In the News

President Fulfills Commitment to Doubling NIH Funding

U. S. Department of Health and Human Services (HHS) Secretary Tommy G. Thompson has announced that President Bush has fulfilled his commitment to a 5-year plan to double the budget of the National Institutes of Health (NIH) when he submitted his fiscal year 2003 budget proposal to congress in February. The President's fiscal year 2003 budget proposal for NIH would increase its budget to $27.3 billion, an increase of $3.7 billion, the largest 1-year increase ever for NIH. The proposal represents a growth of nearly 16% over the $23.6 billion allotted to NIH for fiscal year 2002. In fiscal year 1998, the NIH budget stood at $13.6 billion. President Bush had joined in a bipartisan commitment to doubling the 1998 level. The President could not be clearer about his commitment to medical research, the scientific enterprise and the value of NIH and its work, said Secretary Thompson. The proposed NIH budget will support nearly 36,000 research project grants, an all-time record for the agency.

The allocation of the fiscal year 2003 NIH budget by institute and research area reflects both the professional judgments of the scientific leadership at NIH and challenges presented by the threat of bioterrorism. Of the overall $3.7 billion increase over fiscal year 2002, approximately $1.5 billion would be devoted to proposed bioterrorism research, a five-fold increase over the $300 million budgeted for the previous fiscal year. After September 11, NIH leadership made a recommendation to HHS and the White House for significant expansion in bioterrorism related research. NIH's plan includes expansions in basic research, such as sequencing the genome of potential bioterrorism agents; accelerating development of next-generation anthrax vaccines; and improving diagnostic tools.

Global Vision Community Convenes to Wipe Out Blindness

One of the great moments in history was the signing of the Declaration of Independence in 1776 in Philadelphia, Pennsylvania. On December 6, 2001, Philadelphia once again hosted a historical declaration signing as representatives from the global vision care community and world-wide health, social, scientific, and philanthropic organizations declare their commitment to eradicating preventable blindness by the year 2020. As a symbolic gesture, and as a remembrance of Benjamin Franklin's contribution to the field of optics, Franklin will lead the signatories in the signing of the Declaration to Eradicate Preventable Vision Loss. Following the signing, the American Academy of Optometry and the World Council of Optometry sponsored a symposium on preventable vision loss.

Leaders in the field of vision care and representatives from many international agencies, including Helen Keller Worldwide, Glaucoma Research Foundation, Juvenile Diabetes Foundation International, American Public Health Association, Lions Club International, and Merck and Co. Inc., have affirmed their commitment to working together to encourage research efforts aimed at eradicating preventable vision loss and to identify cures for blindness and expand public education efforts. Although each of these agencies and organizations have spearheaded efforts to prevent vision loss, this is the first such effort aimed at strengthening their commitment toward a shared goal.

According to Academy President Robert Newcomb, We anticipate that this collaborative effort will result in improved knowledge and resources for battling blindness. Currently, every 5 s, a person goes blind, so there is an urgent need for research, treatment, and education to stem this trend. We are thankful to all those agencies, institutions, and organizations that share our commitment and concern and look forward to the developments that will result from this partnership. Dr. Scot Brisbin, President of the World Council of Optometry, added that the entire global optometric community of over 150,000 providers is ready to participate in this historic international initiative.

American Academy of Ophthalmology Publishes LASIK Assessment

The Ophthalmic Technology Assessment Committee of the American Academy of Ophthalmology has issued an ophthalmic technology assessment (OTA) that finds LASIK safe and effective for correcting low-to-moderate myopia and astigmatism, but less predictable for moderate-to-high myopia and astigmatism. The assessment also reports that serious, adverse complications resulting in permanent visual loss occur rarely, but side effects such as dry eyes, nighttime starbursts, and reduced contrast sensitivity occur more frequently. These are the major conclusions of the OTA, published in the January 2002 issue of Ophthalmology. Based on a search of the peer-reviewed scientific literature for the years 1968 through June of 2002, the assessment addresses preoperative evaluation of patients; issues concerning microkeratomes (the ophthalmic scalpels used in LASIK) and the thickness of corneal flaps; necessary operative techniques with the excimer laser, suction ring, and microkeratome blades; postoperative care of the LASIK patient; FDA status of excimer laser and microkeratome approvals; and resources required for physicians to purchase or use excimer lasers and microkeratomes.

