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Jennifer Li, MD, details a talk she gave alongside Melissa Barnett, OD, FAAO, FSLS, FBCLA, at CRU 2025 in Napa, California.

CRU 2025: Neurotrophic keratitis and multidisciplinary approaches to enhance patient outcomes

Deb Ristvedt, DO, details a handful of presentations on glaucoma she gave during CRU 2025 in Napa, California.

CRU 2025: Interventional glaucoma as a proactive approach to glaucoma management

Articles

The decision to discontinue the trials comes shortly after the announcement that COAST missed its primary endpoint.

Opthea discontinues COAST and ShORe trials in wet AMD

Cecelia Koetting, OD, FAAO, DipABO, weighs in on patient assessments, staining pattern insights, and diagnostic tips for patients who may have dry eye disease.

CRU 2025: A closeup of diagnostic approaches and examination tips for DED and OSD

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New data shows that contact lens wear is a healthy option for kids as young as age 8

Transcript: Contact lens wear is a healthy option for kids

Podcast: Contact lens wear is a healthy option for kids

Contact lens wear is a healthy option for kids

Cecelia Koetting, OD, FAAO, DiplABO, details a talk she gave among optometrists and ophthalmologists at CRU 2025.

The importance of comanagement and thorough examination in neurotrophic keratitis cases

Neurotrophic keratitis (NK) is a critical eye condition that is often misdiagnosed and misunderstood, according to Cecelia Koetting, OD, FAAO, DipABO. In her presentation "Neurotrophic Keratitis: Multidisciplinary Approaches to Enhance Patient Outcomes," presented alongside Melissa Barnett, OD, FAAO, FSLS, FBCLA; Jennifer Li, MD; and Quan Đông Nguyễn, MD, MSc; an overview of what to look out for in diagnosing neurotrophic keratitis was given.

Unlike typical dry eye, NK can progress to serious complications such as persistent epithelial defects, corneal ulcers, and potentially requiring a corneal transplant. The key to effective management lies in early detection through careful corneal sensitivity testing. 

Practitioners can use various tools to check corneal sensitivity, including cotton tip applicators, crochet bins, or even dental floss. The primary challenge is recognizing that what appears to be standard ocular surface disease may actually be NK. Misdiagnosis can lead to ineffective treatments, making accurate identification crucial. 

The approach to NK management is multifaceted and collaborative. Successful treatment often involves co-management across different medical specialties. For instance, oncology patients experiencing side effects from cancer medications frequently present with NK symptoms. Similarly, rheumatology patients with conditions like lupus, sarcoidosis, or Sjogren's syndrome may also develop NK. 

Each patient's NK management is unique. Some practitioners may take a more aggressive approach, treating the condition comprehensively, while others might refer to specialists for specific interventions. The goal is to create an approachable and flexible treatment strategy that addresses the individual patient's needs. 

Referral to a cornea specialist becomes necessary when surgical interventions are required. However, many stages of NK can be effectively managed through careful monitoring, appropriate treatments, and interdisciplinary collaboration. The most critical takeaway is the importance of thorough examination and corneal sensitivity testing. By recognizing NK early and understanding its potential progression, healthcare providers can prevent more severe complications and provide targeted, effective care for patients experiencing this complex eye condition.

Cecelia Koetting, OD, FAAO, DipABO, details a talk she gave among optometrists and ophthalmologists at CRU 2025.

Conference

CRU 2025: The importance of comanagement and thorough examination in neurotrophic keratitis cases

This poll is for optometrists and eyecare professionals, only. It will close on Friday, March 25, 2022.

E. Poor understanding of optometry by others

Poll: What is your biggest frustration with optometry as a whole?

Bausch + Lomb has announced the US launch of Arise, a lens fitting system that uses intelligent, cloud-based technology to aid in the orthokeratology lens design process. Arise is capable of syncing directly with topographers to create precise lens designs for the treatment of myopia in the matter of seconds. The system also utilizes the first orthokeratology lens design with toric peripheral curves approved by the US Food and Drug Administration to treat myopia overnight, according to a news release.

“Traditional orthokeratology lens fitting methods can be complex and time-consuming,” said Yang Yang, president of Global Vision Care at Bausch + Lomb, in the release. “The Arise platform’s streamlined fitting process will reduce chair time and increase efficiency for eye care professionals.”

Arise works by utilizing advanced algorithms to interpret corneal topography images and recommends lens designs without a fitting set required. The system evaluates lens centration and patient progress by using an overnight outcome map library and recommends any adjustments needed following overnight wear. Arise’s cloud-based platform also allows secure access to patient data and provides direct support from the Bausch + Lomb expert consultation team. The system is designed for lens fitters of all experience levels.

“Arise combines all aspects of the orthokeratology process—from topography capture to lens design and more—into one seamless, user-friendly technology,” said Brooke Messer, OD, FAAO, FSLS, of Vance Thompson Vision in West Fargo, North Dakota, in the release. “The ease and precision of Arise will be a welcome addition to my practice.”

