Welcome to Optometry Simplified.
In this weekly 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
Happy we are screening, but now we need examinations.
New guidance now recommends annual vision screening for children ages 3 to 6, which is a step in the right direction. At this age, the prevalence of binocular vision issues is meaningful, and even preschool myopia shows up in roughly 4 percent of kids, with some groups closer to 6 percent. These are not problems a quick screening reliably catches. We take our kids to the dentist every six months for teeth they’ll eventually lose. Annual eye exams for preschoolers shouldn’t be a stretch. Primary Care Optometry News
An incredible animation you must see.
Not sure if it's AI-derived or not. Regardless, an incredible animation of the growth of a cataract from the cross-sectional view of the eye. You'll likely need a LinkedIn login to see it. LinkedIn
Research I'm Reading
Another nugget you can share with your diabetes patients.
The longer someone has diabetes, the higher their risk of double vision becomes. A new study highlights the role of disease duration in diabetic oculomotor cranial nerve palsies. Eye
Deep Thoughts
A few weeks ago, we unpacked G2211, the code that reveals whether we are actually functioning like primary care clinicians or simply doing enhanced vision exams. This week, I want to introduce the companion metric that shows how deeply medical care is embedded in your practice: 992xx per refraction.
Here is the recurring tension I see in practices everywhere: most optometrists want to grow the medical side of their practice, but many still associate medical care almost exclusively with acute issues. A red eye, a foreign body, a corneal abrasion.
Those visits matter, but they are not what define primary care.
Primary care optometry is built on the steady management of chronic disease. Glaucoma suspects, early AMD, dry eye, ocular hypertension, diabetes, hypertension, neurologic concerns, and all the patients who look “fine” but carry real risk. If we are practicing full-scope primary care, these patients should return for medical visits throughout the year, not just when they need a new prescription.
This is exactly why 992xx per refraction is so valuable.
Since the 2021 E/M guideline changes, 99213 and 99214 are not only simpler to document, but they also more accurately reflect the clinical work primary care ODs perform, and they reimburse better than 920xx codes for most payers.
So when you look at your numbers:
- If you are consistently managing chronic disease, your 992xx volume rises relative to refractions.
- If you only address disease when it is obvious, the number stays low.
The simplest way to see this is to track 992xx per refraction: How many medical visits does your practice deliver for every prescription check?
This metric tells you whether your systems actually support full scope care or whether most disease is being managed passively, sporadically, or unintentionally deferred.
This may be your most important metric for 2026.
Most practices set vague goals like “grow medical” or “do more disease management.”
But you cannot improve what you do not measure.
992xx per refraction gives you a clear scoreboard:
- Where are we right now
- Where should we be as a primary care practice
- What systems, protocols, and team training do we need to close the gap
When you track this, you quickly see whether your practice is evolving or simply repeating last year.
Soon, we will be rolling out updated offerings in Comprehensive Optometry Simplified, built to help practices resolve the vision-versus-medical conflict, implement clean disease protocols, train teams, and grow the medical side of their practice with confidence and without unnecessary risk.
If you are setting goals for 2026 and want a clearer picture of where your practice stands, keep an eye out for what is coming.
Your patients live with chronic disease every day.
Your practice metrics should reflect your care for it.
Practice Performance Partners Pick
Bill and code dry eye like a pro.
A few months ago, I linked to an article by Chris Wolfe, OD about dry eye and billing and coding.
Now listen to his recent podcast on the same topic!
Can you do me a favor? If you found any of these resources helpful, share this newsletter with one of our colleagues!
See you next week!
--Kyle Klute, OD, FAAO