive sensor embedded in a disposable soft contact lens, and a wearable electronic readout system to collect, store and process the data – making the lens more comfortable. One of the advantages of using the contact lenses to diagnose glaucoma instead of a conventional examination is that the measurements can be taken more easily over a longer period of time, allowing for a more accurate diagnosis, as intraocular pressure can fluctuate greatly within a day. With the newly developed contact lenses, patients can go about their normal daily routine after insertion of the lenses, while their IOP measurements are recorded and sent to a doctor for analysis at the end of the 24-hour test phase.
In addition to intraocular pressure, the lenses can also measure various molecules present in the eye and Professor Torun sees great potential in the technology for the early diagnosis of glaucoma and other diseases.
DOI 10.1016/j.clae.2023.102102
Source: Northumbria University
The team behind the discovery, from the University of Portsmouth in England and Naresuan and Pibulsongkram Rajabhat universities in Thailand, has now explored the potential use of multipurpose formulas containing hydroquinine as a disinfectant for contact lenses.
They examined the antibacterial, anti-adhesion, and anti-biofilm properties of hydroquinine-formulated multi-purpose solutions (MPSs), and then compared it to two commercial MPSs; Opti-free Replenish and Q-eye. The natural compound killed 99.9 per cent of bacteria at the time of disinfection. The paper, published in Antibiotics, says these findings may aid in the development of novel disinfectants aimed at combating the P. aeruginosa bacteria.
Lead author, Sattaporn Weawsiangsang from the Faculty of Allied Health Sciences at Naresuan University, is currently a visiting researcher at the University of Portsmouth. She said: “Our initial findings suggest that soaking contact lenses in a multi-purpose solution containing hydroquinine is possibly helpful to prevent contamination and infection. “However, further investigation is needed to determine whether hydroquinine itself also has adverse reactions or toxicity. “We are continuing to test the compound on a number of cells, and so far, the results are really promising. This potential development could contribute to the creation of new disinfectants from natural products, effectively combating P. aeruginosa infections and reducing cases of corneal infections.”
The paper concludes by recommending further research examining the effectiveness of hydroquinine with several different contact lens materials, and against other pathogenic microorganisms.
DOI 10.3390/antibiotics13010056
Source: University of Portsmouth
Professor Hamdi Torun pictured with the contact lens. Picture: Simon Veit-Wilson/Northumbria University.
The structural characterization of P. aeruginosa ATCC 27853 as a representative strain in different tested solutions: (A) PBS, (B) 100% MPS A, (C) hydroquinine (HQ) 2.50 mg/mL, and (D) HQ 2.50 mg/mL with 100% MPS A. The images are presented at a magnification of 10,000× using the FE-SEM. Picture: University of Portsmouth
New method uses light to clean up forever chemicals
Commonly known as “forever chemicals,” PFAS are notorious for persisting in the environment and in our bodies. Researchers at Ritsumeikan University, Japan, have proposed a roomtemperature defluorination method for the treatment of PFAS. Their study, published in the journal Angewandte Chemie International Edition in June, details a photocatalytic method that uses visible light to break down PFAS and other fluorinated polymers (FPs) at room temperature into fluorine ions. Using this method, the researchers achieved 100% defluorination of perfluorooctanesulfonate (PFOS) within eight hours of light exposure. Professor Yoichi Kobayashi, the lead author of the study, says that the proposed methodology is promising for the effective decomposition of diverse perfluoroalkyl substances under gentle conditions.
The proposed method involves irradiating visible LED light onto cadmium sulfide (CdS) nanocrystals and copper-doped CdS (Cu-CdS) nanocrystals with surface ligands of mercaptopropionic acid (MPA) in a solution containing PFAS, FPs, and triethanolamine (TEOA). The researchers found that irradiating these semiconductor nanocrystals generates electrons with a high
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reduction potential that break down the strong carbon-fluorine bonds in PFAS molecules. Prof. Kobayashi expressed his conviction that the technique will contribute to the development of recycling technologies for fluorine elements, which are used in various industries. An illustrated summary of the process can be read on the webpage of Ritsumeikan University.
DOI: 10.1002/anie.202408687
Source: Ritsumeikan University
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The sophisticated design features all the key aspects to generate high form accuracy and superb polish-free results – a rigid base, fluidic bearings, smooth running motors, and high performance motion controllers. The onboard Fast Tool carries four tools and offers the ideal conditions for freeform lens generation.
The UPC Evo meets that sweet spot where high-quality and performance is complimented by a compact design and an economic price.
Europe's ophthalmic optics united
Meetings of ECOO and EAOO in Helsinki
This year's annual EAOO congress took place from May 10 to 12, 2024 in Helsinki – capital of the happiest country in the world, as the invitation stated. The spring meeting of the European Council of Optometry and Optics (ECOO) took place at the same time as the academy event. Both are fundamentally united in their efforts to achieve greater recognition of optometry and ophthalmology throughout Europe. By Daniel Groß
Finland is well worth a visit. The country in the far north was recently named either the happiest, most livable or healthiest country in the world. It was even named the happiest country in the world for the seventh time in a row in 2024 by the UN World Happiness Report.
Anyone who wanted to see for themselves at the beginning of May was also lucky enough to attend the two parallel conferences of the European optician’s/optometrists’ associations ECOO and EAOO. Membership required, of course.
The impressive location of the Scandic Marina Congress Center, situated directly by the sea and in the immediate vicinity of Helsinki's market square and city center, provided the perfect setting.
TWO NEW MEMBERS
At the ECOO general assembly on May 11 members voted unanimously to accept the Fédération Nationale des Opticiens
de France (FNOF) as a member of ECOO. In his address to the ECOO members, the president of the FNOF, Hugues VerdierDavioud, gave some background information on the French association and its members. He emphasized his conviction that optometrists are health professionals serving the public and that the FNOF is striving for better recognition of their professional skills in France, particularly through the implementation of the Bologna agreements. He looked forward to working with his colleagues in the ECOO to achieve greater recognition of optometry throughout Europe.
The members also voted unanimously in favor of the return of the Panhellenic Union of Opticians and Optometrists (PEOO) to ECOO membership. ECOO now has 25 European countries represented by 46 member associations.
During the general assembly, Dr. Sandra Block, President of the World Council of Optometry (WCO), gave a presentation to
the members. Block highlighted three important initiatives. First, she encouraged members to consider participating in the WCO's optometry course in advocacy and leadership (Opal). She also summarized the recently published competency framework for optometry and provided some insights into the global state of optometry survey, which is due to be published in the coming months.
There was also a presentation by Sarah Bartz from the German Nuremberg-based market research institute GfK. In a market update, Bartz explained that the ophthalmic optics market is showing signs of recovery after the pandemic but has not yet returned to pre-pandemic levels. She also explained the impact of changing consumer trends and future trends. She gave members advance notice of a survey of opticians that GfK planned to conduct in collaboration with ECOO in summer 2024. The aim of the survey is to gain a better understanding of developments in ophthalmology across Europe.
PRESENTATIONS, WORKSHOPS, DISCUSSIONS
In addition to the formal business of the general assembly, ECOO members were also treated to a packed program of presentations, workshops and discussions covering a wide range of topics. In particular, the future role of technology and artificial intelligence (AI) in healthcare was addressed in a presentation by Dr. Ishita Barua. In a lively workshop by Dr. Daniel Hardiman-McCartney and Ian Humphries from the UK College of Optometrists, members had the opportunity to
delve deeper into the various technologies that could be used in clinical and business practice, as well as the advantages and disadvantages of these technologies. Clinical sessions covered how to deliver eye care to patients at home, dispensing to children, managing delegated tasks and the need for new guidelines on the content of an eye examination.
In the final panel discussion, Fabienne Eckert and Ann Blackmore from the ECOO Secretariat discussed how associations could try to inform or influence policy and politicians at national and European level in the run-up to and after the elections. They highlighted ways in which the ECOO manifesto published earlier this year could be used by members.
About ECOO: The European Council of Optometry and Optics (ECOO) was founded in 1992 through a merger of the Groupement des Opticiens du Marché Commun (GOMAC) and the Pan European Group (PEG). The association represents the interests of optometrists and opticians throughout Europe. Its members are national professional associations from 25 countries, which together represent more than 150,000 opticians and optometrists. The aim of ECOO is to promote eye health to the public across borders and to harmonize the clinical and educational standards of optometric and optical practice throughout Europe.
SEE YOU AGAIN – MID OCTOBER IN HAMBURG
The ECOO autumn conference will take place in Hamburg, Germany, from October 11 to 13, 2024 and will be organized by the three German ECOO members, the central association of opticians and optometrists (Zentralverband der Augenoptiker und Optometristen ZVA), the association of German contact lens specialists and optometrists (Vereinigung Deutscher ContactlinsenSpezialisten und Optometristen VDCO) and the scientific association for optometry and ophthalmic optics (Wissenschaftliche Vereinigung für Augenoptik und Optometrie WVAO).
15TH EAOO ANNUAL CONFERENCE
The conference of the European Academy of Optometry and Optics (EAOO) celebrated its 15th anniversary at the beginning
About EAOO : The European Academy of Optometry and Optics (EAOO) is dedicated to providing a voice for the advancement of optometry and ophthalmic optics, the development of the scientific knowledge base and the support and promotion of lifelong learning for optometrists, opticians, vision scientists and all those involved in ophthalmology throughout Europe. The main strategic objectives of the member organization are to develop the scientific knowledge of optometry and ophthalmic optics, to support education and research, and to promote the science and practice of optometry and ophthalmic optics for the benefit of the public. The academy was founded in 2009 on the occasion of the ECOO spring meeting in Lausanne, Switzerland.
of May. It was jointly organized by the EAOO and the Finnish Association for Vision and Ophthalmology NÄE ry. This year's edition, themed "advancing optometry and optics through technology and shared care", offered a wide range of content, including five workshops, 36 hours of educational presentations and 22 posters on display.
The conference was attended by 472 people from 37 different countries, with a further 40 people taking the opportunity to follow the event's presentations remotely via a digital event platform.
CONTENT AND NETWORKING
The lecture program included keynote speeches by Dr. Sandra Block (WCO) and Prof. Dr. Leonard Witkamp. WCO president Block discussed the role of optometrists in the prevention of vision problems in her presentation "Ensuring we as primary eyecare providers are part of the action to address preventable visual impairment: WCO’s role!".
