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Articles

Santen introduces low-dose atropine in Germany, marking a significant advancement in myopia management for children amid a global epidemic.

Santen begins European rollout of low-dose atropine for myopia in Germany

This will be the Flying Eye Hospital’s first visit to Rwanda. 

Orbis Flying Eye Hospital touches down in Rwanda to provide training, education to ECPs

Survey participants cited cost concerns, perceived inevitability, and deprioritization as obstacles to receiving eye care.

Survey finds majority of US patients delaying eye care despite experiencing poor eyesight, eye health

New research reveals collagen mimetic peptides may effectively restore ocular tissue stiffness, offering hope for myopia and other eye diseases.

Healing damaged collagen in the eye with topical polypeptides in patients with myopia 

Optometry Times delivers clinical news, practice insights, and research updates by optometrists for optometrists to advance care and patient outcomes.

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Diane Russo, OD, MPH, MBA, FAAO, Dipl AAO PH, and Nicole Quinn, OD, FAAO, highlight the continued importance of residencies in optometric practices.

What do we lose if we do not value residencies?

The Minnesota Optometric Association is celebrating recent legislation that was passed in the form of the state’s first optometric scope expansion bill in more than 20 years. The law will work to remove outdated restrictions on medications and allow some in-office procedures, and will take effect in August, according to an American Optometric Association news release.

“It’s a big win to reduce some of the frustration points that patients have in our health care system,” says Randy Kempfer, OD, advocacy director for the MOA. “Patients can take advantage of the knowledge and expertise of doctors of optometry.”

The bill is a product of more than 7 years of advocacy by the MOA, with the bill first being introduced in 2018. The first Senate hearing came in 2020 right before COVID-19 pandemic lockdowns. “It killed our momentum that year,” Kempfer said in the release.

The bill will make 3 changes that enhance oral medication usage, with 1 change expanding access to in-office procedures. Kempfer stated in the release that this had a significant impact on patient care in the state.

“Minnesota was in the bottom 10% nationwide in scope of practice for doctors of optometry,” he said in the release. “Patients in Minnesota were struggling to find the eye care they needed.”

Previously, ODs in Minnesota could only prescribe oral antivirals for up to 10 days. “That was a huge barrier,” Kempfer said in the release. The bill removes that restriction, allowing oral antiviral prescriptions with an unlimited timeframe. “Some patients need antivirals long term to save their vision,” he said in the release.

The bill will also work to remove restrictions on prescribing carbonic anhydrase inhibitors for glaucoma. Other medications that were barred from ODs’ prescribing power were oral steroids. Now, the bill will allow optometrists to prescribe the steroids for up to 14 days without requiring a consultation with an MD.

“We join 44 other states in having the ability to prescribe oral steroids,” Kempfer said in the release.

Additionally, optometrists will now be allowed to administer in-office injections to treat minor eyelid issues, including local anesthesia, removing lesions 5 mm and small, and injecting paralytic agents, including for cosmetic purposes.

“Prior, patients would have to wait, potentially months, to see another provider,” Kempfer said in the release. “Now we can help our patients right in the office.”

Minnesota passes long-awaited scope expansion bill. News release. American Optometric Association. July 16, 2025. Accessed July 18, 2025. 

https://www.aoa.org/news/advocacy/state-advocacy/minnesota-passes-long-awaited-scope-expansion-bill

The bill will make 3 changes that enhance oral medication usage, with 1 change expanding access to in-office procedures. 

Minnesota passes first scope expansion bill in over 2 decades

In a press release, Santen Pharmaceutical Co, Ltd announced the European Commission (EC) granted marketing authorisation for its 0.1 mg/mL atropine eye drop. The low-dose drop, marketed as Ryjunea, is licensed from California-based Sydnexis Inc to Santen SA, based in Switzerland.

 In April, the European Medicines Agency (EMA) and its Committee for Medicinal Products for Human Use (CHMP) granted a positive opinion for the atropine drop as a therapy for pediatric myopia.

According to the press release from Santen, the drop, previously known by the development code STN1012701 or as SYD-101, is approved for children aged 3 to 14 years at initiation of treatment. Ryjunea is indicated for myopia progression of 0.5 diopters (D) or more per year and a severity of -0.5 D to -6.0 D.

