Have you taken a moment to really sit down and think about myopia? Studies show 42% of the US population is myopic; up from 25% since 1971. In Asian countries, the condition is even more prevalent with up to 90% of school age children being near sighted. Globally, the World Health Organization reports 2.5 billion people are myopic, but that number is projected to double to 5 billion by 2050, a statistic that influenced the organization to name myopia as a global epidemic.

As eyecare providers, many of us think of myopia as a benign refractive condition.  We prescribe glasses or contact lenses, and schedule our patients back for an exam in 1 year. But for the nearly 10 million Americans that are highly myopic, this condition is far from benign. 820,000 of these patients these patients have degenerative myopia that could lead to blindness in the course of their lifetime due to retinal detachment, glaucoma, or myopic maculopathy all as a result of their progressive near sightedness.

Dr. Ryan Parker is an optometrist and Director of Professional Education at Essilor, and in this podcast he provides insight about how ODs and eyecare providers must change their way of thinking to better serve our patients and raise awareness of the risks of progressive myopia. It starts with a simple philosophy change: myopia Is NOT a benign refractive condition; it can progress to an ocular disease. In his practice, he compares myopia to ocular hypertension.  OHT a benign condition that we monitor closely to make sure the patient doesn’t cross over to the disease state of glaucoma. That’s what we as optometrists need to do for myopia.

Studies show both genetics and environment are playing major roles in the development and progression of myopia in children. The average American’s lifestyle has greatly changed since the 1970s when myopia levels were down at 25%.  We live overwhelmingly indoor lives, and do extensive near work on tablets, computers and phones. To properly discuss and prescribe for myopia, we need to prescribe lifestyle changes – not just write a numeric prescription.

In 2019, Essilor’s mission is to spread awareness about myopia and the importance of routine eyecare. Dr. Parker shares the goal has two major targets:

* Raise awareness among the public directly about myopia and increase the rate at which children and adults are scheduling eye exams.

* Change the mindset of our fellow optometric colleagues and raise awareness of myopia as a potential disease state.

To accomplish this mission, Dr. Parker states that Essilor will be working with a panel of key opinion leaders on myopia to help lead discussions and education in 2019.  They will also be gathering data across a number of myopia studies to create myopia management protocols with a focus on providing information to doctors in a digestible, approachable format. Being a myopia advocate in your community should be easy, and Dr. Parker’s team at Essilor aims to provide easy to use tools to start that informed conversation with patients.

Dr. Parker encourages doctors young and old to be open to chan...

Turkish – Episode 4 – Refraction

Content by Ocular Media

This week the OpTranslate Podcast covers refraction! This section features retinoscopy, subjective refraction, range of clear vision testing, and PD measurement.

 

Thank you to Alcon for supporting this podcast and the optometric profession as a whole. Dr. Amanda Nanasy and Dr. Jennifer Lyerly were both compensated for their participation in this podcast.

Optometrists have never had better technology for enhancing contact lens comfort and vision. Today’s podcast guests—Dr. Carla Mack, Senior Director of Professional Strategy for Alcon, and Dr. Amanda Nanasy, optometrist and sports vision specialist at The Eye Center of Pembroke Pines in Florida—are both passionate advocates for the power of contact lens prescribing both in growing your optometric practice and improving patient quality of life. They outline strategies for improving your practice success by prescribing daily disposable lenses and multifocal contact lenses.

This year Alcon celebrates the 10th anniversary of the Power of One™ Program that revolutionized optometric prescribing habits to enhance patient compliance with a focus on contact lenses with daily and monthly lens replacement frequencies.1,2 Despite increasing numbers of practitioners embracing daily disposable contact lens prescribing, there are huge opportunities for growth in the market yet to be realized.3 Studies show 80% of patients say they are more interested in wearing daily disposable lenses when recommended by their eye care professional, and 99% of eye care professionals want to fit more of their patients in daily disposable lenses.4,5

New research from the Power of One™ 2.0 aggregated from 2.6 million patients proves that contact lens patients spend more at their optometrist’s office than glasses-only patients, and daily disposable lens wearers spend more than monthly or two-week replacement lens wearers.6

Dr. Nanasy has a strong daily disposable practice, and her biggest advice to practitioners wanting to grow their daily market is to offer the technology to every patient, every time. Many optometrists pre-judge patients, or ask questions in the exam lane that fail to elicit patient dissatisfaction with current contact lenses. If you ask a question that can be answered with, “fine” you’re probably not getting a true gauge on how your patients are really feeling about their lenses. Her goal is to make every annual eye exam a chance for her to talk about new and improved technology.

