A critical moment for children’s vision legislation

Dear colleagues,

As we reflect on the recent completion of the Pennsylvania state budget, we find ourselves at a critical juncture. While many important issues were addressed, our children's vision legislation, which aims to make comprehensive eye exams mandatory for children prior to entering school, was not passed or even voted out of committee. However, we have one final opportunity to change that—a chance akin to a hail Mary pass in football or a buzzer-beater shot in basketball. This fall, before we enter a new legislative session next year, we must rally together to advocate for this crucial legislation.

The Importance of Comprehensive Eye Exams for Children

Every day, we see firsthand the difference that early detection and treatment of vision problems can make in a child's life. Comprehensive eye exams are essential for diagnosing conditions that can significantly impact a child's learning and development. Issues such as amblyopia, strabismus, and significant refractive errors often go undetected without a thorough eye exam, leading to difficulties in school and beyond.

The future of the children of the Commonwealth depends on us. By making comprehensive eye exams a standard requirement before children enter school, we can ensure that every child has the visual foundation necessary to succeed academically and socially. This legislation is not just about eye health; it’s about giving our children the best possible start in life.

Rallying for Change: Engaging Hearts and Minds

To achieve this goal, we must appeal to the hearts and minds of our patients and legislators. Share your stories with your patients—stories of children whose lives have been transformed by timely eye care. Encourage them to contact their legislators and express their support for the children’s vision legislation. Personal testimonials can be incredibly powerful in demonstrating the real-world impact of this initiative.

Additionally, you must reach out to your local representatives. Explain the importance of early detection and treatment of vision problems and how this legislation can make a profound difference in the lives of countless children. Emphasize that investing in children’s vision now will pay dividends in their future success and well-being.

A Unified Effort

Our association is committed to supporting you in this advocacy effort. We will provide resources, talking points, and guidance on how to effectively communicate with patients and legislators. Together, we can create a groundswell of support that cannot be ignored.

In closing, I urge each of you to take action. The window of opportunity is narrow, but with a unified and determined effort, we can achieve our goal. The future of the children of the Commonwealth is in our hands. Let us seize this moment and ensure that every child has the chance to see clearly and succeed fully.

Thank you for your dedication and commitment to this vital cause.

Sincerely,

Dr. James Deom

POA President

Access Low Vision in Pennsylvania

I am so proud of what we at the POA have achieved this year. The POA has provided leadership development for over 40 members and established a new Diversity, Equity and Inclusion (DEI) Committee. Additionally, we have developed a new POPAC Proactive Optometry Initiative. After advocacy efforts this year, we've seen the successful passage of the Early Eye Drop legislation. We have even supported Salus University’s Ophthalmic Lasers Procedures for Anterior Segment certification course. You can register here. 

In addition to our established initiatives with the Pennsylvania Diabetic Eye Health Alliance (PDEHA)  and Children’s Vision Care Alliance (CVCA), the POA has now formed a Low Vision Awareness Committee. The overall purpose of the Low Vision Awareness Committee is to promote Low Vision awareness to Optometrists, Ophthalmologists, other health care providers, and the general public.

We are reminding our members that the standard of care for a patient with low vision is to refer to one of the many Optometrists in Pennsylvania who provide Low Vision rehabilitation.

So, what constitutes a referral for Low Vision services? No longer is the trigger for a referral to Low Vision a certain visual acuity, visual field or diagnosis. The standard of care now is to refer any patient who is struggling with at least one activity of daily living due to their vision loss. Examples could be: difficulty reading mail or pill bottles; trouble keeping up in school (at any age); concerns about driving; difficulty performing work-related tasks; difficulty traveling through unfamiliar environments; trouble reading books, magazines, or computers; inability to see favorites hobbies or past-times; difficulty seeing to provide self-care such as shaving; or difficulty seeing to perform housekeeping such as cooking and laundry. 

If you have provided the best optical correction, but your patient is still struggling, please refer to a Low Vision Optometrist. They can tackle the problem, not only by traditional glasses or contact lenses, but also by use of lighting, contrast, prisms, modified working distances, eccentric fixation, various forms of optical and electronic magnification, training with these devices and techniques, and referrals as needed to other supportive professionals. The earlier the Low Vision Optometrist can become involved, the more successful your patients are likely to be.

Of course, at no time should Low Vision care replace proper medical or surgical intervention. But do remember, Low Vision is an essential treatment modality to those with visual impairments. Also, please do not prejudge a patient’s ability to adapt to Low Vision care or pay for the services. Low Vision consultations are generally covered under a patient’s medical insurance. If not, other funding sources are available such as the Pennsylvania Bureau of Blindness and Visual Services. Get to know your local Low Vision Optometrists. They can guide you. Consider the Low Vision Optometrist a part of your team. They do the rehabilitation and you continue to be the patient’s primary eye care Optometrist.