Arise is now commercially available in the US, the UK, and Europe.

The Boston orthokeratology (oprifocon A) shaping lenses for overnight wear available with Arise are indicated for use in reduction of myopic refractive error in non-diseased eyes. The lenses can be used in part of the Bausch + Lomb Vision Shaping Treatment VST process for the temporary reduction of myopia up to 5.00 diopters with eyes having astigmatism up to 1.50 diopters.

Bausch + Lomb launches Arise orthokeratology lens system in the United States. News release. Bausch + Lomb. March 17, 2025. Accessed March 17, 2025.

The system aids in the orthokeratology lens design process by syncing directly with topographers to create precise lens designs for the treatment of myopia in the matter of seconds.

Bausch + Lomb launches new Arise lens fitting system

Okyo Pharma has filed an application for Fast Track designation with the US Food and Drug Administration (FDA) for urcosimod (formerly known as OK-101) for the treatment of neuropathic corneal pain (NCP).

Gary S. Jacob, PhD, CEO of Okyo Pharma commented on the application in a press release from the company.

“Fast track was first introduced by FDA to expedite development and review of drugs to treat serious conditions lacking any FDA-approved drug,” said Jacob. “Notably, neuropathic corneal pain falls into this category, and our application for Fast Track designation marks a significant milestone in our commitment to addressing the urgent needs of patients suffering from this type of pain. It is our belief that urcosimod has the potential to redefine the treatment paradigm for individuals grappling with this challenging condition.”

Fast track designation allows for the company to have more frequent meetings with the FDA to discuss the drug’s development plan, ensure collection of appropriate data needed to support drug approval, as well as the use of a rolling FDA review to expedite its regulatory path

NCP is a condition that causes severe pain and sensitivity of the eyes, face, or head, and the exact cause is unknown, but is thought to result from nerve damage to the cornea combined with inflammation. There is currently no FDA-approved drug to treat NCP.

Urcosmod is a lipid conjugated chemerin peptide agonist of the ChemR23 G-protein coupled receptor, typically found on immune cells of the eye responsible for the inflammatory response. Urcosimod showed clear statistical significance in multiple endpoints in a 

recently completed Phase 2, multi-center, double-masked, placebo-controlled trial to treat dry eye disease

presently being evaluated in a randomized, placebo-controlled, double-masked Phase 2 trial

 to treat 48 neuropathic corneal pain patients.

announced the United States Adopted Name (USAN) of urcosmid, formally OK-101.

 According to the company, the suffix “-mod” in urcosimod denotes its classification as a modulator of key inflammatory and neuropathic pathways, critical to addressing ocular conditions such as neuropathic corneal pain and dry eye disease.

OKYO Pharma files for Fast Track Designation with FDA for urcosimod to treat neuropathic corneal pain. Published March 10, 2025. Accessed March 10, 2025.

https://ir.4dmoleculartherapeutics.com/news-releases/news-release-details/4dmt-announces-first-patients-enrolled-4front-1-phase-3-clinical

Urcosmod is a lipid conjugated chemerin peptide agonist of the ChemR23 G-protein coupled receptor, typically found on immune cells of the eye responsible for the inflammatory response.

Canonical

OKYO Pharma files Fast Track designation application with the FDA for urcosimod for the treatment of NCP

Ocugen, Inc. completed dosing ahead of schedule in the Phase 2 portion of the Phase 1/2 ArMaDa clinical trial for OCU410. This candidate is a novel multifunctional modifier gene therapy candidate in development for the treatment of 

. OCU410 targets multiple pathways associated with GA.

Shankar Musunuri, PhD, MBA, Chairman, CEO, and Co-founder of Ocugen spoke to this milestone in the company’s press release, saying, “Dosing completion is a major accomplishment for our OCU410 program. Based on the multifunctional effect of our modifier gene therapy, the profound unmet medical need, limited treatment options, and the fact that it is designed as a one and done treatment, we believe OCU410 can be a potential blockbuster therapy and the gold standard for treating GA worldwide. The data from this trial will help us design a future pivotal Phase 3 study planned for 2026 and enable our commercial strategy for Biologics License Application (BLA) and Marketing Authorization Application (MAA) filings as soon as 2028.”

Huma Qamar, MD, MPH, CMI, is the Chief Medical Officer of Ocugen. In the press release he shared, “Given the safety concerns associated with currently approved GA treatments, the encouraging safety and tolerability profile of OCU410 offers a promising treatment option. With Phase 2 enrollment now complete, OCU410 has the potential to be a one-time treatment, reducing the burden of frequent injections, improving patient compliance, and ultimately enhancing quality of life.”