Dr. Leonard Witkamp (professor of telemedicine, Amsterdam) explored the future of ophthalmology in his presentation "The hospital in 2030, is it in your eye care practice? - The digital care pathway and the role of ophthalmology practices, optometrists and ophthalmologists".
In addition to the presentations, the conference offered attendees a valuable opportunity to network with industry professionals, visit the exhibition, exchange ideas and gain new insights through workshops, discussions and networking events.
LOVELL-PATEL SUCCEEDS STANKOVA
Marking her appointment as the new president, Rupal LovellPatel thanked Liliana Stankova, who previously held the position,
Hugues Verdier-Davioud, president of the FNOF (center) with ECOO president Matjaž Mihelčič and president-elect Gabriëlle Janssen. Picture: ECOO
The ECOO dinner was organized by the Finnish Association of Vision and Eye Care. Picture: ECOO
for her hard work and commitment to ensuring that the academy supports and develops the professions of optometry and ophthalmic optics.
"It was a great pleasure to finally go to Helsinki and experience an EAOO annual conference," Lovell-Patel told GlobalCONTACT. "The joint conference was supposed to take place in 2020, but due to the pandemic, it was held as a virtual conference in 2021. This made our 15th conference very special as we finally had the opportunity to enjoy the
hospitality of our Finnish colleagues from the Association of Vision and Eyecare. The program was filled with a variety of content. Excellent networking opportunities with colleagues from all over the world and with partners from the industry. It was a great pleasure to start my presidency during this great conference."
The next EAOO conference will be in 2025 in Ljubljana, Slovenia, May 16 to 18. n
The conference of the European Academy of Optometry and Optics took place for the 15th time. Pictures: EAOO
Rupal Lovell-Patel is the new President of the Academy.
Picture: EAOO
50th EFCLIN Congress
European Association of Contact Lens Manufacturers met in Vilamoura
The EFCLIN Congress & Exhibition, from April 25-37, 2024, took place this year in Vilamoura, Portugal. The lovely resort town in Portugal's famous Algarve region attracted 335 visitors from 41 countries, who came to learn about products from participating exhibitors. This was flanked by a high-class conference, which offered interesting lectures and workshops for both the contact lens and IOL industry. By Silke Sage
This edition of the EFCLIN Congress & Exhibition marked a special anniversary: representatives of the contact lens industry and interested parties met for the 50th time. Due to the years affected by the corona epidemic, the anniversary of the congress did not coincide with the anniversary of the association, which had already taken place in Sitges, Spain in 2022. Visitors to the congress had the opportunity to attend various lectures as well as workshops, complemented by poster sessions and technical presentations and the annual general meeting of the federation. At the exhibition, participants were able to view or see demonstrations of tools, the latest machines and instruments, as well as software, accessories and consumables.
With 335 participants from 41 countries, the congress once again underlined its relevance and internationality for the contact lens and IOL industry. Most participants came from the United Kingdom (68), followed by the USA (43), Germany (34), Italy (26) and the Netherlands (21). The other participants came from almost every region of the world.
PFAS THREAT AND AN AWARD FOR DR. MARK EDDLESTON
The role of per- and polyfluoroalkyl substances (PFAS) and their ban or derogation continues to preoccupy the industry. LaureAnne Copel from Euromcontact provided the latest information on this topic in her presentation.
Photos: Silke Sage
EFCLIN President Armin Duddek
Armin Duddek, Ken Payne and Dr. Johannes Pfund
The Board at the beginning of the Annual General Meeting
Congress dinner in Vilamoura
In this context, Dr. Mark Eddleston from Contamac has done outstanding work in recent years and this was recognized accordingly at the end of the congress. He received the EFCLIN Award in the presence of the guests attending. The laudatory speech was given by Alan Bennett. In his speech, he emphasized that he was not just looking at faces of industry members. Above all, he sees friends and family. And everyone has to deal with challenges, be they political, financial or regulatory. A threat like the one currently hovering over the industry is causing sleepless nights for many, he said. And he added: “This is a significant threat to the entire branch. So many people have shown outstanding efforts here, from the material manufacturers, the association and Euromcontact. It shows how important the issue is. Dr. Mark Eddleston stands out as a person who has never tired of delving into the matter and looking for solutions and alternatives where there seem to be none. He has spent many hours, days, weeks and months on this subject and has made an outstanding contribution from which the entire industry benefits."
LAUREATE AWARD FOR ANDY CHRYSSOLOR
This year, Andy Chryssolor received an additional award for his services to the contact lens and IOL industry and his life's work. This award is not given lightly. The previous recipients were David Walker in 1998, Wim Aalbers in 2011, Marcel Kopito in 2015, John McGregor in 2017 and John Smith-Ruddick in 2019, the latter of whom also gave the laudatory speech as a close companion of Andy Chryssolor. As one of the founding members of the association, Andy quickly earned the nickname Mr. EFCLIN and is said not to have missed a single congress. Some of his stations took him from Allergan to B+L, Nissel to Contour. During his time at Nissel, he proved to be very dedicated, and this is certainly the time when he made the biggest and most lasting impression on the majority of the guests present. In the last issue of GlobalCONTACT Andy gave us an insight into this time.
After this highlight of the event, we look ahead to the coming year. Mark your Calendar: From April 10 - 12, the EFCLIN Congress will travel north and take place in Lillestrom / Oslo, Norway.
Andy Chryssolor receives the 6th EFCLIN Laureate Award
Dr. Mark Eddleston receives the EFCLIN Award 2024
Dr. Roland Fromme and Dr. Mark Eddleston (left)
Speed date: Meet the new board members of
There were a number of changes to the EFCLIN board this year. Johannes Pfund from Optocraft (Germany) had been a member since 2017 and could not be re-elected after seven years of service. However, two new members were welcomed: Philipp Polonyi (Falco Linsen AG) and Peter van der Linden (Menicon, B.V.). Meet the new board members.
GlobalCONTACT: What is your professional background and which of your skills are of particular value to EFCLIN?
Philipp Polonyi: I had the privilege of serving on various boards throughout my career in this industry, where I gained valuable experience in governance and strategic decision-making within multidisciplinary and multinational teams. Holding an MBA from Warwick Business School provided me with a comprehensive skill set that complements my professional experiences. Additionally, I have been fortunate to gain experience across different parts of the value chain, both as a supplier to contact lens and intraocular lens manufacturers and as a finished device manufacturer. While it is ultimately for others to determine which of my skills are most valuable to EFCLIN, I believe my expertise in long-term strategic planning and my global market perspective will be beneficial. Above all, I am eager to collaborate with my fellow board members and leverage our diverse skill sets to achieve our collective goals.
Peter van der Linden : I have a master’s degree in computer science from the days when personal computers started to find their way to people’s homes. I had software engineering and system engineering roles in wireless communication industry before I grew into management roles. I worked abroad in several of these roles and also internationally with colleagues from competitors to achieve a common goal. Seven years ago, I joined Menicon and the medical devices industry. I think that the
EFCLIN
international experience combined with industry-wide activities can be beneficial to the EFCLIN community.
GlobalCONTACT: What are your goals and plans for your upcoming time as a board member?
Peter van der Linden: I will first have to learn what it means to be a board member. I know I am expected to contribute but I learn by listening and asking questions. Providing ideas for next year’s congress will be a short-term goal for me.
Philipp Polonyi: My primary goal as a board member is to serve and support our members and industry effectively. While this may seem obvious, it is crucial to consider this responsibility in the context of the diverse landscape of our membership, which includes companies of varying sizes, ownership structures, positions in the value chain, and nationalities.
As board members, it is our duty to identify and address the common denominators that unite companies across this spectrum. It is key to represent these shared interests while also looking ahead to anticipate future challenges and opportunities. By doing so, we can ensure that our actions and decisions benefit the entire industry, fostering growth and resilience.
GlobalCONTACT: What excites you about serving as a board member?
Philipp Polonyi : Whether it is through contact lenses or intraocular lenses, or the advanced equipment, metrology, software and materials (etc.) our members provide, our industry continually enhances the quality of life for countless individuals. This motivates me deeply and I see my role as an EFCLIN board member as an opportunity to contribute further to this.
Peter van der Linden: Being part of an international team of people with a common goal. Learning more about our industry and its needs and then working on moving it forward.
Philipp Polonyi
Peter van d er Linden
GlobalCONTACT: What have you achieved so far (for EFCLIN)?
Peter van der Linden : After the congress in Vilamoura we started to evaluate the event and plan for the next one during an online meeting. I cannot say there was already an achievement on my behalf.
Philipp Polonyi : It may be premature to discuss specific achievements at this stage, particularly since any accomplishments within the EFCLIN board are inherently collective. Nevertheless, I aim to contribute a perspective based on my extensive experience across various segments of the industry and the value chain. Throughout my career, I gained insights from both supplier and device manufacturer roles, encompassing businesses of varying sizes. This diversity has equipped me to understand the diverse pressures and interests that EFCLIN members may experience.
GlobalCONTACT: What does the industry need most right now?
Peter van der Linden: Move forward beyond MDR registration. Start to work with the new regulation with our legacy products and introduce new products within this new reality.
Philipp Polonyi: There is no denying that our industry faces new challenges in sustaining innovation under today's regulatory framework. However, I believe that innovation can and must thrive, albeit through a different prism. Collaboration emerges as a pivotal strategy in this regard. By embracing collaboration as a cornerstone of their innovation strategy, companies may be able to drive advancements that benefit patients and practitioners alike. The EFCLIN community, particularly through its annual congress, stands poised as a pivotal platform for fostering such collaborations.
GlobalCONTACT: What are the biggest challenges in our industry right now?
Peter van der Linden: Next to the previous topic this would be to make sure products remain available to the end users. Even when MDR approval and discussion on PFAS may make the near future uncertain for the industry.
Philipp Polonyi: Regulatory changes have significantly reshaped the landscape, requiring considerable adaptation from manufacturers. However, I do not want to solely focus on MDR matters, as it is clear that these changes are here to stay, and our industry must find ways to move forward. This is, in my
opinion, the biggest challenge we face – adapting and progressing. However, I am confident that, collectively, we will find ways to address the new hurdles, particularly concerning innovation.
