I can't wait to get on the plane to Las Vegas for the annual Global Specialty Lens Symposium.

I personally can't think of a better way to start the new year: to get all excited about the 'hot stuff' in our field and to see what will keep us busy this year by talking to people from all over the world who work on these interesting topics: researchers, clinicians and manufacturers alike. It is like a 'live version' of the I-site newsletter - 4 days long. A few topics will stand out this year: first and foremost is 'the Myopia Epidemic - Can it be Managed or Controlled?' Earl Smith, Pauline Cho and John Phillips form just the perfect team to kick off the symposium by looking at this topic and where we stand right now. A large session is devoted to large diameter lenses in all their aspects. And in both the fundamentals session and the general session (and the free paper session), much attention will focus on corneal topography/the irregular cornea and contact lenses for presbyopia. As a kind of 'preview,' this issue of the I-site newsletter will highlight these topics, which I think will be (or should be) on the front cover of the contact lens journals in 2011. Hope to see you 'Live in Las Vegas' - it promises to be a nice show. I also hope that whatever happens in Vegas at the conference will not stay in Vegas. I'll do everything I can to help to prevent that.

Orthokeratology and myopia control remain in the spotlight this year (agreed: that is a pretty safe prediction). On the verge of 2011, an article in Contact Lens Spectrum looked at 'Slowing Down Myopia With Contact Lenses,' reporting on current myopia progression control developments with contact lenses, including orthokeratology. Tsui-Tsui Lee and Pauline Cho presented a case report in the December issue of Optometry and Vision Science regarding a girl who had been wearing orthokeratology lenses for over 2 years. Axial length increase of the eye during spectacle lens wear occurred at a faster rate compared to during the corneal reshaping period. It was concluded that for this child, corneal reshaping appeared to slow down myopic progression. From the same group of investigators based in Hong Kong, a study on corneal curvature change and recovery after 6 months of overnight orthokeratology showed that steepening of the posterior cornea was seen only immediately after lens removal, and it returned to its original shape within 2 hours after cessation of lens wear. The investigators claim that reduction in myopia from corneal reshaping treatment is therefore mainly due to flattening of the anterior cornea (full access PDF is available from the Ophthalmic and Physiological Optics website).

Another fairly safe assumption for 2011 is that, since it is a new, exciting and developing technology, scleral lenses will also feature in many contact lens-related media in the coming year. A few years ago, only a handful of very specialized lens fitters around the world were capable of fitting scleral lenses successfully, and only a few manufacturers were making scleral lenses. Improved manufacturing processes allow for better design, make lenses more reproducible and decrease costs, which combined with better lens materials has contributed to better ocular health, longer wearing time and ease of lens fit. And we continue to learn more about the scleral shape. An interesting article in Clinical and Experimental Optometry by Gina Sorbora et al looked at scleral shape of the anterior ocular segment over a 15mm cord. They found that as the cornea steepened, the corneal/scleral sagittal depth increased and the nasal/temporal scleral angles became larger. But they concluded that individual differences in scleral shape and small sample size resulted in low correlations between these parameters. The mean corneal/scleral sagittal depth was 3.74 mm for the 40 eyes tested. Indications for scleral lens fitting have been evolving over the last few years, emerging from a lens for severely irregular corneas only to a much broader spectrum of indications. One example of a scleral lens indication was highlighted in Contact Lens Spectrum by Alerino Iacobbo: the use of mini-scleral lenses in filamentary keratitis