Leading Off


Leading Off



Governor to Mull Bill Enabling O.D.s to Use Injectable Anesthesia

■ At press time, Tennessee Gov. Bill Haslam awaited the final form of bill SB220/HB555 that, if signed into law, would permit Tennessee O.D.s to use injectable anesthesia for the eyelid. Currently, the state’s O.D.s are restricted to topical anesthetic.

“The purpose of this bill is to save patients time,” explains Tennessee Association of Optometric Physicians President Tonya M. Reynoldson, O.D. “Topical anesthetic takes between 25 minutes to 30 minutes to take full effect, while injectable anesthetic takes roughly two minutes to three minutes to take full effect.”

Countering arguments regarding patient safety, Dr. Reynoldson noted, “an anesthesiologist on the state’s Senate Health Committee voted for the bill.”

The bill enables O.D.s to use injectable anesthesia to:

▸ Drain an eyelid abscess, hematoma, bulla and seroma

▸ Excise a single epidermal lesion no bigger than 5mm and no deeper than the skin’s dermal layer that doesn’t have malignancy characteristics.

▸ Incise and remove a nonrecurrent chalazion

▸ Repair an eye lid laceration no bigger than 2.5cm and no deeper than the orbicularis muscle that does not involve the eyelid or lacrimal drainage structures

▸ Eliminate foreign bodies in the eyelid that do not involve the lid margin, lacrimal drainage structures and extend no deeper than the orbicularis muscle.

The states’ House Health Committee passed the bill on Feb. 26, and the Senate Health Committee gave it the thumbs up on March 10.

Giving You the BUSINESS
The best of business on the Web:

■ If your practice website lacks a call to action, a business phone number, mobile use optimization and social media integration, you’re costing your business money.

– Catherine Clifford,, Jan. 30, 2014.

■ One action of a great leader is a warm greeting. Friendliness, good eye contact and finding common ground through personal stories humanizes leaders, making them likeable.

– Glenn Llopis,, March 31, 2014.

■ When using social media, connect your practice with other brands, people, events and places that match your practice’s “brand.” Doing so can lead to additional patients.

– Karl Hawes,, March 6, 2014.

■ Place difficult conversations as number one on your to-do list because they impede productivity.

– John Brandon,, March 18, 2014.


Cool Gadgets Guide Available Online

Whether you’re in the market for a new device, looking to replace one past its prime or you’ve got a hankering for a new “toy” to wow your patients and increase your practice’s revenue, the “Ophthalmic Diagnostic Instrument Directory,” a constantly evolving listing, is at your service at

The Directory, which replaces OM’s annual “Diagnostic Instrument Buying Guide,” is comprised of comprehensive listings of equipment vendor resources, cross-referenced by 20 different equipment categories. And, it enables equipment vendors to routinely update their listings.


Here’s How You Can Become a Part of Optometric History

■ The Optometric Historical Society (OHS), a 45 year-old organization that collects and preserves historical artifacts of the profession, is looking to add roughly 50 more members, reports OHS Trustee Irving Bennett, O.D., F.A.A.O.

The OHS houses several historical artifacts of the profession, including the Leland Refractor, shown here, which was used for refraction in the mid-19th century.

“Philosopher George Santayana once said, ‘Those who can not remember the past are condemned to repeat it.’ It is so true in optometry, and our leadership must be aware of what has gone on before so we do not make the same mistakes again,” Dr. Bennett explains.

OHS membership is $25 a year, and there are no membership duties other than to report any data you come across on historical happenings in the profession.

In addition, you get a subscription to the quarterly publication Hindsight: Journal of Optometry History. The publication focuses on vision care and vision science, among other related topics.

The OHS meets once a year at Optometry’s Meeting, where a speaker is present.

If you have an Indiana Jones-like zeal for history and you are fascinated by optometry’s roots, visit for OHS membership information.


Bill Delaying Medicare Reimbursement Cuts Becomes Law

■ At press time, President Obama has signed H.R. 4302, titled the “Protecting Access to Medicare Act of 2014,” into law.

The legislation averts the 24% pay cut to Medicare providers (set to start this month), giving providers a 0.5% payment increase until December 31, 2014, while also maintaining this payment increase until April 1, 2015.

In addition, the law delays the transition from ICD-9 to ICD-10 from October 1, 2014 to until October 1, 2015 and provides a one-year extension on the 1.0 work floor on the Geographic Pricing Cost Index, enabling O.D.s who work in inexpensive areas to maintain their Medicare reimbursements.


■ Brien Holden Vision Diagnostics (BHVD) is developing a retinal imaging camera which will provide same-visit detection of retinal disease, enabling patients to acquire the appropriate eye care fast, while decreasing healthcare system costs. In addition, BHVD is creating a device to assist in concussion diagnosis by assessing neurologic function and dysfunction via measuring and monitoring ocular behavior.

■ University of Michigan researchers have developed a tiny infrared light sensor that can be used for night vision contact lenses, sans cooling equipment, says a University press release. For more information, see “Graphene photodetectors with ultra-broadband and high responsivity at room temperature,” in March’s Nature Nanotechnology.

Will clunky night-vision goggles soon be a thing of the past?


● Low-dose oral doxycycline appears to improve inner retinal function in diabetic retinopathy patients, says a study in March 6’s JAMA Ophthalmology.

● After adjusting for age, income and AMD severity, physical activity and occasional drinking were linked with reductions in vision impairment (VI) risk, while current or past cigarette use, a sedentary lifestyle and alcohol abstinence through the past year were associated with an increased risk of VI, says March 3’s Ophthalmology.

●  Between 1990 and 2010, the prevalence of blindness and moderate and severe vision impairment (MSVI) in high-income regions has decreased by 50% and 38%, respectively, and the amount of blind individuals dropped by 17.4% and 12.6%, respectively, despite the growth of older people in the population, says March 24’s online version of the British Journal of Ophthalmology. Further, AMD is now the “most important” cause of blindness, though uncorrected refractive error remains the leading cause of MSVI.