In the Phase 2 study, the safety and efficacy of OCU410 in patients with GA secondary to dAMD will be assessed. Fifty-one patients were randomized 1:1:1 into either of 2 treatment groups (medium or high dose) or a control group. In the treatment groups, subjects received a single subretinal 200-µL administration of 5 x 1010 vector genomes (vg)/mL (medium dose) or 1.5 x 1011 vg/mL (high dose), while the control group remained untreated.

The ArMaDa clinical trial for OCU410 is being performed at 14 retinal surgery centers across the US.

1. Ocugen, inc. Announces dosing completion in the phase 2 armada clinical trial for ocu410—a multifunctional modifier gene therapy for the treatment of geographic atrophy secondary to dry age-related macular degeneration. Ocugen, Inc. February 12, 2025. Accessed February 13, 2025. https://ir.ocugen.com/news-releases/news-release-details/ocugen-inc-announces-dosing-completion-phase-2-armada-clinical

OCU410 is a novel multifunctional modifier gene therapy candidate that targets multiple pathways associated with GA.

Pipeline

Ocugen, Inc. completes dosing in Phase 2 portion of ArMaDa clinical trial for OCU410

Unless you’ve been practicing under a rock for the past 15 years, you’ve likely heard of the “20- 20-20 rule" for computer eye strain. It has been recommended by almost every major state association and eyecare industry outlet, including the American Optometric Association (AOA), the American Academy of Ophthalmology (AAOpt), The Vision Council and many more. But have you ever wondered where it came from or what was the rationale for the practice?

I graduated from Illinois College of Optometry in 1975. After my 2-year active duty service for the US Navy in San Diego and a few years in private practice, I started working at an office near a local university. It was here where I started seeing patients who had vision problems that didn’t fit “the mold” for their age. For instance, patients in their 20s were just starting to become myopic; others were having headaches, but only during the weekdays and at the end of the day. When I began to ask questions about their lifestyle and activities, I found that most of these people were in the computer sciences division at the university. Since I completed my optometric education during the 70s, we never studied the effects that screens had on the vision of a student or office worker. This area of “display viewing” was new and there were few, if any, studies on the interaction of the computer display and vision. I decided then that this was an area of eye care that was underserved and needed to be addressed.

Fortunately, I was able to contact the renowned James Sheedy, OD, PhD, then professor at the UC Berkeley School of Optometry, who was conducting studies of computer-related eye strain. I followed up with him to see the results of his studies and decided to form a consulting business to go directly to corporations and other businesses where workers were using computers on a regular basis. I would go to their corporate offices and perform on-site evaluations, giving lectures and making recommendations based on my findings. In addition, I started offering presentations to ergonomic conferences due to the fact that many of these professional never had any background on the workings of the visual system.

 in 1998. Soon after this publication, I was invited to give interviews with media outlets (radio and TV), which looked at this new concern for vision stress as another effect—in addition to carpal tunnel syndrome—of computer use. Given time limitations, they all asked for a “nutshell” approach to resolving this issue. This is when I came up with the “3-B” approach, which was to “Blink, Breathe, and Break.”

Around this same time, I came across a research study on carpal tunnel syndrome that noted that shorter, more frequent breaks from computer use were more beneficial than one break every two hours, which was previously recommended. I realized that the same held true for the visual system, so to simplify the discovery, I created the “20-20-20” rule for display users. The rule states, “Every 20 minutes, take 20 seconds and look 20 feet away.” As I mentioned, this rule has now been adopted by the AOA, AAOpt, the Vision Council, and many more organizations and independent eyecare professionals.

I once attended a conference where a speaker was discussing myopia. I found it a bit disconcerting when, toward the end of the lecture, the speaker announced, “The 20-20-20 rule doesn’t work.” I was taken aback at this statement but quickly realized that the speaker was referring to myopia and not eye strain. After the presentation, I met the speaker in the lobby and mentioned that I developed the rule to relieve eye strain and not as a myopia control technique. I had hoped that I got the point across but recently, I’ve seen more recommendations from a variety of sources that promote the rule for myopia control.

I never did trademark the rule but am gratified to have a few organizations and colleagues acknowledge where it originated. One day in 2018, I received a call from an optometrist in San Diego who was writing an article on the source of the 20-20-20 rule. He asked me if I knew where it came from. I said, “as a matter of fact, I do!” He interviewed me, and in February of 2018, Dr. Brian Chou published his article, “

Deconstructing the 20-20-20 rule for digital eye strain

Again, the rule was not trademarked, but I take great pride in the fact that I have not only helped patients, but I have also helped my profession. It was gratifying to have attendees from my early ergonomic lectures return the following year and exclaim, “Hey, you’re that 20-20-20 guy!”

It's funny the way things work out. And to all my colleagues who quote the rule to media outlets and patients: You’re welcome!

The 20-20-20 rule has taken on a life of its own, but it remains a useful trick to reduce digital eye strain.

Jill Woods, MSc, MCOptom, FAAO, FBCLA

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