Article Date: 12/1/2010

Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

American Optometric Association President Discusses Mid-Term Elections

AOA'S INVOLVEMENT IN THE ELECTIONS AND ITS PLANS DUE TO THE RESULTS ARE REVEALED

On the heels of the recent mid-term elections, AOA President Joe E. Ellis held a media teleconference to discuss both the organization's involvement in the mid-term elections as well as its plans due to its outcome.

The highlights of the teleconference follow.

Running with the PAC

AOA members invested almost $2 million in the AOA's Political Action Committee (PAC) to support the campaigns of 363 candidates. Of this number, approximately 329 were elected. “Overall, the results showed that AOA-PAC had a remarkable 90% success rate in its efforts,” Dr. Ellis said. The AOA-PAC political giving in the 2010 election cycle ratio was: 55% to Democrat candidates/incumbents and 45% to Republican candiates/incumbents, according to an AOA spokesperson.

Republican John Boozman, of Arkansas, who became the first optometrist elected to the U.S. Senate, benefitted from the AOA support.

“The AOA-PAC, hundreds of optometrists in Arkansas and thousands from across the country actively backed Dr. Boozman's bid against the incumbent, Senator Blanch Lincoln (Dem.),” said Dr. Ellis. “Also, starting back in early September, the AOA sponsored a well-received radio ad in support of Dr. Boozman.” Incidentally, a total of 13 optometrists now hold seats in their state legislatures, according to an AOA spokesperson.

Protecting children's vision

The AOA is bracing to safeguard the Harkin Amendment and the Children's Vision Initiative. Although the AOA did support many of the newly elected state representatives, Dr. Ellis said the organization is concerned these provisions could still fall by the axe. “We [the AOA] intend to safeguard our patient access gains. Number one, including the Harkin Amendment, which was the first federal provider non-discrimination language we've ever had,” he said. “We also have much work to do on the children's vision essential healthcare benefit (which is set to be included in the 50 statebased health exchanges as part of section 1302 of the Patient Protection and Affordable Care Act) … The key part of this children's benefit is that it's not optional, it's not supplemental, it's not ancillary. It's in fact, essential, so we're going to work real hard about defining that [to members of Congress and to state legislators].”

An eye on healthcare reform

The AOA will work closely with its state affiliates to ensure optometrists across the country have the information they need regarding their state's health exchange. In addition, Dr. Ellis said the organization will work with its third-party center and state government's relation center to help its members acclimate to forthcoming changes. “I project there will be approximately 50 state exchanges out there, and there will probably be 50 mechanisms on how they work,” he said. “So, we're going to have a challenge working with our affiliates out there.”

The biggest challenge healthcare reform presents for the healthcare professions: being equally involved in the implementation process at both the Federal and state levels, Dr. Ellis said. “This is going to be the biggest challenge optometry and other healthcare professions have ever faced because it used to be that you would work in your state capitol on an issue, then you would pull back and go to Washington for some over-riding issue, he explained. “But now, we need to be engaged at the state and the state houses and also the U.S. capitol all at the same time to solidify our patient access agenda.”

CORRECTION
In the What's New section under the subhead “Scanning laser ophthalmoscope,” (OM November), the “P200 DX” should actually appear as the “200Dx.”

Academy Meeting Breaks Records

NEARLY 6,000 ATTEND SAN FRANCISCO AAO

■ It was a record-breaking event: The recent annual meeting of the American Academy of Optometry (AAO), “Academy 2010 San Francisco,” drew more than 5,800 attendees — including more than 3,800 optometrists — making this the largest Academy meeting to date.

According to the AAO, the meeting attracted more than 600 international attendees from 39 countries, including 129 from Canada and 42 from Australia. In addition to nearly 300 hours of continuing education, the meeting offered scientific presentations, social events and an exhibit hall that included roughly 250 exhibitors, according to the AAO.

The meeting introduced the Academy's new board of directors, which includes:

► President Karla Zadnik, O.D., Ph.D., F.A.A.O.
► President-elect Bernard J. Dolan, O.D., M.S., F.A.A.O.
► Secretary-Treasurer Brett G. Bence, O.D., F.A.A.O.
► Immediate Past-President Mark Eger, O.D., F.A.A.O.

Members at-large were also introduced, including: Barbara Caffery, O.D., Ph.D., F.A.A.O.; Michael G. Harris, O.D., J.D., M.S., F.A.A.O.; Timothy T McMahon, O.D., F.A.A.O.; and Joseph P. Shovlin, O.D., F.A.A.O.

The Academy inducted a record 212 new Fellows who completed a candidacy process that included both written and oral presentations. Approximately 10% of practicing optometrists in the United States are Fellows of the Academy.

