Article Date: 11/1/2011

Practice pulse


New York DMV Reinstates License Renewal Vision Screening … for Now

■ The New York Department of Motor Vehicles (NY DMV) has reinstated its vision-screening requirement for non-commercial drivers renewing their licenses, pending the outcome of a newly formed advisory group.

The current vision screening procedure requires the driver to read lines on an eye chart located behind the DMV counter or to provide an eye test report certified by an authorized medical professional. In late September, the NY DMV announced it would discontinue the vision screening requirement for non-commercial license renewal, citing statistics that revealed no negative impact on traffic safety between 1993 and 2000, when the vision screening was suspended, and in answer to Governor Andrew Cuomo's call for state agencies to identify procedures that could be transacted online.

In the red states, driver's seeking license renewal must appear in person at every renewal and undergo an eye exam regardless of age.

“Allowing vision self-certification on license renewals will expand an existing process in which applicants already self-certify that they have no driving-related medical issues, such as hearing or heart ailments or conditions, which lead to unconsciousness,” the September 26 press release said.

Just four days later, however, the NY DMV reinstated the vision screening requirement, due to the significant safety concerns raised by numerous stakeholders, including the New York State Optometric Association (NYSOA), the Medical Society of New York, and the New York State Ophthalmological Society.

“While stakeholders readily acknowledge that the vision test is not ideal, since eight years would elapse between renewals, it provided an opportunity to ensure that a person underwent a nominal vision screening with the possibility of a more thorough examination if decreased vision was identified,” explains Steven Schoenbart, spokesperson for the NYSOA, who also practices privately in Garden City, NY. Dr. schoenbart adds that the stakeholders raised concerns regarding the traffic safety statistics, many other variables have enhanced roadway safety during that period, including improved vehicle and road safety features.

The DMV could not be reached for comment.


Alliance Offers Opportunities for Practice Growth

■ Drs. Neil Gailmard and Jerry Hayes have formed a partnership to create Prima Eye Group, a professional networking and management services firm dedicated to supporting independent optometrists who wish to grow practice revenues and profits. Prima members receive:

One-on-one consulting advice from Drs. Gailmard and Hayes.
Business education.
Access to the Prima Center for staff training.
A variety of centralized support services for managed care, marketing, e-media and tax advice.
Discounts and rebates from vendors, such as Vistakon, Essilor of America, Safilo, Carl Zeiss Vision, CIBA Vision and Marchon.

Membership in the group costs $375 per month. Other offices owned by the same practice cost an additional $75 per month, and practices with revenues of less than $400,000 can lock in a fee of $250 per month for the first two years. Prima asks that O.D.s make a commitment to the alliance for 12 months.

For more information, visit, or call (800) 668-0599.

• Frequent aspirin intake (at least once a week, daily or monthly) in patients age 65 and older was linked with early age-related macular degeneration (AMD) and wet AMD, says September's Ophthalmology. In addition, odds ratios rose with the increasing frequency of consumption.
• Two Phase III multi-center, randomized, double-masked, parallel-group controlled studies revealed Prolensa (bromfenac ophthalmic solution, ISTA Pharmaceuticals) was statistically significantly better than placebo and met the primary efficacy endpoint of ocular inflammation absence 14 days post-cataract surgery and the secondary efficacy endpoint of elimination of ocular pain one day post-op. Also, no serious drug-related ocular or systemic adverse events were noted, and the drug's safety profile was determined as consistent as bromfenac ophthalmic solution 0.09% (Bromfenac), the company's currently marketed NSAID for cataract surgery. Prolensa uses a lower concentration of bromfenac, though maintains Bromday's once-daily use.
• Treatment with anti-VEGF-C may significantly improve dry eye disease, as it has been shown to decrease inflammation at the clinical, molecular and cellular levels in mice with dry eye disease, says September's Archives of Ophthalmology. The researchers say that targeting prolymphangiogenic growth factors or their receptors could inhibit the trafficking of antigen-presenting cells to the draining lymph nodes, and therefore, prove as a potential treatment target for dry eye disease.
• Pre-treating cataracts with a femtosecond laser appears to reduce the ultrasound energy required to soften cataracts, says an American Academy of Ophthalmology press release. In addition, femtosecond laser use resulted in the maintaining of endothelial cells, while standard treatment resulted in 1% to 7% of endothelial cell loss. (See
• Scientists from The University of Adelaide, in Adelaide, South Australia, have developed a yet-to-be-named drug that may prevent cataract-induced blindness. Specifically, the drug inhibits calpain, a protein that when activated by several triggers, breaks down the lens protein crystallins, causing cataracts. Thus far, the drug has proved successful in slowing cataracts in animal trials. Now, the scientists, who've formed Calpain Therapeutics (, plan to test the drug on humans. They say it could be delivered as drops or cream.