Patient Referrals Best Source for New Contact Lens Visits

Referrals from other patients are the best source of new contact lens patients, according to 80% of more than 500 eye care professionals who responded to an e-mail survey conducted by CIBA Vision last October. The second leading source was other, selected by 13% of practitioners, many of whom specified that insurance plan participation was a determining factor. All other sources, such as print advertising, manufacturers' advertisements, yellow pages, television, or radio advertising, received 5% or lower responses.

Most practitioners (45%) reported that they see between 1 and 29 new and refit contact lens patients per month. Another 30% said they see between 30 and 59 new and refit patients, and 16% said they see between 60 and 89 contact lens patients per month. 8% said they see 90 or more contact lens patients a month, and only 1% said they don't see contact lens patients at all. When asked to compare this to a year ago, 31% of the respondents said they are seeing more new and refit contact lens patients, while 57% said the numbers are the same. Only 12% indicated a decrease from last year's numbers. Eye care practitioners overwhelmingly (97% of respondents) said they make the decision as to which contact lens type or brand to fit, and most practitioners (88%) do the actual fitting. 12% of the respondents said a contact lens technician most often fits the lenses.

SOLO-care PLUS Receives FDA Clearance

CIBA Vision has announced that the U.S. Food and Drug Administration (FDA) has given marketing clearance for SOLO-care PLUS. SOLO-care PLUS is a no-rub multipurpose solution for cleaning and disinfecting soft contact lenses that are replaced in 30 d or less. CIBA Vision plans to launch the new product in the United States in spring of 2002.

SOLO-care PLUS offers the cleaning and disinfecting efficacy of other one-bottle systems while eliminating the rubbing and postrinsing steps. Now, patients need only remove lenses, rinse, and drop them into the solution. In addition, the enhanced formulation includes AquaLube, which promotes lens moisture retention while reducing protein deposits. Clinical studies show a 10% increase in patients able to comfortably wear their lenses for 16 h when using SOLO-care PLUS.

SOLO-care PLUS cleans and disinfects lenses without a rubbing step. Tests show that SOLO-care PLUS, without the rub step, removes more protein than other leading one-bottle solutions with rubbing. SOLO-care PLUS represents a major advance in lens care, one that meets the practitioner's requirement for efficacy and the patient's desire for convenience and comfort. By eliminating the need to rub lenses, patients are more likely to comply with the lens care regimen.

New Global Web Site Shows Patients the Power of Prosthetic Lenses

A little girl's smile says it all on the new consumer web site CIBA Vision has launched to inform people around the world about its Special Eyes prosthetic lens program. Located at http://www.special-eyes.com, the site features photos of Alana, a girl from Gardiner, Maine who since age 10 has been wearing prosthetic contact lenses to mask a congenital ocular deformity of her left eye. The web site shows before and after images of Alana without and with her Special Eyes lens. The difference is remarkable, not only in the eye itself, but also in Alana's face, which lights up with her improved self-image.

The site is designed to show people that normal appearance of eyes can be restored with these specially manufactured color soft contact lenses, custom designed to simulate the patterns and colors of the natural eye. Accompanying images show the 3-in-1 color, natural-looking ColorBlends lens technology in several color combinations, with one example showing the darkened pupil to mask opacity of the eye. The CIBA Vision Special Eyes Program special lenses are available with or without vision correction in DuraSoft 2 Colors, DuraSoft 3 ColorBlends, DuraSoft 3 Complements, and DuraSoft 3 Colors. The lens styles come in four different print patterns with clear or darkened pupils designed to mask opacity caused by traumatic injury or disease.

Medicare Now Covers Glaucoma Detection Eye Exam

Medicare now covers an annual dilated eye examination for all people at high risk for glaucoma. This important new preventive benefit will safeguard the vision of millions of Americans enrolled in the Medicare program. This new coverage, effective January 1, 2002, is consistent with recommendations from the National Eye Institute, one of the Federal government's National Institutes of Health, as well as from eye care professional organizations and consumer groups.

