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Articles

Nutrition is not ancillary to eye health—it is foundational.

The importance of nutrition in the preservation of visual function and the prevention and management of eye diseases

New AOAExcel cyber liability insurance minimizes the crippling effect of cyberattacks on optometric practices

Research reveals that increased exposure to green spaces significantly reduces the risk of developing dry eye disease, highlighting urban planning's vital role in public health.

Exposure to green space linked to lower odds of dry eye disease development

Now, PECAA Max members will have access to ABB’s independent lab network and comprehensive portfolio of premium and proprietary lenses.

PECAA, ABB Optical Group partnership expands to optical lab services, specialty vision products

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Clinical Focus

Joe Shovlin, OD, FAAO, sat down with Optometry Times to detail a presentation he gave at AOA's Optometry's Meeting 2025.

AOA 2025: Ocular toxicities in cancer patients – A Q&A with Dr Joe Shovlin

The study found that 17.4% of Medicare patients needed subspecialized procedures relative to 5.6% of surgeons practicing in rural areas between 2012 and 2022.

Rural patients are now outnumbering rural ophthalmic surgeons, study reports

Khanh Hoang, OD, details how comanagement relationships can be streamlined for the benefit of the patient.

The evolving relationship between optometrists and ophthalmologists: Enhancing patient care through collaboration 

Sometimes it takes several tries before settling into an inclusive practice that’s right for you.

Finding the right fit as an LGBTQIA OD

A model to predict iris melanoma

Lori Wright, JD, sat down to talk about a presentation at Collaborative Care Symposium about the risk under federal statutes and how to minimize that risk as an optometrist or an ophthalmic practice.

CCS 2025: Minimizing risk in comanagement as an eye care provider

Editor's note: The below transcript has been lightly edited for clarity.

So we spoke about comanagement, generally, between ophthalmologists and optometrists, comanagement of refractive care and comanagement of cataract surgery postop care. It was a discussion of risk under federal statutes and how to minimize that risk as an optometrist or an [ophthalmic] practice. At the end of our presentation, we talk about the 4 pillars of a compliant comanagement program. So I think those are a really good way to sort of frame up the most important components of a compliant comanagement program that's going to comply with the law. Those pillars start with patient choice, informed patient choice: the patient needs to understand comanagement and make the decision themselves to engage in comanagement. The second pillar is fair market value rates, which are separately set. The third pillar is related to that one: it's typically payment separation, so that the optometrist and the ophthalmologists are charging separate rates independently from one another. And then the last one is an add-on: it's no exchange of value. So often with these comanagement programs, they can sometimes be used as a tool. The issue is that they should not be used as a tool to induce referrals between the parties, and sometimes they can be packaged with perks and things that go between the ophthalmologist and the optometrist, and those perks should be avoided, because those are things of value that federal regulators consider to be inducements for referrals, which are prohibited by federal law.

So one of the pieces of our presentation is going through these 3 enforcement cases that all happened in 2023, all within a few months of each other. That in itself is really informative to the public. Here are 3 examples of what federal regulators believe is not a compliant program. Here's how you shouldn't be doing it. And they did it all at once as a sign to the public, that this is an area of enforcement for them, a trending concern. There are some themes through those 3 enforcement actions that we pick out in the presentation to see which kinds of things might raise the risk. Some of the common perks that might be provided are continuing education, free continuing education programs, sometimes speaker engagements, free entertainment and expensive meals. Those sorts of things are the kinds of perks that the Office of Inspector General is looking for when they're trying to determine if there might be a problematic arrangement.

How often is the legal landscape changing, and how can ECPs best stay compliant?

