Goodbye 2020, Hello 2021!

What a year! We just started and the pandemic hit. Businesses closed, restaurants were take-out only, and good luck getting a haircut or toilet paper. Slowly, the country re-opened with mask requirements, maximum capacities, and short supplies of PPE. Optometry was not immune to this new normal, but we continued to remain on the front-line serving our patients. To add to the mix, later in the year, the FTC imposed mandatory contact lens documentation. Despite these adversities, the POA forged ahead and was successful in passing a modernization of the Optometric Practice Act. The amended Act removes the Secretary of Health from the pharmaceutical approval process and places the management of the profession where it needs to be: the Pennsylvania State Board of Optometry. Additionally, the new Act allows for Epi-Pen use and removes the 6-week restriction for all forms of glaucoma, dry eye, and allergic conjunctivitis. Who would have ever imagined that 2020, The Year of the Eye Examination, would be so “exciting”?

Despite that excitement and  the challenges it resulted in, the POA has adapted well to these COVID times. The executive director and staff were proactive and prepared well in advance for the work-from-home environment. Committees worked non-stop to modify meetings, offer virtual education, and retain business partners. Zoom meetings and remote access became the norm. Meetings changed from live to remote, and live meetings became sensitive to social distancing. Details, too many to count, have all been handled flawlessly. Thank all of you for your extraordinary effort in keeping the organization moving forward.

Twenty twenty-one may well be the year remembered as, “The Year of the Vaccine.” The POA and AOA continue to advocate for optometrists, as front-line healthcare providers, to be some of the first to be vaccinated. The response from the Secretary of Health is positive as the definition for those initially eligible will be broad and inclusive. We stepped up and have been recognized for the excellent primary care services that we provide to the people of Pennsylvania.

My hope for 2021 is that it is remembered as the year that all of the children of Pennsylvania have the opportunity to be on an even playing field upon entering the realm of academia. Pennsylvania has an estimated 400,000 children in pre-school through the sixth grade. According to public health statistics, 3% to 7% (28,000) of those children will have a visual disability. These vision disorders are the fourth most common disability in the United States and the most prevalent handicapping condition in children. Since vision screenings miss at least half of these maladies, we can no longer ignore this pressing public health issue. Pennsylvania State Representative Zimmerman, with the strong support of the POA, has proffered legislation that will address this inequity by mandating vision examinations for all children entering school and at significant developmental milestones thereafter. 

Additionally, members of the POA’s Children’s Vision Care Alliance (CVCA) are committed to elevating the visual well-being of children by adhering to set standards, intervening at refractive and functional levels when necessary. More details can be found at https://pennsylvania.aoa.org/doctors/poa-member-resources/childrens-vision-care-alliance. The entire POA Board has been charged with working to make this a reality and we are asking for your support. 

Together, let’s make this a year to remember, for the kids and Pennsylvania Optometry.

Edward Savarno, O.D.
POA President

What a year!

 As I write my final President’s editorial, House Bill 2561, the Scope of Practice bill, sits on the Governor’s desk. By the time you read this column, he will have passed it or rejected it. All indications are that he will sign and pass this Modernization of the Optometric Practice Act. Through the incredible work by our Legislative Affairs Committee (LAC), lobby staff, executive director, and keypersons, we have finally passed both the House and the Senate and reached the Governor’s desk for his signature. I would be remiss to not recognize our LAC Chair, Dr. Bob Bittel. Bob and I joined the Committee close to 20 years ago. We worked with many dedicated committee members over those years whose goal was to play offense and pass legislation to advance our profession. Unfortunately, we often found ourselves playing defense and protecting our profession from harmful legislation like the “definition of ophthalmic surgery” our opponents have repeatedly introduced. We learned a lot through those years, cultivated relationships with legislators and gained respect as an organization. With Dr. Bittel’s leadership, countless hours of strategizing, difficult compromises and a pandemic that threatened to derail our efforts, we were successful in getting through both houses with one day to spare. Now we wait for the Governor.

I’d like to thank and recognize all the other committees that make up the POA. The word “unprecedented” is getting kind of old by now but they all faced challenges they never expected. All the committees adapted to the new “normal” and continued to function albeit in a totally different manner. We are a much stronger organization as a result of this pandemic.

The POA Board of Directors had many tough decisions to make this year: providing a forgiveness of two months dues, cancelling the in-person Spring Congress and House of Delegates, approving funds to purchase a platform to provide online CE for our members, planning and then having to cancel the fall meeting at Seven Springs, and modifying our bylaws to allow for a fall House of Delegates to elect our 2021 Board of Directors and approve the 2021 budget. 

The POA staff has been incredible through all of this. Their dedication to our profession is unparalleled. They participated in countless Zoom calls, many in the evening and often on a weekend when they should have been off duty. They found new ways to support the Board and the membership. I can’t thank them enough for their support this year.

