Don't Lose Sight of Your Vision

The AOA recently teamed up with the FDA, Entertainment Industries Council and the industry-leading artists from the popular FX show, American Horror Story, to provide an interesting and informative look at decorative lenses and their proper use.

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.

POA Forum: Food, Facts and Fun!

Each year, POA sponsors an event at Pennsylvania College of Optometry (PCO) that allows the Board of Directors and PCO students to discuss the benefit of joining the association. This year's event, titled "Food, Facts and Fun," took place Friday, September 12th in the Hafter Student Community Center.

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.

InfantSEE Success Story - Dr. Daniel Schott

The following InfantSEE success story came from Dr. Daniel Schott.

Schott Associates Eye Care in Potter and McKean counties have found a way to better its InfantSEE screenings by coordinating the appointment with the patient’s pediatrician. The Coudersport location owes its success, in part, to the office’s ideal location in Cole Memorial Hospital, but the other locations have also found this coordination tactic successful despite the pediatrician’s office being in another building.

At the child’s nine-month check-up, the infant comes to the office for a screening first. After the screening, the InfantSEE report is sent with the parent to be delivered to the pediatrician at the child’s visit. This way, the pediatrician is reviewing the report with the parent at the appointment and can stress the importance of early intervention in visual development.

Schott Associates Eye Care has found the nine-month visit to be the best time for this screening because infant cooperation is typically better at this age. Cooperation leads to more accurate data. Also there are usually no immunizations at a nine-month well-child visit, so if the patient must come in after visiting the pediatrician’s office, they are usually not cranky from receiving shots.

This has been a very successful way to market not only the practice, but also the importance of early childhood eye exams. In addition, the interaction with pediatricians in this manner has lead to other cases being referred to the practice. This is a win-win for all parties involved. 

Well done, Dr. Schott! Send your own InfantSEE success stories to Kelsey@poaeyes.org to be included in a future issue of the Keystoner and featured here on our blog.

AOA’s House of Delegates meeting

Richard Christoph, O.D.
POA President-Elect

During Optometry’s Meeting this year, my duty as POA’s president-elect was to attend AOA’s annual business meeting, the House of Delegates, as a POA representative along with POA president Dr. Marianne Boltz. Just as it is for POA, the House of Delegates sets policy for AOA. It is made up of representatives from each affiliated organization of AOA, which includes the 50 state associations, plus Washington D.C., the American Optometric Student Association and the Armed Forces Optometric Society.

As is protocol, the House of Delegates opened with a flag ceremony, the Pledge of Allegiance, an invocation and the Optometric Oath. During the meeting, there were reports and introductions from the member volunteers in the Sergeant At Arms, Credentials, Resolutions and Nominating Committees. There were also votes to approve the handbook and procedures, adopt the agenda and approve the actions of the Board since the last House meeting.

This year, three resolutions were brought forward for vote. One was related to optometric care of brain injury, including concussions. It recommends an optometric evaluation following brain injury to diagnose and treat ocular disorders or vision changes. The Vision Rehabilitation Section of AOA was involved in crafting this resolution. They have assembled an excellent resource, the Brain Injury Electronic Resource Manual, available online at aoa.uberflip.com/i/225867. The other two resolutions were modifications of existing resolutions regarding paraoptometrics. Because the paraoptometric section was dissolved and reformed as the paraoptometric resource center last year, some changes in wording were necessary to reflect the current status of paraoptometrics within AOA.

AOA’s secretary-treasurer, Dr. Andrea Thau, informed the House that AOA’s financial standing was strong. The new dues accounting procedures and restructuring of membership classes has resulted in more consistent cash flow for the organization, without a significant loss of membership. In fact, both total membership and dues revenues have increased.
The AOA-PAC chair, Dr. Ron Benner, reported on the status of AOA-PAC. Donations were down in every measurable way: total dollars, number of donors, average donation and percentage of donors all decreased for 2013 compared to the last few years. AOA has been relying heavily on a small number of larger donors who are approaching the end of their careers. If you are not already an AOA-PAC donor, please make it a priority to donate this year. In addition, please also donate to POPAC. Optometry has to be active at both the state and national levels to ensure our inclusion in healthcare reform. 

Next, there was a presentation regarding the Think About Your Eyes Campaign. AOA members who participate in this campaign may receive discounts. The purpose of its media campaign is to increase the number of eye exams performed. For more information, please see www.thinkaboutyoureyes.com. 

Dr. Teri Geist reported on AOA’s public relations efforts as of mid-June, stating that AOA had over 1 billion positive media impressions so far in 2014. 