That's a really good question, and interestingly, the answer is no, it's not constantly changing. Another piece of the presentation is tracing the regulatory and legal history. This started all the way back in the early 1980s when comanagement really took off, and the general principles have remained the same since then. I put up on the screen some of the language from Senate hearings back in the 1980s that sound really similar to some of the language the OIG has used in the 2023 enforcement action. So this is really something that hasn't changed a lot. I mean, the practice has changed, you know, optometry and ophthalmology has changed. So now we have LASIK. Now we have IOLs, premium IOLs, that we didn't have when this first started. But that's really just a change in the way the comanagement arrangement, the clinical components of the comanagement arrangement. But the basic components of what makes them legally problematic still remains the same. It's that exchange of value, a problematic arrangement doesn't have real patient choice. They're not setting real fair market rates for the services that are actually rendered. Those concepts still remain the same as what they were back in the 1980s even though the clinical components have changed.

How does AI change the dynamics of risk regarding patient confidentiality?

As so many answers around AI are right now, it's kind of in flux. We don't know what we don't know yet. I would encourage clinicians to think carefully about the issues that you've raised: patient privacy. Large language models often use the input in order to train future large language models. So you do have to be careful about HIPAA. You have to be careful about state privacy laws, which can be more restrictive than HIPAA in some cases. And there are some states now that are implementing AI-specific laws. There are only a few of them, but that is something that you want to stay up to date on; just keep an eye on your state and see what specific restrictions might apply to your practice. I've heard there's a lot of efforts about medical scribe using AI, and I think you should be cautious about that at this stage. I can certainly see how that might be useful in the future, but at this point, I have not seen AI scribe materials performance that's really 100% accurate. And as we all know, you've got to have accurate medical records in order to make legitimate medical decisions. So I would just be cautious at this stage, make sure you're vetting any kind of AI tools that you're using to ensure that they are up to professional standards that apply in your practice, and just think about it carefully right now, while we're still in this transitional stage.

What do you hope MDs and ODs took away from the presentation to bring home to their respective practices?

That's an interesting question, in part because we have not seen enforcement yet against an optometric practice in the federal anti-kickback statute space in comanagement. What's interesting about that is that there is nothing in the text of the antikickback statute or the legal application of its concepts that would prevent enforcement against an optometrist. The antikickback statute prohibits both providing and receiving any kind of something of value in exchange for referrals. So either side of that equation should theoretically be equally guilty of a violation if they have an issue. Both sides then, I think, from my perspective as a counselor, should be adhering to the same standards, the same 4 pillars of a compliant comanagement program. I think ophthalmologists continue to be at a slightly higher risk. Just speculating on why they might be the focus of enforcement to date is probably because they are the ones who own the surgery centers. They have slightly deeper pockets. And what I would say is the takeaway for an ophthalmologist should be that there is a present risk, that there are enforcement actions ongoing, and they should be structuring their programs to comply. And then optometrists, on the flip side, should think about both potential risk for themselves in their practice, because there is no legal distinction between the two in this area and also partnering well with ophthalmologists, so they can understand where ophthalmologists are coming from when they're asking for a certain component of the program to be implemented, and why both sides should really be using those 4 pillars of compliant program.

Videos

Peter Hersh, MD, stated that the key takeaway from a handful of presentations he gave at CCS 2025 is that successfully treating patients with keratoconus is identifying the disease early.

CCS 2025: Identifying keratoconus in patients through successful comanagement

Presentations that Peter Hersh, MD, gave at the Collaborative Care Symposium (CCS) 2025 on May 31 focused on keratoconus, a progressive corneal disease that requires early detection and specialized management. He spoke on keratoconus and complex refractive surgery and corneal cross-linking with John Gelles, OD, FAAO, and Steven Greenstein, MD.

Hersh emphasizes the critical importance of identifying keratoconus in younger patients, particularly those diagnosed in their early teens, who are most likely to experience rapid disease progression. Primary eye care providers should be vigilant in screening for keratoconus, recognizing that it is more prevalent in younger populations compared to conditions like glaucoma or retinal disorders. Key diagnostic indicators include patients whose vision cannot be corrected to 20/20 through standard refraction, unusual astigmatism patterns, and irregular keratometric measurements. Advanced diagnostic tools are crucial in identifying keratoconus. Corneal topography and tomography are considered the gold standard for diagnosis, allowing practitioners to detect subtle corneal changes that might indicate the disease's onset. Hersh strongly recommended thorough screening when standard vision correction methods prove ineffective. Interdisciplinary collaboration is paramount in managing keratoconus. 