If you are a POA member who provides Low Vision Rehabilitation, please make sure your AOA profile indicates you have a special emphasis in Low Vision Rehabilitation. Also, join the AOA Vision Rehabilitation Advocacy Network by signing up on the AOA website under practice > specialties > Vision Rehabilitation. By identifying yourself as a Low Vision Provider with your professional association, your colleagues and the general public will be able to find you on the AOA and POA “doctor finder” under Low Vision Emphasis. If you are not a Low Vision provider, search on the AOA or POA websites for a Low Vision Optometrist in your area.

I want to thank the POA for all its support. I ask members to stay involved, join PDEHA, join CVCA, and join or refer to POA Low Vision Optometrists. Become a keyperson. Join the Proactive Optometry Initiative. We all know that Optometry is the premier eye care profession in Pennsylvania. Let’s keep it that way. Great things are being planned for 2023, and I look forward to continued success for Optometry in Pennsylvania. 

Tracy Carpenter Sepich, O.D., M.S.

Doctor of Optometry

Masters of Science in Low Vision Rehabilitation

A strong POA is a diverse and inclusive POA

The Pennsylvania Optometric Association has a long history of providing member benefits ranging from advocacy to education. The Association provides a voice for optometry in Harrisburg and Washington, D.C., offers problem-solving and maintains ongoing relationships with third-party payers on behalf of our members. POA membership opens the door to premium opportunities with buying groups, investment strategies with Fischer Financial, insurance, discounts with Element Risk Management, HIPAA compliance solutions with Abyde, and consultative services with POA legal counsel. Additionally, the POA Electronic Claims Service helps you submit claims to third-party payers while also generating income to reduce membership dues.

When the COVID shutdown hit, we devised quality online education, which has continued as an option in addition to our revived in-person educational offerings, and we will continue to provide cutting-edge education as we explore scope expansion.

Through the Children’s Vision Care Alliance, we form relationships with school nurses statewide, and provide members with no-cost posters, brochures, and presentations to educate local schools and families on the importance of eye examinations. We have similar materials available to promote the need and accessibility of diabetic eye examinations by optometrists through the Pennsylvania Diabetic Eye Health Alliance. These programs keep our member optometrists involved and relevant in these essential areas of vision and eye care. 

We partner with the Pennsylvania Paraoptometric Association which provides education as well as networking and professional development opportunities for your staff. The AOA Paraoptometric Resource Center also provides staff training and certification.

We support our fourteen local optometric societies so members can attend meetings, obtain CE, network, and advocate locally. We work closely with the Pennsylvania Student Optometric Association to recruit new members and keep our initiatives current and relevant.

We update our members through email and this bi-monthly newsletter, which includes a classified section to assist members with practice and equipment sales and job searches.

A new addition to our association structure is a Diversity, Equity, and Inclusion (DEI) task force. As a result of responses to our 2021 membership survey, our new strategic plan calls for the creation of this DEI task force. This initiative is important in making sure all optometrists in Pennsylvania have a home in the POA. We need to make sure all optometrists know they are valued and welcomed. We want optometrists with a variety of backgrounds to contribute to the volunteer structure of the POA. We will be stronger as an association if we have a diverse community of members involved.

In an effort to recognize the AOA’s dedication to all people, at the 2021 AOA House of Delegates, the following statements were added to the Optometric Oath: “I WILL provide professional care for the diverse populations who seek my services, with concern, with compassion and with due regard for their human rights and dignity.  I WILL work to expand access to quality care and improve health equity for all communities.”

Please recognize we all have biases. Please educate yourself. Please attend local conversations about diversity in your community. Simply saying we are welcoming is not enough. When you are at a conference, sit next to someone who does not look like you. Stop into local optometry practices in various settings and invite them to your local society meetings.

I hope to foster a POA in which optometrists of all backgrounds, lifestyles, and practice styles know they belong, are safe and valued, and work together for our common goals. My hope is by nurturing a diverse and inclusive association, we will become better providers and serve a greater community with more acceptance and positive results.

Little things matter. Respect, even in small ways, matters.

If you have an interest in strengthening the POA by participating in the new POA DEI task force, contact me at tsepich@restoreeyecare.com or the POA office at mail@poaeyes.org. Thank you.

Tracy Carpenter Sepich, O.D., MS

POA President

Why do children need the POA?

Did you know there are approximately 1,745,000 students enrolled in Pennsylvania schools? Studies estimate 33% of these students are at risk for vision problems. That is approximately 576,000 students. Did you know 40% of students with learning disabilities have vision issues that affect learning? Did you know Pennsylvania schools spend 9K-15K per student on an IEP (Individualized Education Program), which is required for all special education students? Recent studies have found that children who are spending increasing time on electronic devices have a higher incidence of vision deficits that impact learning. The negative impact of children’s vision problems is likely to get worse if nothing changes. 

Children need the POA because we can uniquely provide the vision and eye care children need to succeed.  The POA's Children’s Vision Care Alliance (CVCA) has been busy educating optometrists, school nurses, and legislators on the importance of proper eye care for our children’s success in and out of the classroom.

Representative David Zimmerman has introduced HB 1343, which would require children in Pennsylvania to have a comprehensive eye health exam when entering school, in 4th grade, in 8th grade, and before qualifying for special education services. This bill currently has 40 co-sponsors with bipartisan support. It is currently in the Education Committee. We feel confident this bill can pass once it is out of committee. 