New ICD-9 Codes for Glaucoma

Larry E. Patterson, M.D., Crossville, Tenn.

■ As of October 1, the ICD-9 codes for glaucoma require you stage the disease as “mild,” “moderate,” or “severe” based on your interpretation of the visual field test printout in the patient's weaker eye. That said, the new staging definitions do not impact coverage.

To obtain hassle-free reimbursements for your services, visit www., and scroll to page 15.)

Dr. Patterson is chief medical editor of Ophthalmology Management, a sister publication of OM.

AOA Launches Resource Tool

The American Optometric Association (AOA) has launched Ophthalmic Resources On-Demand, an online resource tool for AOA members that includes pharmaceutical product prescribing information, patient education on products and medical conditions, coupons, patient assistance programs and clinical trials, which may be suitable for your patients, among other resources. Further, members will have the ability to connect with industry peers and participate in market research. Coming soon: an e-prescribing platform. Visit to access the tool.


Almost Half of Online-Ordered Spectacles Found Deficient, Says Study

■ Close to half (44.8%) of online-ordered prescription spectacles did not meet either the optical requirements of the patient's visual needs or the physical requirements for the patient's safety, reveals a study in September's Optometry: Journal of the American Optometric Association.

“. . . Spectacle eyewear ordered without the benefit of a dispensing process can come with significant risk of error in providing the correct type of lenses needed or ordered, the optical parameters that are within acceptable tolerances and the physical parameters that provide sufficient protection to the wearer,” the researchers concluded.

Specifically, the study showed that of the 154 pairs of spectacles evaluated (308 lenses) from 10 of the most-visited Internet vendors (two pairs of spectacles from each), more than one of every five pairs were delivered incorrectly, with lens treatments added or omitted; more than one of every four pairs had at least one lens with at least one optical parameter out of tolerance; and more than one of every five pairs had at least one lens that did not pass impact testing.

The study was comprised of 10 individuals, from throughout the United States, including the researchers themselves, their colleagues and associates. Through two-months, these individuals ordered an adult and child pair of spectacles, which totaled 200 eye-wear orders. A total of 154 of the orders were received. Frame styles were chosen from the midrange options offered by each vendor, in varying frame materials, lens styles and prescriptions, the latter of which reflect current distributions in the United States.

The researchers then evaluated the spectacles for sphere power, cylinder power and axis and add power (if indicated), horizontal prism imbalance and impact testing, while an independent accredited laboratory assessed the optical requirements using the “drop-ball” methodology.

Various online spectacle retailers could not be reached for comment.


Toric Lens and Widefield Imaging Device Introduced

■ Both Optos and Bausch + Lomb announced new products at the recent American Academy of Optometry meeting in Boston.

Bausch + Lomb launched PureVision 2 for Astigmatism, which features high-definition, or HD, optics designed to provide clarity and meet the special vision correction needs of patients who have astigmatism.

The silicone hydrogel monthly replacement lens incorporates the Auto Align Design stabilization system and a combination of prism and peri ballasting for enhanced stability. The 14.5mm diameter lens provides more area for effective ballasting and improves centration, says the manufacturer.

By reducing spherical aberrations the lens helps reduce halos and glare in low light conditions. The lenses are available as plano to -6.00D (0.25 steps) -0.75D, -1.25D, 1.75D; and available from 10° to 180° in 10° steps.

Optos unveiled the Daytona ultra-widefield retinal imaging device. The device provides clinicians with an optomap, a 200° high-resolution, high-contrast image of the retina. It also includes an option for autofluorescence.

Optos scaled the Daytona so that its footprint accommodates small office spaces. The 60lb. device features workflow-based software, plug-and-play installation, image review capabilities and image storage options. According to Optos, Daytona will ship in early 2012.

