Volume 7, Issue 19│May 26, 2023
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Editor's Note: In observance of Memorial Day, the IOA office will be closed on Monday, May 29, 2023. We wish you a safe holiday. |
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Spring Legislative Update
The General Assembly met this week to take up the state budget. As of yesterday, the Senate has passed the budget and sent it to the House for consideration. Continue reading below for information on the proposed budget and other legislation that passed during the Spring Session.
HB 2450 (NEW AMENDMENT) - This amendment is a compromise between the proponents of SB 2427 and HB 2280 and the coalition of healthcare organizations. The previous language in SB 2427 and HB 2280 would have required 10 hours of Cultural Competency CE. The amendment passed the Senate last week and moved through House Health Care Licenses Committee and the House floor this week. The bill will now head to the Governor's desk for signature.
The amendment provides the following:
- Provides that for health care professional license or registration renewals occurring on or after January 1, 2025, a health care professional who has continuing education requirements must complete at least a one-hour course in training on cultural competency.
- A health care professional may count this one hour for completion of this course toward meeting the minimum credit hours required for continuing education.
- Provides that, notwithstanding any other provision of law, for health care professional license or registration renewals occurring on or after January 1, 2025, a health care professional whose license or registration renewal occurs every 2 years must complete all statutorily mandated topics within 3 renewal periods.
- Provides that if any additional statutorily mandated topics are added by law after the effective date of the amendatory Act, a health care professional whose license or registration renewal occurs every 2 years must complete all statutorily mandated topics within 4 renewal periods.
- Provides that, notwithstanding any other provision of law, for health care professional license or registration renewals occurring on or after January 1, 2025, a health care professional whose license or registration renewal occurs every 3 years must complete all statutorily mandated topics within 2 renewal periods.
- Provides that if any additional statutorily mandated topics are added by law after the effective date of the amendatory Act, then a health care professional whose license or registration renewal occurs every 3 years must complete all statutorily mandated topics within 3 renewal periods.
- Provides that the Department of Financial and Professional Regulation shall maintain on its website information regarding the current specific statutorily mandated training topics.
- Provides that each license or permit application or renewal form the Department provides to a health care professional must include a notification regarding the current requirements for the specific statutorily mandated topics.
- Amends the Illinois Controlled Substances Act. Provides that in accordance with the requirement for prescribers of controlled substances to undergo training under the federal Consolidated Appropriations Act, 2023 every prescriber who is licensed to prescribe controlled substances shall, during the pre-renewal period, complete one hour (rather than 3 hours) of continuing education on safe opioid prescribing practices offered or accredited by a professional association, State government agency, or federal government agency. Effective immediately.
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Heartfelt Gratitude to Legislators for Sponsoring and Passing the Vision Care Fairness and Transparency Bill
The two main sponsors were Leader Cristina Castro in the Senate and Representative Anna Moeller in the House.
Senate Co-Sponsor
Senator Sally Turner (R)
The House Co-Sponsors:
Rep Paul Jacobs (R) (an optometrist for 41 years)
Rep Anthony DeLuca (D)
Rep Dan Caulkins (R)
Rep Travis Weaver (R)
Rep Dagmara Avelar (D)
Rep Adam Niemerg (R)
Rep Larry Walsh (D)
Rep Bob Rita (D)
Rep Debbie Meyers-Martin (D)
Rep Matt Hanson (D)
The IOA expressed our appreciation and gratitude to the members of the Illinois General Assembly, who sponsored our bill, for their unwavering support and dedication to passing the Vision Care Fairness and Transparency Bill, SB 764.
The passage of this crucial legislation is a significant milestone for optometrists, patients, and the entire vision care industry in our state. The reforms introduced through this bill not only
promote fairness but also establish a framework of transparency in contracting with vision plans, ensuring that both providers and patients can benefit from a more equitable and informed system.
One of the most pivotal aspects of the legislation is its provision that prohibits vision care organizations from imposing restrictions on eye care providers' freedom to choose suppliers, materials, or labs. By eliminating these constraints, the bill empowers eye care providers to make decisions based on their professional judgment and expertise, ultimately enhancing the quality of care they can deliver to their patients. This provision truly embodies the spirit of fairness and recognizes the importance of professional autonomy.
Additionally, the law's requirement for eye care providers to post a notice to patients if they do not accept the fee schedule set by the insurer for vision plans is a commendable step toward fostering transparency and informed decision-making. This provision ensures that patients
are well-informed about their provider's fee structure, enabling them to make educated choices and better understand the financial implications of their vision care.
We expressed our sincere gratitude for their leadership, tireless efforts, and commitment to the betterment of our profession and the well-being of our patients. Their vision and foresight in championing this bill have made a lasting impact on our community.
We are immensely grateful for their willingness to listen, engage, and act on the needs of our industry, thereby enabling us to better serve our patients and contribute to their overall health and well-being.