Finally, I’d like to thank all of you for the opportunity to serve as President of the POA. It’s certainly not the year I expected. It’s been challenging and frustrating. I’ve had to make decisions to issues that had no clear answers. When I began my professional career, I couldn’t prescribe an antibiotic or bill Medicare. I owned a visual field instrument but couldn’t treat glaucoma. We are now the primary providers of eyecare due to the hard work of the leaders before me. I joined the Board of Directors because I felt the need to “give back” to a profession that had given so much to me over the years. I hope I have accomplished this and challenge all of you to do the same.

God bless and stay safe,

David Evans, O.D.

POA President

Going with the flow

Who is the Pennsylvania Optometric Association? We are a group of optometrists representing and protecting the interests of our profession for our members in Pennsylvania. We are a member-run organization supported by a staff and executive director in our office in Harrisburg. Our Board of Directors is elected by the membership and is responsible for providing leadership to the many committees that make up the POA and for making the decisions necessary to protect and promote our profession in Pennsylvania 

The POA welcomes all optometrists in the state to belong to our association. All modes of optometric practice are welcome and represented in the POA. You are reading this editorial because you are member of the POA. Imagine what we could accomplish if every optometrist in Pennsylvania was a member. Imagine what we could accomplish if every member was actively involved in the POA. 

The many committees within the POA are staffed by volunteer optometrists who contribute their time and skills to support their profession. Many members, who cannot dedicate time, provide support through POPAC donations and/or act as keypersons with their legislators. Many are available as individuals who are called upon for specific issues that the POA must address. 

We need strength in numbers and involvement by members, especially in these unprecedented times. Please consider getting involved and encourage your non-member peers to join us. Call the POA office and speak to our executive director, Joe Ricci, Esq., to discuss a committee you would like to participate in or a skillset you have that could benefit our efforts. We need members from all demographics to help address the needs of all optometrists in Pennsylvania.

As POA president, I’ve experienced more firsts than I ever imagined. On July 18th, we held the first POA Board of Directors meeting via Zoom. Every effort to replicate a face-to-face meeting was taken and I feel the meeting went well. The Board, local society presidents (or their representatives), POA staff, our executive director, our lobbyists, and our POA attorney were in attendance. At every Board meeting, the actions that the Board has taken since the last official Board meeting are voted on. Each Board member is a DEO (division executive officer) of one or more committees within the POA and is responsible for delivering a written report prior to the meeting for distribution to all parties in attendance. At the meeting, Board members present a verbal report highlighting each committee’s activities and questions from those in attendance are answered. Local society presidents are expected to relay the information in these reports to their respective membership so that our members are well informed. Copies of these reports are available through the POA office by emailing Ilene@poaeyes.org. 

Another first during my presidency will be a Virtual House of Delegates this fall. The Board rescheduled this event from our cancelled Spring Congress to the Fall Educational Conference at Seven Springs this fall. We recently were informed that Seven Springs will be unable to host our event due to COVID-19 limitations imposed on them with regard to group size. The House of Delegates can be attended by any member and I encourage you to join albeit virtually. Information with regard to date and time will be forthcoming.

The continuing education that was scheduled at Seven Springs will now be available via webinars. The schedule and registration are located on the POA website. If you still need the required Act 31 credits, this webinar is being held on September 13th from 7:00 to 9:00 p.m.

Stay well and stay safe! Stay informed. Things are constantly changing both locally and nationally. Get involved if you can. Help the POA and AOA protect your profession. If this pandemic has taught us anything, it’s that we need to be prepared for unexpected threats to our profession and livelihood.

Sincerely,

David Evans, O.D.

POA President

Our new reality

 When I sat down to write this editorial, I was struck by how similar all of us optometrists are, yet, how different our current situations may be. My office reopened a couple of weeks ago and began seeing the medical eye care patients whose visits were postponed due to the stay at home order. Reopening required attaining PPE and equipping the physical office with sneeze guards, signage, and more. Staff education took place, and the process of contacting our patients and rescheduling them continues. We began and still are at a reduced schedule due to the new disinfection protocol following each patient’s visit to the exam room and optical. My exams are taking longer than usual because every patient wants to talk and catch up on what the last three months have been like for them. Everyone is wearing a mask and all of us hope all of this goes away soon. For many of the elderly, their eye exam was the first they have been out in public since the Governor’s stay at home order. 

Advice on steps to reopen our offices is abundant in our professional journals and online. The POA has provided guidance on a multitude of topics concerning the pandemic and optometry. Like you, some of it makes sense in my personal situation and some of it doesn’t. Some optometrists are now wearing scrubs, I gave up my tie. Some offices are washing every frame after it’s touched, others bought disinfection units. The large group practice in a neighboring town is having patients wait in their cars till the office is ready to see them, we are attempting to have our patients go directly to an exam room and bypass the waiting room. 

