New FDA approval: Rocklatan.

What is Rocklatan?

It’s a drop used once daily to lower IOP and it’s a combo of two drugs, latanoprost and Rhopressa. Rhopressa was recently FDA approved at the end of 2017.

How does Rocklatan work?

Two main ways:
1. Increases uveoscleral outflow - latanoprost works here.
2. Increases outflow through the trabecular meshwork by inhibiting Rho Kinase (ROCK) - Rhopressa works here.

What are the side effects?

The most common ocular adverse reaction is conjunctival hyperemia (59%) but others include instillation site pain (20%), corneal verticillata (15%), and conjunctival hemorrhage (11%).

How much more IOP lowering do we get with this combo drop?

According to their studies, 1 to 3mmHg more than monotherapy with either Rhopressa or latanoprost 0.005% alone. In their clinical trials, more than 60% of patients using Rocklatan achieved an IOP reduction of 30% or more.

When can we get it?

The company plans to launch in the second quarter of 2019. (via)

Raindrop near vision inlay recalled.

The FDA issued a Class 1 recall (the most serious type of recall) due to a post-approval surveillance study that showed 75% of Raindrop inlay patients developed corneal hazing.

What is the Raindrop?

It's a corneal inlay placed in the corneal stroma for correction of presbyopia.

What if I have a patient with this inlay?

The FDA is advising providers to monitor patients with the implant for the development of corneal haze, and to monitor patients whose device has been explanted for the development of corneal haze. (via)


Can you tell if I will get Alzheimer's disease

Fox news reported last week that your eye exam could also detect Alzheimer's disease. They are referring to this study that was just published in Ophthalmology Retina.

Tell me about the study.

The study used OCTA to compare the retinal microvasculature between three groups of patients:
1. Patients with Alzheimer's disease (90 eyes).
2. Patients with mild cognitive impairment (79 eyes).
3. Normal healthy controls (249 eyes).

What vasculature did they look at?

They took 3 x 3mm and 6 x 6mm sections centered around the fovea. The OCTA software analyzed the vessel density (VD) and perfusion density (PD). They also acquired a 512 x 128 macular cube and 200 x 200 optic disc cube to be analyzed.

What did they find?

The authors found a significantly decreased VD and PD in Alzheimer's participants when compared with both mild cognitive impairment and control participants.

How can OCTA and early detection help if there is no treatment?

Two things to mention here:
1. Diagnosing Alzheimer's can be difficult - MRI's are expensive and spinal taps are invasive. The OCTA is easy to perform and could serve as a screening.
2. Early diagnosis will allow researchers to study new medications earlier as future treatments may be more effective when given early. Earlier diagnosis would also give patients and their families time to plan for the future. (via)

This news comes alongside a report that dementia-related deaths have tripled in the U.S.


VSP to open three eyewear stores.

This will be an extension of their e-commerce site, Eyeconic. The first three stores will open in Chicago. (via)

If you've spent any time at all working with patients, this stat will not surprise you.

Six out of ten contact lens wearers are likely wearing their contacts too long according to a new survey. (via)


The percentage of practicing OD's that are women. (via)