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This Asian American and Pacific Islander Heritage Month, we would like to honor Bill M. Park, O.D. Dr. Park is a Gold Ivy Leaf honors graduate from Aurora University, and a Beta Sigma Kappa honors graduate from the Illinois College of Optometry. Dr. Park’s extensive list of achievements and community service since opening his practice in 1977 is nothing short of amazing.
Dr. Park was raised in a family who owned their own restaurant business, and that close family dynamic influenced him to choose optometry as his medical focus, a medical career without constant night or emergency surgery calls. “I wanted to be a doctor but… have a normal family life raising a family”.
When asked if, as a young optometrist, he envisioned where he is today, Dr. Park said, "I knew that everyone has to be able to see well, and I wanted to have my own business like my parents thus, I got five years of experience working in a large private eye care business and also in a small private practice on my days off and learned all about running a practice from doctors in the area whom all supported my goal and even helped me when I first opened my own office. The small practice doctor I worked with helped me scout a location for my practice. It was tough at the beginning, but now I have grown the practice to include my two children, who will eventually take over the business that has been established for over 46 years."
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Volunteers Needed for Special Olympics Lions Club International Opening Eyes Program - June 9-10, ISU Campus, Normal, IL
We are back to hosting a 2-day event at the Special Olympics Illinois State Games this year! We need your help again this year! Of particular need are volunteers for Saturday, since it is a full day of screening. As always, your families and friends are welcome to participate, and we need help from opticians and optical technicians. Make it an office and/or family event!
Special Olympics is an international year-round program offering sports and athletic competitions for children and adults with intellectual disabilities. Athletes participating in the Illinois State Games must be at least eight years old to participate. The goal of the Special Olympics Lions Club International Opening Eyes Program is to bring quality vision care to this special population. Our assessment consists of visual acuity testing, cover test, extraocular motility testing, pupils, color vision, stereopsis, non-contact tonometry, slit lamp evaluation, and ophthalmoscopy. If the athlete is determined to need glasses, they are given a full refraction with subjective testing.
Event Details:
Redbird Arena, Illinois State University Campus, Normal, IL
Friday, June 9, 2023 12:00pm – 4:00pm
Saturday, June 10, 2023 9:00am – 4:00pm
To participate, please send the following information to Dr. Christine Allison at callison@ico.edu by May 26:
1. Name of volunteers:
2. Phone:
3. Email address:
4. Address:
5. Availability: June 9, June 10, or both
Or, you may mail the form linked below to:
Christine L. Allison, O.D.
3241 S. Michigan Ave.
Chicago, IL 60616
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Illinois Senate Passes Budget Bill
Health News Illinois reports that the Illinois Senate approved a fiscal year 2024 budget late Thursday night totaling roughly $50.7 billion. The budget packet includes an additional $38 million for 23 safety net hospitals that serve low-income communities. Other measures include the creation of an advisory council to advise HFS to support veteran suicide prevention, establishing an Opioid Remediation Services Capital Plan Investment Grant Program, and giving the Office of Firearm Violence Prevention the ability to award violence prevention organizations grants for evidence-based violence prevention services. The House will reconvene at 5pm today, May 26, with a goal of passing the budget bill by Saturday morning.
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Updated Perspectives in Myopia Management to Advance the Standard of Care
May 12, 2023
by Brooke Herron
With nearsightedness rapidly growing in children, WCO webinars address the latest in mitigation, management and treatment for clinical practice
As World Council of Optometry (WCO) President-Elect, Dr. Sandra Block was involved with the recent WCO Virtual Event, Myopia Management: Advancing the Standard of Care. Below, she addresses today’s growing needs surrounding the myopia epidemic in children.
The alarming rise of pediatric myopia is a global and multi-faceted problem — and to help control the impending epidemic, optometrists need to know (and follow) the most current and effective management and treatment strategies. As simple as this might sound, it becomes more complicated when applied on a global scale: Practice styles and educational backgrounds differ worldwide, as well as access to care and resources. And when these factors are combined, it can become challenging to change practice patterns.
Myopia is more than just refractive error
Before retiring, Dr. Sandra Block dedicated her career to pediatric optometry. Now, as the president-elect of the World Council of Optometry (WCO), she’s bringing her invaluable expertise to a global stage to help elevate the standard of care in myopia management.
Dr. Block says part of this is recognizing that myopia is not only a refractive state — but rather, a disease entity — that can cause vision loss through a number of different pathologies associated with moderate and high myopia. This includes posterior segment conditions like tilted disc, tessellated fundus, posterior staphyloma, thin choroid, macular degeneration, peripheral retinal degeneration and vitreoretinal interface disease.
“Since we are now aware of the association of moderate and high myopia with these relatively common pathologies, it becomes more important for optometrists to look at myopia as a disease entity and consider myopia management to reduce the risk of developing these vision-threatening pathologies,” she said.
Use the latest evidence-based strategies in clinical practice
In addition, the continued increase of myopia prevalence in younger children further contributes to the urgent need for eye care practitioners to get on the same page when it comes to management strategies.
“The profession is learning that the epidemic (almost pandemic) of myopia is continuing to grow,” said Dr. Block. “And it’s clear that there are many researchers providing evidence on how to address myopia management — and it’s imperative for eye care providers to stay on top of current research and how it impacts practice patterns.”
