Optometric Visionary Henry B. Peters Dies
New Glaucoma Treatment Promises Instantaneous Monitoring
Student Debt: You Can't Always Debt What You Want
FDA Panel Conditionally Endorses Holmium LTK
Specialty Opens New Contact Lens Plant
B&L, Alcon Settle Lawsuit
In The News

Optometric Visionary Henry B. Peters Dies

The University of Alabama School of Optometry building is now named after Dr. Peters, who was a professor and dean emeritus of the school. 

During his lifetime, he contributed significantly to the reputation of two major schools of optometry, the University of California at Berkeley as associate dean and UAB as the founding dean and inaugural faculty member. During Dr. Peters' tenure as UAB dean, the optometry students established an outstanding record on state and national board examinations and he created the first optometric clinical teaching program in the Birmingham VA Medical Center. Peters retired in 1986 at the age of 70. 

Pierce Mortuary Chapel is directing memorial arrangements. 

In lieu of flowers, the family requests memorials be made to the Henry B. Peters Symposium on Interprofessional Relations, School of Optometry, University of Alabama at Birmingham. 
Dr. Peters was a native of California. He is survived by his wife, Anne (Ledin); and their daughter Elizabeth; his daughter Lynn; and sons Thomas (and wife Barbara), James (and wife Kathy) and Christopher; and their mother, Carol (Woodhams); two sisters, Leanore Mott (and husband Dorr) and Marilyn "Molly" Bates; a brother, Richard (and wife Ramona); five grandchildren; and six great-grandchildren.

He was born Nov. 2, 1916, to Thomas H. and Eleanor (Hough) Peters in Oakland, Calif. He earned a bachelor of arts/doctor of optometry degree from the University of California at Berkeley in 1938 and his master's degree in public health from the University of Nebraska at Lincoln in 1939. He served in the U.S. Naval Reserve during WWII.

While in private practice, he was active in education and research. His primary research effort, commonly known as The Orinda Study (1959), paved the way for school-based vision screening, and is still discussed in colleges and universities today. 

In 1969, he was appointed dean of UAB's School of Optometry, the first school of optometry to be directly associated with a medical center. At UAB, he also served as professor of public health, senior scholar for several departments and as founding director of the UAB Research Foundation. 

At UAB Dr. Peters worked extensively with the Veteran's Administration to enhance the role of optometry in health care. He served on the board of directors of the National Health Council from 1969 to 1983, and was the first optometrist to be elected president of the organization in 1978. 

He was an active member of the Association of Schools and Colleges of Optometry, the National Board of Examiners in Optometry, the American Medical Association, the American Physical Therapy Association, the California and Alabama optometric associations and the American Optometric Association. He was named a fellow of the American Academy of Optometry in 1946 and remained active in the Academy throughout his career, serving as chair of several committees and as president from 1972 to 1974. The Academy selected Dr. Peters as the first recipient of the Carel C. Koch Medal for Interprofessional Relations in 1974. 

For more on Dr. Peters, visit our RESOURCE/visionaries.htm">Optometric Visionaries archive.
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In the News

New Glaucoma Technology 

Promises Instantaneous Monitoring

Creator M. Marc Abreu, M.D., says the tonometry system that bears his name will improve glaucoma diagnosis and treatment via electromagnetic means. The device will measure IOP and pulsatile blood flow, and will be capable of evaluating aqueous outflow using the frequency response of the eye. Dr. Abreu expects that the latter feature will enable doctors to determine in 10 seconds how well a patient’s drainage system functions and, perhaps, predict future damage from glaucoma. The system is also designed for patients’ use.

“We have created a tonometer that people can use at home, with the doctor setting the target IOP for each patient,” Dr. Abreu says.

The technology comprises an “Intelligent Contact Lens” and an actuator. A magnetic strip or a magnetic disk shaped like a washer is embedded in a hydrogel lens, which has a clear central part for visualization. The actuator is a stand-alone device that generates an electromagnetic field, which acts on the lens and takes corneal thickness into account in its measurements.

The patient looks through the lens at a light inside the actuator, which triggers a circuit, Dr. Abreu says. In 0.01 seconds, faster than the patient can blink, the actuator obtains a measurement from this current based on the distance it’s traveled or on the applanated area.

The system is completely automated. “The patient does not have to press a button and wait for an event to take place,” Dr. Abreu says. “We also don’t have a fright reaction any more, such as blinking or the natural impulse to move back from the applanating device. This technology is based on a silent, invisible and painless actuating force.”

The system will work with either batteries or an electrical outlet. The lenses will cost about as much as disposable contact lenses. The actuator, a one-time purchase, will cost about $200, Dr. Abreu says. But that depends on the patient’s needs. For instance, the system could be equipped with Internet connections, such as those found in a Palm Pilot, to transmit measurements to the doctor. Plans are also in progress to create a handheld version of the device for travel.

Dr. Abreu hopes to submit the system for FDA review in six months and have it available to patients in about two years. Nevertheless, he already has ideas for future generations of the device, including its potential role in LASIK procedures. By attaching the device to a microscope, he says, surgeons would be able to track IOP and pulsatile blood flow as they prepare the eye for a microkeratome pass.

