Article Date: 8/1/2005

practice pulse
Tips, Trends & News You Can Use

Children's Vision Prognosis Looking Up


States that require an eye exam by an eye doctor:


Rhode Island*

* Eye exam required after a failed screening;
# Eye exam required for all special needs students.

First, the bad news: According to the U.S. Centers for Disease Control and Prevention, two out of three children do not receive preventive vision care before beginning elementary school. The good news? The Vision Council of America (VCA) reports a growing trend among legislators to enact laws that increase the number of school-age children who receive preventive vision care, including eye exams and vision screenings.

According to Making the Grade?, VCA's detailed analysis of state and federal efforts to prevent vision problems in children, Kentucky passed a law requiring all children receive an exam from an eye doctor before entering elementary school, and four other states have similar laws. Ohio and Massachusetts require exams, but only for children with special needs who are at higher risk for vision problems; Massachusetts, Rhode Island and Arkansas require eye exams for children who fail a vision screening. "Mandatory eye exams after a failed screening is one of the most exciting new developments in children's vision care," Joel Zaba, O.D., and child development specialist, said. "Many children who fail a vision screening never receive the necessary follow-up evaluation or treatment."

On the national level, Representatives Bill Pascrell (D.-N.J.) and Ileana Ros-Lehtinen (R.-Fla.) introduced H.R. 2238 into Congress, which would provide states with funds to diagnose and treat vision problems in children. More than 130 representatives have endorsed the bill.

However, VCA cautions that much remains to be done. Of the 31 states that require a vision screening, 28 do not require a follow-up exam for those who fail, and 19 states have no laws requiring vision care for children. For the full Making the Grade? report, go to

B&L to buy Chinese Drug Company

Bausch & Lomb will buy a 55% controlling interest in the Shandong Chia Tai (CTF) Pharmaceutical Group from Sino Biopharmaceutical Ltd. The $200 million purchase brings what B&L says is the "leading ophthalmic pharmaceutical company in China" under its control and "significantly enhances" its presence in China's ophthalmic drug market. B&L has also agreed in principle to a future acquisition of an additional 15% of CTF held by two other parties for $54.5 million. The company says the acquisition should be "essentially neutral" to 2005 earnings, five-to-10-cents per share accretive in 2006, and 10-to-15-cents per share accretive in 2007.

CTF develops, manufactures and markets medications used to treat ocular inflammation and infection, glaucoma and dry eye, including the Moisten and Mioclear line of eye drops. CTF has 1,300 employees and posted sales of $63 million in 2004. The acquisition is expected to close in the third quarter.


Bausch & Lomb Honors O.D.s

Bausch & Lomb announced the recipients of its 2005 Visionaries Recognition Award in June at the annual meeting of the American Optometric Association (AOA). B&L's Perfecting Vision. Enhancing Life. program honors eyecare professionals who embody the highest ideals in vision care. Honorees were nominated by their peers and selected by an independent Visionaries Selection Committee. This year's recipients are H. Dwight Cavanagh, M.D., Ph.D., University of Texas Southwest Medical Center, Dallas; Richard M. Hill, O.D., Ph.D., Ohio State University, Columbus, Ohio; Donald R. Korb, O.D., Korb & Associates, Boston; George Spaeth, M.D., Wills Eye Hospital, Philadelphia. B&L will distribute $80,000 in donations to vision-related, nonprofit organizations chosen by the honorees. View biographies of the recipients at

Oasys Lens Aims at Dry Eyes in Challenging Environments

Johnson & Johnson's Vistakon division recently launched the Acuvue Oasys brand contact lens with Hydraclear Plus. It's the first daily-wear contact lens made from senofilcon A, a new silicone hydrogel material that's 50% smoother than currently-available silicone hydrogel lenses, according to the company.

Vistakon called Oasys a breakthrough for contact lens wearers whose eyes feel tired and dry in challenging environments. Its improved Hydraclear technology combines oxygen-rich material with a moisture-rich wetting agent. The lens blocks 100% of UVB rays and greater than 96% of UVA rays. The lens will be available beginning in late August.

In response to the launch, CIBA Vision filed a lawsuit against Vistakon for infringement of patent rights related to silicone hydrogel contact lenses. The company seeks a temporary restraining order to prevent Vistakon from manufacturing, marketing and distributing Oasys.

Vistakon says that the Acuvue Oasys does not violate any patents. The company filed a suit in February for a judgment that the lens does not infringe on any valid CIBA patent. All litigation is pending.


How to Control Your Schedule

In the article, "Control Your Schedule," in the June issue of Optometric Management (page 114), John R. Scibal, O.D., describes template scheduling. Template scheduling allows Dr. Scibal's practice to accommodate both longer appointments, such as comprehensive annual exams, and brief 15-minute "short visits" (contact lens checks, post-op visits, etc.), so that most patients can be scheduled within a few days.

As Dr. Scibal notes in the article, "Telling a patient he must have his annual exam before renewing his contact lens prescription, and then informing him that there are no appointments available, is a good way not to build a practice."