So, how can you help?  Please attend our Optometry at the Capitol Day in Harrisburg on Monday, March 28, where we will be lobbying for important issues. You are all invited to this investment in the future of Optometry. Please register here: https://pennsylvania.aoa.org/education-and-events/poa-lobby-day. Learn more about POA's legislative efforts and send a letter to your legislator by visiting the Advocacy page here: https://pennsylvania.aoa.org/advocacy.

In addition to contacting your legislators, please consider joining the POA Keyperson Committee or POPAC Fundraising Committee. You don’t need experience. You only need a passion for Optometry and helping our patients.

Finally, keep your eyes open for the new POA Proactive Optometry Initiative to help advance current and future Optometry-friendly legislation, like HB 1343. More information will be available soon!

Let's get back to the children, though. One study showed that when students who were identified with visual deficiencies received proper treatment, their grades significantly improved, whereas without proper treatment, these students continued to underperform, leading to a 12% reduction in wages.  Don’t you want to be part of the solution? Educate yourself. Educate your patients. Educate your local schools. Educate your legislators. Join the CVCA. Become a Keyperson. Support POPAC. If you don’t know where to start, call the POA and we will help you. Your children, and your children’s children, will thank you. I thank you. 

(Citations for the facts included in this editorial can be found on the POA Advocacy webpage.)

Tracy Carpenter Sepich, O.D.
POA President

A fond adieu

Have you ever noticed that once you finally figure something out, something changes and you have to adjust? It feels like the last year flew by so quickly. As an association, we started the year virtually, with the pandemic halting yet another Spring Congress. Questions of “will there be a vaccine” lapsed into “which one did you get?” And then there’s the mask thing. One would have thought that someone would have at least mentioned that people had to wear masks in healthcare facilities. Through it all, the POA moved forward. The Children’s Vision bill gained traction and now has 40 co-sponsors thanks to the hard work of our legislative team. The Keyperson Committee and Legislative Affairs Committee collaborated to make “How To” educational videos for legislator meetings. The Children’s Vision Care Alliance (CVCA) also grew, developed talking points, a pediatric near point card, and reached out to school nurses. We began working with ophthalmology on public health issues. The Early Drop Legislation will allow our patients to renew their drop prescription if they run out of drops before the end of the month. I hope that this blossoms into an ongoing collaboration between the eye care professions on matters of public health. 

Just as the strategic plan was set to begin implementation, the unthinkable occurred. We lost our executive director, Joe Ricci, to COVID-19. This virus is a cold, unfeeling malady that has left many to pass quietly on a ventilator without the comfort of family. It was a terrible blow to the POA and to me, personally. However, the Board of Directors are the guardians of the organization, and the Personnel Committee met immediately to develop a plan to maintain the integrity of the POA. With the full support of the Board, past presidents, and many others, we moved mountains: message triage, emergency meetings, and the formation of an executive director search committee—none of which would have happened so smoothly without the POA staff. I called the POA office so often that Deb and Ilene became Debilene. It was a rough few weeks, but we all pulled together to make it work. Our immediate past executive director, Dr. Charlie Stuckey, has stepped up and will be the interim director for the next six months. Over the years, he has been an ED, friend, and mentor for many of us and lends some calm to an otherwise high stress and tragic event. The search committee is actively moving forward to attempt to fill the shoes left behind by Joe. 

I have the unique perspective of not only moving the POA through a pandemic, but also losing our executive director to the virus. If there is one thing I learned about the POA during this time, it’s that it is a family and everyone is essential. Countless calls offering condolences, help, and guidance. It was an all hands on deck situation and the POA structure, once in place, moved forward like clockwork.

I want to thank the POA Board for all of their support and effort, the POA staff… well, for all that you do, and all of the members that offer their time and talents to this great organization. It’s time for me to say a fond adieu to my time at the helm. Expect big things next year. The foundations have been set and you are in some of the most capable, hard-working hands as we move into 2022.

Until soon,

Ed

Essential

Everything looked like we were moving out of the pandemic. Cases were lower, hospitalizations were down, and then variant began to take its toll on the vaccinated and unvaccinated alike. I wondered how optometry fit into all of this and the word ‘essential’ kept coming to my mind. 

Optometry is an essential component of the health care system, but what is essential to optometry? A healthy staff, a sound supply chain, and a professional organization to guide the profession through this unprecedented time. On the surface, the POA has delivered numerous updates regarding the practice of optometry during the pandemic. CDC guidelines, PA Department of Health and OSHA mandates were all brought to the forefront and shared with members to better keep ourselves, our staff, and our patients safe. 

But, as POA Executive Director Joe Ricci would say, “all of the action is under the duck.” In addition to what you see happening, there is even more happening behind the scenes. POA President-Elect Dr. Tracy Sepich is well into our strategic planning for the next three years. By this time, you have already received—and hopefully completed—a survey regarding the strategic initiatives of the POA for the next three years. We are a member-driven organization and rely on your input.