One way for optometrists around the world to stay up-to-date with the evolving research is to participate in webinars, like the recent one held by WCO. During these informative events, optometrists can glean clinical pearls that can be integrated into daily practice — all backed by experts and their personal experience.
“The WCO has realized that we, as global leaders for the optometric profession, need to communicate this research and rethink how we regard myopia,” explained Dr. Block. And it’s not just the optometric societies that are answering the call to halt myopia progression — the industry is also also stepping up in areas of research and development, as well as in supporting education. For example, the WCO, along with Coopervision, created their “Standard of Care Guidelines for Myopia Management” in 2021 to serve as an important resource for optometrists. This includes information on new tools developed for myopia mitigation, measurement and management, supported by well-designed studies that demonstrate successful methods to slow down the progression of the disease.
Embracing change through education
According to Dr. Block, although eye care providers are slow to integrate change in their practices, it is happening — and the WCO is ready to support these efforts through education.
“From my perspective, change will occur faster as schools and colleges of optometry teach myopia management within the core curriculum,” said Dr. Block. “In addition, the number of webinars and articles that focus on the changing preferred practice guidelines, along with the education of the public from groups such as the Global Myopia Awareness Coalition (GMAC), will drive change at the level of patient care. Educational programs will need to continue to be offered to help optometrists maintain the highest level of knowledge and skills to best treat their patients.”
It’s Dr. Block’s hope that viewers of the WCO Virtual Event were convinced to at least update their perspective of myopia — and that’s away from the dated idea that myopia is a refractive error that can be corrected with simple optical lenses … to the reality that myopia is a disease entity that needs early detection, treatment, and follow-up.
“It’s our responsibility to educate patients and parents about lifestyle changes that can help lessen the impact, along with new and emerging tools to improve outcomes,” she said, adding that when it comes to pediatric eye care, parent involvement, and awareness is imperative.
For example, parents should know what risk factors can be modified and which cannot, like genetics: “If a parent has myopia, that immediately increases the risk and that cannot be changed,” said Dr. Block. However, lifestyle changes can be made to help lower this risk, such as spending more time (at least 90 minutes per day) outdoors and less time on devices or doing other close work.
Eye exams also play a crucial role: Starting at age 3 and throughout school-age, children should undergo multiple comprehensive eye exams. “We know that the eyes are still developing, and vision can change up to the age of 20,” she added.
“We need to ensure that our patients are offered the most effective and current treatments that could help maintain a lifetime of good vision,” said Dr. Block. “Optometry is core to the diagnosis and treatment of myopia and I envision that the profession will step up to the call to action.”
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Illinois College of Optometry held its commencement ceremony on May 20, 2023, at the Chicago Symphony Center |
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Chicago College of Optometry held its Commencement Ceremony on Wednesday, May 24, 2023, at Midwestern University. |
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We want to hear your memories of the IOA! In celebration of our 125th anniversary in 2023, the IOA is collecting your stories about the organization.
Please share your thoughts on the importance of IOA membership, favorite memories from IOA, or your thoughts on the history of the IOA.
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Report illegal and unsafe contact lens sales to the FDA & FTC
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September 28-October 1, 2023 - IOA Annual Meeting
Renaissance Schaumburg Convention Center Hotel | Schaumburg, IL
Up to 18 hours TQ CE
Registration opens mid-July
November 5, 2023
Southern IL CE
6 Hrs TQ
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Check out the newest IOA classifieds here!
Highly Established Primary Care practice looking for a FT patient-focused Optometrist in northern Chicago ( Read more)
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Join Members of the IOA at Optometry's Meeting®
Click the photo to view the promo video
Optometry's Meeting® returns to our nation's capital to unite doctors of optometry, future doctors and paraoptometrics for premier education, entertainment and collaboration. Engage in these impactful networking and leadership opportunities alongside an expansive exhibit hall, the Eye Care Square, offering the latest ophthalmic goods and services, and business solutions that position your optometry practice for success.
The American Optometric Association (AOA) and the American Optometric Student Association (AOSA) are energized and eager to once again come together in Washington, D.C., to advance the great profession of optometry!
The 126th Annual AOA Congress & 55th Annual AOSA Conference: Optometry's Meeting® welcomes back our friends, family and colleagues, June 21-24, 2023, in downtown Washington, D.C., where renowned education, networking and business opportunities intersect for one unforgettable experience.
Optometry’s Meeting will deliver world-class learning, networking and business solutions that will power your practice and patient health. From courses offering office-based surgical content to practical guidance on everything from building a medical contact lens practice to preparing financially for any stage of your career, Optometry’s Meeting is packed with discovery, interdisciplinary collaboration, and experiential opportunities.
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Centanarian Dr. James Bazell Stafford Jr., 101, of Peoria, IL,
transitioned from this earthly life to his heavenly home at 1:11 p.m. on Friday, May 5, 2023, at Carle Health Methodist Hospital.