On the left is a sample schedule that illustrates Dr. Scibal's concept, which was inadvertently omitted from the original article. The "short" blocks in the morning and afternoon allow plenty of choices for patients, including those that must be seen that day. The schedule creates separate blocks for cataract post-op and vision therapy because grouping such visits is more efficient and can be correlated to staff schedules.

Note that the schedule includes slots for multiple patients. These maximize efficiency as the doctor and staff will serve two patients concurrently. (For example, the doctor sees an emergency patient while a staff member dilates a second patient.) The key is to evaluate patient needs within the scheduled time and treat them in the most efficient manner possible.

The complete article, which provides guidance on how to quantify office visits and develop the weekly schedule, can be viewed at\2005\june\0605114.htm. Contact Dr. Scibal at


Sample Schedule

8:00 2 short 2 short 4 Cat PO 2 short 2 short
8:30 Long Long XXXXX Long Long
9:00 Long Long Long Long Long
9:30 Long Long Long Long Long
10:00 Long Long Long Long Long
10:30 Long Long Long Long Long
11:00 Long Long 2 OV Long Long
11:30 Catch up Catch up Catch up Catch up Catch up


2:00 2 short 2 short 2 short 2 short VT
2:30 Long Long Long Long VT
3:00 Long Long Long Long VT
3:30 Long Long Long Long VT
4:00 2 short 2 short 2 short 2 short 2 short

Available per week

Long   44
Short   32


What People Value in a Doctor
By Bob Levoy, O.D.

A recent survey of what people value in choosing a doctor identifies some of the factors that ultimately affect patient retention and practice growth. A cross-section of 2,267 adults surveyed by Harris Interactive Poll for The Wall Street Journal, said it's extremely important for doctors to have strong interpersonal skills such as being respectful (85%) and listening carefully to health concerns and questions (84%). In addition, respondents feel it is important for their doctor to: be easy to talk to (84%); take their concerns seriously (83%); and be willing to spend enough time with them (81%).

What's startling is that these interpersonal skills are all valued more than good medical judgment (80%).

The survey also revealed that the biggest "gap" in what people want from their doctors vs. what they actually get, is related to how up-to-date their doctors are on the latest medical research and treatment. Seventy-eight percent feel this knowledge is extremely important for their doctors to have, but only 54% actually described their doctors as being up-to-date.

With interpersonal skills being of such importance to patients, it's no surprise that some have changed doctors due to failures in this regard. Fourteen percent changed because they didn't feel their doctors listened to them carefully, 12% felt as though their doctors didn't spend enough time with them, and 11% felt they weren't treated with respect.

Action steps: Recognize that you have to do business with people on their terms – not your version of their terms. Schedule a staff meeting to brainstorm for ways to communicate to clients that your practice is up-to-date on the latest research, treatment protocols and equipment. Close any gaps that may exist between what people want from your practice and what they get.

References available on request.

Frist Asks for Restrictions on Ads

Senator Bill Frist (R.-Tenn.) claims that the recent rise in direct-to-consumer advertising on the part of drug companies has led to inappropriate prescribing and encourages prescription drug spending. In response, he's requesting that pharmaceutical companies voluntarily implement a two-year restriction on direct-to-consumer advertising for new drugs. Additionally, Senator Frist sent a letter to the Government Accountability Office asking the agency to evaluate the FDA's oversight of prescription drug advertising and the possibility of giving the FDA the authority to review and approve direct-to-consumer advertising, among other issues. "Failure to appropriately monitor and regulate direct-to-consumer drug advertising compromises the safety of the very patients we intend to help," Frist said.

According to, FDA warning letters to drug manufacturers rose more than 20% in 2004 due to promises in marketing campaigns.


l Vitamin Dynamics beefs up on consultants. Vitamin Dynamics Inc., a supplier of vitamins and supplements to the eyecare industry, appointed Dr. Donald S. Teig a consultant to the company. Dr. Teig is Director of the Institute for Sports Vision in Ridgefield, Conn., and founder of Sports Performance Centers of America.

l Panoptx expands sales & marketing teams. Panoptx appointed Lance Meller sales manager of its snow and marine product lines and Steve Kelch director of the Panoptx Endless Eyewear Tour, its first national grassroots initiative.COMPANY NEWS

l Imperial Optical, CIBA Vision make a deal. Imperial Optical and CIBA Vision entered a business agreement that will give Imperial direct access to all CIBA's contact lens products, including diagnostic trial lenses. The company says it will be able to fill all of its clients' non-made-to-order CIBA orders within 48 hours.

l VSP hooks up with America's pastime. VSP volunteer doctors will team with Chicago Cubs players and coaches at a morning sports clinic at Wrigley Field on Sept. 18. Doctors will teach children from local YMCA and Boys & Girls Clubs the connection between healthy eyes and sports performance. The children will receive a gift certificate to visit a local VSP eye doctor for a comprehensive eye exam and glasses, if necessary.


Portions of the listing for Micro Medical Devices PalmScan P-200 FastPach were missing from the Pachymeters section of the "Diagnostic Instrument Buying Guide," which was distributed with the July issue of Optometric Management. The additional information is as follows: More than 200 scans per charge; corneal waveform display; Wi-Fi/IR printing; high-res color touch screen controls.

Optometric Management, Issue: August 2005