As I See It

Dr. Jeff & Cole discuss FSA and HSA.

FSA = flexible spending account

HSA = health savings account

FSA are not very flexible - majority of them to term. They will not roll over and when the year is over, your benefits are gone.

Most HSAs will roll over.

People get busier around the holidays and with benefits running out - we are seeing an additional number of patients in the office. Eye care practices see an influx of patients in the last few weeks of the month (December) as ‘some’ people wait until the last minute to get their annual eye exam.

Lesson 12 - A Conjunctivitis Did Not Just Walk In The DoorWe make it a practice of addressing our patients, not the condition, disease or issue. We care for patients, not their disease.

Lesson 13 - I Can Hear - Why Aren’t You Taking Care Of Me?People are busy and no one likes to wait.

We strive to not laugh and banter outside of the exam rooms or around patients - as they are here to be seen and perception is reality. If the patient perceives that you are playing around and not making them a priority - it quickly becomes their new reality.

Don't lose sight of the patient being in the room.

We should never lose when it comes to patient care.

What is DDD?

Door to Doctor, Done (total cycle time)

**every steps of the way, you should be adding value

**minimize “waiting”

We are providing our patients with excellent care in the timeframe ‘they’ deem acceptable.“We are in the care business” - Dr. Jeff Kegarise

Dr. Jeff and Cole discuss Glaucoma, what signs may be presented when you get Glaucoma.

What’s your cupping?It may not be what you think it is. Dr. Jeff introduces the visual of the doughnut and why your cupping is so important.

Dr. Jeff answers questions that our patients are asking us on a monthly basis.

Can you get Glaucoma from your mom and dad?Yes

Can you get Glaucoma from your neighbor?No

What conversation am I having with my mother / grandmother, that will help us notice signs?Patients, for the most part, don’t have pain. They also won’t have symptoms - it’s less symptomatic for high blood pressure.

What’s happening with your optic nerve?This is what we are looking at every time you come in for an exam.

When you have Glaucoma (garden variety type), it’s bi-lateral (in both eyes) but asymmetric disease - one eye proceeds the other. General, people treat both eyes at the same time.

The invert to Glaucoma is Age-Related Macular Degeneration (ARMD).

Glaucoma loses vision around the circumference of the eye and conversely ARMD loses vision in the center of the eye.

Is my vision going to be full restored?With Glaucoma, when you lose your vision; we can’t bring it back.

We’re looking at millions of nerve wires and seeing if they are thinning to see if you are trending to Glaucoma, over time. We’re watching the nerve, structure and function by the OCT and side-vision test are part of it as well.

12 to 20 is the average eye pressure - it varies day to day and time of day.

4 Types of Glaucoma

Congenital Glaucoma

Unique to You

Closed Angle (painful type, estimate 3%) - very unique - sudden eye pressure rise, blurred vision, comes on very quick. 45-65 years old

Open Angle ("Garden Variety" is 85%) majority of Glaucoma patients

You won’t feel pressure in your eyes until it’s in the mid-40s range.

What does Glaucoma suspect mean?

It means you have risk factors (age, African American, Rx, Diabetes, thickness of your cornea, performance of side-vision test) and that we are watching your measurements, pressures and other risk factors.

Does it mean I will get Glaucoma?No.

9 out of 10 people will not get Glaucoma

Will I get Glaucoma because I’m Diabetic?

No.

Having your annual eye exam is so important to consistently watching the health of your optic nerve, watching your high pressure and the general aging and health of your eyes.

We can see so much more today, just by looking into your eyes.

Dr. Jeff Kegarise discusses diabetes with Dr. Arrindell. Dr. Arrindell grew up in the Virgin

Islands, went to college at Michigan State, went to medical school at the University of Iowa, as

well as did his residency at the University of Michigan. Dr. Arrindell and some of his fellow

medical professionals founded a practice called Tennessee Retina in 2008. Dr. Arrindell's

practice is well known for quality care and advanced high level research into retinal issues and

diseases.

November is National Diabetes Awareness Month and Diabetic Eye Awareness Month. Dr. Jeff

discusses how there is a lot of talk in the healthcare community about the “diabetic epidemic”.

Dr. Arrindell discusses that there is an increasing volume of patients with diabetes however the

number of cases he sees with advanced diabetes and advanced diabetic eye issues has

decreased. Dr. Arrindell attributes this to catching issues in patients earlier.