Through the efforts of the Third Party Center, Versant Health has become a business partner with the POA and will be at the fall meeting in October to answer your questions and listen to your concerns. From October 28 to 30, please join the POA and our exhibitors, business partners, and lecturers in making the most of our meeting. Registration and details can be found at https://pennsylvania.aoa.org/education-and-events/poa-fall-educational-conference. 

In other good news, the Children’s Vision Bill is garnering a lot of attention. Drs. Rich Christoph, Lori Gray, and the POA lobbyists have opened the eyes of legislators regarding the importance and value of this initiative. We expect that the legislature will come to the aid of the more than 30,000 children that are marginalized annually because they have an undetected vision disability. 

Although the Covid variant is looming and this year may end up being as strange and new as the last, I hope you’ll trust the POA to run an incredible educational conference this fall in Hershey. See you there!

Ed

COVID's still the word

Well, here we are again… COVID is still the word of the day but now it’s paired with a more positive word: vaccine. Healthcare providers all over the state have been or are in the process of being vaccinated. Like when the pandemic began, unanswered questions have crossed everyone’s minds. Who is eligible? Where do you get it? Are doses available? Why can’t I schedule for it? Pfizer or Moderna? Do I have a choice? Then there is the question of complications that continue to evolve. The POA continues to advocate for and provide information to members in hopes of answering these questions. Members will know when the POA staff knows. Check out the latest information on the COVID-19 Updates webpage at https://pennsylvania.aoa.org/doctors/poa-member-resources/covid-19. Everything from vaccination locations to SBA PPP COVID relief loans are covered on this resource page. 

One thing to know for certain is that the vaccine is highly effective and limits the serious complications of SARS CoV-19. We all know that the pandemic has had a huge effect on the delivery of healthcare, but it is not the only issue that faces Optometry in 2021. The POA is like a duck on a pond, looking tranquil on the surface, but the feet are moving 100 MPH below the surface. The new ground created by the “Modernization of Optometry Act,” Bioptic driving, and the pending Children’s Vision legislation have many committees in high gear. We are aiding in the development of regulations and standards that will carry these initiatives far into the future. Also, other committees are developing public service messages that highlight Optometry and aids to help school nurses better define children with covert binocular vision anomalies. All of this activity is being performed by volunteers with the outstanding support of the POA staff. 

We are the POA: multiple generations of optometrists working together, giving their time, unique skills, and effort to move Pennsylvania Optometry forward! I am asking you to join us in our effort by participating on a committee and use your unique skills to advance optometry. You will find that the rewards are unlimited. After 35 years, that’s exactly my experience.  

Until soon,

Ed 

Edward Savarno, O.D.
POA President

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

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.

A message from AOA President Andrea Thau, O.D.

Dear Colleague, 

As a practicing doctor myself, I know firsthand the challenges and frustrations that come with keeping up with ever-changing Medicare program requirements. As the Centers for Medicare & Medicaid Services (CMS) begins the new Quality Payment Program (QPP) this year, the AOA is working to support our doctors to protect future reimbursement and maximize incentives.

Just last month, CMS began sending out letters to all Medicare doctors to indicate whether the doctor has qualified for one of the exclusions under the Merit-Based Incentive Payment System (MIPS). CMS also developed an online NPI look up to check participation status. With this information, doctors can now best prepare themselves for MIPS participation. To equip doctors of optometry with the information needed to successfully participate in the program, we’ve developed a number of resources, including:

• A webinar that dives deeply into MIPS program requirements.
• A webinar that provides much-needed guidance on MIPS for those doctors who are not using EHRs in their practice.
• An overview of MIPS and how the AOA’s Measures and Outcomes Registry for Eyecare (AOA MORE) can help support program requirements. 
• QPP frequently asked questions
• MIPS group reporting frequently asked questions

While these are all great resources, we know that many of our doctors are still unsure of the path forward when it comes to these program changes. The AOA wants to do more to support you. Please join us on June 12 at 9 p.m. Eastern time for a webinar that will offer the opportunity to ask your specific MIPS questions. The webinar will be presented by Dr. Zachary McCarty, chair of the AOA’s Quality Improvement and Registries Committee, and Dr. Jeff Michaels, immediate past chair of the AOA’s Quality Improvement and Registries Committee. Register here. If you have a specific question you would like addressed on the webinar, please email Kara Webb, the AOA’s associate director of coding & regulatory policy, at kcwebb@aoa.org.

If there are additional MIPS tools and resources that would be useful to you in your practice, please email me at president@aoa.org.

Sincerely, 

Andrea P. Thau, O.D.

AOA President

A Multi-Faceted Approach to Treating Your Patients

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IDENTITY THEFT: The Aftermath and Prevention

by Mark Dalton, O.D.

Over the past few months, many of us have either heard about, or have been directly affected by, the nationwide data breach affecting optometrists and optometry students throughout the country. This article serves as a brief summary of the breach, how to respond if you have already been victimized, as well as suggested ways to better protect yourself from becoming a victim of identity theft in the first place. 

