Five days in Denver

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Therapeutics

There was a mini-epidemic of viral conjunctivitis in London last year as was evident by the several cases attending the clinic where I work. I am always conscious of having once received a scathing letter from a hospital to which I had referred an adenoviral conjunctivitis, accusing me of spreading an untreatable and contagious condition. I was therefore very interested in a new product launched at the conference, the Rapid Pathogen Screening Adeno Detector. This simple sterile strip acts as an in-practice diagnosis aid for use on suspect conjunctivitis cases. In the US there are 10 to 12 million reported cases of conjunctivitis each year, just over 40 per cent of which are bacterial and a similar number viral (primarily adenoviral). The RPS looks similar to a pregnancy indicator test in that the sterile strip is touched on the watery discharge and within 10  minutes, if adenoviral antigen is present, a small blue colour line appears.

The test has just received FDA approval for optometrist and ophthalmologist use and, in recent published tests, has been shown to have 89 per cent sensitivity (ability to correctly diagnose disease) compared with 90 per cent for lab culture testing and 94 per cent specificity (ability for non-adenoviral cases to be found as such) compared with 100 per cent for lab tests. This simple test should reduce unnecessary referral, reduce potential of contagion as correct advice about hygiene may be given at the point of consultation, reduce unnecessary antibiotic prescribing and improve patient satisfaction – patients prefer a specific diagnosis.

Advanced Vision Research (responsible for the TheraTears products) was promoting its enhanced range of lid care products. The SteriLid Eyelid Cleanser is now available in the US on prescription, the antibacterial foam being dispensed along with 60 50mg tetracycline tablets for bacterial component blepharitis management.

Allergan was supporting a number of presentations relating to the latest direction of its researchers in attempts to minimise dry eye symptoms. Increased aqueous evaporation not only reduces tear volume but increases tear osmolarity. Cells respond to this by a triggered volume regularity adjustment, increasing their own salt content and therefore drawing water in. This process is thought to damage cell structure in the long term. If the cell instead was ‘encouraged’ to uptake another compatible solute to salt, this should effectively protect the cell, a process being described as osmoprotection. Saltwater algae produce a glycerol salt and can tolerate high salt environments with little or no damage. There is therefore a big potential for compatible solutes in dry eye products which can offer osmoprotection for surface cells.

Alcon, on the other hand, was promoting its newest anti-allergy drop Pataday. This contains twice the concentration of active ingredient olopatadine contained in its predecessor (Patanol) and tests have shown significant reductions in allergic symptoms with the new drops.