Dr. Stafford was born on September 16, 1921, in Alton, IL, to James and Mary Jane (Killion) Stafford Sr. He married the love of his life, Evelyn Serena Smith, in St. Louis, MO, on December 13, 1943.
Dr. Stafford was an optometrist for over 60 years and owned his private practice for 50 years from 1953, retiring in 2003. He was a U.S. Army Veteran serving in World War II, where he was an Adjutant at the 335th Station Hospital located in Burma, a country in Southeast Asia. Dr. Stafford also served in the Korean Conflict, where he practiced optometry in the hospital there. He attended Drake University in Des Moines, IA, and Iowa Wesleyan College in Mt. Pleasant, IA, where he was an outstanding football player. He earned his Optometry Degree at Monroe College of Optometry in Chicago, IL, now known as Illinois College of Optometry.
Dr. Stafford was a trailblazer and opened the door for other African Americans in Peoria. In 1959, he became the first African American to hold a seat on the Peoria City Council. He was appointed by a 5 to 2 vote after the council deadlocked on six previous ballots. This was such a mighty accomplishment at this time that it was covered by Jet Magazine in the April 30 and May 7, 1959, weekly magazine. He also became the first African American to serve as president of the Illinois Optometric Association, which he held for two years. In addition to tennis as an activity, he also rode a Honda Motorcycle until he turned 80 years of age. Another hobby of his was designing and crafting stained glass windows. His beautiful, skillful stained-glass designs adorn both his home and his church, Mt. Zion M.B. Church.
He earned the rank of Eagle Scout as a teenager and started the first boy scout Troop, Troop 19, at Mt. Zion M. B. Church. Dr. Stafford was also awarded the Distinguished Scouter Award. He also travelled by car with his wife and two children to attend Philmont Scout Ranch in Cimarron, New Mexico, the training center for scouting. To assist in helping those in need, Dr. Stafford was instrumental in starting the food bank at Mt. Zion, which is still operating today.
Dr. Stafford was an avid tennis player, participating in many tennis tournaments throughout Peoria and the surrounding counties and he won many tournaments. He played tennis until he turned 94 years of age and beat many players many years younger than he. The life of Dr. Stafford was put to paper in a book titled Topspin, the story of Dr. James Bazell Stafford Jr. written by his son, James B. Stafford III, to honor his father’s life of giving to his family, his community and his church.
Dr. Stafford leaves to cherish their most precious memories his loving wife of 79 years of marriage, Evelyn Serena Smith Stafford; one son, James B. (Melanie) Stafford III of Memphis, TN; one daughter, Sylvia Victoria (Ernest Jr.) Thompson of Detroit, MI; 4 grandchildren; 5 great-grandchildren; and a host of other family and friends who miss and love him. He was preceded in death by his parents.
Funeral services will be held at 11 a.m. Saturday, May 27, 2023, at Mt. Zion M.B. Church, with a visitation one hour prior at 10 a.m. Rev. James Fleming will officiate. Dr. Stafford will be laid to rest on Soldier Hill at Historic Springdale Cemetery, where U.S. Army Military Honors will be rendered.
Online condolences may be made at simonsmortuary.com.
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Learn from your Competition
To be successful, don’t be afraid to study and learn from your competitors. They may be doing something right that you can implement to help make your practice more successful.
Make a list of who your primary competitors are, but don’t overlook those who might fall onto your secondary list or even third. A Google search can turn up practices that weren’t even on your radar. Do the same with social media channels.
Through your competitor analysis, determine what content creation your competitors are focusing on. You can follow their Blogs, Videos, Webinars, Podcasts, Press releases, and social media platforms like Twitter, Facebook, LinkedIn, and Instagram to determine their sales approach.
Examine the websites of your competitors. Click every link in the header and dropdowns and every link in the footers. Compose a list of web page titles, URL architecture, H1 tags, internal links, image text, and keywords. You can then plug these into your own site.
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Newly Approved Miebo Holds Power for the Treatment of Dry Eye Disease
May 22, 2023
This single-ingredient tear stabilizer from Bausch + Lomb and Novaliq could become the choice therapeutic for dry eye disease.
For decades, eye care practitioners have struggled with replacing the lipid layer of the tear film when the Meibomian glands are not producing adequate amounts or poor-quality meibom. We have tried petroleum-based ointments, lipid-containing artificial tears of various formulations and delivery platforms, and other natural oils in and around the eye to bolster the lipid layer of the tear film.
With the approval of Miebo (perfluorohexyloctane; Bausch + Lomb, Novaliq), we now have a first-in-class drug with a novel mechanism of action to treat the signs and symptoms of dry eye disease (DED) associated with Meibomian gland dysfunction (MGD).
Miebo is a 100% perfluorohexyloctane eye drop. 100%! No other ingredient. No water. No preservatives. Nothing else. It is a non-aqueous liquid, non-blurring wetting agent. Honestly, how great is that? No wondering if the drop excipient ingredients or a preservative are cause for irritation vs the active ingredient. Miebo is not a steroid, NSAID or immunomodulator. Perfluorohexyloctane demonstrates strong spreading properties due to low surface tension, facilitating small drop sizes and interacting with the lipophilic part of the tear film to form a layer at the film-air interface and to prevent evaporation.