At the end of July, reports began circulating of a possible data breach affecting the optometric community. The suspected breach was discovered when victims began receiving unsolicited, fraudulent applications for Chase Amazon cards. In some cases, the new account requests were denied, resulting in a letter being sent to the victim’s home. In other cases, the credit cards arrived in the unsuspecting victim’s mailboxes.

In early August, the AOA alerted its members, warning them about the breach and how best to respond. The AOA also contacted the FBI and the Federal Trade Commission to apprise investigators of the situation. In addition, the AOA immediately conducted its own internal investigation of its databases, reporting that it was not the source of the breach. Importantly, the AOA does not store social security numbers, which are needed to open the Chase Amazon accounts. In addition to the AOA, the AAO, NBEO, and ASCO all independently denied being the source of the breach. Although there is much speculation, as of this writing, the source of the data breach has not yet been confirmed. 

Since the initial discovery, it appears that more than 1,000 doctors and students have been victimized. While there appeared to be an initial wave of applications in early August, as well as a second one in late August, the reports of new accounts opening have continued to this day. Some victims have reported multiple attempts to open cards in their names, sometimes several weeks apart. In addition, recent reports have surfaced about other non-Chase credit card accounts being hacked with unauthorized charges being made. It is not known at this time if these are related.

So, what can you do? Since it appears all optometrists and students are at risk, the POA recommends everyone call Chase Bank at 1-888-247-4080 to see if an application using your social security number has been submitted. This is an automated system. You will initially be asked to enter your existing 16 digit card number. Ignore this. You will then be given the option to enter “1” to check on the status of your application. After selecting that option, you will be asked to press “3” to check the application status, then lastly, press “1” again. It will ask for your social security number. After entering it, if you are told they can’t find your application, then there is none pending. If you are told you have one pending or approved, hang up and follow these instructions:

1. Call the Chase fraud line at 1-877-470-9042
2. Have the application or card cancelled immediately and ask Chase to report it to the credit bureaus. Follow up with a certified letter mailed to the following address reporting the fraud and requesting that they report it to the credit bureaus to have it removed.
Chase Card Servicing
Attn: FACT Act Request
P.O. Box 15941
Wilmington, DE 19885
3. Obtain a copy of your credit report
4. Report to the FBI at www.ic3.gov
5. File a police report with your local police department. 
6. Visit identitytheft.gov, the federal government’s one-stop resource for identity theft victims. 
7. Request a credit freeze by contacting all three credit bureaus listed below. You can do this online, and there is typically a small fee. A credit freeze will restrict access to your credit report, which in turn will make it more difficult for identity thieves to open new accounts in your name. It is important to remember that any activity that may require legitimate access to your credit report, such as buying a house or car, will require you to lift the freeze temporarily, either for a specific time or a specific party. A freeze remains in place until you ask the credit reporting company to temporarily lift it or remove it altogether. The cost and lead times to lift a freeze vary, so it’s best to check with the credit reporting agency in advance. 
Equifax 1-800-349-9960
Experian 1-888 397 3742
TransUnion 1-888-909-8872
8. Submit an Identity Theft Affidavit (IRS form 14039) at
 www.irs.gov/pub/irs-pdf/f14039.pdf
9. Inform your personal bank and credit card companies of the breach. 
10. Change your passwords associated with your bank and email accounts. 

If you haven’t been victimized by this latest breach, it doesn’t mean that you are completely safe since reports of new fraudulent accounts are still appearing almost daily. Due to the current circumstances, you may want to consider a credit freeze, as described above, and/or a fraud alert. A fraud alert is a consumer statement added to your credit file. This statement alerts creditors that you may be a victim of fraud, including identity theft, as well as requests that they follow certain procedures to protect you in connection with requests for new credit accounts, increasing credit on an existing account, or issuance of a new card on an existing account. There are two types of fraud alerts: an initial fraud alert that lasts for 90 days, and an extended fraud alert that lasts for 7 years. An initial fraud alert is free, and will protect your credit from unverified access for 90 days. To initiate a fraud alert, you only have to ask one of the three credit reporting agencies to put a fraud alert on your credit report. They must tell the other two companies to do the same. Other ways to help protect yourself from identity theft include: 

1. Sign up for a credit monitoring service. Examples of these include LifeLock, Identity Guard, Identity Force, Experian and Transunion. There are many others as well. For a monthly fee, these companies offer a wide array of services. 
2. Check your credit reports regularly. 
3. Never give your social security number or other personal information to strangers who call, text, or email requests to you. 
4. Maintain anti-virus and anti-malware software.
5. Don’t open email attachments from senders you don’t trust. 
6. Handle financial documents with care. Shred documents with personal financial information on them. 
7. Create strong passwords. Use at least 7 characters of lower and upper case letters, numbers and symbols. The more complex, the better. In addition, do not use the same password for all of your accounts. 
8. Avoid entering passwords when using unsecured wi-fi.
9. Monitor credit card and bank accounts carefully.
10. Be careful of over-sharing online. Information like your exact birthday and your mother’s maiden name can be used to answer your security questions. 

It is recommended that each of you do your own due diligence, allowing you to choose the combination of actions and services that best fits your specific needs. 

