Join 7000+ optometrists who want to think clearly, lead wisely, and grow profitably. No hype, no fluff. Just what works.
Share
Optometry Simplified: How I manage macular disorders, fake research trials, myopia semantics, and more
Published about 1 month ago • 3 min read
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.
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... Links I Liked Should you bill the vision plan or the medical insurance? Chris Wroten, OD gives some practical advice on this common dilemma. Optometry Times How much hydroxychloroquine should our patients be taking? Randall Thomas, OD helps us find the sweet...
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... Links I Liked They've Fit Over 5000 Patients With Scleral Lenses. Learn From Them. Scleral lens fitting isn't something I do every day, so refreshing my knowledge from those who do it all day, every day is extremely helpful. Here are some great clinical pearls...
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 What Do You Do When You Are Downcoded by an Insurance Company? If you’ve ever felt blindsided by a denied or downcoded claim, this article by Peter Cass, OD, offers a step-by-step guide to responding effectively. Save it, bookmark it, share it...