Miebo spreads uniformly over the ocular surface upon application, forming a protective surfactant layer over the tear film restoring fluidity, which then prevents evaporation and secondary, sensitizing osmolarity changes. It has the ability to restore tear film balance by increasing and stabilizing the lipid layer for hours to protect the underlying aqueous and mucin layer of the tear film. Miebo also penetrates the Meibomian glands.
Perfluorohexyloctane (F6H8) is a semifluorinated alkane liquid that has been used in ophthalmology as a long-term vitreous substitute. This compound is physically, chemically, and physiologically inert, slightly amphiphilic, colorless, and laser-stable. It also boasts a density higher than water and very low surface and interface tensions. In addition, as it is a non-aqueous liquid, microbial growth is not possible and therefore, it does not need any preservative.
Can this single-ingredient tear stabilizer become the choice therapeutic to standardized corneal surface measurements in cataract and refractive surgery? There would be no question as to the impact of the various lubricant eye drop properties (ingredients, delivery system, viscosity, residence times) on keratometric/other eye measurements. As refractive endpoints become more and more precise—think light-adjusting IOLs—having a standard, predictable, tear-stabilizing agent will be paramount.
I am excited to see how Miebo changes the lives of patients. Are we at the cusp of a paradigm shift in DED management?
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Study Throws Shade on Cost, Benefits of Laser-Assisted Cataract Surgery
— Higher cost, less quality-adjusted benefit with FLACS versus standard phacoemulsification
Laser-assisted cataract surgery failed to pass a cost-effectiveness test versus standard phacoemulsification cataract surgery (PCS), data from the randomized FEMCAT trial showed.
Femtosecond laser-assisted cataract surgery (FLACS) not only cost more than PCS, but yielded less improvement in quality-adjusted life years (QALY) versus PCS (0.788 vs 0.792). The cost of surgery averaged €1,124 ($1,214) for FLACS and €565.50 ($610.75) for PCS. Total cost of care at 12 months averaged €7,085 ($7,652) FLACS and €6,502 ($7,023) PCS.
Combining the higher cost of FLACS and lower QALY resulted in an incremental cost-utility ratio of -€136,476 ($147,394), reported Antoine Bénard, MD, PhD, of the University of Bordeaux in France, and co-authors, in JAMA Ophthalmology
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"FLACS, in its current state of development, was not cost-effective and should not be reimbursed by healthcare systems," the authors concluded. "Nonetheless, investment in research and development is worthwhile, and a more advanced femtosecond laser may represent a valuable option in cataract surgery in the future."
The study provided "conclusive evidence of lack of incremental value" of FLACS versus PCS, according to the author of an accompanying editorial.
"FLACS was introduced about 12 years ago with much excitement and anticipation," wrote Oliver Schein, MD, MPH, of the Johns Hopkins Wilmer Eye Institute in Baltimore. "Here was an elegant procedure with the promise of greater precision and enhanced clinical outcomes compared with conventional ultrasound phacoemulsification for cataract surgery, the most performed operation."
"For many years, achievement of that promise was claimed based on small studies from enthusiastic early adopters," Schein wrote. "However, the strength of evidence showing no incremental benefit is now substantial."
The concept of value in healthcare depends on an individual's perspective, Schein continued. His personal preference is "health outcomes achieved that matter to patients relative to the cost of achieving those outcomes."
"In the U.K. or France ... the estimated per-case difference in costs [between FLACS and PCS] was in the range of $200 to $300," he added. "From the perspective of the surgeon, an extra $300 per case would probably not justify the extra time and expense of FLACS, especially in the known absence of clinical benefit."
Enthusiasm surrounding FLACS turned into disappointment when FEMCAT showed that FLACS was neither clinically superior to PCS nor cost-effective. A second randomized trial, FACT showed that FLACS was not inferior to PCS. FACT investigators published two subsequent reports, both of which showed FLACS is not cost-effective versus PCS.
Collectively, results of the two randomized trials showed that clinical results with FLACS "were below a clinically meaningful difference," Bénard and co-authors stated.
French and British collaborators in FEMCAT performed a prespecified cost-utility analysis to calculate QALYs for FLACS and PCS. They noted that "utility in health economics is more a function of how individuals value their life than of how they value their health. Hence, a cost-utility analysis may not necessary reflect the results observed on an efficacy endpoint but rather provide additional information on the benefits of a healthcare intervention to decision makers."
The analysis included 870 randomized patients, almost two thirds of whom had bilateral cataract surgery. The analysis showed that the cost of surgery and total costs at 12 months both favored PCS. The difference in QALYs also favored PCS, but the difference did not achieve statistical significance (-0.004, 95% CI -0.028 to 0.021).
