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AOA Calls for Withdrawal of Children's Screening Recommendations

AOA SAYS RECOMMENDATIONS WILL HURT, NOT HELP

■ The American Optometric Association (AOA) is calling for the withdrawal of the recently updated and released U.S. Preventative Services Task Force (USPSTF) recommendations for the “Screening for Visual Impairment in Children Ages 1 to 5.” Also, it has requested, via letter, that the USPSTF meet with the AOA for a “collaborative, interprofessional dialog” to strengthen the recommendations.

“This nation's Doctors of Optometry are extremely concerned that the USPSTF children's vision screening recommendations will hamper ongoing efforts to combat unacceptably high rates of preventable vision loss in children —especially among vulnerable and at-risk children in communities across America … ” says AOA President Joe E. Ellis, O.D.

Specifically, the USPSTF recommends vision screening for the presence of ambylopia and its risk factors for all children ages three to five, though it concludes that the current evidence is insufficient to determine the balance of benefits and harms of vision screening in children younger than age three.(See www.Uspreventiveservicestaskforce.org/uspstf11/vischildren/vischildrs.htm.) The AOA maintains that this is the most critical stage of visual development. Also, it questions the recommendation of vision screenings.

“These ill-advised USPSTF recommendations seem to ignore mountains of scientific data showing that the vast majority of vision screenings for children demonstrate an unacceptably high rate of error [false negatives] … ” says AOA President-Elect Dori Carlson, O.D.

Ned Calonge, M.D., M.P.H., a family practitioner and chair of the USPSTF, says the task force didn't find this “mountain of scientific data.” Specifically, he says the USPSTF reviews both randomized controlled trials and observational studies that can be found on Pub-Med, among other online searches. From there, he says the task force uses “evidenced-based practice centers,” which reach out to clinical experts in a specific area to review the chosen studies.

“I can't tell you that the studies were sent to optometrists for review, nor can I tell you that they weren't,” Dr. Calonge says. “But, we do try to make sure we include all the clinical experts in the review process.”

So, will the USPSTF meet with the AOA?

“What might be possible is a conversation between a Task Force representative and representatives from the AOA, probably by phone,” Dr. Calonge says. “We do not engage in debate with professional organizations, but do seek input. If the AOA sends a set of peer-reviewed research articles to the Task Force staff that after review, we believe a discussion will be warranted and useful, we would possibly pursue this course.”

President Obama posthumously awarded the 2010 Presidential Medal of Freedom to optometrist Tom Little, of Delmar, N.Y., on Feb. 15th for his optometric mission work in Afghanistan. His widow, Elizabeth Little (pictured), accepted the medal and a hug from the President at a White House ceremony. (For more information on Dr. Little, visit www.optometric.com/article.aspx?article=104706.)

Kentucky Scope of Practice Bill Becomes Law

BILL ENABLES KENTUCKY BOARD OF OPTOMETRY TO PLOT SCOPE OF PRACTICE

■ As we go to press, Senate Bill 110, an optometric scope of practice bill otherwise known as the “Better Access to Quality Eye Care Act,” has been signed into law by Governor Steve Beshear.

“Access to quality health care is a critical issue for families across the Commonwealth. After careful consideration, along with meetings with many interested parties, I signed Senate Bill 110 to give Kentuckians greater access to necessary eye care,” Governor Beshear released in a statement. “This bill passed overwhelmingly in both legislative chambers (81 to 14 in the House and 33 to 3 in the Senate), showing broad bipartisan support.”

The governor's statement further revealed he will be meeting with the Board of Optometric Examiners to ensure the state's O.D.s undergo extensive training.

New scope

Senate Bill 110 gives the Kentucky Board of Optometry the authority to determine the scope of practice for the state's O.D.s outside the specific exclusions (e.g. cataract and retinal surgery, etc.) listed within the bill, says optometrist William T Reynolds, Kentucky Optometric Association (KOA) legislative chair. Specifically, this legislation will allow optometrists to:

► Use the most up-to-date, cost-effective methods of administeringmedication.

“This legislation allows for new drug delivery technology, as it's being developed,” explains optometrist Ben Gaddie, president-elect of the KOA, who also was the Association's lead testifier for the bill's passage. “That said, the bill prohibits us from, for instance, doing injections into the vitreous or posterior segment of the eye.”

► Remove lumps and bumps from the eye and eye lids via surgical means.

“This legislation allows us to give the patient a sub-dermal injection of anesthetic and then lance a chalazion, for instance,” says Dr. Gaddie. “However, the legislation does not allow us to perform procedures that require general anesthesia.”

► Use laser technology to treat conditions that don't require general anesthesia.

“Under this section of the legislation, we are able to perform procedures, such as YAG laser capsulotomy, LPI, ALT and SLT,” says Dr. Gaddie.

Reasons for bill

The KOA pursued this scope of practice bill for two reasons, explains Dr. Reynolds.