In 2014, the most recent year in which government data is available, an estimated 17.6 million Americans aged 16 or older were victims of one or more incidents of identity theft. That’s up from 16.5 million in 2012. Also during 2014, 3% of persons experienced at least one incident of misuse of an existing credit card account. As many of you have already learned, responding to identity theft can be time consuming, stressful and expensive. For the rest of us, we can’t afford inaction. As more and more of our lives are stored online, it’s is imperative we be proactive and not reactive. As the old saying goes, the best offense is a good defense. 

From the AOA: CMS Will Issue Comparative Billing Reports to 6,500 Doctors of Optometry this Week

Doctors of optometry should be aware that the Centers for Medicare & Medicaid Services (CMS) has contracted with eGlobalTech to provide comparative billing reports (CBRs) to doctors of optometry. CBRs will be sent to 6,500 doctors of optometry this week. The CBR will come directly from eGlobalTech. The majority of doctors who have been selected to receive a CBR will receive the report via fax. In some cases the report will be sent via mail if a physician does not have a fax number listed in the CMS National Plan and Provider Enumeration System (NPPES) or if more than 5 doctors in a practice were selected to receive a CBR. If you are one of the 6,500 doctors of optometry that have received a CBR, here are the top 5 things you need to know:

1. CBRs are educational reports that provide comparative data which demonstrates how you compare to your peers. These reports are not intended to be punitive in nature and are not intended to be used to make assumptions regarding how you practice. CBRs have been issued to many specialties and were issued to ophthalmologists in April focusing on many of the same services that are included in the optometry CBR.

2. CBRs are not an indication of fraudulent or inappropriate billing. Even if a report indicates that you are an outlier compared to your peers, this is not an indication of fraudulent or inappropriate billing. There are many reasons a doctor could be considered an outlier compared to peers. If you received a CBR and are surprised regarding how your practice compares to peers, this is a great opportunity to conduct a self-audit. Additionally, if the data reported from CMS differs greatly from your billing records, the report provides an opportunity to correct any billing information transmission problems between your practice and CMS.

3. A number of factors were considered when selecting which doctors of optometry would receive a CBR. First, the universe of doctors of optometry enrolled in the Medicare program was identified. Then the codes that were reported most frequently by doctors of optometry were identified. eGlobalTech then selected measures to evaluate doctors of optometry based on most frequently billed services. Any doctor who was an outlier based on one of the measures selected was placed into a pool of physicians that could potentially receive a CBR. Out of that pool of physicians, any doctor who treated fewer than 115 Medicare beneficiaries and billed less than $15,000 from July 1, 2014, to June 30, 2015 was eliminated from the pool of potential CBR recipients. Out of that remaining group, 6,500 doctors of optometry were selected to receive a CBR.

4.Attend the CBR Webinar. On Wednesday, November 18, 2015 from 3:00 p.m. – 4:30 p.m. Eastern Time a webinar will be held to review the CBRs. There will be a question and answer session following the presentation. Register for the webinar at: 

https://www.anymeeting.com/PIID=EC51DD85854E38 If you are unable to attend the webinar, a recording will be available 5 days following the presentation.

5. AOA is here to help. If you have questions regarding your CBR, please contact Rodney Peele rpeele@aoa.org or Kara Webb kcwebb@aoa.org.

eGlobalTech can also be contacted through their CBR Support Help Desk: 1-800-771-4430 or via email at: cbrsupport@eglobaltech.com.

ICD-10: one month away!

The October 1st implementation date for ICD-10 is fast approaching. It is not too late to prepare. The AOA has available resources to assist our member doctors in preparing their practices for this major change. Don't be left behind; your claims will not be paid if you are not prepared!

Countdown to ICD-10 Implementation Date

Take these 10 steps to take to maximize the ICD-10 resources the AOA has available and prepare for ICD-10:

1. Order the Critical Resources You Need in Your Office - The AOA’s 2015 Coding Bundle, which includes the 2015 AOA ICD-10 Codes for Optometry Manual, the 2015 AMA Professional Edition CPT Manual and the AOA Express Mapping Card which provides ODs with a crosswalk from ICD-9 to ICD-10 for many commonly used diagnosis codes. Purchase the bundle here.

2. Review AOA’s 10 Part ICD-10 Webinar Series and 2 Hour ICD-10 Overview – This webinar series is available for review at any time. The series covers everything from how to prepare for the transition to ICD-10 to how to code for specific ocular conditions.

3. Check Your Progress – Many of the ICD-10 Webinars include brief quizzes so you can test your knowledge. Access the review material here.

4. Utilize AOA’s Coding Experts – AOA’s coding experts are available to answer your coding questions. Use the online form to contact AOA’s coding experts.

5. Review AOA Focus for ICD-10 FAQs - Each month AOA Focus includes a feature article on a timely coding topic written by AOA’s coding experts. Each article is accompanied by frequently asked questions. From May to October the FAQs are focusing specifically on common ICD-10 questions.