FDA Notes
■ RTVue, from Optovue, has received FDA 510(k) clearance for optical coherence tomography measurements of central corneal power, curvature and thickness in corneas pre-and post-cataract surgery. The device offers a five-micron resolution, high magnification imaging of the cornea, angle and anterior crystalline lens, pachymetry mapping as well as retina and glaucoma scanning and analysis functions.


Essilor Introduces a Light, Thin Spectacle Lens and Optifog Technology

■ Essilor of America recently unveiled TREXA, a new Trivex-based material that is light (1.11g/cm3), thin (1.53 index) and strong, according to the company. The lens was announced at the recent Vision Expo West trade show, held in Las Vegas. Other introductions at the meeting included:

► Optifog, a new technology that offers protection against foggy vision. Wearers activate the lenses by applying a drop of Optifog Activator to each side of the lens once a week. It will be complemented by the Foggy Moment video series available on the Essilor USA Facebook page (

► the Dispensary Management Program, a six-month course to help optical dispensary managers develop business operation skills. The course includes real-world activities, classroom instruction, personalized coaching and project-based learning, the company says.

► an enhanced corporate website (, which offers new features and content and enhanced user-friendly navigation, Essilor of America says.

► a nine-part video series about the Visioffice System, the device that measures the personalized parameters needed to dispense Essilor lenses that provide optical precision.


Shamir Announces Offerings for 2012

■ Shamir recently announced its FirstPAL spectacle lens, which is designed for patients, ages 40 through 45, who start noticing the need for a progressive solution. The company notes that as it is difficult for patients to transition from a single vision to progressive lens with a higher ADD, the FirstPAL will be limited to ADDs from 0.75 to 1.50. The company says it expects to ship the freeform design lens in early 2012.

The lens was introduced at Vision Expo West, where Shamir also announced its first sports-specific freeform lens, the Shamir Golf. According to the company, the lens will offer sharp vision in three zones: far distance for the green, mid-distance for the ball at the player's feet and near for the scorecard. Shamir expects to launch Shamir Golf in 2012.

Ametek, a global multi-industry manufacturer based in Berwyn, Pa., recently acquired Reichert Technologies for $150 million. Reichert has estimated annual sales of $55 million.
■ Through a new partnership, users of Compulink's Eyecare Advantage EHR software will now be able to use the software to order contact lenses electronically from distributor ABB Concise. The service is expected to be available before the end of the year.
OCuSOFT has appointed Ed Shelton as vice president of sales. Mr. Shelton most recently served as the company's vice president of special projects.
NovaBay Pharmaceuticals, a biotechnology company developing its anti-infective Aganocide compounds for the treatment and prevention of infections, has named David W. Stroman, Ph.D., as senior vice president, Ophthalmic Drug Development.
Santinelli International has promoted Kevin Moran to chief financial officer. Mr Moran was formerly director of finance for the company.
Bausch + Lomb has named Sheila Hopkins Global president of the company's Vision Care business. In addition, Peter Valenti III has been named North American Vision Care president, and Steven Robins has been named vice president and chief marketing officer, Global Vision Care.
WebMD/Medscape and Bausch + Lomb introduced new professional resources on where ECPs can engage in a clinician challenge; explore clinical topics, imagery and new information; and engage in peer-to-peer discussions. The companies also introduced a suite of resources on WebMD that will educate consumers about the importance of eye health.
Both Eyecom3 (version 4.51) and Mountain Computer System's Eyebase electronic health records systems have received the “meaningful use” stamp, or ONC-ATCB certification, reported the respective manufacturers. The certification enables users to qualify for federal incentive money under the American Recovery ad Reinvestment Act. went live last month offering business-building tools and resources for O.D.s and optometry students. The practice management content will focus on doctors in the early stages of their careers and appeal to a “much more female and ethnically diverse” demographic, says president Carlos Navarro.
The Hayes Center for Practice Excellence, at Southern College of Optometry in Memphis, has selected Gerald Eisenstatt, O.D. as director.
Contamac has formed the Contamac Specialty Lens Institute to provide eyecare professionals and students with specialty contact lens education, clinical care, research and leadership. For more information, visit

Optometric Management, Issue: November 2011