GlobalCONTACT: How can EFCLIN continue to increase its number of members?
Philipp Polonyi: It would be presumptuous of me to claim that I have all the answers at this stage of my joining of the board. However, in my initial months with EFCLIN, I observed a strong commitment by the board to understanding how best to serve our members and to proactively anticipate future challenges and opportunities. This approach aims to empower current members and create an attractive environment for potential new ones. Drawing from my experience in previous roles and now with Falco Linsen AG, I have seen firsthand the value that EFCLIN brings through the EFCLIN congress. It provides a vital space for industry professionals to engage, forge strategic partnerships, and stay abreast of developments. By continually enhancing these networking opportunities and ensuring they address evolving member needs, EFCLIN not only strengthens its existing community but also fosters an environment that encourages new members to join.
Peter van der Linden : We already have members outside of Europe, but this amount can grow. Europe deserves our continued attention but like the CE mark is also accepted outside of Europe, EFCLIN can be of interest to companies and associations from other continents.
GlobalCONTACT: What would you like to say to the members of EFCLIN?
Philipp Polonyi : I am delighted to have joined the board and greatly appreciate the trust placed in Peter and me by the members during the last AGM in Vilamoura. I look forward to collaborate now with my fellow board members and to collectively make a positive contribution to our industry!
Peter van der Linden: Thank you for your confidence in having me on the board of your association. Looking forward to meeting you at EFCLIN 51 in Lilleström / Oslo, Norway.
GlobalCONTACT: Thank you very much for the interview.
The new elected EFCLIN Board with Dr. Johannes Pfund leaving
Irreplaceable? PFAS in contact lenses
An interview with Roland Fromme from Wöhlk Contactlinsen
The potential PFAS ban within the EU also affects the ophthalmic optics industry and the contact lens industry in particular. After all, rigid gas permeable (RGP) and, in some cases, soft contact lenses are given their very special and important material properties thanks to PFAS. But are PFAS in contact lenses potentially dangerous at all? What would be the consequences of a ban? And can RGPs theoretically be produced without PFAS? Expert Roland Fromme answered these and other questions for GlobalCONTACT in the following interview. By Hanna Diewald
Since 2023, an ECHA draft has been in place that proposes a comprehensive ban on all PFAS compounds in the EU in the form of a restriction procedure under REACH. As part of the European Green Deal, the objective is to significantly enhance protection for people and the environment by restricting or banning substances that are persistent and harmful to health. According to contact lens expert Fromme, this scenario also threatens essential fields of application and high-tech products. It should be noted that the potential ban could apply across all sectors and to all PFAS structures with and without evidence of their specific effects on health. According to Fromme, the envisaged transitional periods of 1.5 to 13.5 years, depending on the availability of alternatives, do not provide sufficient reassurance.
Roland Fromme is the head of the chemical department at the manufacturer Wöhlk Contactlinsen. The expert has more than 30 years of experience with polymers for contact lenses. He is involved in the synthesis and formulation of all types of transparent polymers using various manufacturing processes.
To your knowledge, which ophthalmic optical aids contain PFAS? To put it briefly: almost all of them. And this doesn't just concern ophthalmic optics1. If you are thinking of a durable, stable, universally applicable plastic material with good adhesive and sliding properties in a medical context, you will most likely also find PFAS2 in the formulation.
Of course and rightly so, the ‘eternal chemicals’ have also been reported and discussed in optometry and optician networks for some time, as RGP and silicone hydrogel contact lenses in most cases contain a PFAS component. The widespread use in high-tech products and production processes can be explained in particular by the often hydrophobic material properties in combination with the desired durability. This also applies to optical coating applications and various special polymers for contact lenses. Incidentally, these product groups together account for a market share of at least 75%3. Accordingly, up to three out of four current contact lens wearers would be directly affected by a ban. People who wear spectacles also use PFAS, e.g. through the use of anti-fogging agents 4 .
Photos: Silke Sage
However, it is not only the ophthalmic industry that would be affected by a blanket ban on PFAS. Many other areas of medical technology can hardly do without the use of PFAS. The industry association SPECTARIS in Germany, for example, got involved in the discussion at an early stage, as large areas of analytical, biotechnology and laboratory technology, photonics, as well as sterilization and utility technology, also use PFAS in various devices, some of which are essential to life.
Why are PFAS used in contact lens materials?
The PFAS components contained in traditional and modern contact lens copolymers are not mass-produced products that have various other fields of application. These are special chemical compounds, so-called fluoro methacrylates, which as formulation components make an important contribution to almost all desired product properties. This contribution is required for almost all dimensionally stable polymers and has been used successfully for several decades. This type of PFAS therefore plays an important role in the clinical success of these many (individual) product variants. They are therefore used worldwide and regardless of the manufacturer.
The primary use in RGPs is:
percentage range. This is quite low and will most likely be lower than for some other material manufacturers, especially in the case of highly gas-permeable products. In retrospect, there was no ‘advance warning’ that such a radical ban on PFAS might one day come about in the 20s, so that no developer had worked towards formulating the lowest possible material percentage. However, even the products with high gas permeabilities have certainly only been formulated partially with PFAS methacrylates. There are several chemical reasons for this to ultimately achieve the required overall properties of the polymers. Substituting a relatively high proportion of material, however, places considerably higher demands on the developers.
Is there any ‘danger’ to contact lens wearers from PFAS in contact lenses?
As we all know, the current MDR has imposed very stringent requirements on the European regulation of medical devices, which means that very strict quality tests and very detailed analyses have become the current standard for product approval.
These very thorough biological and clinical assessments significantly complicate and slow down product developments, but in this context also provide even more assessment options for the uncertainties that have arisen in the course of the discussions.
• for material gas permeability (Dk), even without a water content
• for biocompatibility / for anti-adhesive properties (deposits)
• for good copolymer stability and resistance (easy cleaning).
Some manufacturers also use PFAS compounds in their hydrophilic silicone hydrogel materials. These PFAS compounds are only partially chemically identical to the substances in the rigid gas permeable contact lenses. In most cases, highermolecular methacrylates with both hydrophilic and hydrophobic properties are used. These complex siloxane-fluorine components were explicitly developed for highly gas-permeable and welltolerated optical polymers and have also been used successfully for many years. In the case of silicone hydrogels, unlike the rigid ones, there are also some products without PFAS components.
Can you give a rough estimate of the percentage of PFAS in RGP contact lens materials?
In order to best categorize and assess the risks for manufacturers and users of PFAS substances, the polymer or formulation content of the PFAS raw material was also a criterion in the official consultations. Information on this is, of course, strictly confidential, and therefore impossible for me to answer with certainty. For the products from our own production, however, we can say that the PFAS content is predominantly in the single-digit
We do not evaluate PFAS in general, but specifically the few ‘niche substances’ mentioned above. These partially fluorinated methacrylates react chemically through polymerization to form a high-molecular cross-linked copolymer. This contact lens polymer usually has around 4 to 6 other (non-PFAS) components, all of which have chemically bonded and crosslinked with each other.
The result is a very durable material that can be stored for many years and is also geometrically stable and well tolerated for a very long time when used as a contact lens. The materials are analyzed by certified laboratories for the smallest trace amounts (µg amounts). Lenses are treated and extracted under ‘natural’ and also very stressful conditions. These tests prove the very good integration of the PFAS components in the polymer, among other things, which prevents leakage into the patient's eye. The good biocompatibility in vivo has also been proven beyond doubt in daily clinical practice for decades.
How safe is the contact lens manufacturing process, can PFAS be released into the environment?
As is known, the manufacturing process consists of many sub-processes to obtain the individually manufactured medical device. In the risk assessment, a distinction should be made between polymer synthesis and polymer processing into contact
Roland F romme
lenses. As material manufacturers, the employees work with the chemical raw materials (monomers), which generally results in high occupational safety requirements. Like all other monomers, the PFAS monomers are processed (polymerized) in closed systems. No PFAS will escape in these synthesis processes and small monomer residues are always collected and disposed of as hazardous waste.
Multi-stage processing into lenses is carried out using multi-stage cutting and lathing processes, including surface polishing. The polymer swarf is extracted directly and completely at the machine and collected in a sealed container. This polymer waste cannot be recycled and is sent to filtered waste incineration. In general, lathed lenses generate very small quantities of waste in the low kilogram range. The environmental impact of manufacturing these individual lenses is therefore minimal.
It should be emphasized that RGP lenses are a very sustainable option. Due to their long shelf life, they can be used for at least twelve months. With a net weight of approx. 25 mg, a single contact lens wearer consumes only approx. 3 g of plastic in their entire lifetime. By comparison, every German citizen generated an average of around 41 kilograms of plastic packaging waste in 20215. In other words, more than 13,000 times as much. And that's per year. In principle, it is of course still important not to simply “flush away” even small plastics due to their chemical stability. The material structure is durable and does not biodegrade. It is particularly important in the case of the larger consumption figures in the area of 1-day lenses made of silicone hydrogel with PFAS to consciously communicate the closed and controlled production process from the raw materials to the user and to avoid “ill-considered” disposal. This is irrespective of whether PFAS monomers used in this way pose a high health risk at all compared to PFAS compounds, which are known for their risk to humans and the environment and are therefore at the heart of the motivation for a ban.
Is it currently possible to manufacture soft CL and RGPs without PFAS?
In some cases, this can be very clearly denied for the RGP products. The aforementioned material percentage is included for good reason and the many polymers concerned each received their approval as
THESE TESTS PROVE THE VERY GOOD INTEGRATION OF THE PFAS COMPONENTS IN THE POLYMER, AMONG OTHER THINGS, WHICH PREVENTS LEAKAGE INTO THE PATIENT'S EYE.
an optimally formulated component mixture. A reduction or replacement of a material component cancels the existing approval and requires a new approval with all clinical data, evaluations and proof of durability. First, material research is needed to compensate for the PFAS content as a new challenge. However, this process takes many years and is expensive, which could lead to a supply gap in the medium and long term. It is also not yet clear whether the same mechanical properties, high degree of biocompatibility, durability and compatibility can be achieved with “other” components. Current lens care practices also need to be re-evaluated and even storage and shelf life are potentially limited.