A cost-effectiveness probability curve ranging from €0 to €100,000 showed little variation in the likelihood that FLACS would be cost-effective (14-25%). For example, if a lower threshold of €30,000 per QALY were used to defined acceptability (as compared with the standard €50,000 to €100,000), the probability that FLACS would be cost effective is 15.7%.
Investigators also performed a value-of-information analysis, estimating the expected value of perfect information (EVPI), which is the opportunity cost of being wrong when deciding to reimburse an intervention that appears cost-effective or not reimbursing an intervention that does not appear cost-effective. Using the €30,000 per QALY threshold, the analysis yielded an EVPI of €246,139,079 for a wrong decision not to reimburse FLACS.
"The cost-utility analysis of the FACT trial also reported a very small difference in costs, just as we did," the authors stated. "All these results are very consistent, with outcomes of FLACS and PCS very close to each other and always to the disadvantage of FLACS. This is a sign of robustness of our results."
"We believe that an EVPI of approximately €250 million fully justifies budgetary investments in the development of a more efficient laser before spreading this technology," they added.
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FTC Hosts Public Workshop on ‘Eyeglass Rule’
Tuesday, May 23, 2023 12:27 AM
AOA president Ron Benner, OD, vice president Dr. Steven T. Reed and secretary-treasurer Jacquie Bowen, OD, attended the FTC Eyeglass Rule Workshop with participants Jeff Michaels, OD, FAAO, Stephen Montaquila, OD, Mahsa Katherine Masoudi, OD, and MyEyeDr.'s chief medical officer Artis Beatty.
WASHINGTON, D.C.—The Federal Trade Commission (FTC) hosted a public workshop on May 18 to examine proposed changes to its Ophthalmic Practice Rules, also known as the Eyeglass Rule. The workshop, titled A Clear Look at the Eyeglass Rule, was held in conjunction with the Commission’s regulatory review of the Eyeglass Rule. A Notice of Proposed Rulemaking (NRPM) was issued in January 2023 announcing proposed changes to the Rule. The Eyeglass Rule, in place since 1978, is designed to facilitate consumer choice and promote competition in the eyeglass market by requiring ophthalmologists and optometrists to provide patients with a copy of their prescription immediately after the completion of an eye exam.
The four-hour workshop featured three separate panel discussions which focused on:
● The Rule’s prescription release requirement, including the ongoing barriers consumers are facing and the roadblocks to effective compliance.
● The proposed confirmation requirement and how a similar requirement in the Contact Lens Rule has been working in practice since it came into effect in 2020.
● Other proposed changes to the Eyeglass Rule, including changes permitting a digital prescription release in certain circumstances, clarifying that proof of insurance coverage counts as payment, and changing the term “eye examination” to “refractive eye examination” throughout the rule.
Opening remarks were delivered by Sam Levine, director, bureau of consumer protection, FTC, who oversees the commission's attorneys, investigators, and administrative personnel working to protect consumers from unfair and deceptive practices in the marketplace.
In his opening remarks, Levine said, “As many of you probably know, the Eyeglass Rule has been in place since 1978, and since that time, the goal of the FTC in this space has been to promote competition in the eyeglass marketplace and to empower consumers to comparison shop for glasses by making sure they have a copy of their prescription in hand after their eye exam.
“We're holding this workshop because we have been taking a close look at the Eyeglass Rule and how it's working in practice, and we've proposed a few updates to the rule with the goal of improving compliance and increasing clarity around the rule's requirements.”
Levine said, “I hope that today's discussion could help us have a better understanding of what consumers experience when visiting their eyecare professional and when they shop for glasses. And I hope we also come away with a clear understanding of what the prescriber's experience is in terms of complying with the Eyeglass Rule and how the proposed amendments could affect their practice.”
The opening panel discussion centered around the potential need for the Eyeglass Rule’s prescription release requirement in today’s marketplace. The FTC recently sent cease-and-desist letters, as reported by VMAIL, to prescribers of eyeglasses and contact lenses based on consumer complaints that patients were not automatically given, or denied, or charged for their prescriptions.
“I think that the automatic release has been around for so long that I think that it's just a part of what doctors do, and clearly we can find 30 people across the country who may not have complied or the letter response that I read back to the FTC from one of the people who received a letter was that they actually were complying and that it was a misunderstanding from the patient,” said panelist Jeffrey Michaels, OD, co-owner, Family Vision Care. “I think that the automatic compliance with this is so ingrained in optometrists and ophthalmologists that it's just a normal part of the day.”
The second panel featured a presentation by Stephan Montaquila, OD, president, West Bay Eye Associations, and examined the confirmation requirement and lessons learned from the Contact Lens Rule and how the confirmation of prescription release is working in practice. Dr. Montaquila participated at the suggestion of the American Optometric Association (AOA), according to the FTC.
Dr. Montaquila said, “I think that one thing that I must say that is really concerning to the optometry community is that the FTC has decided that it's not enough for a patient to be given the prescription electronically or in their portal. The FTC went a step further and said that doctors have to receive the verifiable affirmative consent to provide the prescription electronically. In the rulemaking, there were actually accusations that doctors would try to make their patient portals challenging to access so that patients would not be able to obtain their prescriptions.