The CHMP decision and subsequent EC approval announcement are based on the phase III STAR study, a clinical study for treating the progression of pediatric myopia. Research findings demonstrated that the low-dose atropine drop reduced the annual progression of myopia by 30% over 2 years compared with placebo, the company said. The safety and tolerability profile of the treatment was favorable.

In the STAR study, the drop successfully reached its 3-year primary end point in the trial, demonstrating efficacy in slowing the annual progression rate of myopia in pediatric patients aged 3 to 14 years at 24 months. The trial is now completing randomized withdrawal for exploratory end points ahead of its fourth year. According to a prior announcement from Sydnexis, third-year results will be announced upon completion of the fourth year of the study.

Peter Sallstig, MD, chief medical officer at Santen, said it was crucial for patients and parents to have an “evidence-based” interventional strategy for pediatric myopia. “For families, watching their child’s vision worsening year after year can be deeply worrying,” he said. “Ryjunea offers the opportunity to act early. As a low-dose atropine eye drop, administered once daily at bedtime, it provides a convenient way to manage myopia that integrates easily into a child’s routine.”

Santen SA will lead registration and commercialization efforts throughout Europe, as well as in the Middle East and Africa.

In the US, the FDA issued Ryjunea a PDUFA date of October 23, 2025.

European Commission Approves Santen’s Ryjunea® to Slow Progression of Paediatric Myopia. Press release. Santen Pharmaceutical Co., Ltd. Published June 5, 2025. Accessed June 5, 2025. 

https://www.santen.com/en/news/2025/2025_1/20250605

Hayes, H. EMA grants positive CHMP opinion for low-dose atropine SYD-101 (Ryjunea, Sydnexis). 

 Published April 1, 2025. Accessed June 5, 2025. 

https://europe.ophthalmologytimes.com/view/ema-grants-positive-chmp-opinion-for-low-dose-atropine-paediatric-myopia-syd-101-ryjunea-sydnexis-

The 0.1 mg/mL atropine eye drop for pediatric myopia is licensed from Sydnexis, Inc.

Canonical

European Commission approves low-dose atropine eye drop Ryjunea, Santen announces

Ahmad M. Fahmy, OD, FAAO, discusses how amniotic membranes can be effectively incorporated into optometric practice as a “reset button” treatment for the full continuum of ocular surface disease severity, from mild to severe cases. This offers patients an alternative to multiple eye drops while being efficiently applied during regular clinic visits.

Incorporating Amniotic Membrane Into Optometric Practice

Video content above is prompted by the following: 

Ahmad M. Fahmy, OD, FAAO, an optometrist at Minnesota Eye Consultants and founder of the Twin Cities Ocular Surface Disease Symposium, presents insights from a roundtable discussion on regenerative medicine for ocular surface disease. The discussion focused on the evolving role of amniotic membranes in treating patients across the spectrum of ocular surface disease severity, from mild to severe dry eye conditions. This treatment provides a valuable “reset button” for corneal and conjunctival epithelium when patients experience refractory symptoms to conventional treatments.

The presentation addresses practical considerations for incorporating advanced ocular surface disease treatments into optometric practice. Modern optometrists are well positioned to improve patient quality of life through various treatments including eye drops, in-office procedures like intense pulsed light and lid margin warming, and regenerative medications including amniotic membranes. Fahmy emphasizes that choosing the right treatment depends on clinical signs and patient-specific information, making clinical decision-making more systematic and effective.

A key advantage of amniotic membrane therapy is that it is performed in the office under direct practitioner supervision, eliminating the need for patients to manage multiple drop regimens. Fahmy uses Cam 360, a cryopreserved amniotic membrane, and has developed efficient protocols allowing quick application during regular clinic visits without disrupting workflow. He reports consistent improvement in epitheliopathy by approximately 1 severity level according to established dry eye staging systems, making this treatment particularly valuable for refractory cases across all severity levels.

Video Series

Advancing Dry Eye Management: Integrating Regenerative Therapies Into Optometric Practice 

Cothran, OD, FAAO, discussed the importance of optometrists addressing mental health with patients in their chair.

AOA 2025: A mental health primer for the optometric physician with Dr Nora Lee Cothran

During the American Optometric Association's Optometry's Meeting 2025 in Minneapolis, Minnesota, Nora Lee Cothran, OD, FAAO, delivered a presentation titled "Hello Darkness, My Old Friend: A Mental Health Primer for the Optometric Physician." Her primary objective was to educate optometrists about mental health, focusing on depression, anxiety, suicide, and intervention strategies. 

