optoblog.com

Kentucky now joins Oklahoma as the only states that explicitly allow optometrists to perform laser surgery on/around the eyes and even lumps and bumps removal.  (Read the article here.  H/T to kevinmd.  Also see a news article here.)

When people ask me what’s the difference between an ophthalmologist and an optometrist, I always like to say, “Optometrists do everything an ophthalmologist does except surgeries.”  (By the way, I don’t consider foreign body removal a surgery. Chalazion removal- yes, definitely a surgery.)  Even one of the ophthalmologists in the feature story seems to agree with that statement:

“We draw the philosophical line in the sand with surgery,” says Dr. David Parke, chief executive officer of the American Academy of Ophthalmology.

Of course, proponents of the bill think that allowing ODs to perform laser surgeries is good for people because, as Governor Beshear explains:

“I signed Senate Bill 110 to give Kentuckians greater access to necessary eye care.”

Now, I would probably refute that it gives people, particularly rural people, greater access to eye care. For a doctor to buy all the necessary equipment to perform a YAG capsulotomy, he would need to invest in a pretty expensive piece of equipment. To keep up payments, he would have to do a lot of procedures. How many YAGs does a rural optometrist usually see a month? Probably not a lot. How far away is the surgeon who did the patient’s cataract surgery in the first place? Probably not that far.

Optometrists are already trained in school to do periocular injections, but can an optometrist be trained to do YAGs? Absolutely. It’s an easily learned skill that is widely studied for potential complications and side effects. This stuff is not magic- it just needs training. But it’s also a skill that, if not done regularly, can get lost. If I had a patient tomorrow that needed a subtenon’s injection, I would have to refer them out because I haven’t had to do one since leaving optometry school. No way would I feel comfortable. I also think that it’s in the patient’s best interest to have a procedure done by someone who does that particular procedure regularly.

Anyway, I kind of like my definition of optometrist. What do you all think?

Tags: doctors, Government, law, OMD, ophthalmologist, optometrist, Organized Optometry, patients, politics

Comments Off on What Should be the Line between Optometry and Ophthalmology?

Well, I know people have been secretly clamoring for more optoblog.com comics, so…you’re welcome!

Those of you who have been watching news only from the networks probably have no idea why current events are so scary. Those of us not simply listening to press releases straight from the White House and its Czars have learned scary things about hyperinflation, monetizing the debt, Cloward and Piven, communist infiltration in the government of a free republic, radical Muslim’s Caliphate, ATF’s Project Gunwalker, George Soros, the Nanny State, Cass Sunstein, back door gun control, Tax and Spend, the lie of Climate Change, Going Green = going broke, and ad infinitum stuff all designed to take away the God-given rights and liberties of Americans.

America, I am sure that the only way we are going to recover from this great big hole we’ve sleep-walked ourselves into is by returning to God. All of us need to repent and increase our Faith, Hope, and Charity. Only then will we be prepared to receive and accept his will regarding what our actions should be. Only then will He prosper our nation again.

Our government was founded upon faith-based principles. Invite everyone you know to increase their Faith in God, Hope, and Charity so that we can restore our government to the founder’s vision and so that God will bless the United States of America.

Tags: economy, Faith Hope and Charity, Glenn Beck, Repent, world events

Comments Off on It’s a Scary World

• RT @mcnaughtonart: BYU censors McNaughton painting "One Nation Under God" for being too conservative! http://tinyurl.com/44wrhmw #
• Higher education is in trouble when even BYU censors probably one of @mcnaughtonart 's least controversial paintings: http://bit.ly/grFzJ4 #

Tags: tweets

Comments Off on Twitter Weekly Updates for 2011-05-01

• Nice summary on why eye exams are important: http://bit.ly/i1wQce #
• Interesting look at decline of solo practice medicine: http://www.nytimes.com/2011/04/23/health/23doctor.html?_r=1&pagewanted=all #

Tags: tweets

Comments Off on Twitter Weekly Updates for 2011-04-24

Over at Student Doctor Networks – Optometry Forums some undergrad started a thread about me.

Am I real? Yes. Maybe you could have read more than just one of the 340+ posts on my blog? Maybe you could have looked at the side bar and seen the link to my twitter feed and my practice website?

Do I hate optometry? Nope. I like it fine. Sure, I’d rather be a rock star, but that will have to wait for now.

