Comanagement

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As primary-care optometrists, we are the gatekeepers for baby boomers inquiring about cataract surgery. Today’s patients have treatment options available not only to address their lifestyle complaints but to provide them with better vision and possibly reduced dependence on glasses or contact lenses.

Patients don’t have to wait for 2020 to achieve 20/20 vision at near without spectacles or contact lenses. Rather, the advancements we have seen just in the past few years should be enough to help manage their expectations.

A U.S. patent was granted to Gholam A. Peyman, MD, in June 1989 for a method of modifying the corneal curvature of the eye. The surgical procedure involved cutting a flap in the cornea, pulling the flap back to expose the corneal bed, ablating the exposed surface and then replacing the flap. The current procedure of laser assisted in-situ keratomileusis (LASIK) was not FDA approved until 1999.

Treating and managing chronic glaucoma can be rewarding as an optometrist. The frequency of office visits to monitor this chronic disease provides ODs an opportunity to develop a close relationship with their patients while providing medical eye care.

In a recent wave of drug price increases that can only be explained by pharmaceutical manufacturers’ desire for profit maximization and which doctors and patients may call price gouging, the drug price war has been brought to the doorsteps of many eyecare providers. As optometrists are increasing their practice of medical optometry, patients are now calling their doctors about prior authorizations and unaffordable drug copays.

Cataract surgery is one of the most successful surgeries performed in the United States. By 2020, it is estimated the number of people having cataract surgery will double, and by 2030 it will triple. The optometrist’s role in comanaging these patients will be of critical importance. Developing and maintaining your post-operative clinical care skills is imperative.

When a colleague or a patient utters the phrase “intelligent design” (ID), it is challenging for me to not roll my eyes as far back as some patients’ contact lenses get lost up there. Honestly, if we really think about it, the design of the ocular system is far from intelligent.

A new study recently published in Retina found that communication between a diabetic patient’s eyecare provider (ECP) and primary care physicians (PCPs) increased the likelihood that the patient would make and keep her eye exam appointment.

At present we are limited with our ability to treat presbyopes. Sure, we have progressives and multifocal contact lenses; however, from a surgical standpoint, monovision corneal refractive surgery is limited, and clear lens extraction is often extreme for emmetropes.

Last month, I wrote about diagnosing my father-in-law’s branch retinal artery occlusion (BRAO) and then teaming up with a vascular surgeon for his subsequent carotid endarterectomy. After the successful “slam dunk” surgery, the nurse who discharged him advised him to “go to the ER” should he have any changes in vision, and in the process, dropped the ball.

It’s March Madness time, and the next few weeks will take college basketball fans on a roller coaster ride of synchronous alley oops and ill-timed, dribble-off-the-foot turnovers. I’m always looking for an apt sports metaphor to help pass the time and get me through the day. A guy can dream, can’t he?

Modern ophthalmic cataract surgery now employs sophisticated techniques to improve outcomes and patient satisfaction. This includes surgical systems providing better control, lasers to perform manual techniques, and intraoperative evaluation to evaluate surgical endpoints before the patient leaves the operating room (OR).