Article Date: 7/1/2009

AOA Votes "Yes" on Board Certification for Optometry
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AOA Votes "Yes" on Board Certification for Optometry

MONTHS OF DEBATE ENDS AT "OPTOMETRY'S MEETING"

■ Board certification of optometry took a giant leap toward becoming a reality at last month's annual meeting of the American Optometric Association (AOA) held in Washington, D.C. There, the AOA House of Delegates, by a vote of 1,126 to 887, agreed on a motion to develop a framework for board certification.

The unprecedented vote authorizes the AOA to participate in the development, formation, implementation and governance of the American Board of Optometry (ABO) and will give the board the authority to officially develop the model for board certification and maintenance of certification. Formal adoption of this resolution is subject to final action by the AOA's Judicial Council.

Varying opinions voiced

Response to the vote was as swift as it was varied. AOA President Randy Brooks, O.D., said the vote indicates, "optometrists see the need for a mechanism to clearly demonstrate continued competency to patients, legislators and payers." Several AOA members who opposed board certification — which is optional — said they would consider resigning from the association. A few questioned whether some of the delegates who voted in favor of certification had represented the wishes of their constituents. Others voiced support for the majority decision.

"As a faculty member, one of my ongoing goals is to continue to develop myself as a professional and as a clinician," says Kimberly K. Reed, O.D., F.A.A.O., associate professor of optometry and director of externship programs at Nova Southeastern University. "Board certification offers the opportunity to demonstrate a commitment to ongoing professional development. For our students and future colleagues, it's critical that we preserve and protect our profession and our scope of practice."

Also, Dr. Reed noted that with the current state of the economy, "optometry as a profession continues to be squeezed from all sides; board certification may allow us to achieve a greater presence in the healthcare arena. Although I am aware that there is significant opposition to this decision, I hope that we can continue to work as a cohesive force in the best interest of our profession and our patients."

(For the opinion of Walter West, O.D., chief optometric editor, Optometric Management, see Viewpoint. See the OM June 2009 issue for a point-counterpoint review of board certification.)

The requirements

Under the proposed model, optometrists must meet initial certification requirements, as well as complete three years of active licensure and accumulate 150 points of postgraduate educational requirements to be eligible for the board certification examination. These requirements must be met within the three years immediately prior to the examination.

Applicants should pass the examination within 12 months of submitting the application. Upon successful completion of the exam, the optometrist will be board certified for a period of 10 years.

Points are awarded through several means in three categories. Category I must make up at least 50% of the points and includes:

► Completion of a residency program, approved by the Accreditation Council on Optometric Education, which will waive the three-year licensure requirement as well as award the applicant 150 points.

► A clinical Certificate of Fellowship from the American Academy of Optometry (AAO), which will reduce the licensure requirement to one year and is worth 50 points.

► Active licensure, which is worth five points per year.

► Fellowship in the College of Optometrists in Vision Development, which is worth 50 points.

Category II can make up no more than 50% of the points and includes educational activities (such as paper and poster presentations), distance learning courses, attendance at educational or scientific portions of hospital meetings, other ABO-authorized performance-in-practice activities, scholarly activities and certain educational programs at colleges or universities.

Category III was established for maintenance of certification only and includes Self-Assessment Modules and Performance- In-Practice Modules. See www.aoa.org for a complete description of the proposed model for certification.

The ABO board will consist of two members from the AOA and one member from each of the following organizations: the AAO, American Optometric Student Association, Association of Regulatory Boards of Optometry and Association of Schools and Colleges of Optometry. The ABO board will also include one public member.

Hall of Fame Honors Two O.D.s
Charles Mullen, O.D., and Edwin C. Marshall, O.D., were inducted into the National Optometry Hall of Fame during the annual meeting of the American Optometric Association in Washington, D.C.
Dr. Mullen was noted for his contributions, which include building institutions of quality education, forming national healthcare policy and strengthening urban communities through quality optometric and ophthalmic care. He retired as president of the Illinois College of Optometry in 2002.
Dr. Marshall is known for work as an educator, administrator, clinician and public servant. Just one year out of school, Dr. Marshall helped found the Community Eye Care Center, Indiana University School of Optometry's first off-campus clinic. He is the founding chair of the Indiana Minority Health Advisory Committee. In 2002, he was elected president of the Indiana Public Health Association.

Bausch & Lomb Presents Daily Lens, Rebrands Solutions, Offers Center

SOFLENS GETS MULTI-MILLION DOLLAR CAMPAIGN

■ Bausch & Lomb's introduction of the new SofLens daily disposable contact lens includes a consumer online marketing campaign. Targeting adults, ages 25 to 34, the multi-million dollar campaign communicates the benefits of wearing daily disposable lenses. Consumers who visit www.soflens.com can participate in promotions, including a free trial offer for the SofLens lens.