Optometrists, ophthalmologists, and surgeons must work together to ensure comprehensive patient care. This collaborative approach is especially critical for early intervention strategies like corneal cross-linking, which can significantly improve patient prognosis when implemented early. Long-term patient management is another crucial aspect discussed. Keratoconus patients require ongoing monitoring, typically with yearly examinations. Contact lens fitting remains a primary treatment modality, and patients will need specialized care throughout their lives. As patients age, additional challenges emerge, such as difficulty managing contact lenses and preparing for potential procedures like cataract surgery. Hersh highlighted emerging innovative treatments that can enhance patient outcomes, including CTAK and topography-guided PRK. These techniques can improve corneal curvature and optical focus, offering new hope for patients as they navigate the complexities of keratoconus across different life stages. 

Ultimately, Hersh underscored the need for heightened awareness, early detection, continuous education, and collaborative medical approaches to effectively manage keratoconus and improve patients' quality of life.

Conference

Steven Greenstein, MD, one of the cochairs of the Collaborative Care Symposium gave some insight into the upcoming conference and what attendees can expect.

A sneak peek into the Collaborative Care Symposium 2025 with Steven Greenstein, MD

Hi everyone. I'm here with Dr Steven Greenstein, one of the cochairs of the Collaborative Care Symposium, and he's going to tell us a little bit about the meeting, which offers CE and some practical pearls on all aspects of refractive surgery. So thanks for being here, I really appreciate it.

So yeah, we're really excited to continue the Collaborative Care Symposium, which we started in 2021 and has continued each year now, in partnership with MJH. One of the great things about the symposium is that we really work on the combination of ophthalmology and optometry, the cutting edge technologies that exist for refractive surgery, and even some glaucoma and retina care, and how that affects refractive surgery, and where both the ophthalmologist role and the optometrist role fit in this. We have particularly some highlights where we talk about some of the law related to the ophthalmology and optometry relationship. So we have expert lawyers who come on and discuss updates in that different symposium on patient experience through refractive surgery, both in the optometry and ophthalmology setting. So it's really a unique chance of learning both clinical information, but also really practical information for your practice that you can implement immediately.

Absolutely, and I think it's super cool that you guys balance the conversation between optometry and ophthalmology and bringing in all of the legal aspects of it, because that's always changing.

So that's always the thing that I think is front and center on a lot of people's minds. There has been a definite changing landscape over the last few years. So really, 1 of the highlights tends to be the expertise from our invited law team to discuss those topics.

Absolutely and you kind of gave me a little bit of preview on that. But are there any other topics that you're discussing or conversations that you're planning to have that you're really, really excited about?

So I think every year it's exciting to really explore the unique nature of the refractive surgery space. It is a unique place where ophthalmology and optometry can work together to treat our patients. And so we always look forward to the topics which discuss some of the new and cutting edge changes in refractive surgery, in refractive cataract surgery, and even in MIGS and glaucoma management in refractive surgery patients. So these are things that really come up on a day to day basis, and can, like I said, be implemented on day 1.

Collaborative care is in the name of the meeting. So what do we gain as ECPs when we learn together?

That's the great part of this meeting is that each lecture usually has an ophthalmologist and an optometrist doing them together, so you canget into the minds of both in 1 topic. You can really see how each side thinks about their patients. And then it helps, really in real time, see how you can bridge that thought process between the 2 fields. So you're watching that relationship in real time happening through each lecture, which I think really mimics the clinical world. I think that's how we really work nowadays. And there are multiple ways that ophthalmologists and optometrists interact, and that's 1 of the nice things on this meeting. We have different ways that comanagement happens. We have some people who are going to speak about more traditional comanagement, where patients are being sent in for surgery to the ophthalmologist and sent back to their optometrist for post op care, and they're happening in 2 separate places, other places where it's all sort of happening under one roof, but with the same kind of distribution of care, and in certain circumstances, like Dr [John]Gelles and myself, where we have real partnership that we complement each other in the same care: for example, our keratoconus patients.

