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.

Declining Eye Health: An Increasing Concern for Adults

78 percent of aging Americans affected by vision loss; Pennsylvania Optometric Association gives advice to protect eyesight

It’s an unfortunate fact of life that vision can change over time, resulting in noticeable differences in how well adults see the world around them. In fact, 78 percent of adults age 55 or older report experiencing some vision loss according to the American Optometric Association’s (AOA) 2014 American Eye-Q^® consumer survey.

“The number of blind and visually impaired people is expected to double over the next 16 years,” said the AOA’s Vision Rehabilitation Section chair, Dr. Brenda Heinke Motecalvo. “This staggering statistic has implications for millions of aging Americans, but these changes don’t have to compromise a person’s lifestyle. Maintaining good health and seeing an eye doctor on a regular basis are important steps to help preserve vision.”

More common age-related vision problems include difficulty seeing things up close, far away or in low light, and sensitivity to light and glare. Some symptoms may seem like minor vision problems, but may actually be warning signs of serious eye diseases that could lead to permanent vision loss. Those diseases include:

• Age-related macular degeneration (AMD): An eye disease affecting the macula, the center of the light sensitive retina at the back of the eye. AMD can cause loss of central vision.
• Cataracts: A clouding of the lens of the eye that usually develops slowly over time and can interfere with vision. Cataracts can cause a decrease in visual contrast between objects and their background, a dulling of colors and an increased sensitivity to glare.
• Diabetic retinopathy: A condition occurring in people with diabetes, which causes progressive damage to the tiny blood vessels that nourish the retina. The longer a person has diabetes, the more likely they are to develop the condition, which can lead to blindness.
• Glaucoma: An eye disease leading to progressive damage to the optic nerve due to rising internal fluid pressure in the eye. Glaucoma is one of the leading causes of blindness.

Another common and often chronic condition that Americans can experience later in life is dry eye. This occurs when there are insufficient tears nourishing the eye. Tears maintain the health of the front surface of the eye and assist in clear, quality vision. Studies show that women are more likely to develop dry eye, especially during menopause.

By 2030, aging Americans will represent 19 percent of the population, which is an increase from 12 percent in 2000. Coping with age-related eye diseases and disorders and the resulting changes in health and lifestyles is a priority for this growing group of consumers. The AOA’s American Eye-Q^® survey revealed that 40 percent of consumers age 55 or older are concerned about losing their independence as a result of developing a serious vision problem. Many eye diseases lack early symptoms and may develop painlessly; therefore, adults may not notice vision changes until the condition is advanced. Creating a healthy lifestyle helps to ward off eye diseases and maintain existing eyesight.

“Eating a low-fat diet rich in green, leafy vegetables and fish, not smoking, monitoring blood pressure levels, exercising regularly and wearing proper sunglasses to protect eyes from UV rays can all play a role in preserving eyesight and eye health,” explained Dr. Montecalvo. “Early diagnosis and treatment of serious eye diseases and disorders is critical and can often prevent a total loss of vision, improve adults’ independence and quality of life.”

For those suffering from age-related eye conditions, the Pennsylvania Optometric Association (POA) recommends the following tips:

• Control glare: Purchase translucent lamp shades, install light-filtering window blinds or shades, use matte or flat finishes for walls and countertops and relocate the television to where it does not reflect glare.
• Use contrasting colors: Decorate with throw rugs, light switches and telephones that are different colors so they can be spotted quickly and easily.
• Give the eyes a boost: Install clocks, thermometers and timers with large block letters. Magnifying glasses can also be used for reading when larger print is not available.
• Change the settings on mobile devices: Increase the text size on the screen of smartphones and tablets and adjust the screen’s brightness or background color.
• Stay safe while driving: Wear quality sunglasses for daytime driving and use anti-reflective lenses to reduce headlight glare. Limit driving at dusk, dawn or at night if seeing under low light is difficult.

Yearly eye exams provide the best protection for preventing the onset of eye diseases and permits adults to continue living active and productive lifestyles as they age. To find a doctor of optometry, or for more information on age-related eye conditions, please visit www.poaeyes.org.

About the 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.

Parents and children aren't seeing eye-to-eye

Identifying vision problems caused by digital devices

Rising technology use in both homes and classrooms is leaving parents underestimating the time their children actually spend on digital devices. The American Optometric Association (AOA) conducted a survey that discovered 83 percent of children between the ages of 10 and 17 use an electronic device for at least three hours a day. Only 40 percent of parents polled on a separate survey were aware that their children were using digital devices for that same amount of time. These statistics may indicate that parents are likely to overlook warning signs associated with vision problems caused by technology use.

Prolonged technology use can cause burning, itchy or tired eyes, headaches, fatigue, loss of focus and blurred vision. This temporary condition is called digital eye strain. To protect vision from digital eye strain, children should practice the 20-20-20 rule: every 20 minutes, take a 20 second break by staring at something 20 feet away. The following tips can also reduce this particular type of eye strain:

• Make sure computer screens are four to five inches below eye level and 20 to 28 inches away from the eyes. Hold digital devices, like phones and tablets, slightly below eye level.

• Turn your desk or computer away from windows or other light sources to prevent glare on the screen.

• Match the room lighting and the computer screen by using a lower-watt bulb in the overhead light.

• Make text bigger and easier to read.

• To minimize the chances of developing dry eye, blink frequently and fully.

Also concerning is the effect that high-energy, short-wavelength blue light emitted from electronic devices can have on the eyes. Early research on the topic shows that overexposure to blue light may be a contributing factor to eye strain and discomfort, and may lead to serious conditions such as age-related macular degeneration.

The Pennsylvania Optometric Association (POA) recommends that children have regular eye exams by an optometrist to keep their eyesight healthy and strong. POA also encourages parents to start their child's eye exams early. Every child should have an examination after 6 months of age and again before age 3. Now, under the Affordable Care Act, children through age 18 are covered for yearly comprehensive eye exams.

To learn more about eye and vision health, or to find a nearby doctor of optometry, please visit www.poaeyes.org.

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 represents approximately 36,000 doctors of optometry, optometry students and paraoptometric assistants and technicians. Optometrists serve patients in nearly 6,500 communities across the country, and in 3,500 of those communities are the only eye doctors. Doctors of optometry provide two-thirds of all primary eye care in the United States.

American Optometric Association doctors of optometry are highly qualified, trained doctors on the frontline of eye and vision care who examine, diagnose, treat and manage diseases and disorders of the eye. In addition to providing eye and vision care, optometrists play a major role in a patient's overall health and well-being by detecting systemic diseases such as diabetes and hypertension.

Prior to optometry school, optometrists typically complete four years of undergraduate study, culminating in a bachelor's degree. Required undergraduate coursework for pre-optometry students is extensive and covers a wide variety of advanced health, science and mathematics. Optometry school consists of four years of post-graduate, doctoral study concentrating on both the eye and systemic health. In addition to their formal training, doctors of optometry must undergo annual continuing education to stay current on the latest standards of care. For more information, visit www.aoa.org.