“First, some of the members of the KOA, including Dr. Gaddie, had attended optometry school, done their residencies or practiced in Oklahoma, where optometrists are taught and allowed to perform the procedures outlined in the Kentucky bill. As a result, they wanted to be able to practice to their full ability here in Kentucky,” he says. “Second, optometric practices exist in 106 out of the 120 counties in Kentucky, whereas ophthalmology practices are located in just 42, and 50% of them are in Louisville and Lexington. Kentucky is a rural state, so a lot of our patients were required to drive a long way —some of them with impaired vision —to see an ophthalmologist for services we can successfully provide.”

He adds that in addition to the inconvenience and additional cost to patients, unnecessary referrals increased costs to Kentucky taxpayers, as Medicaid patients could charge the transportation costs to the state when they traveled to another county for eye care.

“We are thrilled that the governor recognizes the importance of this bill for access to health care and eye care for our citizens here, and we take our responsibility to implement this bill very seriously, and we just look forward to the future and serving the patients here,” says optometrist Julie Metzger Aubuchon, KOA president.

Make Your Practice Senior-Friendly

MANAGEMENT MEMO

Bob Levoy, O.D., Roslyn, N.Y.

■ Making your practice senior-friendly makes sense on many levels. It will differentiate your practice; give it a competitive advantage; and attract new patients. Follow these action steps to achieve the senior-friendly office.

► Make sure your practice is up-to-date on low-vision services, aids and technology.
► If your free-standing office has front steps, install a ramp (that has handrails) as an alternative.
► Have sturdy chairs with arm rests in the reception area, including some with elevated seats.
► Have good lighting, a room temperature that's comfortable for older patients and a selection of reading materials with large print.
► Consider the noise level in your office environment. Many older patients (and others as well) may prefer a quiet reception area or one with soothing music.
► Have a spotless rest room with safety rails to assist patients getting on or off the toilet. Replace knobs on the sink with levers which are easier to use for those who have arthritis.
► If older patients have difficulty seeing or completing patient information and insurance forms, have a staff member offer to assist them.
► Make your staff aware of how to treat older patients in all interactions. This includes speaking slowly, loudly and clearly enough when making appointments, selecting eyewear and discussing lens options, calling them to remind them of their appointments, even helping them get around the office if needed.

“Patience is the key with the elderly,” says Marcy L. Street, M.D. of Doctor's Approach Dermatology in East Lansing, Mich.

► Consulting Editor Dr. Jack Runninger feels that what's most important is to make sure that office personnel treat elderly folks with respect. “In many offices,” he says, “there seems to be a tendency to treat the elderly as if they were in their second childhood —including the first-name usage,” he says. “Many tell me they resent being called by their first name by a 20-year-old employee”.
► Schedule a staff meeting to discuss how to make your office senior-friendly.

Transitions Optical Redefines its Annual Academy Experience

EDUCATION, RESEARCH AND AWARDS HIGHLIGHT MEETING

■ Roughly 1,300 industry professionals attended the 15th annual Transitions Academy held in Orlando, Fla. in late January. According to the company, it “redefined” its Academy experience by offering new programs that challenged attendees to incorporate new strategies into their business planning.

The event included workshops and educational sessions on management, sales, photochromic technology and marketing. In addition to education for opticians, optometrists and lab personnel, the Academy also included educational tracks for vision plan provider representatives and benefits brokers, as well as Transitions “Pro Forum” members —professionals the company has identified as leaders in the optical field.

Coinciding with the meeting, Transitions released research that revealed 24% of employees do not elect to enroll in their company's vision benefit. The second annual Employee Perceptions of Vision Benefits Survey also showed that 32% of those who do enroll don't use their benefits to receive a comprehensive eye examination.

The survey identified even lower utilization of vision benefits among covered children —46% do not receive exams, vs. 35% of parents.

Reaching consumers

Transitions announced three consumer outreach programs at the meeting. The company will continue to leverage Transitions lenses' designation as the Official Eyewear of the PGA Tour, Champions Tour and Nationwide Tour.

The company also introduced an advertising campaign for the summer sun (“Don't get caught squinting… Live a life less squinty”), which promotes the benefits of adaptive lenses and UV protection.

In addition, Transitions will promote a back-to-school message with its “Eyenstein” mobile eyecare clinic, which has completed more than 700 children's eye exams around the country, Bess the Book Bus and Eye Didn't Know That!, a program that features games, information and eye health educational resources.

Recognizing excellence

The grand finale of each Academy is the awards banquet. There, Toledo Optical Laboratory became the first U.S. lab to win the Transitions Optical Lab of the Year Award three times. Also recognized: Central Optical and Walman Optical for their year-long efforts.

Transitions presented its first-ever Retailer of the Year Award to Eye Care Centers of America & Empire Vision (national division) and SVS Optical Centers (regional division). Patsy Akridge, president of Akridge Insurance & Financial Services won Transitions' first-ever Vision Benefits Broker of the Year Award.

Addendum

In the January issue of Optometric Management, the sidebar “Digital Fundus Camera Websites” should have included a listing for Synemed (www.synemed.com). We apologize for the omission.