The advocacy team also reported on their activities for the past year. Between state government relations, third party, federal relations and the clinical resource group, the activities are far too numerous to list here. Some of the newer legislative initiatives are as follows: to advance scope at the state level; to address issues with insurance and vision plans, such as discount on non-covered services, credentialing and restrictive material ordering; telemedicine issues like online exam and kiosks; and Medicaid issues, specifically inclusion and reimbursement. 

The Clinical Resources Group is involved with the creation of an optometric registry, an important tool for optometrists to fully participate with PQRS, meaningful use and other incentive programs. The statistics gathered through this registry will provide individual doctors with valuable information about their own practice, and benchmark data to compare themselves with others. It will also provide state associations and AOA with aggregate data that can be used in negotiations with government entities and insurance plans. Most importantly, it will enable optometrists to improve the quality of care provided to patients. AOA expects this to roll out in early 2015. Doctors will need to be using electronic records to participate.

And lastly, elections were held for 2015 and the following slate of officers was elected: Dr. Steven Loomis (president-elect), Dr. Andrea Thau (vice president), Dr. Christopher Quinn (secretary-treasurer), Drs. Barbara Horn and Samuel Pierce (trustees; three-year term), and Dr. James DeVleming (trustee; one-year term). Dr. David Cockrell assumes the office of president and Dr. Mitch Munson assumes the office of past-president. Drs. Greg Caldwell, Robert Layman, and William Reynolds continue their three-year terms as trustees.

Latest VOSH PA Mission

Paul Halpern, O.D.

A new Volunteer Optometric Services to Humanity of Pennsylvania (VOSH PA) mission site was opened in Pont Sondé, Haiti about sixty miles northwest of Port-au-Prince and just inland from the sea. The mission was sponsored by Sové Lavi, which is liberally interpreted to mean "save lives." Founded by one-time Haitian presidential candidate and American food industry capitalist Dumas Simeus, Sové Lavi is a community-based group that concentrates on uplifting health care in Haiti.

This mission was unique; we stayed in a small hotel located adjacent to the Sové Lavi sponsored community health clinic. This very clean, but small two-story building was a hodge-podge of little examination rooms connected by narrow hallways and located on the main street of the town. Because the building lacked a large standing area, the patients were forced to line up along the heavily traveled street prior to registration causing some episodic breakdown of behavior. As is usually the case, once registered and in line for care, the most outspoken of the patients became sweet and tame.

Our volunteers saw about 1,125 patients and referred 35 for cataract surgery to the ophthalmology residency program at the University of Haiti Medical School in Port-au-Prince. Unfortunately they are not equipped to provide tertiary care for glaucoma patients so we could only provide them with a year's supply of glaucoma medication and our good wishes. We successfully treated several trachoma cases, most notably a seven-year-old who returned for a follow-up the next day and was essentially clear. As is VOSH policy, we instructed the family on the necessity of good personal hygiene as the best way to combat this condition.

We did one remote village clinic on our last day in Noé, a very poor community with few resources. The living conditions were the worst that I personally encountered in all my ten trips to Haiti. Our team made the best of it and did great work despite the circumstances.

On this mission, we were fortunate to have a Surgical Eye Expedition (SEE) physician from Harvard University, Paul Cotran. Dr. Cotran is a fellowship trained glaucoma specialist and educator. He stayed with the group for two clinic days and then moved on to the hospital at the university to tend to the cataract patients we had referred. It is important to note that I saw some of the worst glaucoma sufferers that I have ever come across. At least six patients were totally cupped out and stone cold blind. As Dr. Cotran and I began to see these people and others with emerging glaucoma, we became increasingly frustrated with our inability to provide proper care for them.

We came to the conclusion that Haitian eye surgeons and ophthalmology residents needed to be trained to do more complex and lasting procedures to treat glaucoma. We need to make this care geographically available to the people, perhaps at yet-to-be created Centers of Excellence located in north, central, and southern Haiti. Spaced about 100 miles apart these centers could bring glaucoma care closer to the people. The discussion broadened by taking it online and to various national and international glaucoma experts for extra input and suggestions. A plan began to evolve that centered on ways to best treat for long-term wellness and to also train local ophthalmologists to provide the care needed. It is most important that we stay at the forefront of this exciting new effort.

Finally, we are indebted to the wonderful group of volunteers that made this trip. They were spectacular under difficult conditions. They never faltered; they only asked what else they could do. I don't understand how we are so fortunate to be blessed by this quality volunteerism but we, as an organization, must recognize, treasure, and when possible, reward them.

For more information about VOSH PA, visit www.vosh-pa.com.