Interactive demonstrations describe the "High Definition" optics in the SofLens lens, which, according to the company, help reduce the appearance of blurriness, halos and glare. Also, the company is offering a rebate program plus savings on lens cleaning solutions.

In addition, the new contact lens offers a slow-release moisture formula that works with the eye's natural tears to create a "cushion of moisture that lasts throughout the day," says Bausch & Lomb.

ReNu rebranded

In somewhat related news, Bausch & Lomb Vision Care announced a rebranding effort of its lens care solutions with the introduction of ReNu Fresh Lens Comfort (formerly RenNu MultiPlus) and ReNu Sensitive Eyes (formerly ReNu Multipurpose solution).

According to the company, ReNu Fresh Lens Comfort contains Hydranate, an ingredient that removes protein deposits that accumulate during wear; poloxamine, which helps remove dirt and debris while enhancing wettability and moisture retention; and the disinfection agent polyaminopropyl biguanide (DYMED).

Available this month, ReNu Sensitive Eyes contains fewer ingredients to provide "gentle lens care for soft contact lenses," without sacrificing a high level of disinfection, says the company.

To support the product introductions, Bausch & Lomb has launched consumer campaigns that include the Web sites www.refresh.com (for Fresh Lens Comfort) and www.renu.com (Sensitive Eyes).

Insights front and center

Bausch & Lomb announced the launch of the Center for Patient Insights, which aims to deliver knowledge that helps eyecare professionals (ECPs) better understand their patients, their industry and practice opportunities. The center plans to present unbiased industry information, trends, market research and insights for U.S. ECPs, says the company.

The center will present data gathered from patient and consumer research commissioned by Bausch & Lomb and nationally recognized data providers, such as Health Products Research and Gallup. Such a source creates "a great opportunity for eyecare practitioners to access and reference the market information needed to make informed decisions for their practices and their patients," says Walt West, O.D., chief optometric editor, Optometric Management.

The center's interactive portal, www.CenterForPatientInsights.com, launching in the coming weeks, will provide ECPs with brief "Patient-Points," a summary of industry trends, research on patient attitudes, and insights on how you can use this data to positively impact practices. PatientPoints and other research will be downloadable from the Web site.

Jury Awards O.D. After Optical Store Copies His Patient Files

NEW MEXICO O.D. AWARDED $2.3 MILLION PLUS $1

■ A county jury in New Mexico awarded Willis Muncey, O.D., of Albuquerque, $2 million in punitive damages, $300,000 in compensatory damages and $1 after finding Eyeglass World (EGW), a national optical chain for which Dr. Willis was an independently contracted optometrist, had copied the O.D.'s patient files.

"We polled the jury after the verdict, and the $1 was intended as a message to Eyeglass World that the jury would have awarded more in punitive damages if we'd asked for it," says Dr. Muncey's lawyer Christopher Bauman of Bauman, Dow & Leon in Albuquerque.

EGW, however, is currently preparing post-trial motions, which will seek to have the damage awards set aside, according to a statement issued from National Vision, the company that owns EGW. Failing that, an appeal is planned.

In spring of 2007, Dr. Muncey lined up a new position with Eyemart Express in Albuquerque and gave his notice. He agreed to contract with other optometrists to use his patient files for one month to give EGW time to replace him, says Mr. Bauman. Once that period elapsed, one of Dr. Muncey's former EGW colleagues informed him that EGW had begun copying his patient files.

"Although former management at Eyeglass World copied files in 2007, it securely stored the copies and never used them in any way for its benefit. As the files remained in a box, Dr. Muncey, the plaintiff, and the optometrist in question, was not injured in any way by the files' copying, nor did he offer any evidence of harm at trial …" says a statement from National Vision.

"I don't know how they could possibly believe that they could get away with that [copying the files], and that no one would care," says Dr. Muncey, who now works at Eyemart Express.

In June/July of 2007, EGW asked Dr. Muncey to retrieve his files. At the advice of Mr. Bauman, however, he declined.

EGW then reported to the New Mexico State Board of Optometry that Dr. Muncey had terminated his lease with the optical and had refused to retrieve his patient files after several written requests.

"We have thought about taking the case to Federal Court, but there's no private right of action under HIPPA," explains Mr. Bauman. "In other words, the Secretary of the Dept. of Health and Human Services may have an ability to file a lawsuit against Eyeglass World for HIPPA violation, but Dr. Muncey does not."

Wear Schedule Ignored, Regardless of Practitioner Education

CL WEARERS OVERWEAR LENSES DESPITE AWARENESS OF POTENTIAL COMPLICATIONS

■ Most U.S. contact lens (CL) wearers don't adhere to the manufacturer-recommended replacement schedule (MRRS), despite knowledge of the associated adverse events, says a Centre for Contact Lens Research (CCLR) study.

