After shelling out what seems like a month’s pay for gifts, holiday parties and champagne, no one makes a New Year’s resolution to “spend more money.” But with so many new things coming in 2018, your resolution should be “invest in my practice.” Here’s a look at some promising new products.
Ocular surface issues. One of today’s great opportunities is optometry’s move toward the ‘dental model’ approach of routine preventative care. In-office procedures such as thermal meibomian gland treatments, intense-pulsed light therapy and microblepharoexfoliation will advance patient-pay dry eye care.
Outside the office, tear neurostimulation will advance, and artificial tears containing new agents such as trehalose are on the way. Hyaluronic acid–based products will gain further indications in surface healing. Punctal plugs with six months’ duration may become a mainstay in the field.
How to Fit it All In?
With so many new options out there, it’s hard to know where to start.
First, find what interests you—whether or not it’s in your comfort zone. Some of the greatest opportunities for growth occur when we’re willing to embrace new things.
Second, you may need to set aside more time this year to focus your practice on these new opportunities. One way to carve out time is to outsource management aspects such as human resources, payroll and frame board management. Optometric Medical Solutions allows a doctor to outsource medical logistics like credentialing, accounts receivable, insurance verification and staff training.
Finally, stay online to protect your patients and your business. Companies like Click Optical work directly with the practice at no cost, allowing ODs to compete in online contact lens sales. Consider telemedicine where appropriate, such as EyeCare Live, which is optometry dedicated.
In 2018 meibography may become “OCT for dry eye,” and noninvasive testing (especially tear break-up time) will play a major role in care, given its accuracy, sensitivity and specificity. Point-of-care testing with the ability to know within minutes if the patient has dry eye, plus the level of inflammation and antibody biomarkers present, will change how we practice.
A just-approved product likely to take off this year is Lumify (Bausch + Lomb). This six- to eight-hour eye drop is designed to whiten eyes 300% more than traditional vasoconstrictors without the risks of rebound hyperemia or tachyphylaxis—a new option for patients who always want to be ‘selfie-ready.’
Glaucoma. Not one but two new drops are on their way. The recently FDA-approved Vyzulta (Bausch + Lomb) is a prostaglandin analog that increases uveoscleral outflow plus a nitric oxide donor that works directly on the trabecular meshwork (TM) to increase outflow. Also newly approved is the first rho-kinase inhibitor for glaucoma, Rhopressa (netarsudil, Aerie), which has a multi-pronged mechanism of action that combines uveoscleral outflow, effects on the TM and lowering of the episcleral venous pressure.
Genetics. Spark Therapeutics just debuted one of the first ocular disease gene therapies, Luxturna, which uses an adeno-associated viral vector to transmit the proper genetic code necessary to treat rare retinal dystrophies. Avellino Labs is working on a genetic test for keratoconus that could allow for earlier treatment and stave off progression.
Retina. This year, we may see progress in treatments for other conditions once considered untreatable, such as AMD with geographic atrophy or ischemic optic neuropathy (Quark Pharmaceuticals). Further advances in OCT, ultra-widefield imaging and ultrasound technologies will keep ODs a part of the management team for retinal diseases significantly longer in the disease course before there’s a need to refer out.
Vision care. Last month’s approval of RxSight’s light-adjustable IOL places optometry as the key doctor in determining what, if any, prescription change is required post-procedure. Presbyopia will have a new foe in 2018 if the Visability scleral insert (Refocus) gains approval. Eye alignment/prism correction will see a major boost with the NeuroLens and SightSync (eyeBrain) technologies.
There’s no shortage of new technologies, treatments and business management resources to help make 2018 your best year yet. Any number of them can better position your practice and address patients’ vision care needs and ocular health.
Note: Dr. Karpecki is a consultant for many companies mentioned here.