Article Date: 5/1/2004

practice pulse
Tips, Trends & News You Can Use

Canadian Optometrists Stand on Guard

Ontario's optometrists have practiced for 15 years without an increase in service fees and they now face a crisis that jeopardizes the eye care of all Ontarians, says Judith Parks, O.D., president of the Ontario Association of Optometrists (OAO). The OAO reports that the fees no longer cover the costs of providing insured services.

"Optometrists cannot continue to subsidize the cost of eye examinations in this province," Dr. Parks says.

In protest, more than 500 optometrists recently marched on Toronto's Queen's Park, the seat of the provincial government. "We are here to fight for our patients," says Dr. Parks.

The government pays optometrists a single fee for exams, regardless of service levels. However, M.D.s receive additional fees for tests such as fundus photography and threshold visual fields.

The province's optometry funding agreement, which sets the reimbursement rates for its 1,300 O.D.s, expired four years ago. Negotiations between the OAO and the government broke down last summer.

The government has yet to act on the OAO's request for a mediator. If talks are not resumed, the OAO will consider legal action.

"In my two years as president of the association, this has been our number-one issue," says Dr. Parks. "We plan to keep up the pressure."

Fighting the danger in B.C.

In British Columbia, optometrists expressed alarm at a Ministry of Health Services ruling that would allow opticians to perform sight tests and issue prescription glasses without the supervision of an optometrist or ophthalmologist.

"If opticians are granted the right to perform sight tests and issue prescription glasses without medical supervision ... it will only be a matter of time before someone suffers permanent, irreversible damage to their sight," says Mary Lou Riederer, O.D., president of the B.C. Association of Optometrists (BCOA).

The Ministry expects the change to become effective following a three-month consultation period. The government will not permit opticians to perform sight tests on individuals under 19 or over 65 or those with medical conditions that may cause eye disease. Also, opticians may not perform site tests on individuals with certain categories of eye prescriptions.

Other changes in regulations will allow optometrists to diagnose and treat some eye diseases and disorders, as well as prescribe some therapeutic drugs.


Media Exposure Boosts Credibility
By Bob Levoy, O.D., Roslyn, N.Y.

"It's amazing how your credibility goes up when you appear on local radio or TV or are written about in the local newspaper," says Dr. Bernardine Cruz, of Aliso Viejo, Calif. Such exposure on a regular basis is a low-cost, effective way to become better known and will benefit your practice.

Dr. Cruz has done segments on local radio. She also does segments for "Smart Solutions," a nationally broadcasted, cable HG-TV (House and Gardens) show. Here are some of her suggestions for getting exposure in your local media:

► Write to the producer of a radio or TV show (or newspaper columnist) for which you think there's a good fit with your message. Keep it low-key such as: "If you ever need someone to talk about _____, please call me." Include a brief background about yourself and your practice. If a need arises, the producer may call (which is exactly the way it worked for Dr. Cruz when she started out).

► More effective than writing is going to the station or newspaper, introducing yourself to the proper person and making the same request.

► Have a topic of interest -- something that affects their listeners, viewers or readers personally.

► Have realistic expectations. It may take many "tries" before you're called for an interview. Be willing to do it on short notice or accept a last-minute cancellation.

You'll impress your patients but it will likely take repeated exposures in the media to attract new patients.


AMD Treatment on Track

Miravant Medical Technologies submitted a New Drug Application (NDA) to the FDA for SnET2-PDT as a treatment for "wet"age-related macular degeneration (AMD). SnET2-PDT uses a light-activated drug to selectively destroy abnormal blood vessels and stabilize vision loss. The NDA is based on clinical data from two Phase III studies conducted at 60 U.S. sites. Miravant also filed a Premarket Approval Application with the NDA for the Iris Medical OcuLight 664 Ophthalmic PDT laser, the device component of the combination treatment.


Video Teaches Business Skills

The Spectacle Lens Group of Johnson & Johnson Vision Care Inc. has a new tool (in DVD format) to help eyecare practitioners grow their businesses. The DVD identifies "Five Steps to Success" (1. Educate, 2. Prescribe, 3. Transfer, 4. Reinforce, 5. Request) in achieving improved patient satisfaction and profitability with premium products such as DEFINITY Lenses. This educational presentation includes three video segments that show specific tactics for dispensing premium products. The "Five Steps to Success" DVD is available through DEFINITY Lenses sales reps while supplies last. To request your copy, call (800) 920-2021, ext. 3700.




l Lupin Joins with Allergan to Promote Zymar. Lupin Limited's wholly owned subsidiary Lupin Pharmaceuticals Inc. has entered into an agreement with Allergan Inc. to promote gatifloxacin ophthalmic solution 0.3% (Zymar) in the U.S. pediatric specialty area.

l 1-800 Files Lawsuit for Multiple Claims. 1-800 Contacts recently filed legal action against Coastal Contacts Inc. for trademark infringement, unfair competition, trademark dilution, copyright infringement, unfair trade practices and other related claims. The company is seeking an end to the "hijacking" of its Web site, and damages for the customers inappropriately taken by Coastal Contacts and attorney's fees.

l Eschenbach offers low vision seminars. Eschenbach is currently offering "Low Vision Care . . . What's It All About," an introductory, hands-on seminar for those interested in the field of low vision. It's approved for three CE credits by ABO, JCAHPO and ACVREP. "Making Money at Low Vision," a free, one-hour practice management course, follows immediately after. For more information, visit, or call (800) 549-3656.


l CIBA Reorganizes Management Team. CIBA Vision has appointed Karen Gough as president of the North America Region and John Rex as finance officer for the company.

l VSP Honors Six O.D.s. Vision Service Plan (VSP) recently released the winners of its 2004 People First Award: Carol Marusich, O.D., M.S., FCOVD,of Eugene, Ore.; Jack Hostetler, O.D., of Mesa, Ariz.; Daisy Chan, O.D., F.A.A.O., of Chicago; Kimberly Friedman, O.D., of Moorestown, N.J.; Cathy Doty, O.D., of New Bern, N.C.; and Ronald Solomon, O.D., F.A.A.O., of Colorado Springs, Colo.