Glaucoma, a leading cause of blindness, affects about three million Americans-half of whom don't know they have this eye disease. The new benefit defines high-risk Medicare beneficiaries as those with diabetes, those with a family history of glaucoma, and African Americans aged 50 and older. Glaucoma is five times more likely to occur in African Americans than in whites and about four times more likely to cause blindness in African Americans than in whites. Preventive benefits, such as this new glaucoma coverage, help keep people enrolled in Medicare healthy and improve their quality of life, said HHS Secretary Tommy G. Thompson. An eye exam now can prevent serious problems later, even blindness. It is important that we make taking care of our eyes a part of our overall health maintenance program.

Glaucoma, and the risk of vision loss, remains unrecognized for millions of Americans, said Paul A. Sieving, MD, PhD, director of the National Eye Institute. The expanded Medicare coverage will help people keep their vision, especially those at high risk for eye disease. Once vision is lost from glaucoma, it cannot be restored, the damage is irreversible, said Dr. Sieving. Studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease.

Paragon Receives Recommendation for Approval of Contact Lens Corneal Refractive Therapy

The Ophthalmic Devices Panel (ODP) of the Food and Drug Administration (FDA), in Washington, DC, has unanimously recommended approval of Paragon Vision Sciences' Corneal Refractive Therapy contact lenses, Paragon CRT, for overnight wear for the temporary reduction of myopia and myopia with astigmatism. On the basis of this recommendation, the FDA is expected to issue its final clearance after Paragon completes a few appropriate revisions to product labeling and supplies some additional requested information. This is the first and only recommendation for approval for the corneal reshaping overnight wear indication. Paragon had previously received clearance for daily wear use only. The presentation made to the ODP panel was the culmination of several years of research and development, including the most extensive clinical study to date to establish the safety and efficacy of contact lens corneal reshaping in overnight use.

Jerome A. Legerton, OD, MS, FAAO, one of the developers of Paragon's proprietary, patent-pending design for contact lens corneal reshaping, Paragon CRT, said for years many dedicated eye care professionals and pioneers have believed in the potential for overnight contact lens corneal reshaping. We are pleased to bring the nexus of science, research, and documentation necessary to replace previous anecdotal information and move us closer to final clearance. When clearance is granted, this modality, Contact Lens Corneal Refractive Therapy, will move to the forefront of nonsurgical options for eye care practitioners to offer their patients. Everyone will benefit.

When final approval is granted, Paragon, in conjunction with their authorized laboratory partners, will officially launch Paragon CRT across the United States, Canada, and, eventually, worldwide. Paragon CRT with Proximity Control Technology offers eye care practitioners a unique lens design. Unlike traditional reverse geometry designs, Paragon CRT allows an unprecedented level of professional control using design elements such as a sigmoid return zone and a straight-angle landing zone. The Paragon CRT lens will be featured in Paragon HDS 100 material and also available in Paragon HDS. For more information on Paragon CRT and other Paragon products, contact an authorized Paragon laboratory partner or the company's customer service team at 800-528-8279 within the United States and Canada, or 480-892-7602 from other countries, or visit http://www.paragonvision.com.

BioSante Pharmaceuticals Announces Positive Intraocular Trial Results

BioSante Pharmaceuticals, Inc., has announced results of a preclinical trial demonstrating the effectiveness of its calcium phosphate nanoparticulate (CAP) delivery system for administration of drugs into the eye. The results were presented at the sixth U.S.-Japan Symposium on Drug Delivery in Hawaii, cosponsored by the Massachusetts of Technology, Kyoto University, Controlled Disease Society, Inc., and the Japanese Society of Drug Delivery Systems.

In the study, a dopamine D3 receptor agonist, known as 7-hydroxy-dipropyl-aminotetralin (7-OH-DPAT), was combined with CAP in a propriety formulation prepared by scientists at BioSante's research center in Smyrna, Georgia, and therapeutic efficacy was tested in two types of rabbits. The study was designed to test the effects of CAP on the ability of 7-OH-DPAT to decrease intraocular pressure (IOP). Results showed that the addition of CAP to 7-OH-DPAT resulted in significant extension of the IOP lowering effect of the drug in New Zealand White rabbits compared with the same amount of drug without CAP. In Dutch Belted rabbits, which have pigmented eyes, the addition of CAP caused a dose-proportional reduction in IOP that was pronounced and sustained, while 7-OH-DPAT alone had no effect.

These results show that BioSante's proprietary CAP are vehicles for delivering drugs and vaccines more efficiently and enhancing their therapeutic effects. BioSante is developing Bio-Air, using CAP to improve the delivery and therapeutic effects of proteins, including insulin. Bio-Vant is being developed using CAP as an adjuvant to improve the safety and efficacy of vaccines. Additional information is available online at http://www.biosantepharma.com.