Soft contact lenses without PFAS (conventional hydrogels) are not affected by this and are still available, but a significant proportion of current silicone hydrogel materials is also under threat and would have to be fundamentally revised in the research and development departments. Here too, it is only possible to predict to a limited extent whether the same material properties can be achieved with alternative materials.
In your opinion, would it be possible to manufacture contact lenses without PFAS in the future?
At Wöhlk, we have been working intensively on this issue for two years. In my chemical R&D team, we started to investigate on a laboratory scale which properties we could achieve or maintain without our (low) PFAS content.
To find new formulations, we started by compensating without adding "new" methacrylates, i.e. just by changing the weight proportions. The gas permeability decreases significantly, but above all we also lose the mechanical strength for processability and the (external) rod quality from which the contact lenses are made.
It became clear that changed polymerization conditions would be required, meaning that we would have to develop new chemical processes and also new, adapted manufacturing processes. Although we have been developing contact lens polymers in all areas of materials for more than 40 years, which has enabled us to avoid many “wrong turns”, we still recognize many parallel new requirements here. In the meantime, we have also started researching new gas-permeable substances and developing new cross-links.
In addition to the already ongoing activities in materials research, this work will now take a long time in order to ultimately arrive at polymers that come close to the current quality level so that they can continue to be well tolerated and effective for the user for a long time.
In this context, what do you think of the much-discussed transition periods?
A great deal of research is now being carried out into alternatives without PFAS components, but only isolated cautious successes can be reported. Against this backdrop, the transition periods are highly questionable and may lead to further setbacks in healthcare, especially as supply chains are also threatened by prolonged uncertainty. As with the introduction of the MDR (Regulation (EU) 2017 on medical devices), it is to be feared that people with special and therefore rare needs in particular will have to expect gaps in care or even restrictions.
When can a decision be expected on whether there will be a transitional period for PFAS in medical devices?
After the end of the consultation phase in September 2023, in which around 5,600 comments were submitted by authorities, associations, companies and private individuals, it has so far been announced that this volume will postpone the original time frame and that there will be gradual announcements sorted by sector in 2024/25.
The scientific committees for risk assessment and socioeconomic impact decide on the information submitted. There will be no decisions on contact lenses and other medical devices in 2024. If a restriction were to be adopted, there would be at least 18 months until it comes into force. This would realistically be at the end of the 2020s at the earliest.
What scenario would you like to see for the future – regarding consumers and the contact lens industry?
The fluoropolymers used in the vast majority of rigid contact lenses worldwide have been clinically tested very successfully and have been proven biologically very safe as a polymer. It would be rash to lose this type of product for originally quite different and also quite understandable reasons in the use of contact lenses, among other things, and hopefully this will be understood and evaluated in a differentiated manner.
In many cases, eye health and visual performance cannot otherwise be achieved in the same quality and therefore the everyday quality of life of these users cannot be maintained.
We advocate a return to a risk-based approach in line with the existing REACH regulation. The current proposal goes beyond reasonable measures and leads to legal uncertainties. The distinction between fluoropolymers and other PFAS compounds is one solution.
Fluoropolymers have proven their long-term safety in medical applications. Persistence of a substance alone is not a risk6
We are therefore hoping for at least a very long-term transition period if a time limit is unavoidable.
Thank you for the interview. n
References
1 A n Overview of Current Uses of PFAS; https://doi.org/10.1039/d0em00291g
2 Per- u nd p olyfluorierte C hemikalien ( PFAS)“, I nternetseite de s B MUV: „ https://www. bmuv.de/ FQ148“ (Abgerufen am 23.06.2023)
3 CONTACT L ENSES 2017 - C ontinuing upward t rends in d aily disposable p rescribing and other key segments maintained a healthy industry
4 Press release of the NRW consumer advice center- 2020
6 Spectaris e .V.: S tandpunkte P aper z u d en vorgeschlagenen P FAS-Beschränkungen in Europa, Berlin, 03. April 2024 (Transl.: Position paper on the proposed PFAS restrictions in Europe)
Blocking Without Compromise
When planning a new manufacturing facility or optimizing anexistingoperation,it’seasytofocusonthelatheandneglect theroleplayedbysupportprocessessuchasmaterialhandling. While the lathe is arguably the single most important piece of equipmentinacontactlensorIOLmanufacturinglaboratory, its precision can be easily undermined by underperforming equipment elsewhere in the process, most notably blocking. Today’s CNC lathes and lens design software combine to offer unprecedentedoptionsformeetingtheneedsofpatientsthrough precise control of lens geometry and sub-micron level surface accuracy,yetthiscanbeeasilyundonebymisalignedsurfaces or unintended prism.
“Ifbackandfront[surfaces]arenotperfectlyaligned,youcan get decentered optics, prism and poorly formed edges.”, says Manoel Carvalho, Director of Lab Operations and fitting consultant for BostonSight in Needham, Massachusetts. “All lensesneedtohaveperfectoptics.However,whendealingwith multifocalorHOAcorrection,thatbecomesevenmorecritical.”
DACInternationalhasaddressedtheseconcernsbyre-imaging the blocker from the ground up. The DAC Precision Blocker is a ‘no-compromise’ solution for RGP, Soft and IOL blocking that was developed to maximize the full potential of the DAC lathe’s edge contouring capability and form accuracy. Back or front surfaces are blocked with a high degree of accuracy and repeatability, and a minimum of time and operator attention.
The DAC Precision Blocker offers fast, reliable calibration, easy and intuitive initial setup, and stable, accurate and repeatable blocking. Additionally, the rigid, ½” steel construction and a designthatmanagesambientheatinthemachineframemeans that the DAC blocker holds calibration reliably over time, without the need to re-calibrate during the workday.
Ablockerthatholdscalibrationyieldsbetterlenses,butitalso saves time and money. Greg Wicker, Maintenance Manager for X-Cel Specialty Contacts in Duluth, Georgia, has worked out the numbers: “Based on the average maintenance tech spending about 15 minutes setting a traditional blocker twice aday,[that’s]30minutesadaytimes255workingdaysperyear -7,650minutestotal,or127.5hoursperyear”. Gregcontinues “Althoughmoreexpensivethantraditionalblockers,Ifeelthat itpaysforitselfwiththereductionofprismrelatedrejectsand downtime for setting blockers.”
Whileaccuracyandreliabilityareimportant,anidealblocker also needs the versatility to handle the wide range of specialty productsmanufacturedbyamodernlaboratory. Safe,consistent
Pedro Araujo of BostonSight working with the DAC Precision Blocker
wa x dosing, interchangeable waxpots and a fully programmable interface ensure that the DAC Precision Blocker has the flexibility to cover the full gamut of RGP, soft and IOL lenses currently in production.
Drop size is fully adjustable from zero to 2.5ml, and multiple drops can be programmed. Wax pots are hot-swappable with no down-time required to rapidly switch between waxes for different applications. Additionally, an on-board timer for wax pot warm-up lets lab managers start their morning without any waiting time; different start times may be set for each workday.
Finally, the DAC Precision Blocker is fully programable, with an LCD touch screen providing an intuitive interface that allows the user to optimize blocking variables to suit individual process needs. Key parameters such as drop count, temperature, and air-cooling controls can be accessed, configured and saved to any of six independently configurable blocking tables.
Treating blocking like the mission critical process that it is means looking seriously at the needs of a rapidly evolving industry and providing a robust and flexible solution that takes no shortcuts in design, materials or construction. To DAC International, this is the meaning of blocking without compromise. n
Time, errors, productivity and profit
Decisions, decisions!
In my time in the industry, some general themes are prominent. One that comes to mind is the number and frequency of decisions that a lab technician/machine operator needs to make from order entry to packaged lens. Yes, really. It matters because more decisions introduce errors and wasted time and materials. Less time and fewer decisions in the manufacturing process = more usable lenses per technician/day = more profit. By Erik Larsen
Over the decades, the evolution of processes and machines has reduced the number and frequency of decisions technicians need to make, but there is still room for improvement. More on this later.
DECISIONS HAVE ONE OF THREE OUTCOMES: CORRECT, INCORRECT, OR
INDECISION
(CONFUSION).
Decisions have one of three outcomes: correct, incorrect, or indecision (confusion). The likely-hood of making the incorrect decision or confusion can be due to systematics, distraction, or in-adequate training. Each task requires a decision. For example: at the beginning of the process, the lab tech has the work order specifying the lens material. Typically, he/she takes a job tray to the material inventory, pulls the two lens blanks
from the appropriate bin and places them in the tray. There is a chance that the wrong material may be pulled. There is an opportunity to correct the mistake if the person at lens blocking sees the error before blocking. This is not guaranteed, and it puts an additional burden on these lab techs. With the orderentry software now in common use in the CL industry, jobs can be grouped into similar types by design, material, diameter, or other categories. Imagine the time saving of running similar lenses that use the same diamond and tooling.
AREAS WITH IMPROVEMENT POTENTIAL
Measuring the thickness of the lens blank and recording it is the next task. Imagine if all the lens blanks in a bag were the same thickness. How much time would that save? It would result in a tremendous reduction in the number of decisions. Setting up the blocking machine to block the lens blank is another task. This is a repetitive task, but still requires checking the state of the blocking machine and sometimes setting it up for the lens blank. The machine will need to be re-set up for front blocking; another decision.
Using a dedicated lens blank station is a process that is always set up for that task and requires no decision on the part of the tech. Anyone can use it. A blocking machine may not be needed. Imagine a lens blank workstation where a person blocks 100 lens blanks into an autoloader tray in, say, ten minutes. In the procedure above, even if the blocking machine is set up for lens blanks, the cycle time is about 30 seconds. Blocking 100 lens blanks would take at least 30 minutes, (realistically much longer). With the advent of bar code scanning on lathes, the order entry process is greatly simplified with far fewer decisions required. The lathe process is further streamlined by auto-loading batches of lenses. As I mentioned above, sorting the jobs by category helps autoloading proceed more efficiently. Polishing the back surface is the next process. This task required decisions about the pitch lap, polishing weight, spindle speed, and stroke. They were determined by the geometry and material and presented lots of room for error. Now the only decision the operator needs to make is between a corneal or scleral lens, which requires a change in stroke.
