Bitoric rigid and soft contact lenses prescribed in tandem for keratoconus: Preliminary results

Use of spherical rigid and spherical soft contact lenses prescribed in a “piggyback” modality has generally failed in the past. A new technique uses a back surface toric soft contact lens, which becomes bitoric when placed on the highly astigmatic keratoconus cornea, and a bitoric rigid gas-permeable contact lens worn in tandem. The lessening of rubbing and the good contact lens centration appear to be an improvement over the rigid contact lens alone. The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article.     

Addressing refractive error visual impairment: volunteer organisations' alignment with Vision 2020 and public health principles

Background: Eye care professionals have been making short visits to developing countries for decades in an effort to reduce visual impairment caused by refractive error. A 2006 survey revealed that volunteer organisations were not working within the Vision 2020 framework. Recommendations were made for volunteer organisations that would better align their work with accepted Vision 2020 and public health principles. Methods: This study re‐evaluates the alignment of volunteer organisations with Vision 2020 and public health principles. To determine their philosophies and methods, a web‐based survey was sent to 89 volunteer organisations identified from an internet search. Results: The response rate was 48 per cent. Many (70.7 per cent) organisations exclusively mention direct service provision in their statement of purpose, often provided by student volunteers (75.6 per cent). A few (19.5 per cent) provide short training in refraction, not necessarily following best principles. The majority (82.1 per cent) dispenses recycled spectacles and many use medications not on national essential drug lists. Few attempt to follow aid effectiveness principles with only 26.8 per cent stating they follow Vision 2020 country plans. Overall, as in 2006, the work of these organisations is largely not in alignment with Vision 2020 and public health principles. Conclusion: Organisations interested in decreasing visual impairment due to refractive error in the developing world are encouraged to transition to organisations that not only recognise but also implement public health principles. This should include reprioritisation of their work to developing human resources and infrastructure, determining the burden and causes of disease, assisting in the training of mid‐level personnel and providing professional and community education, collaborating via partnerships, discontinuing the use of recycled spectacles and inappropriate medications, and evaluating their outcomes. Following these recommendations as well as creating a better alignment with public health principles in general will increase the likelihood that their programs will be effective in decreasing visual impairment due to refractive error in the developing world.     

Purification of Hageman factor (factor XII) on columns of popcorn- agarose

Purification of Hageman factor (HF, factor XII) from human plasma is a tedious procedure and the product is not always in the precursor form. Hojima has described a protein derived from corn kernels that inhibits the enzymatic properties of HF. This inhibitor binds to the precursor form of HF. Rapid purification of HF was achieved by using as the major purification step adsorption of this clotting factor to popcorn inhibitor bound to agarose. The product had a specific activity of 50.0 to 67.1 coagulant units of HF per milligram protein, and the yield was 33% to 40% of the HF content of the starting plasma. The purified protein displayed a single band upon unreduced or reduced sodium dodecyl sulfate polyacrylamide gel electrophoresis and less than 0.1% was in an activated form, as measured in coagulant assays. The technique described is more rapid and reliable than methods described earlier.     

Smoking cessation counselling practices among Québec optometrists: evaluating beliefs,practices, barriers and needs

Background: Despite the fact that cigarette smoking is a well known risk factor for many ocular diseases, very little data exist regarding optometrists' interventions in smoking cessation counselling with their patients. The aim of this study was to evaluate the practices, perceptions and educational needs of Québec optometrists regarding smoking cessation counselling. Methods: A self‐administered questionnaire pertaining to smoking cessation counselling practices was mailed to 600 optometrists licensed in Québec. Results: The response rate was 51 per cent. The majority (90 per cent) of respondents (n = 288) reported having the required knowledge of ocular diseases related to smoking. Most respondents recognised that optometrists should ask their patients if they smoke (73 per cent), should advise their smoking patients to stop smoking (65 per cent) and should be cognisant of the resources available that can support patients in their efforts to quit smoking (65 per cent). Few responders asked their patients on a regular basis if they indeed smoked (16 per cent) or advised them to stop, if such was the case (29 per cent). Moreover, only eight per cent of respondents knew the resources toward which they should direct their patients who wish to stop smoking. Only eight per cent of respondents perceived themselves as being competent to offer counselling. For 72 per cent of the respondents, the main obstacle to smoking cessation counselling was the lack of knowledge about counselling. Approximately half (48 per cent) of respondents are interested in acquiring competencies in smoking cessation counselling. Conclusion: Based on the results of the present study, optometrists in Québec are well aware of the effects of smoking on ocular health and the importance of educating their patients; however, they might not possess the required skills to assist their patients in quitting smoking. Because they have not received sufficient training, optometrists in Québec remain an untapped resource in tobacco cessation counselling.