The biggest opportunity for contact lens growth is in multifocal lens technology. The American population is getting older; by 2020 there will be approximately 1,800 presbyopic patients for each eye care professional,7,8 only about 13% of eye care professionals in the US are currently fitting multifocal or monovision lenses.9 Recent data shows presbyopic patients suffer through a range of emotions, including feeling old (51%) and frustration (43%),10 and multifocal contact lenses can help meet the needs of these patients who are physically and socially active, embrace technology and are appearance conscious.11-14

Through the Practitioners Visiting Alcon Program, Dr. Nanasy has seen firsthand how Alcon’s new fitting process leads to increased first lens fit success. With the new fitting guide, there is a 96% fit success with 2 lenses or less per eye.15,16 For doctors that have struggled with multifocal patient success in the past, Dr. Nanasy encourages practitioners to keep the process simple and follow the fit guide. In her own practice she had a patient complain of distance blur in her initial lens selection. Every part of her previous body of optometric knowledge told her to hold up minus lenses and over-refract, but the fit guide recommended adding plus. She decided to follow her own advice and adhere to the fit guide, and was amazed at her patient’s positive response.

Dr.

If your New Year’s Resolution in 2019 is to do a better job staying up to date with what’s going on in optometry, then Dr. Jaclyn Garlich has you covered. Her weekly email subscription, 20/20 Glance is a perfectly consumable snapshot of the biggest studies, FDA approvals, and pop culture news that will shape your daily practice. Every year since we launched the Defocus Media podcast, we’ve been catching up with Dr. Garlich to test our knowledge of the biggest news of the prior year, and to say that Dr. Glover and Dr. Lyerly are competitive is an understatement. 

Join us in testing your skills on this new podcast, focused on the biggest FDA approvals of last year that you’ll be prescribing in 2019. From new medications to new contact lenses, it’s a great way to get a jump start on what you need to know this year.  And if you didn’t feel great about your podcast quiz skills while listening, you can always study up with Dr. Garlich’s 2018 FDA Approval blog post recap. 

We’ve been such huge fans of everything Dr. Garlich is doing in optometry, we’ve been working to find a way we can collaborate more since the very beginning. We’re so excited to announce that all past editions of 20/20 Glance now have a forever home on defocusmedia.com. Want to look up a study you remember reading in a Glance edition a few months back?  Well now you can! We’re excited to work together to bring you the news each week, and also be a resource any time you need to look up a quick fact or big announcement in optometry.

Turkish – Episode 3 – Entrance Testing

Content by Ocular Media

Our third weekly Turkish lesson teaches you how to measure visual acuity, perform cover test, confrontation fields, EOMs, pupils, color vision, stereo, and keratometry.

Turkish – Episode 2 – Medical Case History

Content by Ocular Media 

The second lesson of our weekly series teaches you medical case history for a comprehensive eye exam in Turkish.  Learn how to ask patients about their medications, allergies, and systemic ailments like diabetes.

Thank you to Alcon for sponsoring this podcast and supporting optometry as a profession. Both Dr. Jennifer Lyerly and Dr. Catherine McDaniel were compensated for their participation on this podcast.

Optometry is so much more than just prescribing glasses and contact lenses, but how can we spread the word about all we provide for our patients? In today’s podcast we dive into exciting new patient outreach efforts seeking to build optometry’s connection as a primary care resource for finding ocular and systemic diseases, protecting against childhood vision problems and their possible detrimental effects on classroom performance, and reshaping how the average American mistakenly correlates dry eye to a condition of the elderly. Our guests—Dr. Carla Mack, Senior Director of Professional Strategy at Alcon, and Dr. Catherine McDaniel, Associate Professor at The Ohio State University College of Optometry—share their insights on these unique patient communication assets and how you can incorporate these tools into your practice!

One of the largest initiatives in optometry right now is Think About Your Eyes, a national public awareness campaign that has generated over 3.4 million eye exams and resulted in $752 million in industry revenue.1  The campaign is raising major awareness about the ability of optometry to detect systemic health conditions during a routine eye exam, and the eye exam’s importance as yearly primary healthcare. Alcon is a proud supporter of this American Optometric Association–backed campaign that is committed to raising patient awareness about the importance of visiting optometrists for comprehensive eye care at every age and stage of a patient’s life.

As a pediatric specialist and mother of two, Dr. Catherine McDaniel has witnessed first hand how difficult it is to get children into the optometrist’s offices for comprehensive eyecare, and how much apprehension about the exam process exists for both parent and child. That one in five preschool children have vision problems, yet only 15% of them have had an eye examination conducted by an eye care professional highlights the importance of overcoming this apprehension.2 In partnership with Alcon, she authored Howard and the Amazing Eye Exam, a free downloadable e-book for children and parents to learn about what happens during the exam, and the importance and value of the visit and diagnostic tests performed. The e-book can be found at theeyesolution.com, so you can put it on your websites for easy access for patients.

