Article Date: 4/1/2006


Wise to the World

Shedding Pounds May Save Sight

MOST AMERICANS know that obesity increases the risk of diabetes, heart disease, stroke and high blood pressure, but few of them realize these systemic diseases can lead to sight-threatening conditions such as diabetic retinopathy, glaucoma and cataracts.

"As optometrists, we focus on our patients' eyes, therefore we have a duty to educate them about the visual risks of obesity," says Hal Bohlman, O.D. "The American Optometric Association encourages O.D.s to teach patients that obesity isn't just a cosmetic problem."

Dr. Bohlman offers this advice on how to explain the visual risks of obesity without offending patients. 

"We don't have the tools to calculate body mass index in our offices, so we have to identify obese patients by visually assessing their waist-to-hip ratio," he says. "Choose your words carefully so patients know you're concerned about their health and not expressing an aversion to their appearance. The first few times I talked to patients about their weight, I felt like I was committing a social faux pas, but now I'm comfortable broaching the subject."

Phasing Out Paper

ACCORDING TO the 2005 American Optometric Association (AOA) New Technology Survey, 18% of optometry practices have switched from paper records to electronic medical records (EMRs). "EMRs enhance practice productivity because they directly incorporate data from several diagnostic tests into a single record," says Richard Edlow, O.D. "Predictions from the 2005 AOA survey suggest that the number of practices using EMRs will increase by more than 50% in the next few years."

No Bubble, No Trouble

Some of my patients who wear large-diameter gas permeable contact lenses (10 mm and larger) complain that air becomes trapped under their lenses during application.

I tell them to fill the bowl of the lens with rewetting solution, look down and insert the lens as if they're dipping their eye into a bowl of soup. The solution takes up space that otherwise would be filled with air and prevents the lens from trapping bubbles against the eye.

Stephen P. Byrnes, O.D., F.A.A.O., Londonderry, N.H.

Glaucoma to Hit New High in 2020

A STUDY BY Quigley and Broman in the March 2006 issue of the British Journal of Ophthalmology predicts that more than 80 million people worldwide will have glaucoma by 2020. What can you do to prepare for and manage this growing disease burden?

"Thirty years ago, it was illegal for optometrists to treat glaucoma," says Irving Bennett, O.D., F.A.A.O. "Fortunately, times have changed. Our biggest problem now is letting the public know O.D.s are well-equipped to deal with this disease."

Janice M. Jurkus, O.D., M.B.A., F.A.A.O., believes O.D.s can prepare for this impending crisis not only by honing their clinical and medical skills, but also by educating patients. "Patients need to understand that glaucoma is a sight-threatening condition," she says. "In addition to monitoring IOP and detecting optic disc changes, O.D.s have to improve their communication skills and teach patients about the importance of adhering to medical therapy."

To help prevent unnecessary blindness due to glaucoma, be sure to:

• Use your practice newsletter and in-office brochures to educate patients about the predicted spike in glaucoma cases.

• Encourage yearly diagnostic tests, such as tonometry, ophthalmoscopy and pachymetry. Always explain the purpose of these tests to patients.

• Use technology, such as retinal nerve fiber layer analysis, to perform glaucoma assessments.

Optometric Management, Issue: April 2006