Specifically, 59% of two-week replacement CL wearers, 29% of one-month replacement wearers and 15% of daily disposable wearers wore their lenses longer than the MRRS.

Although 87% of patients reported discussing the health effects of noncompliance with their eyecare practitioner, and 77% said they talked with their eyecare practitioner about the effect noncompliance has on CL comfort, 51% said they didn't adhere to the MRRS because they forgot which day to replace their lenses, while 26% reported doing so "to save money."

So, what can you do about this? this? "Give patients an easy-to-remember replacement schedule, such as the first of every month," says Susan Resnick, O.D., a New York City-based CL specialist. "For the frugal patient, emphasize how inexpensive their lenses really are in the context of every day purchases, such as designer coffee, for which they pay more, yet have no bearing on health and vision. For both patient groups, explain how following the replacement schedule is much less aggravating and costly than trying to clear up any CL problems."

The CIBA Vision-sponsored random study (meaning CCLR only looked for CL wearers and not specific brands) was comprised of 1,654 patient surveys.

HEALTH Notes
• Topical cyclosporine emulsion, 0.05% (Restasis, Allergan), provides patient value and is a cost-effective therapy for moderate to severe dry eye syndrome that is unresponsive to conventional therapy, says a recent Archives of Ophthalmology study.

dry eye disease (DED) (clinically diagnosed dry eye or constant/often dryness and irritation) prevalence appears to increase with age, from 3.90% among U.S. men age 50 to 54, to 7.67% among men age 80 and older, says a study in June's Archives of Ophthalmology. Also, high blood pressure, benign prostatic hyperplasia, use of medications to treat benign prostatic hyperplasia, antidepressants and antihypertensives were linked with an increased DED risk.

Tamsulin (Flomax, Boehringer Ingelheim Pharmaceuticals, Inc.) use within 14 days of cataract surgery may be associated with retinal detachment, lost lens or lens fragment or endophthalmitis post-cataract surgery, says a study in May's Journal of the American Medical Association.

Dexamethasone 0.7mg (Ozurdex, Allergan) has received FDA approval for macular edema treatment following branch retinal vein occlusion or central retinal vein occlusion. The corticosteroid is contained within an intravitreal biodegradable implant, enabling its extended release and effect. The company's Novadur sol-id polymer delivery system administers it into the vitreous cavity. Clinical studies showed that 20% to 30% of patients had a three-line im-provement in best-corrected visual acuity with-in the first two months post-treatment.

Diabetic retinopathy prevalence is growing, says an American Diabetes Association comparison between the 1988 to 1994 and 2005 to 2006 National Health and Nutrition Examination Surveys (NHANES). Its occurrence in non-Hispanic whites has risen almost 13%; almost 22% in non-Hispanic blacks; and al-most 7% in Mexican Americans. Also, every five additional years of diabetes duration raised diabetic retinopathy odds by 60%. The survey comparison, however, is complicated by differences in methodology and sample size.

O.D. NOTEBOOK
Marco recently announced the Marco EMR Certification Program to assure doctors that Marco products will integrate seamlessly with those vendors who are Marco certified EMR partners. To become certified under the program, an EMR company must demonstrate that its software integrates with all Marco automated products. The program will ensure that the integration between both companies will continue as Marco and/or its EMR-certified companies introduce new products and technologies.

Essilor of America, Inc., announced that it will offer an e-commerce solution for independent eyecare professionals (ECPs) to provide optical products online to their current and future patients. FramesDirect.com, an online optical business founded by optometrists David Cooper and Guy Hodgson, will assist with the initiative, which received endorsement from the AOA, Transitions Optical Inc. says. Beta testing of the initiative will begin with several practices this month.

Transitions Optical, Inc. has released "Putting Your Practice on Facebook," a guide that explains social media and how Facebook can help you connect with other professionals and patients. You can download the guide at www.Transisitions.com/fb.

■ The Food and Drug Administration has developed a new video and article on contact lens safety, both of which are aimed at consumers. The message of each will be familiar to optometrists: Use a rub-and-rinse method of disinfection; empty the solution from contact lens cases after each use; do not top off or reuse solution, etc. If you'd like to refer your patients to these educational tools, both can be found at www. fda.gov (search on keywords "contact lens").

LENSCO, a specialty contact lens company, appointed Mike Hodges to the position of vice president of operations for the company. Mr. Hodges formerly ran the sales and marketing divisions of the company.

Corrections:
• To clarify, the height, width and depth measurements in the sidebar on the Pascal Dynamic Contour non-applanation contact tonometer (DCT), featured in the May 2009 issue's Instrumental Strategies column, should be in mm and not inches.

• To clarify, "ICP" of the "Diagnosis And Management of Optic Disc Elevation" article (June 2009) should read "increased IOP."


Optometric Management, Issue: July 2009