PRACTICE PULSE
Tips, Trends & News You Can Use

Medicare Legislation
New Glaucoma Benefit

More than two decades ago, optometrists weren't in any position to diagnose or treat glaucoma. Today however, optometrists in 45 states can treat the disease with topical medications.

The National Institutes of Health (NIH) estimate that almost 3 million Americans have glaucoma and that half of these people aren't even aware of it. Of those who've been diagnosed, about 120,000 are blind.

Now, here's some news for those of you who do treat glaucoma: the President signed legislation calling for the first glaucoma detection benefit under Medicare. The new law becomes effective January 1, 2002.

The glaucoma detection provision includes coverage of a dilated eye examination with an intraocular pressure measurement and direct ophthalmoscopy or a slit lamp biomicroscopic exam for people who are at the highest risk of developing the disease. Under the law, at-risk individuals can be examined every 2 years. About 18% of Medicare-eligible seniors are expected to qualify for the examinations.

Another provision provides a funding increase (14%) for the NIH. The National Eye Institute (NEI) will receive a 13.5% budget increase.

Ophthalmology also benefited from this legislation. A provision prevents the Secretary of Health and Human Services from implementing a revised prospective payment system for services before next January 1, and extends the phase-in to 4 years. This provision is an effort to counter large proposed cuts to ambulatory surgical center payments.

In a letter to the House of Representatives, the American Optometric Association expressed its satisfaction with the glaucoma eye exam benefit, noting that the provision is an important step in preventing blindness from undetected glaucoma.

Laser Legislation
Still Battling in Wisconsin

Optometrists in Wisconsin are still battling ophthalmology for rights to perform laser procedures. The American Academy of Ophthalmology, the American Medical Association, the Wisconsin Academy of Ophthalmology and the Wisconsin State Medical Society sued the Wisconsin Optometry Examining Board and four of the O.D.s performing PRK on May 15.

"The assistant attorney general of Wisconsin is leading the defense of the Optometry Examining Board in trying to get the case dismissed because we believe there is no legal basis for the suit," says Charlotte Burns, O.D., M.S., president of the Wisconsin Optometric Association. An injunction preventing O.D.s from performing procedures is part of the overall lawsuit.

The Wisconsin Optometry Examining Board withdrew its petition for rulemaking regarding lasers and broadened the issue to optometry's scope of practice.

Says Dr. Burns, "Our focus is the advancement of optometry with new technology and procedures, not just lasers. The Wisconsin Optometry Examining Board determines our scope of practice, not ophthalmology. Wisconsin's optometry law provides for the need to expand and keep up with new technology and the need to define our profession."

Netherlands
Wins DPAs

After several decades of struggle, Dutch optometrists gained legislation allowing the use of diagnostic drugs (mydriatics, cycloplegics, local anesthetics and staining agents). The law was implemented November 15, 2000, despite fierce opposition from ophthalmology. The Netherlands is the first continental European country to achieve diagnostic drug usage. -- Feike Grit, BSc, DSc, FCOptom, F.A.A.O.

NEW APPROVALS

Contact Lens Care
No Rub Approval Expanded

Alcon Laboratories has announced that the Food and Drug Administration (FDA) has cleared Opti-Free Express Multi-Purpose Disinfecting Solution to be used without the rubbing for all soft-lens wearing schedules.

According to Ralph Stone, Ph.D., Vice President Consumer Products, Research & Development, "The approval culminates years of research to develop a lens care product that provides high capacity disinfection and excellent cleaning without rubbing for all wearers of soft lenses."

In the past, a manual daily cleaning was considered to be one of the most important steps in effective lens cleaning and disinfection. However, a survey this past March of soft lens wearers showed that fewer than half of the respondents claimed to rub their lenses most or all of the time.

"Now that clearance has been extended to all wearing schedules for soft lenses, I foresee a dramatic reduction in problems my patients experience that are related to digital cleaning noncompliance," says Ken Lebow, O.D. "With No Rub Opti-Free Express, even these noncompliant patients can have clean, disinfected, comfortable lenses."

New Contact Lens
Keratoconus Lens Launched

Epicon, a contact lens made of carbosilfocon and intended to help patients with keratoconus, was launched at the recent American Academy of Optometry (AAO) meeting in Orlando. According to its maker, Specialty UltraVision, the lens is made of a new material that combines the comfort benefits of soft lenses with the visual and health benefits of rigid lenses.

In other company news, Specialty UltraVision has completed a multi-year agreement with Nihon Optical Corp., an optical retailer in Japan, to exclusively manufacture, supply and co-develop disposable soft lenses throughout Asia.

D-I-V-A
Women in Optometry Gather

Nearly 100 women O.D.s gathered for some camaraderie on the patio of the Disney Beach Club Resort this past December at the annual American Academy of Optometry meeting in Orlando.

This reception served as the kick-off event for a new group, DIVA, that has formed to help women O.D.s network among their peers, further their careers and share their experiences in practicing optometry.

DIVA, stands for:

• Dedication
• Innovation
• Vision
• Achievement.

In the words of the co-founders of DIVA, Jan Jurkus, O.D., M.B.A., Carol Schwartz, O.D., M.B.A., and Julie Ryan, O.D., F.A.A.O., DIVA members will help each other avoid "re-inventing the wheel," and will aim to foster mentoring of all kinds.

Earlier the day of the reception, which was sponsored by Optometric Management, a group of female O.D.s from all areas of the profession joined in on a rousing panel discussion. Some topics included:

• Have women been more successful breaking into management positions in educational settings than in private practice?
• Will the upcoming generation of female O.D.s change the face of leadership in our profession?
• Are the professional organizations addressing the needs of women?

These topics and more will be highlighted in a supplement that OM will publish this April.

If you'd like to join DIVA, please e-mail Dr. Jurkus at DIVA@ico.edu. We'll publish details about how to become a part of this innovative group in an upcoming issue of .

Operations
Integration Plans for CIBA Vision and Wesley Jessen

CIBA Vision and Wesley Jessen, both units of Novartis, announced their plan for integrating operations after the recent merger. The new entity is called CIBA Vision, and it has a single management team and combined sales force that began training later last month. The Wesley Jessen name and trademark will be dissolved over time.

According to the company, Freshlook ColorBlends Toric launched January 2, and it's the first disposable cosmetic toric contact lens for astigmatism. It's available in a limited range for myopia and in three colors: blue, green and honey, with gray to follow. Free-pair and rebate offers are accompanying the launch. Also, a new integrated Web site, www.colorcontacts.com, is debuting this month. And, a consumer advertising campaign using the tagline "Just for tonight" will emphasize the ease of eye color change. Rebates will encourage purchases of Freshlook opaque and Focus enhan- cer lenses.

Focus Dailies daily disposables will become a North American marketing priority with ads in teen magazines, as well as rebates. The rebates will include a $40 manufacturing rebate and a free 5-day trial. The dollar-a-day pricing per pair will continue in 2001. Professional education will also debut to encourage doctors to prescribe these lenses.

Distribution of Focus Progressives contact lenses will broaden with the help of the larger sales force and new professional education to help doctors simplify the fitting process.