You mentioned that you and Dr John Gelles helped found this meeting in 2021. Do you mind just telling me what about the Collaborative Care Symposium you are proudest of?

So I think it really reflects the relationship that Dr Gelles and I have created over the years. So I think 1 of the things that we felt internally in our practice was that our relationship, clinically, really complements one another. So we felt that we manage our keratoconus patients best because of the fact that we're actually working together. We do separate parts of the management, but we're doing them to complement one another for each patient. And 1 of the things we felt that was lacking and sometimes harder to see was even though we knew was out there – we knew that that same complement existed across the refractive surgery space – it wasn't being really talked about enough. It wasn't really being something that you would see happen in a meeting. Most meetings were really relegated to 1 side or the other. And so we felt that, because of our own experience, we wanted to try to see whether we could bring that to real life through a virtual forum, and it's really only taken off from there. It's only gotten better and better with more diverse lectures as the years have gone on, and more diverse topics to continue to grow the meeting.

Fantastic. And is there anything else that you want to mention about the meeting that I haven't asked you about?

I think the key feature of the meeting is really the practical take home messages that are conveyed in this meeting. I think the meeting is really geared for doctors, both in optometry and ophthalmology, that want to learn about both practical clinical things to be implementing for comanagement and also administrative, law, and business, all kind of combined in 1.

Absolutely. Well thanks again for being here, Dr Greenstein. It's been a pleasure, and I really appreciate it.

Steven Greenstein, MD, one of the cochairs of the Collaborative Care Symposium gave some insight into the upcoming conference and what attendees can expect. 

Canonical

Dr Neda Shamie speaks on cataract and refractive surgery at CIME 2025

CIME 2025: How Neda Shamie, MD, optomizes cataract and refractive surgery comanagement

 meeting, Neda Shamie, MD, passionately discussed the transformative potential of both refractive 

. For Shamie, these procedures represent more than clinical advancements; they embody a modern, patient-centered approach to vision correction.

Refractive cataract surgery, she explained, is about leveraging today's technological innovations to reduce a patient’s dependence on glasses at the time of cataract surgery. “It’s a more contemporary, elevated approach,” she said, emphasizing the importance of engaging patients in conversations about their lifestyle and visual goals. With options like multifocal, toric, extended depth-of-focus, light-adjustable, and small-aperture IOLs, practitioners now have an expansive tool kit to match the right lens to the right patient.

Preoperative education is an opportunity for optometrists

Shamie encouraged optometrists to initiate these discussions early, educating patients on the variety of options available. While these conversations may lengthen chair time, she believes they significantly enhance the patient experience and ensure surgical success. “I spend the time with patients to really engage in what they like to do, what their visual needs are, and see if I can match-make them to the right lens,” she said.

The conversation extended to refractive surgery more broadly. While LASIK and photorefractive keratectomy remain excellent options, Shamie warned against a one-size-fits-all approach. “When you only offer those two, you tend to stretch the limits of safety,” she noted. Today’s refractive surgeon must also consider alternatives like the EVO ICL for non-LASIK candidates or refractive lens exchange for hyperopic or presbyopic patients.

Shamie highlighted the role of optometrists in identifying candidates for these alternatives, especially when patients express dissatisfaction with glasses or contact lenses. “It’s a wonderful way to really extend their trust in you,” she added.

Collaborative care is the foundation of optimal outcomes

Shamie closed with a reminder of the meeting’s founding purpose: promoting true collaboration between optometrists and ophthalmologists. Citing the vision of Robert Maloney, MD, MA, who began the conference nearly two decades ago, she reaffirmed her belief that optimal patient outcomes stem from seamless, respectful comanagement.