In addition, three were awarded diplomate status by the Cornea, Contact Lenses & Refractive Technologies Section of the AAO: Drs. Peter W. Bickel (Research), Danielle Marie Robertson (Clinical), and Cindy W. Siu (Clinical).

Schapero Award announced

During the annual meeting, Joseph Barr, O.D., M.S., F.A.A.O., vice president, Global Clinical & Medical Affairs and Professional Services, Vision Care, Bausch + Lomb, received the AAO's 2010 Max Schapero Memorial Award. The AAO presents the award to a clinician, researcher or scholar who has made a significant contribution to the cornea and contact lens field.

While at Academy

The meeting featured a number of events that recognized the global importance of optometry. The Brien Holden Vision Institute hosted “a very special dinner” to honor Optometry Giving Sight (OGS)’s major donors and sponsors. The event celebrated the impact of the charity on blindness prevention and low vision throughout the world.

OGS recognized a number of optometrists for their personal annual contributions at the Chairman's Club level, including Drs. Victor Connors, Steve Schock, Sidney Stern, Brien Holden, Mario Gutierrez, John McCall, Rick Franz, Sylvie Franz and Volunteer Optometric Services to Humanity President Greg Pearl. OGS also welcomed to its Chairman's Circle Optos, Primary Eyecare Network, Drs. Don Robinson, Randall Yumori, Stuart Bark, Scott Brisbin and Barry Weiner. (See www.givingsight.org for a complete list of key donors.)

OGS also honored CIBA Vision, the Brien Holden Vision Institute, Marchon Eyewear Incorporated, Vision Source, All About Vision, Abbott Medical Optics Australia and Essilor Australia for their sponsorship of the organization, which now funds projects in more than 18 underserved communities throughout the world.

Historic meeting

Also at Academy, the Optometric Historical Society held its annual meeting, which included a lecture by Alden N. Haffner, O.D. In his lecture, Dr. Haffner discussed several of the pivotal moments in optometry, including the first attempt to increase the scope of practice of optometry, which occurred in 1937 (Pennsylvania House Bill No. 1119). This took place 39 years before West Virginia passed its therapeutic pharmaceutical agent (TPA) law, the first to expand optometry's scope.

Dr. Haffner also discussed D. Elva Cooper, the first female optometrist to make a mark on optometric history when, in the absence of the president and first vice president of the American Optometric Association, she defied convention and presided over the national meeting in 1911. To place the moment in perspective: Women would not gain the right to vote until 1920.

Rapid-fire presentations

The Academy press conference, a rapid-fire series of 20 five-minute presentations, featured scientific papers as well as company information, including:

► an update on the Focus DAILIES Toric and expanded parameters for AIR OPTIX for Astigmatism contact lenses by CIBA Vision, which will result in increased patient coverage from 88% to 99%;
► the Synergeyes Duette hybrid contact lens for astigmatism;
► the Tearlab Osmolarity System, a dry eye test, which will receive a CPT code in 2011 and be reimbursed by the CMS at $24.01 per eye;
► the Carl Zeiss Vision i.Profiler system, an automatic autorefractor/keratometer based on wavefront technology and the i.Scription, an optimized algorithm that can refine the results of a subjective refraction to 1/100 of a diopter;
► the Optovue portable iVue spectral domain (SD) OCT, which provides retina, cornea and glaucoma scans;
► the Eschenbach Optik Powerlux, iZoom and portable video magnifier low vision aids;
► Posterior Pole Asymmetry Analysis software for the Heidelberg Spectralis SD-OCT;
► Abbott Medical Optics’ RevitaLens OcuTec Multi-Purpose Disinfecting Solution, developed with input from more than 600 eyecare professionals;
► the Eye Photos Systems EC100 slit lamp imaging system;
► Carl Zeiss Meditec's HFA-Cirrus combined report that combines data from the Humphrey Field Analyzer and Cirrus HD-OCT.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES INCLUDES OCULAR HEALTH IN FUNDING FOR COMMUNITY HEALTH CENTERS

Eye Health Included in Expanded Services Initiative

Through its Expanded Services Initiative, The U.S. Department of Health and Human Services has allotted up to $335 million for community health centers to increase preventative and primary health care. Included in this funding: ocular health.
The Patient Protection and Affordable Care Act — signed into law by President Obama in March — has made these funds possible. Specifically, The Act provides $11 billion in funding through the next five years for the construction, operation and expansion of health centers throughout the United States. Approximately $9.5 billion of these funds will be used to develop new health center sites in medically underserved areas and expand both preventive and primary healthcare centers at existing sites. Further, an additional $1.5 billion will be used for major construction and renovation at nationwide health centers, so they can serve nearly double the patients they do now, despite these patients’ insurance status or ability to pay.
“More than 29 million adult Americans are currently affected by vision problems. And, vision disorders are the most prevalent disabling childhood conditions in the United States,” says Hugh R. Parry, president and CEO of Prevent Blindness America. “Through the Expanded Services Initiative, we can help to protect the vision and eye health of communities across the United States.”
If you are affiliated with or know of any such health centers that could use this funding for ocular health services, grant application information is available at www.hrsa.gov/grants/apply/assistance/expandedservices, with applications due January 6, 2011 at 8:00pm Eastern Standard Time.