Whether you are an OD in private practice, group practice, specialty practice, or commercial practice, please know that the POA is here to support you. We will continue to take steps to protect and promote our profession. We are adapting to the new reality that social distancing may be here for a while. Investment in platforms that allow the POA to provide online CE to our members and Zoom meetings that take the place of in-person events is complete. Our first Zoom Board of Directors meeting with local society presidents has been scheduled for Saturday, July 18th. Continuing education webinars have been very successful and should our fall meeting in Seven Springs not be allowed to take place, the House of Delegates and continuing education courses will still happen, albeit virtually. 

I wish each of you best of luck and success in reopening your practices. Through this pandemic, we have proven that we are essential providers. We should be proud of the contribution Optometry has made to the health and welfare of the citizens of Pennsylvania. 

Unprecedented Times

I’ve got to be honest: when I figured out during the early years of my Board service that I would be president of the Pennsylvania Optometric Association in the year 2020, I thought “wow, how many ODs get to say that?” Both the POA and the AOA prepared for this unique year with big plans to promote our profession. None of us ever expected what we currently face both in our personal and professional lives. Like you, I am unsure of how long things will take to get back to normal and what the new normal will look like. The POA faces many of the same concerns and challenges as we wait to see what the future holds. However, as members of the POA, we are fortunate to have a strong professional organization that employs dedicated staff who truly care about us as individuals and as an organization. They are working from home to support and protect the POA in ways they never anticipated. As members of the POA, we are also fortunate to have a committee structure with volunteer ODs that are passionate about our profession.

Since the onset of COVID-19, the following optometry-centered events have been cancelled:

• Vision Expo East
• POA’s Lobby Day in Harrisburg
• POA/VSP eye exam clinic in Harrisburg
• POA’s Spring Congress in Gettysburg
• AOA’s Optometry’s meeting in Washington, D.C.
• POA’s CE in Italy trip

Keeping members updated during this time is the POA’s topmost priority. Here is an update on several of the committees and their current strategies:

THIRD PARTY COMMITTEE
This committee continues to work with the insurances we deal with every day. Their in-person meetings have been replaced with conference calls and Zoom events. They continue to advocate for us and work to resolve the ongoing issues between the insurance industry and optometrists as providers. Of utmost importance is their efforts to ensure that optometry is included in telehealth delivery of care to our patients.

LEGISLATIVE AFFAIRS COMMITTEE
The way the Pennsylvania Legislature functions during this pandemic has changed dramatically. There are no in-person meetings between our elected officials and constituents or lobbyists. Communication happens via email or phone calls. The LAC is working to update and modernize the optometric practice act as this pandemic has proven we are the primary eyecare profession and our diversity geographically increases patient access to urgent and emergency care.

Governor Tom Wolf has designated optometrists as life-sustaining providers. The Federal Government has recognized us similarly. We are on the frontline of urgent and emergency eye care statewide. The time is now to make your legislators aware of optometry’s expanded role during the pandemic and how we can continue to be a vital resource as we move out of this crisis.

CLINICAL EDUCATION COMMITTEE
The Clinical Education Committee has been working overtime to develop educational programs to assist members in renewing their licenses in 2020. The governor has allowed optometrists to obtain 100% of their credits for license renewal online for this renewal period only. The Committee sent out a survey to the membership and based on the responses have developed a series of webinars to include the core requirements for renewal and beyond. By now, you have hopefully participated in one or more of our web-based offerings. With the unexpected cancellation of our Spring Congress, the POA sustained a substantial loss of income. The Committee is doing what it can to give the membership what they need. Please support this endeavor when choosing the source of your online credits. Your financial support enables your professional organization to better support you!

As of now we are moving full steam ahead on our Fall Education Conference from October 23 to 24 at Seven Springs Mountain Resort. A few weeks ago, the POA emailed the membership a survey regarding continuing education this year and were encouraged by the number of members who still want to attend an in-person meeting this fall. Topics covering glaucoma, therapeutics, Act 31, and opioids for doctors still needing to meet the core requirements will be offered as well as additional educational topics.

I hope that you can appreciate all that the POA continues to do to support its membership. It is so very important to every Pennsylvania optometrist that the organization remains strong to support us in the coming weeks, months, and years. Your continued support of the POA and its programs is vital.

David Evans, O.D.

POA President

Contact lenses continue to evolve to meet patients’ needs

Contact lenses have become modernized over several decades including large strides that have changed the health and optics available. In the past two to three years, major manufacturers of contact lenses have continued to expand the population that can be potentially served by innovative technology and combining successful design models from the past.

