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Welcome to Optometry Simplified.

In this biweekly newsletter, I've curated the best resources to help you grow personally and professionally.

My mission is to find what's best for my patients and my practice.

Here's what I've found...

My Favorite Links

How Do You Manage These Macular Disorders in Primary Eye Care?

In primary eye care, one of the top dozen or so chronic conditions to manage are vitreomacular interface disorders, i.e., epiretinal membranes (ERMs), vitreomacular traction (VMT), and full-thickness macular holes (FTMH). Review some practical insights on these conditions and see my "Deep Dive" below on how I manage these in my primary eye care practice. Review of Optometry​

Yes, These Conditions Can ALSO Be Managed in Primary Eye Care

Whatever term you use to categorize these conditions - oculoplastics or aesthetics broadly (I don't particularly like either, so I'm open to other suggestions) they should all be viewed in the purview of primary care optometry. Why? Because many are comorbidities of ocular surface disease. Here is a helpful article by Selina McGee describing a comprehensive approach to managing these conditions in optometric care. Modern Optometry​

5 Questions David Kading Uses to Preserve His Bottom Line

Itching to add that shiny new piece of equipment or that new product all your colleagues are claiming "sells itself"? Dr. Kading recently shared some wise words on LinkedIn about adding new technology and products to his practice. Bravo.

Journal Articles I'm Applying to Practice

Do You Say Myopia Control, Myopia Management, or Myopia Control?

Many may see this as "splitting hairs," but semantics are important. Especially when communicating effectively with parents and patients. This short and helpful article offers some definitions and recommendations to create a common usage amongst practicioners. Investigative Ophthalmology & Vision Science

What is Your First Line Treatment for Demodex Blepharitis?

While many espouse the use of tea tree oil wipes and foams, IPL, or blepharoexfoliation, this group of experts says lotilaner 0.25% bid. I tend to agree if my patients can get access to it. Clinical Ophthalmology​

Move Over Fake News, Here Comes Fake RCTs

A new article in JAMA Ophthalmology wanted to determine if AI (GPT-4o) could produce fake data sets to be used in clinical trials. Answer: Yes, and they can be created so we can't tell they are fake. Here's their conclusion: "A large language model can fabricate synthetic datasets capable of evading forensic analysis to support false scientific evidence." JAMA Ophthalmology​

Deep Dive

This edition's Deep Dive is short but dense. Hope it helps.

Here is how I manage ERMs, VMT, and FTMH in my primary eye care practice.

Just like all other forms of chronic eye diseases, I usually detect these conditions initially at annual comprehensive exams.

Typically, the patient is at the practice using their lovely MVC plan.

So, along with my disease management plan, I also must have a plan for when to utilize either their MVC or their medical insurance.

The two criteria I utilize within the disease management plan are the macular findings and best corrected visual acuity. It goes something like this:

• Presence of ERM or VMA, no foveal distortion, BCVA 20/20 = RTO in 6 months (MVC at initial visit, medical at f/u)
• Presence of ERM or VMT, foveal distortion, BCVA 20/20 = RTO in 1-2 months (medical at initial, medical at f/u)
• ERM or VMT, BCVA 20/25 to 20/40 = RTO in 1-2 months, q3 months thereafter if stable (medical at initial, medical at all f/u)
• ERM or VMT or FTMH, BCVA 20/50 or worse = Referral for surgical intervention (medical at initial, medical at all f/u)

Again, this is the heartbeat of primary care optometry. Several retinal findings, like symptomatic tears and macular holes, are in the detect-and-refer category. Most vitreomacular interface disorders are not.

If you still lack confidence in managing these conditions, I encourage you to read the Review of Optometry article above.

Or better, read and store away the American Academy of Ophthalmology's recently updated Idiopathic Epiretinal Membrane and Vitreomacular Traction Preferred Practice Pattern.

New at Practice Performance Partners

Will AI Replace You? What Do You Need to Know For Your Practice?

In a recent Christopher Wolfe podcast episode, Chris interviewed Dr. Masoud Nafey and discussed how to navigate AI technology in private practice.

Are you feeling threatened by AI? Watch or listen to this episode?

Are you confused about how AI can help you serve your patients better? Watch or listen to this episode.

Can you do me a favor? If you found any of these resources helpful, share this newsletter with one of our colleagues!

See you in 2 weeks!

--Kyle Klute, OD, FAAO

1515 S 152 Avenue Circle, Omaha, Nebraska 68144
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