IMAGINE POSSIBILITIES
In order to adopt the dedicated work-station concept, many labs are installing separate polishers for corneal and scleral lenses, so the operator only needs to load the lens and start the machine. Imagine a workstation that autoloaded the BC lenses, applied polish, and rinsed the lenses before they were placed back in the tray. How many decisions would that eliminate?
IMAGINE A LENS BLANK WORKSTATION WHERE A PERSON BLOCKS 100 LENS BLANKS INTO AN AUTOLOADER TRAY IN SAY TEN MINUTES.
Front blocking: In one process, the operator needs to know the general type of lens so the blocking machine can be set up to yield the proper wax thickness and amount and convert it for front surface blocking; another decision. Plus, they need to choose the correct front arbors.
In an alternate process, the blocking machine has the capability to block any geometry and center thickness lens either corneal or scleral. The operator only chooses the correct front arbors. Wax amount for corneal or scleral BC’s still needs to be determined. Imagine a blocking machine that did that automatically! As in back surface turning, grouping similar lenses together will improve the process efficiency. De-blocking remains an individual lens task. Deblocking 100 lenses in an ultrasonic without maintaining the identity of
IMAGINE A WORKSTATION THAT AUTOLOADED THE BC LENSES, APPLIED POLISH, AND RINSED THE LENSES BEFORE THEY WERE PLACED BACK IN THE TRAY.
each lens is problematic. Some labs have a solution, no pun intended! Imagine what that could be. How about a rack with positions that identifies the individual lens?
Edge polishing remains a discrete task. Modern machines reduce the number of decisions that are required. For example, before lens edges were lathe profiled, an edge roller was used. This removed a lot of material and with practice produced a good edge profile. It still depended on the geometry from the lathe. Now with fully profiled edges from the lathe, the operator loads the edge polisher and adjusts the polishing sponge to the lens diameter, applies polish, and pushes the start button. The reader will notice that I ask you to imagine a possibility. That is the foundation of progress. Most of what I proposed is in action or soon will be. This may seem to be too far out there for your lab, but some labs embrace them.
At the recent EFCLIN congress, Mr. Mike Denison spoke about lean manufacturing. I interpret his comments as getting line people fully engaged is the starting point to lean manufacturing. The next step is to instill a sense of who you serve (as in customer) in the organization and strive to meet their needs.
FEWER DECISIONS – HIGHER PRODUCTIVITY
In my experience, in almost all the labs I have visited (more than I can count on my fingers and toes), the technicians are heads-down and busy. The question is: Are they busy making decisions or busy making lenses? The reality is somewhere in between. I submit that they are working their tails off while following instructions. My observation is that the most successful labs (lowest cost of manufacturing/highest quality) are the labs that required the technicians to make the fewest number of decisions. n
Erik Larsen graduated from the University of Washington with a Mechanical Engineering degree in 1981 and started Larsen Equipment Design later that year. Erik Larsen has industry awards from CLMA and EFCLIN.
Dropouts
One-size-fits-most – but-not-all
Dropout in contact lenses is a major problem, and one that is hard to influence. The ‘pooled dropout frequency’ according to Pucker and Tichador1, based on several studies in the past which cover 8,190 subjects altogether, is estimated to be 21,7%. One thing that is certain is that the dropout rate is preventing the contact lens market from growing. But there are different reasons for dropout in different modalities. By Eef van der Worp
In scleral lenses, for instance, Macedo-de-Araújo et al. 2 in 2019 showed that the main reason for dropout in that sector is ‘handling’ – which is something we all should look at (industry, eye care practitioner/staff and patients together). Those are ‘patients’ factors’, and handling and other patients’ factors, also in soft lens wear, has been frequently quoted a prime reason for dropout. In this paper we focus on ‘contact lens factors’ though. When focusing on contact lens factors
in the broad group of soft lenses and dropout, we should break it up into different categories, three to be more specific. Let’s separately approach ‘new lens wearers’ (neophytes) from existing lens wearers and presbyopes.1
NEOPHYTES
Studies from Sulley et al. 3 and others have shown that in neophyte lens wear, ‘vision’ is the number one reason for
dropout, while difficulties with lens handling and complexity of the lens care regimen are mentioned as prime reasons as well. Most of these issues can be overcome by 1) asking patients what the issue is, 2) giving it more time and attention (training and education) in the initial month, and 3) trying different lens options. Daily disposables, for instance, have a much shorter list of ‘to do’ steps in correct care management than reusables do (26 instead of 53, according to Efron and Morgan).4 The mentioned Sully et al. study3 showed that most contact lens dropouts (71%) had not been offered another lens option in the first two months of wear after dispensing.
PRESBYOPES
Let’s jump to ‘category 3’, the presbyopes, next – as this group really needs a different approach and a full article in itself (stay tuned for a future edition of GlobalCONTACT on this topic). Presbyopes are a different species for whom
the dropout rates are enormous. After the age of 40, we see a huge incline in vision correction demand and a stunning decline in the number of lens wearers. Vision in this category is key too, as it is hard to provide an excellent visual outcome at three different distances (near, intermediate and far). My students always left the auditorium after ‘the bifocal lecture’ with the message, ‘teach them the two-out-of-three rule’: we can get two distances ‘solved’, but the third one may be harder to fix. This is so important because first, patients can choose two distances out of the three themselves, as they know much better where their prime visual demands are, and second, we give them the subtle message that we need to compromise things a bit (without actually putting it that way).
The second main factor with age, after vision, is ocular surface changes that can result in dry eye symptoms. The tear film over the ocular surface is a very stable structure, about 2-5 microns thick, which can be subdivided into three or more structures if desired. What is inevitable with contact lens wear is that we will put a huge ‘mass’ of maybe 80-120 microns thick (in soft lenses), or a multiple of that in rigid corneal and scleral lenses, on this thin and fragile layer. It is no wonder that dry eye issues are common, and more so in elderly patients as the tear film is already more unstable. The thing is, these factors are very hard to influence – as is the case with, for instance, allergies –although there is a whole industry and scientific category that tries to cope with these issues.
EXISTING LENS WEARERS
That brings us back to category 2: the existing lens wearers. Here, there is no question that ‘discomfort’ is by far (light years ahead) the number one reason for dropout. But discomfort is a broad term; it is important to note that these patients specifically are referring to ‘end-of-the-day’ discomfort. In fact, contact lens practices should in theory extend their evening opening hours, as this is where the magic happens; not at 9 am in the morning, when someone has just applied their lenses 30 minutes ago. End-of-the-day comfort (we can simply ask for it too) is the parameter to work with and to go by when assessing soft lens fit and success.
Contact lens wear is simple: a piece of (soft) plastic that roughly mimics the shape of the anterior ocular surface is put on the eye at the desired chord (diameter) where the lens lands. Then the lens wearer blinks, and the real interaction starts. Most adults blink about 14 to 17 times a minute. That comes out to 840 to 1,020 blinks every hour. If you sleep for eight hours every night, that means you probably blink about 13,440 to 16,320 times a day while you're awake. Contact lens wear is all about the mechanical interaction, or shear forces, that take place between the eyelids, the contact lens and the ocular surface.
SHEAR FORCES
It is thought that shear stress could cause epithelial cell damage over time and may contribute to contact lens discomfort, according to Hart et al. and Efron. 5,6 Jessica Mathews discussed this in an article in Contact Lens Spectrum,7 in which she referred to a study conducted at the University of Florida where a biotribometer was used to measure the effects of shear stress on an in-vitro epithelial cell monolayer under controlled conditions (pressure, speed, time and number of cycles). Pieces of contact lens materials are placed on a membrane-covered probe and slid across the epithelial cells for 1,000 cycles at forces that mimic typical ocular lid pressures. The sliding method was used to simulate the sliding of the contact lens against the eyelid and over the cornea during blinking at typical lid pressures. Different materials were tested, and some materials resulted in 100 to over 300 damaged epithelial cells per mm 2 – while other materials revealed hardly any effect (7±4 damaged cells). This was after 1000 cycles, which roughly translates to one hour of lens wear. Imagine what this would be after 8 or 16 hours of lens wear. And – it is speculation – but what would this mean in terms of lens fit? If a lens fit is slightly suboptimal, what would shear forces do to the ocular surface after 15,000 cycles?
One might think this is something new, but that is not the case. The ‘science behind sheer forces’ is a known entity, and in fact there is word for it: tribology. The Wikipedia definition of this phenomenon says: ‘Tribology is the science and engineering of understanding friction, lubrication and wear phenomena for interacting surfaces in relative motion.’ That is exactly the situation with a contact lens on the ocular surface. Perhaps even more surprising: Leonardo da Vinci already described an instrument to measure those forces (Fig. 1) in a basic but similar way. If we apply all this to contact lenses, we need to look at lens surface properties and at lens fit.
As eye care practitioners or even as labs, we have little or no say over lens material factors – we have to leave that up to the industry. But we do have control over lens fit, at least to some degree. As stated in the previous GlobalCONTACT: we can distinguish what normal eyes are, and we know we have better lenses than we’ve ever had for these eyes – up to daily disposables.
A study by Eric Papas et al.8 even tried replacing lenses during the day. But changing the daily disposables halfway through the day did not add anything to the comfort rating. What it might add are germs if people are replacing their lenses in the middle of the day while at work or at school.
But in essence, replacing the lenses more often than once daily is not the solution to improve comfort. To reduce ‘shear forces’, it may be worthwhile to look further at lens fit in those eyes that do not meet the ‘normal’ criteria. Matthew Andrew et al. from Ohio State (OH, USA) at ARVO 2024 took another look and another approach to this: that of inflammation. They determined that patients (n=25) who developed a contact-lens-related corneal infiltrative event (CIE) or a microbial keratitis (MK) had a corneal sagittal depth (OC-SAG) that was less than the population mean. These data suggest that one-size-fits-most soft contact lenses may have a sagittal depth that is too deep for patients with a shallower-than-typical corneal sagittal depth, which could increase adverse event risk.
In an ongoing study by Debarun Dutta et al. at Aston University (Birmingham UK), eyes with low, median and high OC-SAG were selected and fitted with several lenses of varied CL-SAG values. Preliminary outcomes of the study showed that it can potentially be clinically relevant to optimize lens fit (CL-SAG) in terms of lens comfort and soft lens fit on-eye in out-ofstandard eyes with lower or higher OC-SAG values.
