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The 2020 Springer Lecture honored Toronto-based optometrist Barbara Caffery, OD, PhD, FAAO. During her lecture, titled “Corneas, Contact Lenses and the Vale of Tears,” she noted the current leading matters of concern being faced by optometrists as well as the role of optometrists in unveiling the natural history of eye disease.

According to Caffery, one of the important current challenges is understanding how devices, such as computers, tablets and cellphones, change our eyes over time. Are we creating dry eye disease through our lifestyles? Another matter worthy of focus is the need for more optometrists to contribute to the understanding of eye disease through clinical research.

“Our offices serve all communities so the social and ethnic differences can be analyzed,” she said. “This will greatly contribute to our understanding of the prevalence and natural history of dry eye, for example, in all populations.”

Caffery is a known expert on contact lens and Sjögren’s syndrome. She completed her PhD program in Vision Science at the University of Waterloo in 2009 upon defending her thesis titled, “Sjögren’s Syndrome: A Clinical and Biochemical Analysis.” Currently, she is a member of the University Health Network Multidisciplinary Sjögren’s Syndrome Clinic and the Kensington Vision and Research Centre’s Therapeutic Contact Lens Clinic.

Through the years, she has charted the evolution of how optometrists prescribe contact lenses.

When she entered the profession, a contact lens appointment would last one hour as doctors measured and tried various lenses and calculated. Now contact lens fittings are done quickly with little measuring unless the patient is receiving specialty lenses like scleral lenses. One thing that has not changed, despite technological advances in contact lens materials and disposability, is the rate of contact lens-related infections. The only change is that daily disposable contact lenses have lowered the rate of serious infections. As a result of this knowledge, she believes optometrists should prescribe daily lenses more frequently.

Caffery has noted how the treatment and evaluation of Sjögren’s syndrome have changed as well.

“Most important to me has been the recognition of Sjögren’s syndrome by optometrists,” Caffery said. “I hope that my thesis work contributed to that. Then came the evolution of the definition of dry eye disease through TFOS. We learned about inflammation, recognized symptoms and understood the complexity of the disease.”

She added that today’s treatments are directed at the known pathophysiology with anti-inflammatories and autologous serum tears, for example. We have also recognized the importance of the meibomian glands.

“The question I have is what can we learn about prevention. How can we find the Sjögren’s patients early enough to prevent the destruction of the lacrimal gland? How can we prevent meibomian gland obstruction? What is good preventative dry eye hygiene and does diet matter?”

The first Canadian woman to serve as president of the American Academy of Optometry, Caffery believes optometrists have the responsibility of asking questions and thoroughly observing their patient’s in order to understand the history of eye disease and to question clinical norms.

“There is so much to question in every observation that we make,” she said. “We are the finest observers of the eye and we need to use our collective observations to unveil the natural history of eye diseases. Clinical research is important. There are diamonds in every chart.”

Caffery is the 22nd Springer Lecture honoree. Due to the COVID-19 pandemic, the December 11th lecture was held live via Zoom.

 About the Springer Lecture

The lecture is supported by the Nathaniel E. Springer Memorial Fund, which was established in 1999 to bring distinguished visual scientists or clinicians to the School of Optometry to share knowledge with faculty and students.

The fund was created by Donald Springer, O.D., who was instrumental in the founding of the School of Optometry and a leader in optometry in Alabama and the U.S. along with other members of the Springer family, in memory of Springer’s father Nathaniel E. Springer. Donald Springer died in 2011.