“The whole journey of vision recovery is optimized when there’s a clear and streamlined handoff,” she said. From preoperative education to ocular surface optimization, optometrists lay the foundation for surgical success.

Shamie encourages taking a contemporary, elevated approach to refractive surgery.

CIME 2025: How Neda Shamie, MD, optimizes cataract and refractive surgery comanagement

CRU 2025 provided the latest insights regarding glaucoma, dry eye disease, retina, myopia, neurotrophic keratitis, and keratoconus.

CRU 2025: What eye care providers took home that is current, relevant, and useful

The rustic landscape of Napa Valley hosted CRU 2025, which allowed optometrists and ophthalmologists to learn the latest in glaucoma, retina, and more. In between wine tastings, eye care providers had the chance to reflect on what they are taking back to their practices that is current, relevant, and useful. 

Melissa Tawa, OD, FAAO, highlighted what she learned about inherited retinal diseases at the conference. "I really learned a lot from Dr [Rachelle] Lin's lecture about the changes in inherited retinal diseases and the available gene therapies that we have, and also what's coming down the pipeline in terms of treatment for these patients who were otherwise told that there was nothing available to them, novel mechanisms of getting cells into the eyes that could create enzymes that our bodies are lacking," Tawa said. "It is a really exciting time for me, and it's so wonderful to be at this type of convention where we're learning from experts in all different areas of optometry, from inherited retinal diseases to glaucoma, but also keratoconus management, which is not something that I am focused on, but I get to come to this conference and learn from experts in the states."

Deborah Ristvedt, DO, has gained a revitalized outlook on glaucoma surgery in her commitment to staying relevant with changing treatment options. "There's so many things now that I continue to push myself and challenge myself as a surgeon," she said. "I think the biggest thing is staying relevant with how glaucoma is changing right now. I wish we had an answer to why some people develop glaucoma and others don't, or why some people progress and others don't. That's where minimally invasive glaucoma surgery, as well as procedural pharmaceuticals, have totally changed my practice and my mindset to say, 'We know that we can control pressure. Why not doing do it earlier in the disease?' 

"Thank you so much for having me at CRU," Ristvedt continued. "It's been such a fun opportunity to be amongst my colleagues who are constantly up to date and looking for useful information."

Other ODs also found value in the insights they gained from MDs at CRU. Cecelia Koetting, OD, FAAO, DipABO; and Melissa Barnett, OD, FAAO, FSLS, FBCLA, took the importance of comanagement and collaborative care back to their practices.

"It's CRU; this is its fourth year. I've been here every year," Koetting said. "This is my first year here as a speaker. I'm really excited to be a part of it, but the reason I've kept coming back, and the reason I came to begin with, was because CRU: current, relevant, useful. I find that every time I leave here, I'm learning new things. Yes, I educate, but I'm also learning always. And the big thing here, especially just sitting on the panel with a couple of ophthalmologists recently, just listening and hearing what they have to say as far as their take on neurotrophic keratitis, the different treatments, and then just putting a spin on my thought for things as well."

"What I'm taking back from CRU, which is current, relevant, and useful, is the importance of collaborative care," Barnett said. "So collaborative care, we're talking about patients who have keratoconus, those who have neurotrophic keratitis, and the importance of great communication in order to be best care for our patients."

Melissa Tawa, OD, FAAO, provides insights to take glaucoma management from reactive to proactive in presentations given at CRU 2025 in Napa, California.

