Here's a post for all the nerds out there:  Yesterday I got the news that what we thought we knew about the cornea (the clear layer of tissue located on the front of the eye) was actually all wrong.  Scientists have a discovered a new layer of corneal tissue, and since the cornea is where many ocular surgeries are performed, this new discovery could have a huge impact on the way we treat corneal diseases and procedures for corneal transplants.

Cornea with scarring from surgical procedures (via ) The new discovery of Dua's layer could help surgeons target this strong tissue and hopefully limit surgical complications.

Traditional thought had the cornea with 5 distinct layers: the epithelium, Bowman's layer, the stroma, Descemet's layer, and the endothelium.  Each layer is susceptible to particular corneal degenerative conditions, and these layers are routinely used as markers for the depth of incisions needed for surgeries.  The new layer, named Dua's layer after the scientist who discovered it, is located between the corneal stroma and Descemet's.  It
is remarkably thin -- only 15 microns in total!  But it is incredibly strong, able to withstand a large amount of pressure.  Due to its strength, surgical procedures may utilize this area in future as a location to guide laser incisions, preventing damage to weaker corneal layers. With a discovery this new, we have yet to realize the impact on applied science.  But we do know that a lot of textbooks will need to be rewritten!

Looking for something a bit different in sunglasses this summer?  Mirrored sunglasses have been a staple in sportswear for athletes in highly-reflective or bright conditions (like most snow sports), but have crept into the fashion scene this summer for street wear. Try this retro-look for something new this summer:

Trussardi

Wildfox Couture

RayBan

Via Marie Claire China

If you can't tell by the subject matter of my last few posts, I have been really inspired by the wave of new technology on the horizon in the eyecare industry.  Whether it is the more universal intrigue of Google Glass or the promise of sophisticated performance goggles that could monitor pulse and heart rate while protecting you from UV damage, our eyes are at the forefront of tomorrow's innovations.  And living where I do, my patients are often telling me about new technologies at the companies they work for before I even hear about them in optometric journals!   Here's another example of a local Raleigh company bringing the ocular world the next wave in advancement:

Corinthian Ophthalmic is a small start up that has received funding to produce the first electronic ocular  dropper.  This device would help solve major issues for patients who take eye drops every day but have trouble either getting the drop in or remembering to do so.  Imagine trying the squeeze a small eye drop bottle when you have arthritis, and then trying to be certain that you actually got one drop out, and in to the eye instead of on your cheek.  Patients will even routinely scratch their corneas when struggling with instilling eye drops!  An electronic drop delivery device could eliminate all of these problems by:

Corinthian's early prototype via

• controlling the exact size of the drop that enters the eye; preventing wasting of drops which can greatly help with a patient's monthly bills
• electronic guiding system that would tell the patient when the device is centered to deliver medicine to the eye's surface
• reminder alarm to tell you when to put the drop in
• reporting system that your doctor could access to see if you have been using the drops as directed
• no squeeze necessary, so no difficulties with small bottle size or highly viscous drops getting stuck in the bottle
• potentially a shake setting that would shake the medication for the patient if needed (studies routinely show that patients do NOT shake their drops on a regular basis when educated to do so by their doctor and on the prescription label)

Do you get a lot of build-up on your contact lenses by the end of the day?  See if these symptoms sound familiar:

• your lenses feel very uncomfortable as you blink
• your vision gradually reduces as you go through your day
• when you take your lenses out at night you see debris or film on the surface of the lens

1) Check your disposal time
If you know you are prone to overwearing your lenses, build-up is a big red flag that your lenses are past their expiration date.  Check with your doctor or you can look things up online to reaffirm how often you should be throwing away your lenses.  Many of my patients that get depositing in Acuvue lenses find that their issues completely resolve once they begin throwing the lenses away every 2 weeks like the lenses are approved for.

Miraflow is hard to find, so I often recommend the Walgreens version below.  Both via

2) Change your Cleaning Process
There is a reason that so many contact lens solutions are available on the market -- different people need different options to get the best results from their contact lenses.  There are a number of great cleaning options out there, so here is how to best maximize your results.

