optoblog.com

I posted on my practice website the information that I wrote for a patient handout on allergy eyes. There’s some new stuff in there reflecting the current research on intestinal flora and allergy symptoms.
See also:

• http://www.nature.com/nm/journal/v20/n2/full/nm.3444.html
• http://www.marksdailyapple.com/seasonal-allergies-treatment/
• http://www.marksdailyapple.com/leaky-gut/
• http://www.ncbi.nlm.nih.gov/pubmed/24690419
• http://www.ncbi.nlm.nih.gov/pubmed/3745938 (Asmtha, Eczema, Allergies are all closely related)

It appears that most of America’s health problems could be solved by ceasing the Standard American Diet and implementing the Paleo/Atkins/LowCarb diet. I’m betting research will someday show it helps with glaucoma, AMD, dry eyes, MGD, and many other eye conditions related to inflammation and blood vessel pathology.

Tags: allergies, eye drops, eye health, paleo diet, patients

Is there anything I can do to not get that gunk buildup by the nose pads?
An ultrasonic cleaner will take out the gunk. To help it not build up, try cleaning your glasses daily under the sink with dish soap that doesn’t contain lemon.

Yesterday I didn’t have to bill a single insurance. I love no insurance days.

New phones chirp like the phones in IHS used to. They also chirp louder and more frequently if no one picks them up quickly.

Lately people are confusing the non-contact tonometer with dilation. “Okay, I’m going to put some drops in your eyes to dilate them.”
“Didn’t we already do that with the puff of air?”
“No, that was just an eye pressure measurement.” (I already explained that when doing it, BTW.)

AlwaysCare website is down, probably due to hurricane Isaac since the call center is apparently in Baton Rouge. Earlier in the day, the website just timed out. Later it has this message: “AlwaysAssist website is currently having technical difficulties.. Please check back later to access any information. Thank you for your patience. For immediate assistance, please call [toll-free and local numbers] in Baton Rouge. ”

Of course all circuits are busy when you try to call that number. I think it’s ridiculous that they don’t have redundant servers across the country available. I guess these hurricanes inconvenience everybody…

Tags: @optotrician, air puff, eye drops, insurance, patients, phones

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

For you optometry students trying to make up numbers for your business plan, here are some percentages from my average Walmart practice:

In 2007 and 2008 I didn’t track the percentage of patients using insurance because I didn’t have to bill very much back then.

For more interesting stats to help you make your business plan, the OBA-CE has compiled these:

• Revenue Per Exam
• Complete Exams per OD Hour
• Annual Revenue Growth Rate
• Internet Site Penetration
• Contact Lens Usage by Lens Type
• Recall System Independent of Vision Center
• Walk-in Ratio
• Contact Lens Exams Percent of Total Exams
• Medical Eye Care Visits as Percent of Total Visits
• Exams Percent of Active Patients
• Professional Fee Income Percent of Total Location Revenue
• Performance Metrics by Years at Location
• "Elite” Practice Metrics
• Performance Metrics for Walmart and Sam’s Club Locations

Tags: Answers, contacts, eye drops, Income, insurance, management, optometry school, Wal-Mart

Systane Ultra is safe for use while wearing with contact lenses according to a new study.

Clinical Evaluation of Systane Ultra Safety in Contact Lens Wearers

This investigator- and patient-masked, single-site, randomized, and prospective study involved 45 successful contact lens wearers to evaluate the safety of Systane Ultra Lubricant Eye Drops in contact lens wearers. A currently marketed contact lens rewetting drop was the control solution. Eligible subjects’ baseline biomicroscopy findings, visual acuity, and corneal staining score were recorded. Subjects received either the test or control solution with masked labeling. Subjects were instructed to instill their assigned solution in both eyes: 15 minutes prior to lens insertion, at least one drop during lens wear and another drop immediately following lens removal. After 14 days, biomicroscopy results, visual acuity, and corneal staining score were recorded.

No adverse events were documented for either the test or the control solution. For subjects using Systane Ultra, no statistically significant change was detected in visual acuity or corneal staining score. For subjects using the control solution, the change in visual acuity was not clinically relevant and there was no significant change in corneal staining score.

This clinical study provided evidence of safety and compatibility of Systane Ultra Lubricant Eye Drops in contact lens wearers.

SOURCE: Kading D. A two-week clinical evaluation of the safety of Systane Ultra in contact lens-wearing patients. Clin Ophthalmol 2010;4:27-32.

I have actually wanted to find out whether it binds to and gums up the contact lens. Or is this condition considered part of the “no adverse events.” Also, does it matter whether the contact is a two week lens verses a one month lens?

Tags: contacts, eye drops

I got my copy of the February 2010 National Geographic today (I have a fair and balanced waiting room: Guns and Ammo and National Geographic). There’s a big feature article about life in the FLDS church. On page 61 with the photo of the Jessop family offering a morning prayer, there is a small bottle on the sink counter-top in the background, and I’m pretty sure it’s a bottle of Systane Ultra.

I’d post the picture, but I’m not sure if I’d get sued by NG, so just go find a copy and tell me if you think it’s some other eye drop brand.

Tags: eye drops, medicines, off topic