Organizations Launch Outreach Programs

PROGRAMS FROM ICO, VSP, TRANSITIONS AND DAVIS

■ Several organizations have announced optometric outreach programs recently.

Through its newly launched Chicago Vision Outreach program, the Illinois Eye Institute (IEI) of the Illinois College of Optometry is connecting its optometrists and students with patients in the community, who suffer from ocular issues and are least likely to receive eye care.

Vision Service Plan announced it's the exclusive sponsor of the Improving Diversity in Optometric Careers (IDOC) program at the Ohio State University College of Optometry. The program's goal is to inspire both undergraduate and high school students of diverse populations to pursue a career in optometry.

As part of its “Focus on America” outreach program, Davis Vison announced, “Bring a Book, Get a Book, See a Book,” a nationwide literacy campaign. Davis plans to hold 52 vision screenings across the country, many held at libraries where children can also receive a library card and participate in a book swap. Davis Vision will donate a book to any child who is unable to bring one.

Transitions Optical Inc. partnered with the National Council of Negro Women to launch its “Healthy Sight for Life: Focus on African American Eyes” campaign. The campaign raises awareness about the importance of proper vision care and vision wear among the African-American community.

American Board of Optometry Makes Progress Toward BC Exam Offering

CERTIFYING BODY ANNOUNCES SEVERAL UPDATES REGARDING BOARD CERTIFICATION

■ The American Board of Optometry (ABO) has progressed toward its goal of offering the first board certification (BC) exam in June, 2011, the Board announced.

This progress:

► Phase 2 of the MyABO Web portal is officially open. This allows BC candidates to upload their postgraduate activities to complete the 150-point requirement to qualify to take the inaugural exam.
► The ABO website (www.americanboardofoptometry.org) now provides further details on activities that qualify as Category 2 education.
► The ABO has completed the development of the Board of Optometry Examination Test Specifications/Content Outline.
► Item writers have begun drafting the BC test questions.
► The ABO Examination application and reservation system opens in January.

In related news, the ABO's motion to dismiss the American Optometric Society's lawsuit claiming false and misleading statements on the ABO's website was granted in part and denied in part.

Specifically, the ABO's motion to dismiss was granted for the following statements on the website:

► “Demand an optometrist who has gone ABOVE the basic requirements through ABO board certification.”
► “STAY ABOVE THE CROWD.” (ABOVE is acronym for American Board of Optometry Verification of Excellence.)
► Part of a practitioner's quote: “They will know that I have proven my ability to provide the best care possible.”

The reason for these dismissals: A United States District Court in California ruled that these statements are mere puffery (extremely unlikely to induce consumer reliance), as a matter of law.

The motion to dismiss was denied for the following:

► “Board Certified Optometrists will demonstrate their competence beyond entry level for optometric licensure.”
► “Board Certification is a voluntary process that establishes standards that demonstrate that the doctor of optometry has exceeded the requirement(s) for licensure.”
► “Only Board Certified Optometrists have demonstrated their competence beyond entry level for optometric licensure.”
► Part of a practitioner's quote: “I want my patients and the public to see that I have achieved the highest level of certification available in eye care.”
► “Board Certified Optometrists will be able to demonstrate their competence beyond entry level for optometric licensure.”
► “Board Certification is a voluntary process that establishes standards that demonstrate that the doctor of optometry has exceeded the requirements for licensure.”

The reason for these denials: The court ruled that these statements are not, as a matter of law, non-actionable puffery.

Research Notes
• Open-angle glaucoma patients may be significantly more likely than patients without the disease to have comorbidities, such as hypertension, hyperlipidemia, diabetes, systemic lupus erythematosus, hypothyroidism, fluid and electrolyte disorders, depression, psychosis, stroke, liver disease and peptic ulcer, after adjusting for age, gender, urbanization level and monthly income, says November's Ophthalmology. All study subjects were Chinese.
• Femtosecond laser surgery appears to produce anterior capsular incisions that are twice as strong and more than five times as precise in size and shape than manual capsulorhexis, says November's Science Translation Medicine.
• Corneal arcus appears to be associated with high intraocular pressure and low central corneal thickness, regardless of age, sex or systemic and ocular factors, says November's Archives of Ophthalmology. The researchers say further research is needed to determine the clinical implications of these findings for IOP assessment in eyes that have corneal arcus.

