I often joke that most third-year students know more about contact lenses than I, a 27-year-old optometrist. So when I think of collaborative care or co-management, my perspective is often skewed on the surgical options that can benefit our patients.
Lately there has been a tool that connects this contact lens and refraction based mindset to the like minded optometrists of ophthalmology. Have I piqued your interest?
Good, read on.
When I was a young clinician and started participating in clinical trials, I often thought of investigator-initiated trials (IITs) that would revolutionize the profession. Think Steve Martin in The Jerk – great concept, bad design. In fact, Nerd Wax takes his idea to a new level. In my opinion, the Holy Grail of study was and remains the eradication of the greatest refractive scourge facing all of humanity. I’m not even exaggerating or provocative. i speak the truth What I am talking about is presbyopia. Yes, the dreaded presbyopia that will and does affect every living person.
For decades I have written about the natural selective nature of Darwinian evolution and this idea of survival of the fittest. Exceptions to this rule are the natural lens of the eye and the retina. Maybe you subscribe to the intelligent design theory. Well, I have news for you: the lens of the eye is at the bottom of the class. Now might be a good time to take a break and reflect on this concept.
The eye, the most wondrous of all organs, is lagging behind (again, see retina) and its most important component is beginning to shrink just 4 decades after the journey. Imagine a way. Something that is non-surgical but widely accepted and easy to use. Hello!
If I could have developed and implemented my IIT I would be writing this from space because all billionaires for some reason need to go to space instead of fixing our planet’s woes. Similar to most of my ideas, it turns out that another entity either thought of it first or it’s already available. And we’re in a presbyopic awakening, so buckle up.
Surgically, the correction of presbyopia has been advanced by the new and newer IOLs. Lenses like the Alcon PanOptix and the Johnson & Johnson Symfony and Symfony Synergy have made clear lens extraction a must for every patient over the age of 50. Similar to pale is the new tan, lens extractions (cataract or clear lens) is the new LASIK. The Kamra corneal inlay is also an option for patients using pinhole technology. The non-surgical options were limited to refractive devices such as contact lenses and extraordinary progressive lenses. Call on Essilor for this Varilux X lens. It’s amazingly clear.
I like wearing glasses, but what about all the patients who don’t want to be tied down and don’t want to have surgery? It’s finally time for the surgical and refractive method to offer our patients an alternative. Very soon we will have a drop to offer our patients relief from the plague of presbyopia. Like any treatment, it is only effective if you use it. So this is our opportunity to spread the science of presbyopia treatment.
The landscape of ophthalmic presbyopia drops is expanding rapidly, with many companies looking to provide long-term near vision relief. Allergan is able to hopefully be first out of the gates within months using a proprietary vehicle that offers a pH balance near that of natural tears and pilocarpine 1.25%. This contracts the iris sphincter to an optimal size while activating the ciliary muscle for a comfortable and safe increase in accommodation.
In the double-blind clinical trials, patients aged 40 to 55 noticed a clinical effect within 15 minutes, and more than half of the patients felt that the results lasted 5 to 6 hours with 1 application and significant improvements in near vision in mesopic conditions showed without loss of distance vision.
The Gemini studies showed very few side effects and significant improvement in patient-reported outcomes such as: B. An improvement in reading skills related to near vision and a reduction in the impact of presbyopia on their daily lives. It feels like 2006 all over again.
It was yesterday talking to patients about this presbyopic killer. When a patient walks your alley, they expect (pun intended) for you to tell them something they don’t know. The possibilities of offering a drop that maintains near vision for most of the day and with a pinhole effect – we are talking close range beyond monovision. My post-operative LASIK patients are now turning 40 and my standard cataract patients are all hearing about the drop that will be available soon. Spread the word.