Did I make a whole bunch of inflammatory blog posts? Yes. But I can’t please everybody. I like Walmart optometry more than private practice for numerous reasons, but not the least of which is I feel like less of a salesman and more like the doctor I was trained to be. I think you can get that in other settings too, but I don’t want to work for the government anymore. I’m not academic enough to be a professor, and I don’t want to be an OMD’s “super-tech.”

In private practice, everyone else got paid…except me. The frame reps, the contact lens distributors, and labs, the staff, the landlord, , the bank, the equipment vendors…they all get their money up front or first thing. You, the doctor, get paid last…if at all. Risky.

if you like taking risks, then why not take a better bet in a different profession selling or manufacturing widgets with less restriction on maximum possible income?

Undergrad, if you really want to be a private practice optometrist, go ahead. I won’t stop you. I would ask you why you would gamble so much when you could practice in a setting with MUCH less risk. It does work out well for lots of O.D.’s, but that doesn’t mean it will work well for you.

By the way, I don’t think pointing these things out should be labeled “negative.” It’s reality. There are pluses and minuses to every profession. Undergrad, I don’t want to sugarcoat your potential career choice. I once thought I was going to be an architect because I wanted to design houses. I actually talked with an architect and found out very few architects design houses because most people buy their plan from a catalog. Most architects design banks and rest-stop bathrooms and other utilitarian buildings. That’s not what I would be happy with, so I switched majors. I’m thankful that architect shot straight. If you don’t believe me, then I hope you talk with an optometrist that you can trust who will also shoot straight.

Now, knowing more of the risks and potential negatives, if you still want to be an optometrist, then at least you’re not going into this blind. You won’t be able to say, “Why didn’t anyone tell me it would be this way?”

Anyway, I’ve spoken enough about this subject. I need to get back to writing/selling the next great screenplay so I can have a retirement.

Tags: optometrist, private practice, Wal-Mart

Comments Off on Undergrad, I Don’t Want to Sugarcoat Optometry

• @GlennBeck leaving FoxTV is good; he didn't OWN content of his very insightful b-casts. Now he can pour effort/research into what he OWNS! #

Tags: tweets

Comments Off on Twitter Weekly Updates for 2011-04-10

• Listening to #ldsconf on ksl.com or lds.org
  davidlangford #

Tags: tweets

Comments Off on Twitter Weekly Updates for 2011-04-03

Flurisafe comes in a 6 mL dropper manufactorered by AL-ROSE Enterprises and is composed of Fluorexon disodium with benoxinate. Fluorexon’s heavier molecular weight makes it “safe” for use with soft contact lenses since it won’t permanently dye it yellow like fluorescein will.

If you don’t use Flurisafe, then you should try it out. I’m confident that you and your patients will like it better than fluorescein sodium/numbing drop combinations (benoxinate or proparicaine).

Here are my reasons:

1. My patients report less stinging with Flurisafe compaired to FluorBenox and especially proparicaine.
2. The mild stinging from Flurisafe seems to have a few seconds delay after installation, so that allows me to get the drop in both eyes easier for the little kids.
3. Most older patients report NO stinging with Flurisafe.
4. I can use it on any patient and not worry about rinsing it out with eyewash if they happen to want to try soft contact lenses later.

On the downside, it is a little more expensive than FluorBenox, but not significantly more. Also, I turn up my light level a little more using the blue light compared to using a Fluorette or BioGlo Strip; however, Flurisafe still lights up nicely while using a yellow Wratten filter (my slit lamp has one integrated; I just lower a pin.)

I get mine from Wilson/Hilco, but your usual ophthalmic supply company should have it also.

Try it! You’ll like it.

Disclosure: I have to financial interest in any companies or products mentioned above, and to date none of them have ever given me any free stuff.

Tags: eye drops, optometrist, pharma

Comments Off on Flurisafe Review

• This is worth a read for all doctors: A primer on brand name drugs and generics http://t.co/iEJctDc via @kevinmd #

Tags: tweets

Comments Off on Twitter Weekly Updates for 2011-03-13

I just got word that Ciba will discontinue O2Optix soft contact lenses. The time line appears to be:

• 7-1-2011 Doctors will no longer get trials for O2Optix
• 1-1-2011 Product availability not guaranteed
• 7-1-2012 O2Optix lens discontinued.

Ciba has been pushing strongly the one month replacement modality which flies in the face of the two week replacement schedule philosophy of their competitor, Vistakon. Ciba’s recommended alternative for those who have been in O2Optix lenses is to have their doctor refit them in Air Optix Aqua.

Tags: contacts, optometrist, patients, Wal-Mart

Comments Off on CibaVision is Discontinuing O2Optix