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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

• Do you have a protocol to evaluate your patients for ocular surface disease (OSD) before referring them for surgery? This insightful video by Christopher Starr, MD at Optometry Times explores the benefits of using a systematic algorithm to evaluate and treat OSD. I've recently implemented an OSD eval for all patients before their surgical referral using these recommendations.
• As optometrists, we are inherently in the business of prevention and longevity, striving to protect vision and eye health for a lifetime. This article by longevity guru Peter Attia, MD, dives into the strengths and limitations of evidence based medicine and specifically how randomized controlled trials (RCTs) aren’t always the best fit for studying complex interventions like lifestyle changes—something we see every day in managing conditions like dry eye or glaucoma. It’s a compelling read that challenges us to think about evaluating evidence and embracing a multi-method approach, combining RCTs with other tools to advance patient care and long-term health outcomes.
• How can you start managing more dry eye at your practice on a tight budget? Ada Noh, OD at Review of Optometric Business gives practical guidance and few treatment recommendations to help optometrists make a big impact on dry eye with little cost to the practice.​

Journal Articles I'm Applying to Practice

• A new patient is at your practice. You diagnose severe/advanced glaucoma. Do you choose drops or surgery as first line therapy? A new study, Treatment of Advanced Glaucoma Study in Ophthlamology compares the outcomes of primary trabeculectomy (surgical treatment) versus medical treatment for newly diagnosed advanced open-angle glaucoma. Bottom line: surgical treatment offers better long-term outcomes. Consider switching your approach if you consistently choose drops for these patients. (Full text)
• Are their age-related patterns associated with different types and severities of uveitis? A new study from the American Journal of Ophthalmology assessed >4300 patients presenting with uveitis in order to determine age related factors influencing uveitis etiology. A few interesting findings: Toxoplasmosis was the most frequent cause of infectious uveitis in patients aged 0-19. Younger patients are more likely to develop posterior synechiae whereas older patients are more likely to develop cystoid macular edema and elevated IOP. (Abstract only)
• ​Could oral supplementation with nicotinamide (a form of vitamin B3) be a future treatment option for glaucoma patients? The American Glaucoma Society and the American Academy of Ophthalmology have released a position statement evaluating the use of nicotinamide for glaucoma neuroprotection. While preliminary laboratory and clinical studies suggest potential benefits, the statement emphasizes the need for further research to establish safety and efficacy before recommending routine clinical use. (Full text)

Deep Dive

Meet Sarah, a 37-year-old mother of two, new to your practice. She's come to your practice with a mix of hope and concern - hope that her vision issues can be resolved and concern for her family's eye health.

Sarah has managed her vision with contact lenses for years, but lately, her intermittent red eyes and a new floater have caused concern. At -11D, she’s already accustomed to regular eye care, yet now her needs feel more urgent.

Sarah is a -11D myope and has two children, ages 4 and 6, who have never had eye exams. During her visit, she casually mentions that her mother, a -7D myope on drops for glaucoma, is searching for a new eye doctor because her vision has been worsening.

Here's what you find:

• SpecRx: -11.50 OD 20/20, -11.50 OS, 20/20
• CLRx: Daily disposable -10.00 OD 20/20, -10.00 OS 20/20
• Ant Seg: 2+MGD OD, 3+ MGD OS
• Post Seg: OD: 2 atrophic retinal holes with lattice 360; OS: lattice 360

What will you do?

Now imagine Sarah's care under a subspecialization model:

Sarah would be managed by the primary care optometrist for her contact lenses and glasses and referred to a dry eye specialist for advanced treatment.

If the primary care optometrist felt unsure of their retinal evaluation skills, they would refer her to a retinal specialist, just in case.

The optometrist would see the two kids for their exams and find they are both slightly nearsighted already. They would be prescribed glasses and sent to a myopia control specialist.

Sarah would be told the optometrist could see her mother to assess the need for a new Rx, but for ongoing glaucoma management, she would be referred to a local optometrist or ophthalmologist who specializes in glaucoma.

Is this the type of care we are after for our patients?

But what if Sarah’s entire family could receive comprehensive, expert care in one place—under a single provider practicing Comprehensive Optometry?

For decades, optometrists have been the first line of defense in eye health, diagnosing, treating, and guiding patients through a complex landscape of vision and medical concerns.

Sarah's story exemplifies why the specialization narrative appeals: specialization promises mastery and advanced solutions. However, it also fragments care, leaving patients to navigate multiple providers.

But this story misses the equally powerful, equally vital role of the primary care optometrist who does it all.

The optometrist who practices to the fullest extent of their licensure.

The optometrist who takes full responsibility for the totality of their patient's vision and eye health.

Whether we call it primary eye care, comprehensive optometry, or general optometry, the result is the same: becoming the trusted provider who addresses patients' immediate needs and sees the bigger picture of their eye health.

These optometrists diagnose glaucoma, manage dry eye disease, control myopia, and offer precise refractions—all within a single exam room. They are the guardians of their communities’ eye health, practicing to the full extent of their training and statutes.

Patients want providers who can solve their problems holistically.

Communities need accessible, versatile optometrists who can deliver care where specialists aren’t an option.

And as optometrists, we should be proud to embrace a narrative that champions versatility and continuity.

The story of specialization has been told—and told well. It appeals to our desire for mastery and professional growth.

But now it’s time to tell another story: one where Comprehensive Optometry is not just an option, but a calling.

It’s the path where primary care meets excellence, and optometrists become indispensable to their communities. By embracing and defining this narrative, we can create a future where full-scope care isn’t overshadowed but celebrated.

So which will you choose?

What's New at Eyecode Education

A recent article in Review of Optometry explored the growing trend of specialization in optometry, offering insights into how practitioners are branching beyond primary care.

Through real-world examples, such as doctors focusing on myopia management, dry eye care, and neuro-ophthalmic disease, it illustrates the diverse pathways to building a niche practice.

But is subspecialization best for most optometrists at most practices for most of our patients?

Listen to Christopher Wolfe, OD as he critiques the premises of the article and provides insights into how to better think about specialties in optometry:

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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