Bausch + Lomb Changes Multi-Purpose Solution Labeling

EYECARE COMPANY RECOMMENDS “RUB AND RINSE” REGIMEN FOR ALL ITS MULTI-PURPOSE SOLUTIONS

■ Bausch + Lomb (B+L) has chosen to change its multi-purpose solution labeling to only include a rub and rinse regimen for cleaning and disinfecting contact lenses, according to a press release issued by the company.

“Improving patient hygiene and contact lens wear is an ongoing priority for Bausch + Lomb, and this initiative allows us to help advance patient compliance with lens care directions,” says Joseph Barr, O.D., M.S., F.A.A.O., vice president, Global Clinical & Medical Affairs and Professional Services, B+L, Vision Care. “We look forward to bringing several additional tools to our clinical partners to help improve patient compliance in the near future.”

Specifically, the rub and rinse labeling directions instruct patients to gently rub each lens for 20 seconds before rinsing each side of the lens for five seconds with the multi-purpose solution. Patients are then advised to place their cleaned lenses in a lens case filled with fresh solution, and to soak the lenses for, at minimum, four hours. The labeling also includes instructions to always use fresh solution and to never reuse or “top off” solution. Finally, the labeling includes specific directions to replace lens cases monthly.

The company's labeling change has been in motion since the start of 2010. Thus far, the Biotrue and renu sensitive labels include rub and rinse directions, and the company is in the process of removing the phrase “no rub” from its renu fresh labeling. B+L says it expects to complete this transition by May 2011.

Drugs in the Pipeline
QLT Inc. has expanded its Phase Ib open-label, single-center, multinational proof-of-concept study of its synthetic retinoid replacement drug QLT091001 on leber congenital amaurosis patients to include retinitis pigmentosa patients.
Bausch + Lomb (B+L) has begun a phase IIb randomized, singlemasked, parallel-group study to determine the most effective night dose of its nitric oxide-donating prostaglandin F2-alpha analog BOL-303259-X for intraocular pressure reduction. The drug was licensed to B+L by NicOx this past March.
Regeneron Pharmaceuticals, Inc. and Bayer HealthCare announced that all regimens of its aflibercept ophthalmic solution intravitreal injection (VEGF Trap-Eye), including an every-two-month dose, successfully met the primary endpoints in two parallel Phase III studies in wet age-related macular degeneration patients. As a result, the companies are planning to submit regulatory applications in both the United States and Europe in the first half of 2011.
RegeneRx Biopharmaceuticals, Inc. has announced that in animals treated with the company's ophthalmic preservative-free eye drop (RGN-259) for the treatment of Dry Eye Syndrome, a “dramatic” and statistically significant reduction in corneal staining was observed.

O.D. NOTEBOOK
CIBA Vision announced it is actively working with partners, including the Vision Cooperative Research Centre, to conduct a multi-year clinical study in China with myopic children to evaluate the efficacy of specially designed myopia-control silicone hydrogel contact lenses. The six- and 12-month results show promise, according to CIBA Vision.
Transitions Optical Inc. now offers a bilingual pocket card in simplified Mandarin for those eyecare professionals who communicate with Mandarin-speaking patients. You can download the card free-of-charge from the Multicultural Tools section of www.Transitions.com/Pro.
Eyefinity/OfficeMate announced that OfficeMate/ExamWRITER version 10, is 2011/2012 compliant and was certified as a Complete EHR (electronic health records system) by the Certification Commission for Health Information Technology (CCHIT). A list of all certified EHR systems can be found at http://onc-chpl.force.com/ehrcert.
Alimera Sciences accepted the 2010 “Southeast BIO (SEBIO) Deal of the Year: Strategic Transaction” award. The company was selected as a result of its initial public offering and venture debt raise totaling more than $100 million.
□ The American Optometric Association's (AOA) Paraoptometric Section is seeking nominations for the Paraoptometric of the Year Award (POY). For more information, contact the AOA at (800) 365-2219, ext. 4108, or e-mail JMAprahamian@aoa.org.
□ Both the VisionCare Ophthalmic Technologies Implantable Miniature Telescope, designed to improve vision in patients who have end-stage age-related macular degeneration, and Bausch + Lomb's Biotrue multipurpose contact lens solution were named “Best of What's New” 2010 by Popular Science magazine.


Optometric Management, Issue: December 2010