The greatest ideas are often so simple that one’s response is, “Why didn’t I think of that?” Simple doesn’t mean lack of innovation, though. Just look at Post-it Notes and Spanx; both made billions. It got me thinking, do we have similar innovations in eyecare?
Bruder Moist Heat Eye Compress
It took an optometrist in primary care practice to recognize this technology belonged in dry eye. He was using a Bruder Sinus Compress with MediBeads on his dry eye patients. After witnessing impressive success in dry eye, he inquired as to the possibility of a half-sized version that would only cover the eyelids. Today, it is known as the Bruder Moist Heat Eye Compress (Bruder Healthcare). The uniquely designed MediBeads allow for just the right amount of moisture, lasting eight to 10 minutes after 20 to 22 seconds in the microwave. It’s not too hot to cause excess steam, nor do the beads become mushy with exposure to moisture over time. This turned out to be far more valuable for dry eye management than any other clinical application.
Who knew the No. 1 cause of nonresponsive dry eye would be inadequate lid closure at night? Publications by one of our most gifted researchers, Donald Korb, OD, identified this condition early. He developed tests to confirm it and understood its significant role in nocturnal evaporative stress, resulting in symptoms upon wakening.
SleepTite/SleepRite (Eye SleepTite) is a hypoallergenic, latex-free, disposable eye cover that has the ideal level of adhesive to anatomically seal the eyelids but not stick to lashes. Patients discover that all of their symptoms, including dry eyes, are resolved.
If more than 90% of patients have greater prismatic need at near than far, why wouldn’t someone come up with a “progressive prism”?1 Well, that is exactly what Neurolens offers—a lens that often starts with base-in (and sometimes vertical prism correction) that increases inferiorly to resolve headaches, neck stiffness and asthenopia. I can see this option being a common upgrade for patients suffering from headaches or wanting less eye strain, just like transition lenses or anti-reflective coatings.
Ocular Response Analyzer and CATS Tonometer
We’ve known that inaccurate IOP measurements occur with Goldmann tonometry, especially post-LASIK, in high or low hysteresis or in thin corneas. The Correcting Applanation Tonometry Surface (CATS) tonometer prism adjusts for surface irregularities and hysteresis, and provides the exact IOP of that patient.
I’ve seen glaucoma patients with Goldmann IOP of 17mm Hg continue to progress only to find out that when measured with the Ocular Response Analyzer (Reichert Technologies) were 20mm Hg. The upside was hysteresis, which turned out to be the single most predictable measurement for visual field loss progression.2 A high hysteresis is protective but a low one signals concern, especially if other subtle signs of glaucoma are present.
Before Lumify (Bausch + Lomb) came to market, doctors had observed glaucoma patients on Alphagan P eye drops presenting with white eyes. Those who realized this incredible need, given the number of people using harmful products like tetrahydrozoline, did extremely well. Today, it works by constricting venules (not restricting oxygen/arteries) and results in three times more whitening effects.3
Creating a complex technology is often easier than a “Why didn’t I think of that?” invention. Hopefully as you read this, you, too, will come up with fresh, simple ideas that have a profound effect on millions of patients’ lives.
Dr. Karpecki is medical director for Keplr Vision and the Dry Eye Institutes of Kentucky and Indiana. He is the Chief Clinical Editor for Review of Optometry and chair of the New Technologies & Treatments conferences. A fixture in optometric clinical education, he consults for a wide array of ophthalmic clients, including ones discussed in this article. Dr. Karpecki's full list of disclosures can be found here.
1. Association of American Medical Colleges. 2021 Physician Specialty Data Report. https://www.aamc.org/data-reports/workforce/data/number-people-active-physician-specialty-2021. Accessed June 21, 2023.
2. Rothman AL, Stoler JB, Vu DM, et al. A geodemographic service coverage analysis of travel time to glaucoma specialists in Florida. Glaucoma. 2020;29(12):1147-51.
3. Congdon N, Azuara-Blanco A, Solberg Y, et al. Direct selective laser trabeculoplasty in open angle glaucoma study design: a multicentre, randomised, controlled, investigator-masked trial (GLAUrious). Br J Ophthalmol. 2023 Jan;107(1):62-65. doi: 10.1136/bjophthalmol-2021-319379. Epub 2021 Aug 25.