The lecture emphasized the importance of recognizing mental health changes in patients, staff, family members, and health care professionals. Cothran highlighted that mental health disorders can be triggered by significant life events like losing a loved one, experiencing divorce, or job loss, but can also emerge unexpectedly. She stressed the significance of observing behavioral changes, such as deteriorating personal hygiene or missed appointments, which could indicate underlying mental health issues. Cothran encouraged health care professionals to ask open-ended questions like "Are you okay?" and demonstrate genuine care, as sometimes simply showing someone they are valued can be life-changing. The presentation covered various mental health conditions, including major depressive disorder, seasonal affective disorder, and peripartum depression. She shared alarming statistics, such as 1 in 7 women experiencing peripartum depression, which is the leading cause of maternal mortality in the US. 

A critical aspect of her talk was destigmatizing suicide discussions. Cothran emphasized that talking about suicide does not drive individuals toward it but can actually prevent it by making people feel supported and understood. She noted that during psychological distress, individuals might not think rationally, and compassionate intervention could be life-saving. Cothran also discussed how chronic or sight-threatening conditions impact mental health. For instance, 60% of stroke patients experience poststroke depression, which increases the risk of subsequent strokes and mortality. 

Cothran's core message was for health care professionals to adopt a holistic approach to patient care. By looking beyond medical symptoms and considering patients' entire well-being, doctors can provide more comprehensive and compassionate care. She urged her colleagues to be observant, supportive, and proactive in addressing mental health concerns. The lecture concluded with a powerful call to action: Health care professionals should look out for their patients, family members, and themselves, recognizing that mental health is an integral part of overall health.

Nora Lee Cothran, OD, FAAO, discussed the importance of optometrists addressing mental health with patients in their chair.

Conference

Karen R. Hoffman, OD, shares how customizable scleral lenses can transform vision for patients with complex corneas, achieving 20/20 outcomes and enhanced comfort.

AOA 2025: Highlighting microvaults in customizable scleral lenses for patients with complex corneas

At the 2025 AOA Optometry’s Meeting, Karen R. Hoffman, OD, presented 3 cases in which patients with complex corneas were fitted with customized scleral lenses (Zenlens; Bausch + Lomb); in the end, each patient achieved 20/20 vision and were happy with their vision and were able to wear the lenses comfortably for extended periods.

Hoffman's poster, which is entitled, "Utilization of customizable toric peripheral curves to optimize scleral lens fit and vision outcomes in patients with irregular astigmatism and corneal complexities," showcased the clinical work of herself, Cian Gildea, BscOptom, and Boris Severinsky, OD, FAAO, FBCLA, FSLS.

Hoffman spoke on the clinical utility and customization potential of microvaults in scleral lens design. Her work highlights an underutilized yet powerful approach to managing complex corneal irregularities and improving outcomes for both patients and practitioners.

According to Hoffman, microvaults can be placed anywhere on a scleral lens, including the vaulting chamber or at the lens edge. With dimensions up to 900 microns in depth and 9 millimeters in diameter, these design modifications allow for precise vaulting over corneal abnormalities such as scars or elevated tissue.

In one standout case, Hoffman describes a patient with a peripheral corneal scar. By placing a microvault inside the vaulting chamber, the lens achieved complete clearance, avoiding any contact with the sensitive area. "We don’t want the lens touching the eye anywhere except at the landing zone," she emphasized.

Clinical outcomes: Better vision with fewer revisions

One of the most surprising and encouraging aspects of her findings was that in all three presented cases, patients achieved 20/20 vision with only 2 to 3 lens revisions. "It is possible in our practices to fit these lenses successfully—even in challenging cases," she said.

Patients reported high comfort and long wear time, while eye care professionals (ECPs) also expressed high satisfaction with the fitting process and outcomes. These findings speak not only to the viability of advanced scleral lens designs but also to the importance of broader adoption.

Hoffman sees a significant gap in access to specialty lens fittings, noting the demand far exceeds the number of providers currently offering these services. “This is a big underserved area in our field,” she stated. “My hope is that my presentation inspires even one optometrist to take that next step and begin fitting scleral lenses.”