CRU 2025: Exploring minimally invasive glaucoma surgeries

Melissa Tawa, OD, FAAO, from Marshall B Ketchum University's Southern California College of Optometry discusses the evolving landscape of glaucoma management, focusing on a proactive and comprehensive approach to patient care. In collaboration with Deborah Ristvedt, DO, she delivered 3 lectures on glaucoma, specifically exploring minimally invasive glaucoma surgeries (MIGS). The lectures delved into the various devices available, their mechanisms, and patient selection criteria. Key considerations include whether procedures bypass the trabecular meshwork, their invasiveness, and whether they can be standalone or combined with cataract surgery. Tawa emphasizes a shift from reactive to proactive glaucoma management. Modern technologies like optical coherence tomography (OCT) now enable early glaucoma detection before visual field defects occur. New medications, drug delivery systems, and surgical procedures allow clinicians to control intraocular pressure (IOP) more effectively and prevent progressive vision loss. She stresses the importance of communication with ophthalmological specialists, recognizing that access and comfort levels with glaucoma management vary among practitioners. When making referrals, Tawa recommends creating comprehensive patient history packets that provide a holistic view of the patient's condition. These packets typically include:

Previous discussions about potential interventions

The goal is to make the referral process seamless, giving receiving ophthalmologists immediate insight into the patient's background. By understanding patient preferences and previous conversations, specialists can approach treatment discussions more effectively. Tawa's approach underscores the importance of personalized, proactive glaucoma management, leveraging technological advancements and fostering collaborative communication between optometrists and ophthalmologists to optimize patient outcomes.

CRU 2025: Exploring minimally invasive glaucoma surgeries 

Shan Lin, MD, and John Berdahl, MD, share their perspectives as ophthalmologists regarding the importance of comanagement.

Comanaging with the goal of better patient care

On February 7, ODs and MDs gathered to discuss innovations and advancements in glaucoma treatment at Glaucoma 360. The Eye Care Network sat down with Shan Lin, MD, and John Berdahl, MD, for exclusive insights into the future of comanagement.

"As our health care system evolves, of course, we need to all work together on this, and so often optometrists are the very first line of seeing and screening patients, and also starting to get them treated, or getting them to the right ophthalmologist for further treatment as well," Lin said. "So I look forward to a very collaborative role, especially as medicine evolves. There's just going to be this explosion, or this wave, of new glaucoma patients. As people live longer and our population just expands, we're going to have more and more glaucoma. Most of us can't see all the patients that need to come to us. So I think this collaboration is very important."

According to the 2020 US Census, 1 in 6 people were 65 years old and over.

The Population Reference Bureau estimates that the number of older Americans will rise 47% from 2022 to 2050.

Subsequently, the number of US patients in glaucoma is predicted to double between 2022 and 2050, from 2.7 million to 5.5 million cases.

Although glaucoma has proven its prevalence, patients may have difficult finding an ophthalmic surgeon with a subspecialty in glaucoma. A recent study found that rural patients are increasingly outnumbering ophthalmic surgeons practicing in rural areas.

 Between subspecialties cornea, glaucoma, oculoplastic, and retina, glaucoma surgeons were found to have decreased the most (3.3%) between 2012 and 2022. John Berdahl, MD, highlights the importance of comanagement in rural areas to alleviate the burden on ophthalmologists. 

"We live in a rural state. It is not uncommon for a patient to drive 4, 5, 6 hours for them to have their glaucoma surgery, cornea transplant, even cataract surgery, sometimes with me," he said. "Now, we have a same mission: take care of eyeballs. Can't we can do that together? We want to respect the boundaries of training, but what we always want to do is put the patient first. 

"I have the privilege of working with 2 absolutely stellar optometrists in my practice that provide excellent clinical care and pretty much run the day-to-day clinic. And then I get involved when we have to make surgical decisions and if something bad is going on, or if we're having an outcome that isn't right, and otherwise, we're working together to make sure that these patients get the most effective and most efficient care possible so that we can take care of our rural state."

Caplan Z. US older population grew from 2010 to 2020 at fastest rate since 1880 and 1890. United States Census Bureau. May 25, 2023. Accessed February 20, 2025. https://www.census.gov/library/stories/2023/05/2020-census-united-states-older-population-grew.html

Mather M, Scommegna P. Fact sheet: aging in the United States. Population Reference Bureau. January 9, 2024. Accessed February 20, 2025. https://www.prb.org/resources/fact-sheet-aging-in-the-united-states/

Prevention CfDCa. Vision loss: a public health problem. 2022. Accessed February 20, 2025.

