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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

• It seems like everyone's talking about Mindset these days. See the Deep Dive below for 9 mindset shifts to improve AMD management. For now, read Dr. Bethany Fishbein's article in Review of Optometric Business about how our perceptions can impact the success of our practice.
• What can OCT findings show us about systemic and neurodegenerative diseases beyond glaucoma? Read OCT Biomarkers: The Eye, The Body, and The Brain to learn more and get some free CE.
• I really liked this Ortho-K troubleshooting article at Review of Cornea & Contact Lenses. It is an article that I will definitely be coming back to for reference. Also, there are a few other articles on Ortho-K in this issue here (ideal candidates) and here (design principles).

Journal Articles I'm Applying to Practice

• Which patients are most likely to suffer from significant vision loss from geographic atrophy? Those with GA within 1mm (~2/3 of disc diameter) of foveal center and better starting BCVA according to a new study in Ophthalmology. These are patients that a referral for one of the new GA drugs might be a great option since they have the most to lose. (Abstract only)
• The detection of uveal melanomas has risen dramatically in the last 20-30 years thanks to optometrists in primary care says a new study. Acta Ophthalmologica reports routine ultrawide field imaging in primary care has resulted in earlier and and an increase in detection in primary eye care. (Abstract only)
• Should we be routinely measuring central corneal thickness in all patients over 50? This article from Clinical Ophthalmology says "yes" due to its association with the risk of glaucoma, increased risk of progression, and faster field loss on patients with glaucoma. (Full text access)

Deep Dive

Age-related macular degeneration (AMD) is one of the most common causes of vision loss we see in practice—yet we’re missing it far too often.

A 2017 study found that 1 in 4 patients diagnosed with “healthy maculas” actually had AMD when analyzed with fundus photography.

But here’s the good news: AMD is not an inevitable march toward blindness.

Research continues to prove that lifestyle modifications, structured imaging protocols, and early intervention CAN slow progression—if we embrace a proactive approach to detection and management.

That starts with changing how we think about AMD in primary care optometry.

If we want to elevate our role as primary eye care physicians, we need to shift our mindset in how we approach AMD detection, prevention, and management.

Here are 9 key beliefs that will redefine how we practice and improve outcomes for our patients.

• We Are the Frontline Defenders Against AMD-Related Blindness.
  • Fact: 25% of AMD cases go undiagnosed in primary care settings​.
  • Mindset Shift: If we don’t identify early AMD, our patients may not be diagnosed until vision loss is irreversible.
  • Action: Every patient over 50 deserves a retinal health risk assessment—not just those with symptoms.
• AMD Is a Chronic, Progressive Disease—Not Just a “Wait and See” Condition
  • Fact: By the time AMD is symptomatic, irreversible damage has likely occurred​.
  • Mindset Shift: Our job isn’t just to confirm AMD, but to delay or prevent progression.
  • Action: Routine imaging (OCT, FAF, fundus photos) should be standard in AMD risk assessment, even before visible clinical signs appear.
• Early Detection of AMD Is as Important as Early Detection of Glaucoma
  • Fact: Studies show that fundus photos detect AMD missed on dilated exams​
  • Mindset Shift: We proactively screen for glaucoma, so why not AMD? It’s time to treat AMD risk assessment like we do glaucoma risk assessment.
  • Action: Automate early detection by integrating multimodal imaging (OCT, FAF, fundus photos) into routine exams.
• AMD Risk Is Modifiable—Prevention Should Be a Standard Part of Patient Education
  • Fact: Lifestyle factors greatly influence AMD risk—smoking, diet, and cardiovascular health impact progression​
  • Mindset Shift: Our role isn’t just diagnosing AMD; it’s actively coaching patients on prevention.
  • Action: Make AMD risk reduction part of every conversation with at-risk patients (e.g., discuss AREDS2, Mediterranean diet, and smoking cessation).
• The Mediterranean Diet & Nutritional Strategies Are Powerful Tools, Not Just “Extras”
  • Fact: Higher adherence to a Mediterranean diet reduces AMD progression risk
  • Mindset Shift: Nutrition should be part of every AMD discussion, just like IOP is part of every glaucoma exam.
  • Action: Encourage patients to increase leafy greens, omega-3s, and colorful fruits & veggies.
• Co-Managing AMD With Retinal Specialists Improves Patient Outcomes
  • Fact: The earlier a patient with wet AMD starts anti-VEGF therapy, the better their long-term visual outcome​
  • Mindset Shift: We must recognize the urgency of early neovascular AMD detection and establish strong referral pathways.
  • Action: Create a referral workflow for suspected wet AMD (direct scheduling, immediate OCT, etc.). Ensure patients understand the importance of follow-up—delays lead to vision loss.
• Geographic Atrophy (GA) Requires Proactive Monitoring—Not Just a “Nothing We Can Do” Approach
  • Fact: GA progression can now be slowed with new FDA-approved treatments​
  • Mindset Shift: We are not powerless—tracking GA progression helps determine when referral for new treatments is warranted.
  • Action: Use OCT & FAF to track atrophy, and educate patients on clinical trial options.
• Dark Adaptation Testing May Detect AMD Before Visible Drusen Appear
  • Fact: Impaired dark adaptation is often the first functional sign of AMD, preceding structural changes​
  • Mindset Shift: Functional testing should be part of AMD screening in high-risk patients.
  • Action: Consider implementing dark adaptation testing for patients with strong AMD risk factors.
• AMD Care Is a Standard Part of Full-Scope Optometry—Not Just a Specialist’s Job
  • Fact: Many optometrists underutilize their full scope in AMD care, defaulting to referrals for even early disease​
  • Mindset Shift: If we want to elevate the perception of optometry, we must embrace AMD management as a primary care responsibility.
  • Action: Train staff to support AMD protocols (e.g., imaging workflow, patient education). Commit to routine AMD risk screening for all patients over 50.

What's New at Eyecode Education

As an optometrist, you juggle compliance, coding, and clinical excellence—while trying to grow your business.

It’s a lot. That’s why Practice Performance Partners was created.

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Now, you can focus on what you do best—caring for patients—while knowing your practice is set up for success.

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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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