Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

3D Media Can Usher in New Patients

3D MOVIES, TVS, TV SHOWS AND VIDEO GAMES CAN GROW YOUR PRACTICE

■ Because 3D media has become both extremely popular and an unintentional screening tool for binocular vision (BV) disorders, such as convergence insufficiency, it has the potential to garner you several new patients.

Here, your colleagues provide you with four tips on how you can attract 3D vision complication patients.

1. Ask 3D viewing questions

"Our field has done a great job creating public awareness about the signs and symptoms of convergence insufficiency. The first step to creating this awareness was a symptom survey for patients," explains optometrist Leonard J. Press, chair of the American Optometric Association's (AOA) Pediatrics and BV Committee. "We should use a similar strategy for 3D vision complications, as most consumers have no idea that their dizziness, for instance, while viewing a 3D movie is related to a binocular vision disorder."

Specifically, Dr. Press suggests you include the following 3D viewingrelated questions in your patient history form:

1. Do you experience discomfort or eyestrain during or after watching 3D media?
2. Do you experience dizziness or headaches during or after watching 3D media?
3. Are you unable to see 3D differently when looking with one eye compared with both eyes?

The American Optometric Association (AOA) recently took this same approach to educate the general public about 3D vision complications through a press release that includes a set of "red flag" questions (http://www.aoa.org/x15123.xml) the consumer should ask himself.

Optometrist Barry M. Tannen, who specializes in vision therapy (VT) in Hamilton Square, N.J., adds that you should include all these questions in letters to current patients, in practice newsletters and in a press release to the local media as a means of attracting these unaware patients.

"If you ask the right questions, you'll discover several patients who have undiagnosed binocular vision disorders," says optometrist Dominick Maino, a professor of Pediatrics/BV at the Illinois College of Optometry's Illinois Eye Institute. (See "Identify Binocular Vision Disorders," OM December 2009 at www.optometric.com/article.aspx?article=103756.)

2. Provide related literature/resources

If you have an office newsletter, include an article about 3D vision complications, says Dr. Press. Also, refer your patients to the AOA website (www.aoa.org), as it contains an educational video about 3D vision complications.

"In addition, refer patients to the College of Optometrists in Vision Development (COVD) website http://covd.org/home/inthenewsarchives/tabid/186/Default.aspx," he says. "This section of the website contains numerous stories about 3D vision problems."

Dr. Maino advises your practice website include a 3D vision complication section that contains links to all the AOA materials on this topic. Further, he suggests you check out his blog (www.mainosmemos.blogspot), and type "3D" in the search box. This will reveal a slew of 3D vision complication links you can provide for your patients on your own website.

"Also, place a poster of one of the recent 3D movies in your reception room with a sign next to it that says something like: ‘The 3Ds of the 3D viewing experience: If you experience Discomfort, Dizziness or lack of Depth while viewing this or other 3D movies, you may have a binocular vision disorder.’" This will prompt patients who experience these symptoms to seek your help, he says.

3. Include a 3D test in the exam

"A 27-year-old female patient recently presented to me with complaints of headaches, double vision, eye strain and dizziness while viewing Avatar in 3D. She said she suspected her symptoms were due to her vision because she'd been having "reading problems" since the 5th grade, explains Dr. Maino. "When I asked her to have her doctor send me any information that related to binocular vision problems from her last exam, the doctor told her he hadn't conducted any binocular vision testing."

This patient experience reveals the importance of including 3D testing as part of the comprehensive exam, says Dr. Maino. Doing so not only educates patients about 3D vision complications, but also about the fact that we have the skills to diagnose and treat these problems.

"The Random Dot E test is a quick and simple way to screen for the presence or absence of a binocular vision disorder," says Dr. Press.

4. Brush up on BV disorders

"I just received an invitation to attend a meeting at the University of Southern California, in which vision scientists and experts are going to examine and discuss the health-related issues associated with 3D viewing," says Dr. Press. "This, to me, is an indication that the 3D industry is starting to realize it needs to take these issues into consideration."