Ahmed A, Ali M, Dun C, Cai CX, Makary MA, Woreta FA. Geographic distribution of US ophthalmic surgical subspecialists. 

2025. Epub ahead of print. doi: 10.1001/jamaophthalmol.2024.5605

Three EnVision Summit faculty members weigh in on the importance of comanagement in glaucoma management, where artificial intelligence will lead eye care, and what hopes are on the horizon for corneal ectasia treatments.

EnVision Summit 2025: What you missed in keratoconus, AI, and comanagement

From February 14-17, ophthalmic and optometric professionals gathered at EnVision Summit 2025. Besides soaking up the Puerto Rican sun, ODs shared their expertise on keratoconus, myopia, glaucoma, and everything in between. The Eye Care Network sat down with OD Envision faculty members to hear their insights during the meeting.

Sherrol Reynolds, OD, FAAO, weighed in on what she thinks will be the biggest innovations to come in eye care.

"Artificial intelligence will really revolutionize the eye care industry: the ability to detect early, diagnose early, and intervene earlier in our patients," Reynolds said. "Having instrumentation not only in the eye care practice, but I see some of these devices in primary care physicians offices, and we could get these patients the next level of care sooner rather than later. Again, the whole goal is to preserve sight, and I think for me as an optometrist and my colleagues as an optometrist, we just play an important role. It's not just about seeing for our patients: it's preserving their sight. So if we can better, detect earlier, detect changes, and then get those patients to our colleagues, the retinal specialist, I think that it's a win for the patient. It's a win for the profession."

Ashley Wallace Tucker, OD, FAAO, FSLS, said she is looking forward to seeing more treatments for corneal ectasias.

"I mainly in my practice focus on interior segment disease. I have a passion for keratoconus and fitting specialty contact lenses," she said. "So what I would love to see are more treatments for patients that have these ectasias. I know we have corneal transplants and those sorts of things, but patients are really desiring vision rehabilitation. They really would like an alternative, sometimes, to contact lenses. And I have so many patients that want to wear contacts but can't, so to have technology that would allow those types of patients to be free from contact lenses, like some sort of refractive procedure that would be suitable for patients that have keratoconus or other ectasia. I would love to see that, and that would really impact my patient base."

Jessica Steen, OD, FAAO, finds comanagement is a vital part of successful patient care in glaucoma management.

"I was fortunate to be able to have with my colleagues, Dr James Murphy, Dr Mary Qiu, and Dr Rachel Simpson, 3 glaucoma surgeons practicing in very different environments really centered around how we best comanage and take care of our glaucoma patients through their lifetime," Steen said of a talk she gave with the MDs. "Now, of course, we talked about new therapeutics, thinking about how we choose a therapeutic based on mechanism of action and true efficacy and tolerability, and most importantly, how we think about interventional therapies, when to consider therapies surgical decision making and comanagement. I think it's conversations like this between optometrists and ophthalmologists that really allow us to get to the core of best patient management and best practices. 

"You know, it even sparked a conversation yesterday to reach out again to a glaucoma surgeon locally in Fort Lauderdale, I realized it had been a number of months since we had touched base. We share a fair number of patients, and considering that we are in different physical locations, I wanted to ensure, and do want to ensure that we're carefully and correctly and actively co managing patients to the best of both of our abilities. 

"The partnership in optometry and ophthalmology in managing patients really is something that we always need to keep in mind. You know, we really do rely on one another to take the best care of our patients, whether they are currently in our office, whether they are coming back to us from the ophthalmologist or treating physician. It's really about these careful and real, clear discussions to manage our patients again through their lifetime and course of disease."