Many patients come into optometrists’ offices having gone more than 10 years since trying a contact lens and are unaware of the available options. No longer are conditions of astigmatism or presbyopia restrictions from achieving excellent visual outcomes from contact lenses. The availability of trial contact lenses to every optometrist allows a wide variety of options to meet a patient's needs for those that work indoors or outdoors, as well as those with specific lighting sensitivities. 

Innovative eye care professionals are ready and able to work with patients to problem-solve the demanding vision environments and find a lens fit that is right for them. Sensitive, strained eyes may also suffer from dryness and can be helped by the benefits of contact lenses. Fortunately, dry eye conditions can be better managed to help promote the wear of contact lenses and return once disappointed patients into healthy contact lens wearers.

Daily wear contact lenses can provide full-time comfort or be used for patients who wear lenses for special occasions. These offer the lowest risk of infection of all of the current contact lens modalities and are available in thousands of customized parameters to meet the most stringent needs. In addition to daily wear contact lenses, monthly and two-week contact lenses still offer a cost effective and convenient way to treat vision and manage ocular surface health. Contact lens companies have utilized advancements in manufacturing techniques and materials to develop contact lenses that are healthier and more comfortable than traditional varieties of years past. The surface of the lens is more comfortable and more resistant to infection-causing bacteria than ever before, which also contributes to long-term health. Specialty contact lens manufacturers now offer healthier options from reputable vendors for theatrical and cosmetic contact lenses.

In the hands of an experienced eye care provider, manufacturers can offer significantly better quality-controlled lenses reducing the risk of complications. Less reputable contact lens providers that break down the doctor-patient relationship can cause short-term and long-term complications that can be addressed and sometimes reversed while under the care of an eye care professional. Considerations should also be made for specialty contact lenses that can be utilized for therapeutic purposes for the treatment of complex ocular diseases and dry eye disease.

Doctors of Optometry continue to learn and apply expertise to the implementation of individual plans to make contact lens wear more successful for their patients. The future of contact lenses is brighter than ever and is an excellent topic of discussion for yearly eye exams. 

PCO/Salus University update

It seems appropriate that in the year of 2020, we should institute periodic updates on PCO/Salus University and enhance transparency between our state association and our state’s optometric college. Along that line, I will start providing an overview of President Dr. Mike Mittelman’s updates to our alumni board on Salus’ status and some of the upcoming PCO events. 

This year’s first meeting was on 1/19 and opened with a review of the upcoming class of 2020. There have been 582 applicants, which is a decline from 646 in 2019. This trend is reflective nationally with a decrease of approximately 15-20% and is also evident at the undergraduate level with a decline of approximately 11%. To align with this decrease and assure that quality students are accepted, the target size for the 2020 PCO class is 135, which has been deliberately reduced over the past four years. An interesting side note is a declining birth rate in the US since 2012; in 2018, there was a reduced birth rate of 2%, the lowest in 32 years.

Proactively, there is a proposed restructuring of Salus University into 3 colleges: PCO (600 students), Audiology (128 students), and a condensed College of Health Sciences, Education and Rehabilitation (CHER), which includes the programs of PA, OT, Biomedicine (PhD), Speech-Language pathology, post baccalaureate (for a total of 280 students) and a proposed orthoptics/prosthetics program. This will streamline the academic administration and allow stand-alone primary doctoral programs with master levels within single colleges.

Financially, the Centennial Campaign was successful in generating over $4.2 million in donations and the “Looking Out for Kids” event was also a success (>$135,000). It is scheduled this year on 11/14/2020 at the National Constitution Center (there is a solicitation for donated items for the silent auction). Student travel grants were approved for 11 students to represent Salus by presenting posters, papers, and participating in academic “challenge” bowls.

Politically, Salus continues to host visiting legislators. Most recently, House Majority Leader Rep. Bryan Cutler, Sen. Sharif Street, and Rep. Joanna McClinton. Dr. Mittelman along with the Salus faculty are very gracious hosts and provide an informative overview of our training that better educates our legislators. You are encouraged to invite and escort your legislator on a field trip to Salus; PCO will coordinate the arrangements.

Salus is lobbying PA to reinstitute a “line item budget” for $2 million to help reduce student tuition by $6-7,000. This was eliminated in 2008, with exception to the University of Pennsylvania’s veterinary program, since it was the only such program in the state (argument for reinstituting this budgeting for PCO). 

Upcoming events: Alumni gatherings at SECO (Atlanta, 3/06) and AOA (DC, 6/26). Salus is hosting a Woman’s Leadership Forum on 4/03. Consult Salus’ website for more events. Our next Alumni Board meeting will be on 7/12.

Respectfully submitted, 
Bob Owens, O.D., F.A.A.O.