“And while the FTC noted in the footnotes of the rule that there's no evidence to suggest this is actually happening in any practice across the country, the rule change went forward with this requirement for verifiable affirmative consent to provide their prescription electronically. So doctors are unable to seek this consent verbally and document that in their medical record. The FTC did also indicate that doctors could record their patient giving consent. And I'll just be frank, the idea of pulling out a recorder and asking a patient to consent on tape is really incredibly demeaning to the physician or their staff.”
The final panel focused on the other proposed changes to the Eyeglass Rule and the likely effects these changes would have on patients and prescribers.
In conjunction with this event, the FTC is seeking additional public comment. The public has until June 20, 2023 to submit comments and to provide input on the topics discussed at the event. Information on how to submit comments can be found on Regulations.gov.
The transcript from the workshop can be found here.
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FDA Advisory Committee Favors Approval of Intranasal Epinephrine
In a recent vote, an FDA advisory committee favored the approval of the first intranasal epinephrine spray, with a final decision anticipated in the coming months.
May 17, 2023 - On May 11, 2023, the United States FDA Pulmonary–Allergy Drug Advisory Committee (PADAC) favored the approval of Neffy, the first intranasal epinephrine spray for allergic reactions. The panel convened to assess the pharmacokinetics and pharmacodynamics of medication in adults and children with type 1 allergic reactions and anaphylaxis.
The panel voted in favor of approval for adults and children, with a 17:5 vote for approving the spray in pediatric patients who weigh at least 30 kg and a 16:6 vote favoring approval for adults.
“We believe our clinical data from more than 600 individuals demonstrate Neffy’s absorption-enhancing nasal spray technology is comparable to injectable products in delivering potentially lifesaving epinephrine, but with unique advantages of being small, needle-free, and conveniently sized. We are committed to making it easier for patients and caregivers to carry and administer epinephrine without the anxiety and hesitation associated with using a needle-based device,” said Richard Lowenthal, o-Founder, President, and Chief Executive Officer of ARS Pharmaceuticals, in the press release.
According to the press release from ARS Pharma, Neffy was comparable to intramuscular epinephrine injections. Both versions of the medication had similar pharmacokinetics with analogous clinical responses.
Additionally, the pharmacodynamics of the nasal spray was equivalent, if not better, to the intramuscular form. The safety profile of the spray was also favorable.
Across the US, health officials estimate that 25–40 million people have type 1 severe allergic reactions; however, only 3.3 million have an up-to-date epinephrine prescription, with even fewer regularly carrying the medication. Additional insights into epinephrine use found that many people delay or do not administer it when necessary.
Creating nasal epinephrine may make the drug more accessible to a broader range of people. A more manageable and less painful administration method may make patients more willing to use it when necessary.
“Patients need options — with different administration methods — to facilitate actual epinephrine use in an emergency event,” said Carlos Camargo, MD, DrPH, Professor of Emergency Medicine, Harvard Medical School, in the announcement.
Although the recommendations by the advisory committee are not binding, they tend to be good indicators of final FDA decisions. ARS Pharma anticipates a final decision by the middle of 2023 — within the coming months.
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FEEL GOOD STORY OF THE WEEK |
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British Superbike Star has World Title in his Sights with Help from Brighton Optician
Britain’s top superbike rider is now gearing up for the World Championships with help from a Brighton optician.
Published 23rd May 2023, 14:21 BST
Updated 23rd May 2023, 14:24 BST
Fans were thrilled when Bradley Ray took the British Superbike title last October at Brands Hatch and in April he will travel to the Netherlands to begin competing in the European rounds of the World Championships.
Among those cheering on the 25-year-old will be the opticians at Eyesite Brighton who enabled him to follow his dream of competing professionally, despite no one else on the grid wearing glasses.
Eyesite Brighton managing director and practice manager Jim Green said: “Bradley is the only biker on the world circuit who wears eyewear while racing and we like to think of that as his superpower.
“It’s massively important that we get the right eyewear for him because he’s travelling at top speeds of 180 miles an hour and he’s almost horizontal when he’s going around the corners.
“We chose Oakley Trajectory frames for him which are designed for high-level performance across a range of sports.
“They have a super sports fitting which means they’ve got at least three points of contact on the face so they stay on when he’s going round the corners.”
Eyesite Brighton has been providing all of Bradley’s eye care since he was 14. They describe his prescription as ‘phenomenal’ and it requires elite personalised lenses which are curved to fit into his frames.
They are designed to give him 170 degrees of clear vision when he is looking forward and receive the Sapphire treatment which makes them water resistant, as well as scratch resistant, so they do not steam up and any rain or perspiration beads up and runs off them.
The team also provides him with any tests he needs for his specialist motorsport licence so it’s not surprising that Bradley has previously credited Eyesite Brighton with helping him to progress his career.
In an interview with Optometry Today, he said: “When I first put on those personalised racing specs it was almost like seeing again, everything was crystal clear.
