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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

• What Kind of Leader Are You? - If you’re leading a team but feeling stuck or stretched, this quick breakdown of leadership styles is worth reflecting on. Not every OD needs to lead like a CEO—but we do need to know how we naturally lead and how that affects our teams. Read here​
• Lab Testing for the Medical Optometrist - If you are increasing medical management of chronic diseases in your practice, ordering your lab tests is an important step in that process. This article gives a nice stepwise approach to integrating lab testing and a great summary of commonly ordered labs. Read here​
• Where Myopia Management Is Headed - As myopia management evolves, so do the standards of care. This roundup from the experts in the field is a great way to assess whether your current protocols are in step with the latest evidence. Read here​

Journal Articles I'm Applying to Practice

• MMP-9: Not the Final Word​
  I've found MMP-9 testing for evaluating ocular surface disease patients super helpful for years. However, new research shows its sensitivity hovers around 47% for dry eye patients. This confirms what many of us have seen: it’s helpful, but not definitive. Use it as one piece in a multifactorial puzzle, not the whole diagnosis. Read here​
• CRAO in the ER: Room for Improvement​
  This nationwide study analyzed U.S. emergency department encounters for central retinal artery occlusion (CRAO) over a 14-year span and found persistently low rates of urgent imaging and stroke workups, despite CRAO being a medical emergency with clear stroke risk. The data points to a gap in emergency care coordination and highlights the need for ODs to be proactive in patient education and referral pathways for acute vision loss. Read here​
• Adherence to PGAs in Glaucoma: Still Terrible​
  Even among patients who filled their scripts, adherence, and persistence with prostaglandin analogs were dismal. This should make us rethink SLT as a true first-line option—not just when drops “fail.” Read here​

Deep Dive

A new study in the American Journal of Ophthalmology evaluated long-term adherence and persistence to prostaglandin analogs (PGAs) for glaucoma. Even when including only patients who filled their prescriptions, the numbers were discouraging:

• After 1 year, just 30% of patients were still using their drops consistently.
• Adherence steadily declined after that, despite reminders, instructions, and clinical follow-up.
• Persistence was particularly poor among younger patients and those new to therapy.

So, here's the real question:
Are we building glaucoma treatment plans that reflect how people actually behave…

Or how we hope they’ll behave?

We’ve all had the patient who insists they’re taking their latanoprost “every night without fail,” but whose pressure, fields, and OCTs tell a different story. The data now confirms this isn’t anecdotal—it’s systemic.

That’s why we need to reframe what it means to manage glaucoma.

It’s not about drops.

It’s about the plan.

If most patients will struggle with adherence, then SLT as a first-line treatment makes sense—not as a backup when drops fail, but as a proactive, behavior-informed choice. And when cataract surgery is on the table, we should be ready to recommend MIGS early, not as a last-ditch add-on.

But more than that, we, as optometrists, need to embrace our role as the quarterback of the chronic care plan. Whether a patient is on drops, post-SLT, or post-trab, they still need:

• Regular IOP monitoring
• OCT and VF interpretation
• Education and coaching
• And a trusted guide to help them understand their disease trajectory

So maybe the best care isn’t defined by who prescribes the medication…

But by who keeps the plan moving forward.

That’s us.

And that’s where optometry makes its most significant impact.

New at Practice Performance Partners

Do you practice what you preach?

Dr. Chris Wolfe discusses the gap between beliefs and actual habits in optometry as it relates specifically to dry eye management.

If you believe that dry eye is a chronic, progressive condition, are your protocols aligned with that belief?

Do your in-office treatments like RF, IPL, and thermal pulsation reflect that belief?

Listen to Chris unpack what we found in a recent survey on IPL utilization for optometry practices managing dry eye. Listen here.

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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