Applegate Named as Inaugural Borish Chair in Optometry at the University of Houston

Raymond Applegate, OD, PhD, FAAO, who was mentored by the man known as the father of modern optometry, has been named as the first person to hold the Irvin M. Borish Endowed Chair in Optometry at the University of Houston. The position was created as a tribute to Dr. Borish for his more than 65 years of leadership and service in the profession of optometry. I had the distinct pleasure of being taught and inspired by Dr. Borish as an optometry student at Indiana University in the early 70s, Applegate said. Over the years, Dr. Borish served as a mentor, pushing me to contribute at the highest levels. I am extremely honored to be named the first Borish Chair in Optometry and to be establishing a Visual Optics Institute to further Dr. Borish's legacy.

Dr. Applegate moves to Houston from University of Texas Health Science Center (UTHSC) at San Antonio with more than 20 years of research, teaching, and service in academic optometry and ophthalmology. He has been with UTHSC since 1988. Before that he was an assistant professor at the University of Missouri at St. Louis. He received his doctorate of optometry (1975) and master of science in physiological optics (1976) from Indiana University. He practiced optometry with Marshall Marvelli, a fellow of the American Academy of the Optometry in Northern Illinois before completing his doctorate training at the University of California, Berkeley (1983). As the holder of the Borish Chair, Applegate will continue his world-class research on optical aberrations in normal and clinical populations and work to establish the world's first Visual Optics Institute.

All Eyes on Philadelphia's Vision Screening Van

On December 6, 2001, the Pennsylvania College of Optometry (PCO) unveiled its state-of-the- art vision screening van. Funded by the National Eye Institute of the National Institutes of Health, the Vision in Preschoolers (VIP) van will assist area Head Start programs by offering vision screening to 3- and 4-year-old preschoolers. Philadelphia is one of five cities that were selected to receive federal funds for this nationwide pilot program. The VIP van is one component of the VIP Study, a multicenter, interdisciplinary clinical study that will examine the accuracy of tests that screen for significant vision disorders among 3- and 4-year-old Head Start preschoolers. Staffed by eye care professionals and fully equipped with comprehensive screening instruments and equipment, the VIP van will provide a range of vision tests, including preschool visual acuity, stereoacuity, cover/uncover tests, noncycloplegic, retinoscopy, and hand-held autorefraction. Vision disorders that are the focus of the study are amblyopia, strabismus, and significant refractive error.

Topical Interest Groups Now Offered Free to AOA Members

Two Topical Interest Groups (TIGs) are now being offered to American Optometric Association (AOA) members interested in the topics of Refractive Surgery or Children's/Binocular Vision. There will be no annual dues associated with TIG membership, and AOA members can join both TIGs if interested. The TIGs will exist solely in cyberspace. Offering TIGs in cyberspace keeps expenses to a minimum and allows AOA to offer this as an added benefit at no cost to its members. TIG benefits include electronic newsletters covering pertinent refractive surgery and children's vision issues, an online member directory for networking purposes, and an online forum. For information or to join the Children's/Binocular Vision TIG, contact Denise Belleville at 800-365-2219, ext. 107 or e-mail her at [e-mail]. For information or to join the Refractive Surgery TIG, contact Lila Rickard at 800-365-2219, ext. 137, or via e-mail at [e-mail].

Xalatan More Effective than Alphagan for IOP Control in Patients Treated with NSAIDs in New Study

Xalatan (latanoprost ophthalmic solution) maintained its intraocular pressure (IOP) lowering effects when administered once daily in the morning in patients with open-angle glaucoma or ocular hypertension who also take indomethacin, a commonly prescribed oral nonsteroidal anti-inflammatory drug (NSAID) for arthritis, according to a study published in January 2002 American Journal of Ophthalmology. Data from the study also showed that Xalatan provided greater IOP reduction vs. twice daily Alphagan (brimonidine tartrate ophthalmic solution) in patients before and after indomethacin treatment. In addition, Xalatan significantly increased ocular blood flow and maintained the effect during indomethacin treatment, while Alphagan twice daily did not alter ocular blood flow significantly regardless of whether the patient was taking indomethacin.