The device should also allow physicians to determine the exact IOP at which an individual patient is at risk of harm, by artificially increasing IOP while monitoring observable physical and chemical changes, such as in glutamate levels. A device that would provide continuous measurement of IOP, using radio waves and resonant frequency, is also in the works.
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FDA Panel Conditionally Endorses Holmium LTK

The approved indication is for the temporary reduction of +0.75D to +2.50D of hyperopia for patients over 40. Sunrise officials predict full FDA approval in the next 3-6 months, and hope to convince the FDA that it has sufficient data to make the conditions unnecessary.

In July the FDA panel unanimously rejected Sunrise’s PMA and called for more comprehensive data on stability. Although Sunrise submitted additional data, the panel still had a problem with the indication statement for the procedure. The panel gave suggestions on how Sunrise could rewrite the indication statement to reflect the conditions. 

Key changes involved changing “correction” of hyperopia to “reduction,” and stating that “the magnitude of correction diminishes over time.”
The panel finally voted 9-0 to approve the LTK treatment with these conditions:

•  Write in the indication that the effect is “temporary.”
•  Add a warning that the data on effective treatment is insufficient at the present time and that available data suggests that the retreatment effect also decreases over time.
• Add specific data on the number of patients who need to wear spectacles or contact lenses after having the procedure.
• Add information on patient symptoms, such as difficulty with night driving, glare and photophobia, and state that data on the frequency of these symptoms within the first 6 months after the LTK is not available.

Even if the current conditions are adopted, Mr. Trenary says, the end result will be positive for Sunrise.

Sunrise expects to have machines ready for shipment by the time the FDA makes its final decision.
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Specialty Adds New Contact Lens Plant

Specialty UltraVision will spend up to $20.65 million to build a new manufacturing facility near Montreal to meet growing global demand for its contact lens products.

This plant will produce the UltraCon toric contact lens, among other Specialty UltraVision products. UltraCon is the world’s first molded, flexible, gas permeable lens, and is intended for monthly replacement.

Specialty UltraVision also plans to move its Canadian headquarters, including research and distribution operations, from Calgary to the new facility in St. Hubert, Quebec. The company’s U.S. headquarters will remain in Campbell, Calif., near San Jose.

The new 75,000-square-foot manufacturing and distribution facility will have an annual production capacity of 150 million contact lenses.

Meanwhile, Specialty UltraVision has agreed to supply CIBA Vision with soft contact lens products. These lenses are not part of Specialty’s existing product line.
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You Can’t Always Debt What You Want

• Southern College of Optometry, up 9.5%.
• New England College of Optometry (including undergraduate debt), up 22%.
• Southern California College of Optometry, up 26%. Indeed, the average optometry graduate student’s debt (including undergraduate) increased by 64% from 1990 to 1996, according to the current issue of Optometric Education.¹

1. More graduates will choose commercial jobs. It’s a common perception, but there’s nothing to prove that more young optometrists are “going commercial” because of their debt, says Lawrence McClure, Ph.D., associate dean for financial affairs at Pennsylvania College of Optometry and author of the Optometric Education article.

Dr. McClure found that debt was actually the number-four predictor of mode of practice. (The number-one predictor of mode of practice? The area in which you live.) These are factors for optometrists at one year after optometry school. Anytime after that, you can’t predict anything, Dr. McClure says.

2. Optometry school tuition is too high. Not necessarily. Some colleges are making good: Illinois College of Optometry froze its tuition last year and hopes to hold the freeze for four years, says Mark Colip, O.D., dean for student affairs.

Despite ICO’s stance, tuition is rising. Meanwhile, the amount of student debt is rising even faster. Dr. McClure reviewed data from the Association of Schools and Colleges of Optometry and says that increasing debt is tied to the lack of available funding other than student loans. ¹

Optometry students, like Americans in general, are increasing their debt load. “We’re an economy awash in debt,” Dr. McClure says. “There are no inhibitions about borrowing.”

Some students are borrowing to their debt limit, even if they don’t need it, Dr. Colip says. Still, others are managing their debt carefully and gaining alternative means of funding.

Southern College of Optometry is one school that tracks debt. Each student gets a debt status report every year and meets with a financial aid officer, says Scott Andreas, dean of students and director of financial aid. He points out that undergraduate debt has also been significantly increasing each year. The SCO program is a counterbalance against a growing debt mentality, he says.

Of course, student debt must take potential income into account, Dr. McClure reminds. And even though student indebtedness is increasing faster than income, optometrists’ earning potential is still quite good. 
The average optometrist makes at least $30,000 more than the average American worker with a 4-year college degree.

1. McClure L. Student indebtedness: The challenge of financing an optometric education. Optometric Education 2000;25(2):45-53.

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B&L and Alcon Settle Lawsuit

As part of the settlement, Alcon will pay B&L $25 million upfront. The Texas company will also fork over a “stream of royalties” over the next 8 years for a worldwide license under B&L’s patent for the simultaneous use of a chemical disinfecting solution with an enzyme protein remover, Bausch & Lomb says.
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Return to February Highlights

© Review of Optometry OnLine 
February 15, 2000