6. Utilize the AOA’s Online Coding Resource – AOACodingToday.com is a no cost, members only, online resource that houses ICD-10 and CPT information. The site allows you to browse ICD-10 codes and provides an ICD-10 crosswalk.

7. Watch for ICD-10 Articles in AOA Publications – Leading up to the implementation date, look for additional information and guidance in AOA’s publications such as AOA Focus, the AOA Alerts Page and the AOA News Page. 

8. Register for the Centers for Medicare & Medicaid Services (CMS) August 27 call “Countdown to ICD-10.” This call will be held five weeks prior to the ICD-10 implementation on October 1, 2015. A national implementation update will be provided along with coding guidance and tips, and updates from CMS.

9. Use AOA’s Website as a Gateway - AOA’s ICD-10 Resources Page includes links to ICD-10 tools and information from CMS, Medscape and other groups.

10. Contact AOA Staff – AOA’s Associate Director for Coding and Regulatory Policy is available for guidance on resource use and welcomes any suggestions for additional ICD-10 tools and resources doctors of optometry may need. Please contact Kara Webb at kcwebb@aoa.org.

Purchasing Contacts without a Prescription is More Than Dangerous

Over half of Americans unknowingly buy decorative lenses illegally

A growing American trend in recent years is the use of decorative contact lenses to alter the appearance or color of the eyes. Mostly used as costume accessories around the Halloween holiday, these non-corrective, decorative lenses pose the same health issues as corrective contact lenses. Like all contacts, these should only be acquired through a prescription from a licensed optometrist.

The U.S. Food and Drug Administration (FDA) classifies contact lenses as medical devices requiring a valid prescription. The accessibility of these decorative contacts have eye doctors growing increasingly concerned about the risks for consumers who purchase them illegally on the Internet, at flea markets, off-the-shelf in retail or drug stores and even on the street. The American Optometric Association (AOA) has collaborated with the FDA and the Entertainment Industries Council (EIC) to help educate consumers about only acquiring lenses with a valid prescription from an optometrist.

Decorative contact lenses, without a prescription from an eye doctor, can cause serious eye and vision problems, just like any contact lenses. Many consumers mistakenly believe a prescription is unnecessary for decorative contacts because they do not provide vision correction. It’s important that consumers get an eye exam and only wear contact lenses that are properly fitted and prescribed by an optometrist, regardless if the lenses provide vision correction or not.

According to the AOA’s 2014 American Eye-Q^® consumer survey, 11 percent of consumers have worn decorative, non-corrective contacts, and of that 11 percent, 53 percent purchased them illegally and without a prescription. Wearing illegally purchased lenses can result in unhealthy consequences such as bacterial infections, allergic reactions or even significant damage to the eye’s ability to function, which can lead to irreversible sight loss.

When used properly, contact lenses are among the safest forms of vision correction. A medical eye and vision examination from your optometrist is a great way to determine if you are eligible for contact lenses. During the exam, the eye doctor will make sure the lenses fit properly and teach you how to safely care for them.

The Pennsylvania Optometric Association (POA) identifies six common mistakes made by patients when it comes to handling contact lenses:

• Not washing and drying hands. It is common sense to wash your hands, but the American Eye-Q^® survey found that 35 percent of contact lens wearers skip this important process. Drying your hands before applying contacts is also important because tap water can contain harmful microorganisms that easily transfer from your hands, to the lens and therefore onto your eye.

• Wearing lenses longer than recommended. Many contact lens wearers allow their contacts to overstay their welcome until irritation in the eye occurs. The American Eye-Q^® survey found that 57 percent of contact lens wearers admitted to wearing disposable lenses longer than directed. Optometrists recommend a changing schedule for contact lenses to help prevent eye irritation or permanent eye damage from bacterial infections.

• Not replacing contact lens cases regularly. Lens cases should be replaced at least every three months, with frequent cleaning and disinfecting in between replacements. Despite eye doctors recommending this, only 41 percent of contact lens wearers follow this rule.

• Sleeping in contacts overnight. The American Eye-Q^® survey revealed that 21 percent of lens wearers are guilty of this bad habit. Sleeping in contacts puts consumers at risk for eye infections unless the lenses are specifically designed for day and night use and monitored by your doctor.

• Reusing old contact lens solution. Use only fresh solution to clean and store contact lenses. Products recommended by your optometrist to clean and disinfect lenses are the best bet. Remember that saline solution and rewetting drops do not disinfect lenses.

• Wearing contact lenses while swimming or in a hot tub. More than a quarter of contact lens wearers report swimming in their contact lenses. This act can lead to serious sight-threatening eye infections and irritation. According to the FDA and POA, contact lenses should not be exposed to any kind of water, including tap water or water found in swimming pools, oceans, lakes, hot tubs and showers.

To educate yourself on the risks associated with decorative contact lenses, visit www.contactlensart.org. For additional resources about contact lens hygiene and safety, please visit www.contactlenssafety.org or http://pennsylvania.aoa.org/x5230.xml.