CLOSING REMARKS
The TFOS workshop main paper on contact lens-related discomfort by Lyndon Jones et al.9 lists scientific evidence from the peer-reviewed literature. The list with ‘poor evidence to support a link with comfort’ includes, surprisingly maybe, items such as higher Dk/t, bulk material (ionic, etc.), modulus/ stiffness and tear film exchange under the lens. In the category ‘supportive evidence of a link with comfort’, the variable ‘good lens fit’ is mentioned as the first factor. But somehow, this item does not get the attention it maybe deserves in our field (other items in this category are shorter frequency of wear (replace more often), shorter wear period during the day (as comfort is worse at the end of the day) and material properties (low friction especially).
As an industry and as eye care practitioners, one way or the other we have to deal with dropouts – but there are many factors, such as environmental/systemic and work/life-related factors, that we have little or no say over. One of the few factors we can control, to some degree, is the lens fit. If we embrace this, we can make a difference in some people’s lives. One-sizefits-all is a utopia, as we know; it should be ‘one-size-fits-most’ at best. This also means there is a ‘but-not-all’ group. We can make the difference in that category as a specialty lens industry and profession.
CASE REPORT: 'FLAT OUT THE BEST OPTION'
A young woman came to the practice of Gerard Smits10 (Ralph Optiek) in Amsterdam in the Netherlands. For this patient, several standard soft lenses were tried, including Dailies Aqua Comfort Plus (Alcon) 8.70 ø14.0, Clariti 1 Day (Alcon) 8.60 Ø14.1, Dailies All Day Comfort 8.60 Ø13.80, monthly disposables Biofinity (Coopervision) 8.60 Ø14.0, and Fresh Excellent (Microlens/Wölk) 8.3 Ø13.6. All lenses failed because of lack of movement and mobility and poor comfort. Their contact lens practice places special emphasis on the shape of the entire anterior ocular surface, not just the (central) cornea. The Medmont corneal topographer has for this purpose a special tool: the E-H (estimated height) software. With that, the overall sagittal height of the ocular surface (OC-SAG) over 15 mm can be estimated. In this case, the E-H in the 0-180° meridian is 3524 microns (Fig. 2, OD shown). This is well below the OC-SAG of the average eye (which is estimated to be in the 3750-micron range) and even falls outside the one-standard-deviation range (estimated to be between 3550-3950 microns) – which indicates that this is an exceptionally flat eye. Based on
keratometry values alone (8.09/7.88), this is not easy to judge in that same way, especially because the eye has an average e-value and standard corneal diameter.
The patient ultimately was refitted with a custom soft lens based on the patient’s corneal topography. The Medmont file was uploaded to the manufacturer, and an individual
World leader in wavefront metrology
Fig.
monthly disposable, silicone hydrogel lens was created for this patient: the Indivisual (Menicon, Emmen NL) in the Definitive 74 material (efrofilcon A V 3) with a sagittal height of the lens (CL-SAG) of 2900 microns and a tangential peripheral shape (tangent angle 54°) S+2.75 in a Ø14.1. The lens design is in line with the way many scleral lens designs are constructed, and the lens fit
CASE REPORT: 'DAILY LENS OR CUSTOM MADE?’
A case report by Ineke Janneman - ten Hoope11 from Eyecare in Bloemendaal in the Netherlands supports the idea that eye care practitioners, together with specialty lens labs, can make a difference also in explaining to patients what the issues are. This case involves a 56-year-old man who started with soft lenses last year.
Lens details:
• Right: +2.25 add 2.00 Saphir RX MF: 9.50 diameter 15.00 CD by Mark’ennovy = SAG 3390
• Left: +1.75 add 2.00 Saphir RX MF: 9.20 diameter 15.00 CD by Mark’ennovy = SAG 3550
References
1 P ucker AD, Tichenor AA. A Review of Contact Lens Dropout. Clin Optom (Auckl). 2020 Jun 25; 12:85-94.
2 M acedo-de-Araújo RJ, van der Worp E, González-Méijome JM. Practitioner Learning Curve in Fitting Scleral Lenses in Irregular and Regular Corneas Using a Fitting Trial. Biomed Res Int. 2019 Jan 28; 2019:5737124.
3 S ulley A, Young G, Hunt C. Factors in the success of new contact lens wearers. Cont Lens Anterior Eye. 2017 Feb;40(1):15-24.
4 E fron N, Morgan P. Daily disposables versus reusables: which technology wins? Contact Lens Spectrum, May 2024:112-19.
5 H art S, et al. Surface gel layers reduce shear stress and damage of corneal epithelial cells. Tribology Letter. 2020; 68:106.
6 E fron, N. Contact lens wear is intrinsically inflammatory. Clin. Exp. Optom. 2017; 100: 3-19.
7 M athews J. Biological Rationale for Contact Lenses with Water Surface Technology. Contact Lens Spectrum, July 2021:20-1.
8 Papas EB, Tilia D, Tomlinson D, Williams J, Chan E, Chan J, Golebiowski B. Consequences of wear interruption for discomfort with contact lenses. Optom Vis Sci. 2014 Jan;91(1):24-31.
9 J ones L, Brennan NA, et al.: The TFOS International Workshop on Contact Lens Discomfort: report of the contact lens materials, design, and care subcommittee. Invest Ophthalmol Vis Sci 2013; 54;11: TFOS37-70.
procedure would be close to fitting a scleral lens: changing the tangent angle would ‘lift’ the lens or decrease the lens to a lower sagittal height. For this patient, this lens design resulted in an optimal lens fit with excellent movement, which is believed to be the result of the tangential peripheral shape of the lens in conjunction with the customized CL-SAG height.
The patient was very satisfied with his custom-made lenses, which had unusual diameter and base curves. However, he indicated that he would like to try daily disposables, 'because it is so convenient'. The patient was informed immediately that they had gone straight to custom lenses because of his out-of-standard eye shape. But still, the patient wanted to experience it himself. They opted for one of the flattest standard daily lenses (low sagittal value) from the Pacific University SAG chart: the Alcon Dailies ACP with parameters 8.7/14.0 - SAG 3468 microns. Interestingly, this lens is not as 'flat' as the 1-day J&J Acuvue Moist, for instance, with parameters 9.0/14.2 - SAG 3468 or the 1-day J&J Acuvue Oasys (9.0/14.3 – SAG 3469). This means that base curve is not all that relevant in the currently used frequent replacement lens family. The Dailies ACP lenses moved minimally/moderately (grade 1-/1-) and centered well, but over the course of the day, they increasingly caused a burning sensation, with end-of-the-day discomfort complaints for the patient.
Looking at the SAG of the eye (Fig. 3, OD shown OC-SAG 3105), it is clear that this lens has a very high SAG value – despite being one of the 'flatter' standard lenses. The problems the patient experiences are quite simple to explain in this case: the low SAG values of the eye are well outside the normal range. Thus, it is clear, even to the patient, that a standard lens is not optimal. Back to the originally fitted lenses, and now a satisfied customer – who now also understands why daily disposables are not an option. n
10 S mits G. Case series: using a customized soft lens SOMETIMES ‘flat out’ the best option for a flat eye. Global Insight, 28/02-2023.
11 Ten Hoope I in: De Menselijke Maat: case report: daglens of maatwerk. Eyeline 3/2024:77-9.
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.
Fig. 3
Larsen Equipment
In 2004, Keith Parker and I opened Advanced Vision Technologies (AVT). At that time, the economy was going through a very bad recession and as a result, it was impossible for a new business starting up to get a loan. We immediately reached out to Erik and Pam at Larsen Equipment to get refurbished equipment to use in our Laboratory. As AVT’s business grew, we invested in many different pieces of new equipment from Larsen Equipment and this helped us grow into one of the Premiere Labs in the United States. Our success is due in part to Erik and his Team with their state-of-the-art equipment and maintenance of their products. AVT is forever grateful for Larsen Equipment’s support of AVT. It is great to know AVT is working with Industry leaders with the Larsen Equipment and their Team!
Janine Bungo, VicePresident
QUALITY MANAGER: RANDY MINGOY
I have known Erik Larsen since 1992. Since then I have used just about every piece of equipment his company has built. My experience with Erik and the Larsen team has been one of great appreciation as they have always helped me in my needs of fully understanding equipment used to manufacture quality contact lenses. Erik has also been able to engineer any part needed for me even it was a custom part. Erik (Larsen Equipment) has been and still is a pioneer in the contact lens and optical industry, and I am thankful to him for his support over the years.
Randy Mingoy
Quality Manager
Advanced Vision Technologies
DIRECTOR OF OPERATIONS: JORDAN GOBEL
There can be a lot of moving parts when it comes to managing operations, so it is key to have reliable precision equipment that assists in overall efficiency. Larsen Equipment delivers just that! I have been utilizing Larsen manufacturing equipment for over 15+ years and have yet to run into an issue they could not resolve. I am a satisfied owner of bladder polishers, edge roller’s and auto-blockers etc. Each one of these units greatly assists in the reduction of rejects and manufacturing waste. Their ability to customize and retrofit specific tools certainly sets them apart from the competition. Larsen stands behind their equipment with a knowledgeable staff that provides exceptional service. Simply put, we are a better laboratory because of our relationship with the folks at Larsen.
Jordan Gobel
Director of Operations/Consultant
Advanced Vision Technologies
PRESIDENT: KEITH PARKER
I have had the pleasure of working with Erik since the beginning of Larsen Equipment. The first piece of equipment, a 6 spindle horizontal arm polisher revolutionized our production of GP contact lenses. Through the years, I watched his business grow as he and his team listened to our Industry needs and developed now numerous products not only simplifying many tasks of manufacturing but improving the consistency of quality in our finished products. Innovation has been an ongoing experience of our Company only made possible through the innovation of necessary equipment developed and made available by the Larsen team.
Larsen Equipment is a family owned business hosting a team of willing Staff all having the attitude of serving their Customer’s needs. As a Customer, we are made to feel like we have a friend in the business helping us develop a more efficient process allowing our Company to deliver better products for our Customers. Our success of AVT simply could not have been possible without the help, assistance and dedication of Larsen Equipment. I will be forever grateful for my opportunity to work with Erik and his very capable Staff.
Keith Parker President
7 myths about ...
