The inaugural BCLA Asia Conference was held in the Cordis Langham Place Hotel in Hong Kong, Asia’s World City from September 13-14.
Day 1
09:00-09:30
After a lively welcome address by Helen Eng, president of the Hong Kong Cornea and Contact Lens Society (HKCCLS), and Brian Tompkins, president of the British Contact Lens Association (BCLA), the inaugural BCLA Asia clinical conference was officially under way.
09:30-10:00
Kate Gifford, an award-winning optometrist and eminent researcher and educator in the field of contact lenses, binocular vision and myopia control, presented an excellent lecture on myopia management. Kate outlined the problems associated with myopia and discussed potential management options available. Case studies were used to encourage delegates to think practically about the application of myopia control in their day-to-day practice. Details of available resources were provided in order to support the implementation of myopia control.
11:00-12:30
This fully-booked workshop provided delegates with a comprehensive guide on how to correctly fit ortho-k lenses, enthusiastically delivered by Sander Sterk. This superb session emphasised the importance of corneal topography, fitting the lens periphery and controlling the point of touch in relation to ortho-k fitting.
13:30-15:00
Presbyopia session
In an enlightening session, Professor Lu Fan comprehensively outlined the epidemiology of presbyopia and the challenges it presents to optometrists charged with its management. Professor James Wolffsohn then discussed the principles behind presbyopia correction, outlined the wide range of currently available – and future – correction options and their clinical application, including patient selection.
Research findings were presented by Professor Michel Guillon relating to the influence of lens material on the ocular surface of Asian presbyopes. Professor Guillon highlighted the importance of material selection when fitting Asian presbyopes with contact lenses.
Professor Guillon continued by presenting research relating to the success rate achieved when fitting neophyte functional emmetropic presbyopes with a daily disposable multifocal. Professor Guillon concluded that, contrary to popular belief, neophyte emmetropic prebyopes can be successfully fitted with a daily disposable multifocal lens.
15:30-17:00
Speciality lenses session
Lynne Speedwell, head of optometry at Great Ormond Street Hospital for Children and part-time principal optometrist at Moorfields Eye Hospital, demonstrated her wealth of knowledge and expertise in speciality contact lens fitting with a double lecture. In both of her presentations during this session, she discussed the principles of fitting therapeutic lenses to patients, of all ages, with a range of abnormal ocular conditions. These sessions were extremely beneficial to increase understanding of which types of therapeutic lenses to fit to which patients.
Dr Stan Isaacs presented a convincing and entertaining case for the fitting of speciality lenses including soft, RGPs, scleral, semi-scleral and hybrid lenses for irregular corneas and certain corneal conditions. He argued practitioners should get over their reluctance to fit speciality lenses as they are generally the best options for these patients.
Day 2
09:00-10:30
Myopia: epidemiology, mechanism and development of myopia control options
The myopia management day was opened by Professor Padmaja Sankaridurg, a world-renowned researcher, and leader of the myopia programme at the Brien Holden Vision Institute. Professor Sankaridurg presented findings of a recent report in which predictions were made on the future prevalence of myopia worldwide. Approximately half of the global population will be myopic by 2050 and 10% will have high myopia (≥-5DS).
Professor Thomas Lam Cheun, who is based at Hong Kong Polytehcnic University, presented some of his fascinating, but complex, research on the novel application of proteomics to myopia and other eye conditions.
Arthur Back provided delegates with an insight into the translation of a novel myopia control soft contact lens from research to clinic. Convincing data was presented on the potential for dual focus soft contact lenses to correct myopia refractive error while preventing myopia progression.
11:00-12:30
Myopia control
Professor To Chi Ho, head of the School of Optometry at Hong Kong Polytechnic University and eminent myopia researcher, discussed the mechanism by which myopic defocus prevents eye growth in animals; and how this could translate to human myopia. He presented research which shows that, like in animal eyes, human eyes were able to integrate competing and simultaneous myopic and hyperopic defocus, resulting in intermediate eye growth. This is the first study to prove that Defocus Incorporated Soft Contact (Disc) lenses are able to slow myopia progression and axial elongation in school children, by up to 60%. These lenses could play an important role in managing childhood myopia.
Professor Sankaridurg returned to make the case for the role of spectacles to prevent myopia progression. She argued although research to date does not show that multifocal/novel spectacles are able to slow myopia progression to the same levels as soft contact lenses, orthokeratology and atropine, they could still play a role in reducing progression for some children.
Dr Janis Orr, a lecturer in optometry at Aston University and myopia researcher, made the case for the use of pharmaceuticals for the prevention of myopia progression and axial elongation. She concluded that lose-dose (0.01%) atropine is likely to be the most effective method for myopia control but the current barriers to its use are commercial availability and uncertainty over effects of long-term use.
13:30-15:00
Myopia control and global attitudes
Chi Sing Fan and Gary Orsborn gave an informative headline sponsor presentation on behalf of CooperVision. They conveyed the mission of CooperVision: to fulfil the unique needs of each patient, to help them see better every day and to do this with passion and ingenuity, through innovation.
Professor Xie Pei Ying, director of the Optometry and Ophthalmology Centre at Peking University, and Professor Pauline Cho, Professor at Hong Kong Polytechnic University, the immediate past president and founding member of the HKCCLS and world-renowned myopia researcher, adopted a novel question and answer approach during this session. The need for advancement of orthokeratology and its potential benefit was outlined, however, Prof Xie recommended, if this was adopted in China, there needs to be government control to safeguard patients.
The findings of a global survey of more than 1,000 participants were discussed by Professor James Wolffsohn and Professor Pauline Cho. This survey suggested that, although practitioners were generally aware of the problems associated with myopia, the vast majority of them are reluctant to prescribe anything other than single vision spectacles. The reasons given for their reluctance to engage with myopia control included concerns about safety, efficacy and risk versus benefit. These findings highlight the challenges faced by myopia researchers in transferring their findings to optometric practice. Unless researchers adopt a united front on myopia control, and form guidelines for practitioners; children will become more myopic, and be at risk of ocular disease.
13:30-16:30
This ‘round-table’ session, chaired by Kate Gifford, featured all of the speakers who proposed the cases for methods of myopia control during the previous three myopia sessions throughout the day. A range of insightful, and sometimes provocative, questions were put to the panel by chair Gifford and delegates in the audience. Although no firm consensus was reached on a definitive myopia control approach was reached, the panel agreed with each other on many areas; and disagreed on others. This gave delegates a real insight to the current state-of-play in myopia control.
Thanks must go to the BCLA and the HKCCLS for organising this magnificent event. I look forward to the next one.