Hoffman’s work at the 2025 AOA Optometry’s Meeting reinforces the transformative potential of modern scleral lens technologies, especially for patients with challenging ocular conditions. With tools like microvaults, today's optometrists are equipped to provide life-changing vision correction—one custom lens at a time.

In its debut year, the AOA Innovation Hub encouraged conversation between clinicians, tech titans, startups, and industry reps about the road ahead for technology and artificial intelligence (AI) in eye care. Moderated by Scot Morris, OD, the Innovation Hub was split into 3 panel discussions on assessing future health through AI-enabled tools, addressing patient workflow challenges through AI, and enhancing treatment through new technologies.

"This isn't just another summit—it's a call to action to challenge your perspectives, engage with these industry titans and be at the forefront of the evolution of eye care," said Scot Morris, OD, session moderator.

Assessing future health through AI-enabled tools

Panelists Laure Pichereau, CEO of SiView; Patrick Sauvageau, OD, MSc, CEO of Zilia; and Catherine Bornbaum, PhD, MBA, president of RetiSpec, joined moderator Scot Morris in discussing the broad challenges of integrating AI into practice. One of the biggest challenges cited was overcoming resistance to change, but panelists agreed that AI could be a powerful tool to delegate and streamline routine tasks, which would give practitioners more time to dedicate to complex patient needs and enhanced care quality.

In addition to streamlining routine tasks, the experts discussed the eye’s position as the “window to health,” which creates an opportunity to leverage quantifiable ocular biomarkers to discover problems elsewhere in the body. AI has the potential to make this particularly powerful. However, the panelists agreed that seamless integration into existing workflows was the key to adoption to minimize disruption to the staff and the patient. Other factors in successful adoption were discussed, with the panelists especially interested in models that leverage established reimbursement pathways, such as CPT codes, and a tangible return on investment. Collaboration between eye care providers and technology developers would be key in creating a model that meets the needs of most optometric practices.

In terms of future outlook, Morris made the key point of how difficult it is to secure substantial funding for research and development of AI models, particularly if they require clinical studies to validate. Interestingly, the panelists discussed how AI should be included in academic curricula to prepare the next generation of optometrists appropriately; they agreed that education on AI would help the industry move forward and march toward becoming the primary “gatekeepers of health.” They did not discuss the need to continuing education in AI.

Addressing patient workflow challenges through AI

The next panel, also moderated by Morris, analyzed the impact of natural language processing (NLP) and AI on eye care workflows. Panelists Grant Shmid, VP of business development at Altris AI; Colton Calandrella, cofounder and CEO of Barti; and Easy Anyama, OD, an AOA volunteer, chatted about their experience with AI scribes and electronic health records (EHR).

The discussion underscored the value of AI in these cases; at one point, it was stated that using an AI scribe was “10 times better” than using a traditional EHR due to time savings. Together, the panelists envisioned a future in which AI would become so engrained in workflows that it is functionally invisible, which would ultimately make doctors irreplaceable because they are now free to provide high-value patient interactions. As stated before, optometry and eye care in general have the power to detect pathology early using biomarkers in the eye, making the industry well-positioned to lead the charge in AI adoption in practice.

Enhancing treatment through new technologies

The final session pivoted away from AI a bit but honed in on new and exciting technology. This session, moderated by Nora Lee Cothran, OD, featured panelists Mile Brujic, OD, for MediPrint Ophthalmics; Ben Bergo, president chief business officer of Tenpoint Therapeutics; and Elan Weiner, founder and CEO of ECI Therapeutics.

Each panelist discussed the technology under investigation by the company they were representing. Brujic spoke about the bimataprost-eluting contact lens for the treatment of glaucoma from Mediprint; Bergo described Tenpoint’s proprietary brimochol, a combination of brimodine and carbachol for presbyopia; and Weiner discussed ECI’s platelet-rich, plasma-derived growth factor eye drops. Underscoring each of these participants was a desire to improve patient outcomes through innovative means—which is hopefully always the goal as optometrists invite technology and AI into their workflows.

The Innovation Hub was split into 3 panel discussions on assessing future health through AI-enabled tools, addressing patient workflow challenges through AI, and enhancing treatment through new technologies.

Nicole Quinn, OD, FAAO

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