For Ashley Wallace Tucker, OD, FAAO, FSLS, Dipl ABO, last week's conference gives a unique opportunity for optometrists and ophthalmologists to collaborate.

EnVision Summit 2025: An opportunity for streamlining comanagement

Ashley Wallace Tucker, OD, FAAO, FSLS, Dipl ABO, one of the faculty members of EnVision Summit 2025, details the importance of comanagement and the opportunities that the conference gave attendees to improve comanagement tactics.

Ashley Wallace Tucker, OD, FAAO, FSLS, Dipl ABO:

I think it's incredible that ophthalmology and optometry are coming together in this conference. I don't think I've ever had a learning experience quite like this. It's just great to have a collaborative approach to eye care. You know, we have a lot to offer each other as 2 professions that are different but aligned in the mission for the best eye health and eye care for our patients. Because we have so much to offer each other; we don't even know what we don't know that we can offer each other as a profession. Again, we're all eye health eye care professionals, and we all have the same mission. We want the very best care for our patients. So if we can make that collaborative, if we can make referring back and forth to each other seamless and confidently, we could have such a better experience as practitioners and our patients can have a much better experience.

Envision Summit 2025: Patient-centered care and newest treatment strategies in neovascular AMD and DME 

At the Envision Summit 2025 in San Juan, Puerto Rico, Sherrol Reynolds, OD, FAAO, participated in a discussion on patient-centered care and the newest treatment strategies in neovascular AMD and DME. 

My name is Dr Sherrol Reynolds, and I am a professor of optometry at Nova Southeastern University, College of Optometry in Fort Lauderdale, Florida. And it's indeed a pleasure to be here. This is my second Envision Summit, and I think what sets this conference apart from some of the others is that optometry and ophthalmology come together to educate, to inform, and to highlight the latest development in eye care.

And as a person who is in retina and director of our retina service, it was a great opportunity for me to be part of a panel discussion yesterday with noted retinal specialists from Baskin Palmer and other areas, and we talked about patient centered care and the newest treatment strategies in neovascular AMD as well as diabetic macula edema. And what was important to highlight is how we both as retinal specialists on their side and optometrists, can educate our patients about the latest treatment options that are available to these patient. Extended treatment so they don't have to get injections every month. What's new in the pipeline and development of treating patients with neovascular AMD and diabetic maculapathy. So it's exciting times in retina and again, today, we had another opportunity to partner with a retina specialist and my optometric colleagues and further discussion about other conditions that can mimic AMD and how we can differentiate those conditions. What are the latest treatment modalities for these conditions, such as Macular telangiectasia, type two and type one. You know, patients that have polypoidal, choroidal vasculopathy, central serous chorioretinopathy. What's new in the pachychoroid spectrum of diseases.

So in conclusion, you know, emerging therapies, things in retina. Retina is a hot topic. We're seeing new treatment for patients that have geographic atrophy–giving those patients hope. We're seeing treatment modalities where the patients can have an extended treatment. They don't have to get treatment every month, and we're just excited about what's coming down the pipeline.

I think comanagement and collaboration and working together is so critically important. Our patients, especially those that have diabetic retinopathy, diabetic maculopathy and age-related macular degeneration, usually, optometry is that first line, you know, their first entry into eye care. We're seeing a disproportionate number of these patients, so it's important, when these patients have conditions that's vision threatening that not only are we talking about their condition with them, educating them on their condition, but as we're referring them to our colleagues, our retinal specialist, we also want to make sure that they're aware of what the latest treatment option is. A lot of times, our colleagues may have a busy practice, and so these patients go in and, you know, they don't have time to ask their questions. So we, as optometrists, we serve an important role in just getting our patients, not only their diagnosis detected early, but educating them, and then getting them to our colleagues.

Additionally, a lot of times, our patients will come back and may not feel comfortable or have some fears about treatment and may not go back to the retinal specialist. It's important that we again educate our patient and work together well, because the goal is to preserve our patient's sight. So I think it's so important that we work together in doing that.

Comanagement

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