• Add a specific daily cleanser to your regimen

• Products like Miraflow Extra Strength Daily Cleanser or even the generic Walgreens version are specific cleansers safe to use with soft contact lenses and Synergeyes hybrid contact lenses for removal of deposits.  They are alcohol based, so it is always best to rinse the lenses with a cleanser afterwards.  Just apply a drop to your contact lens in the palm of your hand, and gently rub in a circular motion for 15 or so seconds.   Then you can rinse off with your regular multi-purpose contact lens solution or sterile saline

Change to Clearcare for overnight cleaning

Anyone who reads this blog has picked up on the fact that I am enamored with Clearcare.  This solution solves so many of patients problems due to the strong overnight cleans you receive with a peroxide based solution.  Just remember to let the lenses sit overnight and never put the solution directly into your eye.  This solution works perfectly with soft contact lenses of all shapes and sizes, and if you are a known depositor I still use it with my Synergeyes patients (though for many patients in Synergeyes Duette the preferred solutions are Aquify or Biotrue).  All other types of Synergeyes lenses (Clearkone, etc) should use Clearcare for best results. 

3) If you are still having issues, it is time to see your doctor
 Sometimes there is a medical condition causing you to get more build-up on your lenses, and without treatment, you may not have complete resolution.  Allergies or the more aggressive GPC (giant papillary conjunctivitis) where your eye basically rejects contact lens wear can cause depositing as a side effect. Treating the eye with anti-histamines or stronger steroid eye drops can help decrease the inflammation to your eye and make lens wear possible again.

4) Change to Daily Disposables
While dailies aren't available in every prescription, sometimes it is easiest to just change to a lens that you throw away every day instead of trying several cleansing products nightly to combat lens build-up.  Check with your doctor to see if daily lenses are available for you.

Imagine biking down a winding mountain road, wind in your face--but not your eyes because they are protected by full coverage sports goggles.  And then oh no, your bike chain breaks.  And you don't know how to repair it.  But wait--those goggles that were shielding your eyes from sun and wind just a second ago can also access an electronic repair guide!

Bolle designs performance goggles for outdoor sports ranging from biking to snowboarding.  Via

Smart goggles like these are not so distant in our future according to entrepreneurs at Laut Design.  They are partnering with performance glasses enterprise Bolle to help design the next generation of sports goggles.  The concept sounds similar to Google Glass with electronic projection that can be accessed to view maps, odometers, heart rate monitors, and endless possible applications.  All while utilizing the highly performance based goggle design that Bolle has popularized with glare and UV protection, and specialized tints to enhance performance in a variety of light conditions.

There are no projected release dates on when a smart goggle design may first hit the market, but expect the next generation of performance glasses to perform at a whole new level!

The product has launched in Europe, but not yet in America.  Via

We are merely months away from the American launch of another new daily disposable product, this time courtesy Ciba Vision!  Daily disposable products are the major forces on company's pipelines these days, with Bausch and Lomb's new Biotrue daily launching earlier this year, and Cooper Vision's Proclear 1-Day Multifocal launching last fall.  For contact lens wearers suffering from dry eye, the new daily materials offer a reason to hope!

What makes the new DAILIES TOTAL 1 product different?  Ciba reports that this lens is the first "water gradient" technology on the market.  The daily is made from a new silicone hydrogel material called delefilcon A.  At the central core the lens has only a 33% water content, allowing for record high oxygen transmissibility (a stunning 156 Dk/t!).  But this relatively low water content would have meant questionable comfort as the lens drew water from the eye during the course of the day.  The solution?  The water content of the lens increases gradually towards the front and back surface of the daily lens.  At the surface of the lens, the water content reaches 80%, which matches the water content of the cornea.  The theory is that if the contact lens and the cornea have the same water content, there will be less drawing of water from the eye into the lens, meaning better end of day comfort.  Another plus?  The lens has an 8.5 base curve, whose closer fit to the eye can offer better initial comfort to the average myopic lens wearer with steeper corneal curvature.

We are hoping to see these lenses available in our office later this fall, and can't wait to see the results.  As with any product, this lens may or may not work for your particular needs, but it is great to see companies focusing so much on combating dryness and switching concentration to daily disposable products which offer the best in comfort and safety to all contact lens wearers!

Somewhere in the distance a bone chilling screech breaks the silence of the exam room.  "You mean, I can't wear my contact lenses at all?  For an entire week?"  If you are a contact lens wearer, nothing chills the heart more than hearing the dreaded words: "you have to wear your glasses."