Dry eye is another huge opportunity for optometry to make a difference in patients’ daily lives. Estimates show that 30 million Americans suffer from dry eye,3 and as many as 1 in 3 ophthalmic patients report symptoms of dry eye.4 To reach these patients experiencing ocular discomfort and change the script about what dry eye looks like, Alcon has launched a brand new direct-to-consumer campaign with a focus on digital outreach and communication. The face of the campaign is award-winning tennis champion and chronic dry eye sufferer, Venus Williams.

The TFOS DEWS II study has completely reshaped our understanding of dry eye as a profession, and we now know that a majority of patients with dry eye have mixed mechanism dry eye (including components of both evaporative and aqueous deficient dry eye disease).5 Alcon’s new SYSTANE® Complete offers one simple choice for every major type of dry eye.6-10 The drop features advanced nano-droplet technology,7 that allows more effective distribution of the lubricant across the ocular surface for fast hydration6,7,

There’s no doubt that private equity is becoming a major force in the optometric landscape. But why has there been such a large influx of private equity money in our field? We sat down with Dr. Brian Chou to review the optometric landscape and his insights gleaned from a year’s worth of research behind the publication of “Private Equity and The Investment Effect” in Review of Optometric Business.

It’s not just optometry that’s being affected by private equity consolidation.  Dr. Chou reports that dentistry, veterinary care, and medical specialties like dermatology are all targets for private equity today.  The appeal in eyecare is due to the fact that optometry practices are highly fragmented – we all do things differently in our individual practices.  Private equity owners see this type of fragmentation as ripe for bringing in business systems to streamline productivity and financial return.

For many owner doctors, it’s meant their practices are suddenly worth a lot more money. Practices are valued on EBIDTA: earnings before interest, depreciation, taxes, and amortization. Traditionally a doctor’s office would sell for roughly 2 times EBIDTA when a doctor sells a practice. In today’s marketplace, private equity groups are routinely paying 6-10 times EBIDTA for desirable practices, making it an extremely appealing option for doctors looking to retire in the next 5 years.  Dr. Chou explains the end is nowhere in sight – there were roughly 30 big private equity players in eyecare at the time he wrote his article, but new groups are joining the marketplace all the time. He estimates there are billions of private equity dollars out there looking to be invested into eyecare practices in the coming years.

This is not the first time private equity has been interested in eyecare, however.  In the early 90s, PPMC (physician practice management companies) were buying up optometric and ophthalmology practices at a fast clip to better compete for HMO insurance contracts. This model largely crashed by the early 2000s due to changing insurance landscapes that left consolidators in debt with little option for quick profit returns. Today’s private equity buyers do face similar challenges. Consolidators are tasked to not only put in systems for billing, human resources, and distribution, but they also have to create a uniform culture across their acquisitions.  Changing culture at offices that are often so individually different is no easy task, and the success of the private equity company at being able to accomplish this uniformity of culture is essential to their success.

If you want to sell your office to private equity, it may not be as simple as it sounds. Not all offices are attractive to private equity consolidators. Dr. Chou reports that many offices don’t have positive EBIDTA.  The doctor, staff, and associate doctor’s salaries all have to be subtracted out of the EBIDTA value, which leaves many offices at break even or even negative in value. Private equity groups are only interested in offices with positive EBIDTA.  The offices that a private equity firm would want to acquire also need to be within a geographic area that works for consolidation. Typically a private equity company will buy a larger group of offices, often with an OD/MD model, and establish this larger group as the central site or hub.  Acquisitions will then spread out to smaller offices within the geographic area of the hub designed to build referrals to the main central location (the spokes on this hub and spoke model).

For students graduating from school, Dr.

Corporate Optometry Nation interviews Dr. Curtis Ono.  Dr. Ono is the Chair for Affiliate Relations and Membership Executive Committee of the AOA,  Chair- Membership Development Committee,  Immediate Past-President and Washington State Director.  This podcast goes into depth on why all optometrists should join the AOA and advocacy to promote our profession. We discuss telemedicine, managed care plans, threats to optometry and recent wins to legislation in optometry. 

Dr. Ono

Attend the Optometry Meeting in St Louis in 2019 to collaborate with other optometrists and learn how to get involved. 

Membership Recruitment/Retention Resources: http://affiliateconnection.aoa.org/

Time Magazine called 2018 the year of the woman. So, we decided to celebrate! We went through the Internet and Instagram, Facebook, and anywhere we could find a woman doing something great. We celebrated women in politics getting elected, and women in optometry rocking the world, changes to improve women’s rights throughout the world, and we celebrated some other phenomenal women along the way. Listen in, and let’s celebrate the great things woman did in 2018!

Until Next Time,

Rachel and Kate