The Benchmark for Optometry

The estimated size of the U.S. ophthalmic market was $25.6 billion in 2003, an increase of $2.2 billion from 2002. Private practice optometrists held the greatest share of this market, at 38.9%, followed by the chains, super-opticals and mass merchandisers (31.9%).

These are some of the statistics presented in Caring for the Eyes of America, the most recent edition of the American Optometric Association's (AOA's) profile of optometry and the ophthalmic industry. At Vision Expo East, Richard Edlow, O.D., chair of the AOA's Information and Data Committee, said the profile is a valuable resource for industry vendors, managed care providers, government and the investment community. And of primary importance to the readers of OM, "it's a benchmark for optometrists," says Dr. Edlow.

Caring for the Eyes of America includes practice management information, including the average hours per week doctors engage in practice, the number of patients seen in an average week, and return time for eye exams. Economic data includes both self-employed and employed/affiliated optometrists.

The compendium contains data from recurring surveys on consumer trends, third-party/managed care participation rates, optical dispensing and optometric income. Caring for the Eyes of America also examines changes in optometry over time.

For more information call (800) 365-2219, ext. 238.


Treating Dry Eye with BP Meds

New research suggests that treatment with certain blood pressure drugs (ACE inhibitors) seems to reduce the risk of dry eye syndrome. Researchers from the University of Wisconsin at Madison reported the results of their study in the March issue of Archives of Ophthalmology. During the study period, 322 of the 2,500 subjects (ages 48 to 91) developed dry eye. It occurred in 9% of subjects taking an ACE inhibitor versus 14% among those not taking an ACE inhibitor. The authors suggest that the protective effect of these drugs may involve their anti-inflammatory effects.

Barbados Study Reports Cataract Findings

Investigators with the Barbados Eye Studies Group followed nearly 3,000 Barbadian-born adults for nine years and found that the overall incidence of lens changes was significantly higher in blacks (46%) than in whites (35%). The risk of new cataracts (taking into account the effects of age and sex) was 80% higher in blacks than in whites. The study's lead author says that the high risk of cataracts in blacks may be related to the higher prevalence of diabetes, abdominal obesity and high blood pressure in black populations than in white.


Criteria Under Scrutiny

In a March issue of British Medical Journal, researchers question the concept that certain eye injuries are indicative of shaken baby syndrome. The condition is usually recognized by subdural and retinal hemorrhages and brain damage, but after searching medical literature, the authors found that the ocular criteria used by some to diagnose it "aren't supported by objective scientific evidence" when taken out of context. In an accompanying editorial, experts say we need to reconsider the diagnostic criteria, if not the existence, of the syndrome while another argues that the diagnosis of shaken baby syndrome rests on a careful evaluation of all the features of the injury.


OSI Offers a Mail-Order Option

Ocular Sciences Inc. recently introduced, its solution to losing patients to mail-order, Internet contact lens replacement services. Here's how it works: Eyecare practitioners (ECPs) recommend to their patients and give them an instruction card. Patients log onto the site and establish their own account, including the name of their ECP, lens brand and prescription. Gotlenses verifies the patient's prescription with the ECP via fax or e-mail. If the ECP fails to confirm within 24 hours, gotlenses calls the ECP (charging $0.95 per call). The service won't send orders without verification.

Gotlenses manages security, transaction processing, site hosting, management, development, administration, order fulfillment and customer service. ECPs receive a monthly check of the net profits, minus the $0.50 transaction fee per order and 2.4% credit card fee gotlenses charges. The service also provides a monthly activity report listing all transactions, including names of patients who placed orders, lens brand and volume.

According to a company executive, the value gained by using the service more than compensates for the fees. Additionally, gotlenses notifies patients when they need more contact lenses and gives you electronic communication privileges with your registered patients. For more information, go to the Web site or call 1-877-gotlenses.


Essilor Educates

Essilor Laboratories of America is introducing a new series of in-office educational training -- the StimulEye Education Series, which offers the following:

► Eyecare practitioners and their staffers can learn to capitalize on the opportunities within the anti-reflective lens category

► Understand new ways to fine tune progressive growth strategy

► Discuss ways to thrive in today's tough competitive climate

► Determine if current product mix and retail pricing are in line with the practice goals for greater profitability.

The courses are free. Future enhancements to the StimulEye Education Series include online training and ABO certification.


Time to Focus on the World

"The expanding role of ophthalmic multinational chains, the delivery of optometric goods over the Internet from outside the U.S., the consolidation of the industry, the increasing application of 'international optometric graduates' for U.S. licensure -- are all strategically important issues to the future of the profession," says Damien P. Smith, A.M., Msc. Optom., Ph.D., F.A.A.O., president of the World Council of Optometry (WCO).

These issues will be the subject of the first World Congress on Optometric Globalization (WCOG), which is sponsored by the WCO and is planned for June 21 to 24 in Orlando. Visit



Optometric Management, Issue: May 2004