He adds that he believes the 3D industry will likely create a disclaimer that will appear prior to a movie or telecast that reads: "If you experience dizziness, discomfort or depth perception problems, seek an eyecare practitioner."

If you want to be this eyecare practitioner, you need to brush up on BV disorders and the latest VT techniques, Dr. Press says.

"Get busy with educational opportunities through the American Academy of Optometry, the AOA, College of Optometrists in Vision Development and the Optometric Extension Program Foundation," he says.

This month, Toy Story 3 makes its 3D movie debut, providing you with the perfect opportunity to gauge whether your patients have 3D vision complications.

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Lessons From Montefiore Medical Center Bob Levoy, Roslyn, N.Y. Is there anything about your practice that possibly irritates patients and about which you and your staff are completely unaware? Hard to believe? Consider this recently discovered problem at Montefiore Medical Center in New York City. It started when the hospital surveyed patients who were discharged. The survey asked about a range of topics from doctors to food to housekeeping. Of all things, the patients' number one complaint was the high level of noise in the hospital. What had been completely overlooked (or underestimated) by management was the cacophony of seemingly unavoidable noises: beeping monitors, ringing telephones, squeaky medication and meal carts, blaring intercoms, loud TVs, and late-night conversations among staff in the halls. A noise reduction program was subsequently initiated on the fifth floor of Montefiore by Elodia Mercier, R.N., the administrative nurse manager of the floor. As a result, overall decibel levels have fallen significantly. On Mercier's unit, noise levels had been as high as 90 decibels, which is comparable to that of a busy street. Today, the floor maintains decibel levels of about 65, on a par with a typical library. The effects have been remarkable, says Ms. Mercier. "Within two weeks, patients said they were sleeping better, and the staff told us they were less stressed." Lesson Learned: In the day-to-day rush of seeing patients, staying on schedule, dealing with assorted emergencies and returning phone calls, it's easy to lose track of the "little things." Periodic feedback is essential. Brief patient surveys, follow-up phone calls of selected patients and focus groups are among the ways you can assess patient satisfaction. In the case of Montefiore Medical Center, "noise" as a major complaint, let alone the number one complaint, was the furthest thing from anyone's mind. Reality Check: Consider whether there may be comparable complaints in your practice that could be solved with a simple change of work habits or the physical surroundings.

ABO To Select Quality Assurance Team

GATHERING INPUT FROM THE PROFESSION

■ The American Board of Optometry (ABO) plans to appoint a quality assurance team that will assist in reviewing promotional and educational materials and ensure the new organization continues to gather input from the profession.

"We want to actively engage practicing optometrists to work with the ABO to provide a board certification process that is credible, attainable and defensible," says optometrist David Cockrell, ABO chairman of the board.

Dr. Cockrell says the board wants to select a team that has a "wide range of opinions and as broad a base of experience as possible." The board plans to select team members in the coming weeks.

One of the team's first assignments will be to review existing and proposed promotional materials to ensure they aren't only clear, but also reflect the profession's intent. Since the ABO recently began accepting applications for board certification at its website (www.americanboardofoptometry.org), some have expressed concern that the site contained promotional statements that could be misconstrued as divisive or confusing to the profession.

To become an active candidate for ABO board certification, complete an online application at the board's website. The site contains additional information regarding the certification process.

FDA News

■ Gatifloxacin Ophthalmic Solution 0.5% (Zymaxid, Allergan, Inc.) has received FDA approval for the treatment of bacterial conjunctivitis caused by susceptible strains of Haemophilus influenzae, Staphylococcus aureaus, S. epidermis, Streptococcus mitis group, Streptococcus oralis and Streptococcus pneumonia. It is expected to be available this month.

■ The Crystalens AO intraocular lens, from Bausch + Lomb, has received FDA approval to be marketed in quarter diopter steps. Quarter diopters will be available for the models AT50AO and AT52AO in the ranges of 18 to 22. The company says it expects to have a wider dioptric range available by the end of the year.