... children and contact lenses
Contact lenses can be a fantastic alternative to spectacles for children – even those under the age of 14. They can cope with everything during sports, they don't fog up, they don't impair the field of vision and, quite honestly, many children and teenagers simply like themselves better without spectacles. On the other hand, some parents worry when they suggest contact lenses to their children. They do not trust their offspring to use them responsibly, have too little knowledge about contact lenses and care and therefore fear a risk to their children's eye health. So, what do you tell skeptical parents if they have concerns? By Silke Sage
In 2011, data from over 100,000 contact lens fittings were examined in a large-scale study. Of these, 0.1% were fitted in infants and young children up to the age of 5, 1.6% in children aged 6 to 12 and 11% in adolescents under the age of 181. The fact that the proportion of contact lenses in children and adolescents is still low today is sometimes due to incorrect or outdated assumptions about children and contact lenses, which nevertheless persist.
Here are the seven common myths about children and contact lenses and what is so wrong about them.
1. THE CHILDREN ARE NOT OLD ENOUGH TO WEAR CONTACT LENSES
Wrong: Children can theoretically wear contact lenses at a very young age. In this case, parents help with inserting and removing. However, the decision as to when a child can use contact lenses independently depends largely on the child's individual maturity, as inserting, removing and caring for the lenses requires a certain amount of responsibility and dexterity. Experts usually recommend that children can start using contact lenses when they can perform these tasks independently and reliably, which is often the case at around 10 to 12 years of age. In special cases, such as high ametropia, myopia management or certain eye diseases, children may need contact lenses earlier, which is then done under close supervision.
2. AS LONG AS THE EYE IS GROWING CONTACT LENSES ARE OUT OF THE QUSTION
Wrong: The point at which contact lenses are fitted is always a snapshot in time. The perfect contact lens is selected based on the current refraction and slit lamp findings. Although the eye grows very slowly – much slower than the rest of the person – follow-up checks and reappointments should take place somewhat more frequently than for adults. Apart from that, the following still applies: a child's feet grow too, but of course the child still gets shoes – nobody waits until the foot is fully grown before buying shoes.
What's more, the above statement could not be more wrong when it comes to careful myopia management. Especially during growth, it is important to intervene, e.g., with contact lenses that inhibit longitudinal growth in order to influence the process.
3. CHILDREN ARE CARELESS ABOUT HYGIENE
Wrong: A common argument from parents regarding contact lenses for their children is that they are not yet able to care for their contact lenses properly. However, various studies have shown that most children have no problem following the
relatively simple rules. Regardless of which contact lenses they wear, children will reliably follow the rules when it comes to care, especially if they are motivated to do so themselves. Nevertheless, safety in terms of hygiene when using contact lenses should play a central role in the consultation with parents before they decide for their child. It is important that both the parents and the child are well informed about hygiene, wearing and care of the lenses.
4. CHILDREN DO NOT CARE HOW THEIR DEFECTIVE VISION IS CORRECTED
Yes and no. Up to a certain age, the type of correction plays a rather insignificant role. The important thing is that the correction takes place at all. However, the older the child gets, the greater the importance of appearance and the effect on others.
Research conducted by Jeff Walline in 2007 and 2009
already showed that both children and adolescents who received contact lenses experienced a general improvement in lifestyle compared to their spectacle-wearing peers2,3. The switch led to greater confidence and activity in the older children, but even primary school aged children reported a more positive self-image. These results show how important this detail is when advising around the contact lens option.
5. CHILDREN NEED STABLE PRESCRIPTION VALUES BEFORE THEY ARE GIVEN CONTACT LENSES
Wrong: See point 2. If the prescriptions for children change too frequently, it does not mean that they cannot wear contact lenses. To keep costs manageable at first, a change can be combined with daily disposable lenses and spectacles (e.g., for sports).
Otherwise, the intervals for new contact lenses are usually shorter than the replacement intervals for new spectacles.
6. CONTACT LENS FITTINGS FOR CHILDREN
TAKE TO MUCH CHAIR TIME
Yes and no: Children certainly need to be treated differently from adults, especially when it comes to counseling and explaining the procedures during the eye examination. However, many steps are the same as for adults. While teenagers can be treated in a similar way to adult clients, (younger) children may need more time to handling their lenses for the first time3. This can add a few minutes to an appointment, ideally conducted by an assistant to a contact lens practitioner.
7. CHILDREN DO NOT NEED SPECTACLES IF THEY WEAR CONTACT LENSES
Wrong: Just like adults, children should not rely solely on their contact lenses. There are cases in which contact lenses are not an option, e.g., in the event of an eye injury or infection. In addition, children should not wear their contact lenses for more than approx. twelve hours a day. It is therefore clear that spectacles with the current prescription should always be prescribed. n
References
1 E fron et al. Survey of Contact Lens Prescribing to Infants, Children, and Teenagers. Optometry and Vision Science, 2011 April.
2 W alline et al. Benefits of contact lens wear for children and teens. Eye Contact Lens, 2007.
3 W alline et al. Randomized trial of the effect of contact lens wear on self-perception in children. Optometry and Vision Science, 2009.
For a better wearing experience
Contact lens cleaning with electrophoresis technology
A contact lens cleaner that uses electrophoresis to disinfect contact lenses, achieving a 99.999% bacteria-killing rate and 95% protein removal with 0.9% preservative-free saline, was presented at the EFCLIN conference and exhibition. The device, developed over ten years with 100 patents, offers a quick, user-friendly process, has received positive patient feedback and features an environmentally friendly design. By Alex Yang
Contact lens cleaning, including disinfection and protein deposit removal, remains a significant challenge for both patients and doctors due to several reasons:
• The current solution-based methods have their limitations.1
• The cleaning process can be complicated, especially for rigid contact lenses. 2
• Patients often fall into incorrect cleaning practices. 3
THE KEY TO AN EFFECTIVE CONTACT LENS CLEANING SOLUTION LIES IN
EFFECTIVELY REMOVING PROTEIN…
These issues can lead to discomfort and infections. To address this problem, a new technology in contact lens cleaning is introduced with an innovative solution incorporating electrophoresis. This technology can disinfect contact lenses with a 99.999% bacteria-killing rate and achieve a 95% protein removal rate using only 0.9% preservative-free saline.
FROM THE IDEA TO THE INNOVATIVE SOLUTION
The idea of using electrophoresis emerged after numerous attempts to elegantly solve contact lens disinfection and protein deposit removal issues. Before deciding on electrophoresis technology, the developer experimented with ultrasonic cleaning, automatic pumping, and automatic rubbing lenses. All these attempts failed due to significant negative effects on contact lenses, such as breakage, scratching, or surface coating delamination.
The key to an effective contact lens cleaning solution lies in effectively removing protein, including those blocking the air pores inside the lens material, and killing bacteria and viruses without damaging the lens or complicating the process for patients. After over ten years of extensive development, the "Elepy" technology was introduced, applying boundary electrophoresis technology to contact lens cleaning.
THE TECHNOLOGY
Proteins can be charged and moved in electrical fields. Using this property, this contact lens cleaner applies electrical fields in the cleaning capsule, causing the protein deposits on the contact lens to move toward the electrodes inside the capsule. Meanwhile, as microcurrent is applied, the plasma membrane
of the microbes on the contact lens will be broken, leading to sterilization of the contact lens.
As the process only requires the fluid inside the cleaning capsule to have electrical conductivity, 0.9% preservative-free saline solution is sufficient to let the ReO2 cleaner function effectively. When in operation, part of the saline solution turns into hypochlorous acid under the electrical field. Hypochlorous acid is effective in killing bacteria and safe for the human body.
Thus, the ReO2 cleaner can effectively remove up to 95% of protein deposits and kill 99.999% of bacteria, all using only 0.9% preservative-free saline solution.
THE CHALLENGE
Electrophoresis technology is not new in laboratory environments for moving proteins. However, adapting it to a much smaller device that can fit in a handbag remains a significant challenge. Furthermore, maintaining a delicate environment during the cleaning process to ensure only protein deposits are removed and
bacteria are killed without damaging the contact lenses is crucial. To address these technical challenges, 3N Eyecare developed over 100 patents, successfully miniaturizing electrophoresis technology and balancing its effectiveness while protecting the lens.
… AND KILLING BACTERIA AND VIRUSES WITHOUT DAMAGING THE LENS.
USER EXPERIENCE
Traditional contact lens cleaning processes can be frustrating, often only removing a fraction of the protein deposits and involving complicated or lengthy procedures, especially for RGP and scleral lens wearers. The ReO2 cleaner is designed to enhance the user experience. It has only a few buttons with
RGP CL before (left) and after (right).
clear signs, making it easy for any patient to use. The cleaning process takes just 10-15 minutes and two button presses, eliminating the need for complicated procedures.
THE CLEANING PROCESS TAKES JUST 10-15 MINUTES AND TWO BUTTON PRESSES, ELIMINATING THE NEED FOR COMPLICATED PROCEDURES.
STUDY RESULTS
A recent multi-center study4 shows the ReO2 contact lens cleaner exhibits superior efficiency in cleaning, disinfection, sterilization, and protein removal compared to traditional multipurpose solutions. The study found a significantly higher proportion of lenses rated as ‘clean’ or with a ‘mild deposit’ (96.4%, 79/82) in the experimental group compared to the control group (85.7%, 66/77), with a significant difference (P < 0.05).
POSITIVE FEEDBACK FROM REAL PATIENTS
As a contact lens cleaning system with unmatched results, the contact lens cleaner has received positive feedback from patients. In a survey conducted among 1,200 long-term users, 98% provided positive feedback on the cleaner, and 90% would recommend it to others.
ENVIRONMENTALLY FRIENDLY DESIGN
Traditional solutions often contain preservatives, surfactants, and bactericides, which can impact the environment during production and disposal. However, the ReO2 cleaner only requires 0.9% preservative-free saline solution, minimizing environmental impact and being friendly to those sensitive or allergic to additives. Despite the main body of the cleaner being built to last 3-5 years, the cleaning capsule needs regular replacement to ensure optimal cleaning quality. To minimize environmental impact, 3N Eyecare initiated a recycling program in some countries, offering discounts on replacements when patients return used saline solution bottles or cleaning capsules.