About the American Eye-Q® survey:

The ninth annual American Eye-Q^® survey was created and commissioned in conjunction with Penn, Schoen & Berland Associates (PSB).  From March 20-25, 2014, PSB conducted 1,000 online interviews among Americans 18 years and older who embodied a nationally representative sample of the U.S. general population. (Margin of error is plus or minus 3.10 percentage points at a 95% confidence level)

About the Pennsylvania Optometric Association (POA):

The Pennsylvania Optometric Association is the professional organization for over 1,250 doctors of optometry in Pennsylvania. An affiliate of the American Optometric Association, POA promotes the highest quality eye and vision care by optometrists, represents optometry to state government, provides its members with post-graduate education and membership benefits, and conducts activities in the interest of the visual welfare of the public. For more information, visit www.poaeyes.org.

About the American Optometric Association (AOA):

The American Optometric Association, a federation of state, student and armed forces optometric associations, was founded in 1898. Today, the AOA is proud to represent the profession of optometry, America’s family eye doctors, who take a leading role in an individual’s overall eye and vision care, health and well-being. Doctors of optometry (ODs) are the independent primary health care professionals for the eye and have extensive, ongoing training to examine, diagnose, treat and manage disorders, diseases and injuries that affect the eye and visual system, providing two-thirds of primary eye care in the U.S. For information on a variety of eye health and vision topics, and to find an optometrist near you, visit www.aoa.org.

E-health information exchange assures better patient care

In order for patients to receive better and safer care, all players in the healthcare system, like hospitals, doctors and pharmacies, must be able to quickly find, evaluate and understand a patient’s medical information. The process of securely sharing this information prevents a patient from receiving medications that interfere with those previously prescribed. The gap in communication between a patient’s physician and a doctor in the emergency room can have serious health-altering consequences.

To close this gap, electronic health information exchange, soon enabled by the Pennsylvania Patient and Provider Network (P3N), is here to help. For this to work correctly, local healthcare providers need to connect to a regional health information organization (HIO). The HIO connects to the P3N hub and patient’s information flows to other HIOs and participating healthcare providers. 

P3N, a service from the Pennsylvania eHealth Partnership Authority, is currently under development, but pilot programs will launch later this year in the Lehigh Valley and southwestern Pennsylvania. 

Electronic health information exchange is important for patients and providers alike. The information exchange benefits everyone by cutting down on redundant testing and medications. It will help to reduce unnecessary costs; in Washington state, a similar data-sharing initiative saved $33 million in Medicaid ER costs in the first year of the program alone.

For this program to be successful, maximum participation from doctors, hospitals, pharmacies and others in the healthcare system is a must. The more patient information provided, the better. 

For additional information, please see: www.pennlive.com/opinion/2014/07/in_emergencies_minutes_matter.html.

Accommodating patients with a hearing disability

What your obligations are and are not

Sooner or later, a practice will face a communication challenge when a patient with a hearing impairment schedules an appointment. The protocol on how to deal with this type of disability in an examination has led to some confusion in the past.

First and foremost, an optometric office, regardless of the title ‘private practice,’ is a public accommodation. As a public accommodation, steps to ensure the practice and services are accessible to individuals with disabilities should be taken. Individuals with disabilities, as defined by the September 2008 amended Americans with Disabilities Act (ADA), are those with a physical or mental impairment that substantially limits one of more major life activities of such individual; a record of such an impairment; or being regarded as having such impairment.

Patients with a hearing impairment may request a sign language interpreter, but an optometrist is not required to hire one unless both parties have agreed on it. Other means of communication are an option, like having a family member of the patient or a certified employee interpret, writing a conversation with the patient on a note pad, or using various tools like a computer or phone to communicate. Auxiliary aids or services should be agreed upon prior to the scheduled appointment.

An optometrist is permitted to deny the use of an interpreter if there is proof that the cost or service of the interpreter would be an undue burden. An undue burden is a significant difficulty or expense for the practice. Factors in deciding the inclusion of an interpreter are: cost against financial status of the practice, the need for enhanced communication and the availability of the service desired. If an interpreter is needed, the optometric office is responsible for covering the cost. The patient holds no obligation to incur the fee. Passing this cost along to the patient would be a violation of the ADA, as would refusing to see the patient based on the needs of their disability or referring the person to another physician solely because the patient wants an interpreter.

The person with disability is entitled to only reasonable accommodation and cannot demand an interpreter if other alternative services are available. If no satisfactory services can be found, the practitioner is required to provide an interpreter. The downside to this justification is that ‘satisfactory’ differs for each person, but this means an interpreter is not always necessary. If a reasonable alternative is found, and would otherwise be acceptable, the patient cannot refuse the accommodation.

If hiring an interpreter, the best way to find one would be through a licensed audiologist. Using one of these professionals can ensure premium service and occasionally a discount.

Under the ADA, an optometrist is responsible to accommodate every disabled patient wanting to use the practice’s services, but are not obligated to accommodate with only an interpreter. Exploring all options is beneficial to the practice and the patient, who may assume the only option is an interpreter. Discussing all available auxiliary aids and services with patients helps to reduce financial cost in the long run. A person may not be denied an appointment or referred away from the practice based on their disability or desire to have accommodations made.