“The first time going onto the track with them was an absolute gamechanger and allowed me to take that next big step at a crucial time.
“There was a period where I thought that I may not be able to compete professionally, as there was no-one on the grid that even wore glasses, never mind had my unique prescription.
“But since that first visit to Eyesite, I have never once thought that my glasses would stop me competing at the highest level.”
In December, Bradley delighted customers at Eyesite when he brought his British Championship trophy to its open day and spent time chatting to visitors and signing photographs.
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Optometry Graduate Jacob Travis learns to meet patients where they are through humanitarian work in Kansas City and Alaska
But the COVID-19 pandemic had other plans, squashing any chances for Travis and his fellow optometry students to engage in humanitarian efforts throughout the community during their first few years in the program.
That finally changed this past fall, when the College of Optometry was able to return to its charitable work for the first time in several years. In October, Travis was one of two fourth-year optometry students to participate in a OneSight Essilor Luxottica Foundation humanitarian eye clinic in Kansas City.
Along with fellow student Tiffany Lee – the president of UMSL’s chapter of Student Volunteer Optometric Services to Humanity – Travis worked alongside a handful of licensed optometrists to serve hundreds of children from underserved areas in Kansas City.
During the clinic, they conducted full eye exams, including refraction tests and ocular health assessments, and dispensed eye drops when needed. If deemed necessary, the children participating in the clinic were given a free pair of glasses. Of the 509 kids they saw during that time, the need rate for glasses was 94%.
“It’s a really innovative program that serves some of the more underserved areas in Kansas City,” Travis said. “It definitely underscored that not all people that need glasses show up at the eye doctor. Sometimes you have to take services to places that you know people already are. I think meeting people in their place rather than expecting them to come to you is something that’s hard to learn and hard to teach but is vital when learning to care for new patients.”
Dr. Tareq Nabhan, an assistant clinical professor at UMSL and one of three national member optometrists serving on OSELF’s Clinical Advisory Panel, is lead optometrist for the Kansas City clinics. He made note of the thoughtful and compassionate way Travis interacted with patients during the clinic.
“Jacob is an excellent student clinician and pulls from his many different skillsets in caring for patients,” Nabhan said. “His ability to connect with patients on a number of levels will serve him well. Moreover, Jacob is an excellent communicator, and today more than ever, thoughtful and effective communication is a requirement to improve health care outcomes.”
In addition to underscoring the importance of meeting patients where they are, Travis said the OnesSight Essilor Luxottica clinic helped demonstrate for him how corporations can give back to their communities.
His experience this past semester, meanwhile, showed him what that work can look like in a private practice setting. As part of his fourth-year experience, Travis spent the spring semester working in Nome, Alaska, at Last Frontier Eye Care and Tundra Health Initiative, a 501c3 nonprofit organization that seeks to provide quality eye care to the children of rural Alaska at no cost to enrolled students within the Norton Sound region. Over the past five months, Travis has traveled to different rural villages in the bush to treat children in need of eye care, providing comprehensive vision screenings, eye exams and glasses.
“This is what life looks like when real people – private practitioners, private doctors – have to find their way to give back and kind of keep doing what they want to be doing while also making enough money to live,” he said. “OneSight paid for hotel rooms and for flights or gas out – it was luxury. There, we slept on cots and sleeping bags that we packed with us everywhere we went.”
Throughout his experience in Alaska, Travis was exposed to patients dealing with completely different circumstances than he was used to, which forced him to think more critically about his approach as a health care professional.
“People in western Alaska – and rural communities and native people all over the U.S. – have been on some level marginalized or taken advantage of in very different ways,” he said. “You have to be really aware of those things and be thoughtful – way more thoughtful – in your approach than just showing up and saying, ‘Hey, come see us. We’ll take care of you.’
“It’d be kind of like in Missouri, if you’re trying to go into rural communities, don’t go when calves are being born or crops are ready to harvest because people can’t come to get their eyes checked. Don’t expect farmers to come to your eye clinic when they’re supposed to be making their living for a year.”
Travis, who returned from Alaska earlier this month and took part in commencement on May 12, knows his experiences both in Kansas City and Alaska will serve him well in his future career. While he’s still finalizing his next steps, he plans for humanitarian work to continue to play a large role in his personal and professional life for years to come. Knowing the impact this work had on him personally, Travis is also interested in helping to strengthen opportunities for other students to participate in humanitarian work and engage with patients in real-world settings.
“I think it’s really important to integrate and make a priority the necessity for giving back and not just doing it for making money,” he said. “So, not just expecting students to show up to some after-school meeting and saying, ‘These are the people that want to volunteer,’ but rather encouraging people to go on those trips and making it an enriching experience for students. I think it would be really fun, helpful and educational. It’s a pretty impactful experience for students from any walk of life. I did not grow up with much money, so it was impactful for me because I was able to help people similarly to how others helped me. But in the same way it can be a more humbling experience for those who didn’t have to go through the same experiences. It’s a positive no matter what an individual’s life experiences have been.”
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THANK YOU TO OUR INDUSTRY PARTNERS! |
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