LOOKING BEYOND
Improper contact lens cleaning is the main cause of many eye infections. The 3N Eyecare cleaner addresses all causes of improper cleaning practices, enhancing the contact lens wearing experience and simplifying the cleaning process, especially for RGP and scleral lens wearers. n
References
1 Luensmann D, H eynen M , L iu L , S heardown H , J ones L T he e fficiency of c ontact l ens c are regimens on protein removal from hydrogel and silicone hydrogel lenses. Mol V is. 2010 Jan 20;16:79-92. PMID: 20098668; PMCID: PMC2808856.
2 C ope JR, Collier SA, Schein OD, Brown AC, Verani JR, Gallen R, Beach MJ, Yoder JS. Acanthamoeba Keratitis among Rigid Gas Permeable Contact Lens Wearers in the United States, 2005 through 2011. Ophthalmology. 2016 Jul;123(7):1435-41. doi: 10.1016/j.ophtha.2016.03.039. Epub 2016 Apr 23. PMID: 27117780; PMCID: PMC4921294.
3 Cope J R, C ollier S A, N ethercut H , J ones J M, Yates K , Yoder J S. R isk B ehaviors f or Contact Lens–Related Eye Infections Among Adults and Adolescents United States, 2016. MMWR Morb Mortal Wkly Rep 2017;66:841–845. DOI: http://dx.doi. org/10.15585/mmwr.mm6632a2
4 Yong-li Zhou et al., Contact Lens and Anterior Eye, https://doi.org/10.1016/j. clae.2023.102106
Alex Yang serves as the VP of Global Marketing at 3N Eyecare. He holds a degree in Mechanical Engineering and Automation from the prestigious Shanghai Jiao Tong University. Despite his engineering background, Alex has amassed over a decade of experience in the contact lens care industry. Leveraging his unique blend of engineering expertise and medical device knowledge, Alex has played a pivotal role in 3N Eyecare's successful global expansion.
All about markets
Regional prevalence of vision impairment
In terms of regional differences, the prevalence of distance
Global eyewear market 2024
In 2024, each person worldwide is expected to generate sales of USD 19.17 in the eyewear market, which is expected to reach USD 148.60 billion. The average volume per person is expected to be 1.3 units. Non-luxury eyewear is expected to account for 85% of sales.
vision impairment in low- and middle-income regions is estimated to be four times higher than in high-income regions. Rates of unaddressed near vision impairment are estimated to be greater than 80% in western, eastern and central sub-Saharan Africa.
Source:WHO
Global eyewear market growth
The global eyewear market is expected to grow from USD 146.1 billion in 2023 to USD 215 billion by 2033, at a compound annual growth rate (CAGR) of 3.9% during the forecast period. North America is expected to hold the largest share, and eyewear is expected to form the largest segment.
Source:SphericalInsights&Consulting
Talent shortage
75% of employers report difficultly in filling roles according to the Global Talent Shortage report 2024 by staffing firm Manpower.
Pioneers of ophthalmic optics
Josef Dallos
In this series, we take a look back at pioneers who have made efforts to establish contact lenses as a correction for refractive errors. In this issue, we introduce Josef Dallos. With his innovative molding technique at the time, he made a significant contribution to the development of new designs for contact lenses, which were an enormous relief for many patients. By Silke Sage
Josef Dallos was born in Budapest (HU) in 1905, the son of a teacher. He qualified as a doctor in 1928 at the age of 25 and worked there in the "University Clinic No. 1" for ophthalmology, which is now Semmelweicz University. He soon began fitting contact lenses, using original Zeiss contact lenses, the only ones available at the time. Using a novel molding technique, he proposed some improvements to the design, which were jointly patented with Zeiss in 1934.1
His experiments with the molding technique were revolutionary, as he was able to take molds of the living eye using a malleable material (Negocol), which provided information about the actual shape of the cornea and sclera. Negocol was a material obtained from algae, which was heated to 41° to 42° C and injected onto the anesthetized eye. It hardened as it cooled, and Dallos transformed the mold into a positive cast using a waxy preparation (Hominite). Later, he even used a positive cast made of brass, formed a glass lens over it and made all the necessary adjustments by grinding.2
Some historians believe that these were the first modern scleral lenses to be made individually for the patient's eyes. In later years, the Negocol was replaced by a molding compound called Moldite and the brass cast was replaced by a positive casting compound called Castone.2
These were the foundations for producing precision-fit contact lenses. In 1933, he published his first article on contact lenses in a German ophthalmology journal, "Ueber Haftglaser und Kontaktschalen". In the same year, he received a Hungarian patent for the manufacture of contact lenses that could be stabilized under the eyelids without touching the cornea and was licensed as a specialist in ophthalmology.
RELOCATION TO GREAT BRITAIN
Josef Dallos came to Great Britain to escape the Nazi threat in his home country of Hungary. In May 1937, he moved to England with his brother-in-law George Nissel. Dallos worked at 9 Wigmore Street before setting up the first pure contact lens center at 18 Cavendish Square. Between 1938 and 1948, he fitted lenses in Moorfields and attended St. Mary's and the Western Ophthalmic Hospital. During the war, he treated many soldiers so that they could return to active service. He also fitted many former soldiers who had suffered from mustard gas keratitis after the First World War with glass scleral lenses, worked intensively on the oxygen supply to the cornea, developed molds of the cornea for the production of corneal lenses made of glass and developed a method for disinfecting soft lenses. He was the first to take the physiology of the eye into account when fitting contact lenses. In short, he laid the foundation for all contact lenses as we know them today.3
CHANCE AND FENESTRATION
Dallos preferred parallel-fitting, ventilated glass scleral lenses. Nissel later estimated that Dallos fitted around 6,000-7,000
Josef Dallos
patients with scleral lenses between 1937 and 1964. He was one of the first to describe fenestration to prevent corneal edema and prolong wearing time.
According to various sources: An incident, initially reported as a mistake, in which a support point had to be removed from a patient with keratoconus, paved the way for a new technique. Unfortunately, the incident resulted in a hole in the lens. Dallos polished the edges of the hole, apologized, and initially wanted to produce a new lens. However, the patient did not return for several months, and later it turned out that the lens was comfortable and could be worn all day. He subsequently researched the placement of such a fenestration.
Profile: Hungarian-born British ophthalmologist 1905-1979 who invented the technique of taking an impression of the living eye in 1930. In 1937 he moved to London with George Nissel and founded the first pure contact lens practice in Cavendish Square (1937-1964). Probably the greatest contribution Dallos made to the emerging contact lens industry was in 1933, with a technique for making molds of the eye. This was the basis for accurate contact lens designs.
In 1964, he set up his own premises at 17 Devonshire Place and fitted them out for the manufacture of glass and corneal lenses. Josef Dallos never retired and was present at his practice every day until his death in the summer of 1979, according to a former employee (Don Ezekiel).
IN MEMORY OF...
The British Contact Lens Association's (BCLA) Dallos Award, established in 1982 to commemorate the life and work of Josef Dallos, funds a research project related to contact lenses or the anterior eye. In 2004, this was renamed the Pioneers' Lecture to honor all pioneers in the contact lens industry.
The American Contact Lens Manufacturers Association (CLMA) also commemorates his name with a regular award.
A memorial plaque for Josef Dallos was unveiled at 18 Cavendish Square in London on June 23, 2010. (See GlobalCONTACT 2010_02 page 44 ff.) n
References
1 h ttps://www.andrewgasson.co.uk/josef-dallos-1905-1979 nach Tom Bowden 2009.
2 P atrick Caroline, Craig Norman 2023 Contact Lens Spectrum nach Sabell, 1988 und Mann et al, 1996.
3 GlobalCONTACT 2010_02 44ff., Timothy J. Bowden.
Josef Dallos (right) grinds glass cleral lenses in Budapest (HU) in 1935 together with Petrus Thier. Picture, page 47, had been publised in GlobalCONTACT 2010_02.
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Global Insight: Stay ahead with our worldwide perspective on industry dynamics and emerging trends. Expert Analysis: Benefit from in-depth analyses, exclusive interviews, and thought-provoking articles. Innovation Spotlight: Explore cutting-edge technologies shaping the future of vision care. Community Hub: Join a global network of professionals passionate about advancing the Contact Lens and IOL industry.
Blocking Wax & Contact Lens Polish
GLOBAL CONTACT
CLOSING WORDS
Name: Marion Beeler-Kaupke Position: Executive Director EFCLIN Organisation: EFCLIN
If I wasn't doing this job, then... I would look after another non-profit organisation or get more involved in local politics.
The best thing about this job is... working for lots of interesting and nice people and being constantly up to date with all the developments in the industry.
It's not difficult in this job... being challenged every day and finding new areas to familiarise myself with.
The last time I was disappointed with my job was... when there wasn't enough money to realise more ideas at the congress.
The craziest thing about my job is... travelling all over Europe with the EFCLIN Congress and Exhibition and, above all, meeting people from all over the world.
I was surprised that... I got this position at EFCLIN at all, because the competition at the time was very strong. When I joined EFCLIN in 2015, I was given a very warm welcome. I was also surprised that the EFCLIN community not only respects each other professionally, but also has a friendly and warm relationship with each other.
Talking to participants and exhibitors is... always a high-light for me and a valuable mirror for myself and my work.
I can see why a conference will be successful when... I see the commitment of all those responsible for organising it and when the participants arriving are smiling and happy to be there.
When I think of those who work with me, I am glad that... I have a harmonious, innovative and challenging team with the EFCLIN Board.
A day is perfect when... I have laughed heartily and have been able to complete the tasks I set myself.
I can't live without... my family, my friends and good books.
If I had superpowers, I would... end the wars of this world.
On my bedside table I keep... a notepad and a pencil for spontaneous ideas at night.
My greatest wish is... to grow old with my husband and, if the world situation would allow it, to visit Isfahan again.
In my next life I will be... a lawyer or a historian or both.
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Why Choose GlobalCONTACT
Global Insight: Stay ahead with our worldwide perspective on industry dynamics and emerging trends.
Expert Analysis: Benefit from in-depth analyses, exclusive interviews, and thought-provoking articles.
Innovation Spotlight: Explore cutting-edge technologies shaping the future of vision care.
Community Hub: Join a global network of professionals passionate about advancing the Contact Lens and IOL industry.
