Today's Spotlight

Not Just Another Headache

Headache is one of the most common patient symptoms and a frequent condition encountered by optometrists and other health care providers. Millions of Americans are living with the complex, recurrent headache disorder known as migraine. The name migraine is derived from the Greek word hemikrania, meaning half of the head, representing one of the most striking features of the condition: In many cases the pain is unilateral. Migraine often comes with visual signs and symptoms, and patients will present to your office looking for relief. Knowing what to look for is the first step in properly diagnosing migraine and starting patients on the path to better control.
Today's Spotlight

Decoding MIGS Coding

Minimally invasive glaucoma surgeries are becoming more common in the surgical management of glaucoma. A number of procedures are in development, and several currently FDA-approved. Each procedure is unique based on the mechanism of action and method of insertion: ab interno and ab externo. Just as unique is the coding that accompanies the comanagement of patients undergoing one of these procedures. A clinician’s first task is to remember the difference between an HCPCS level I code and a HCPCS level III code.
Today's Spotlight

Mastering MIGS: Today and Tomorrow

In recent years, minimally invasive glaucoma surgeries (MIGS) have exploded onto the scene to help fill a gap in the glaucoma treatment algorithm. Traditionally, first-line therapy for primary open-angle glaucoma (POAG) relied on topical glaucoma medications or selective laser trabeculoplasty to lower intraocular pressure (IOP). If those treatment options didn’t work, the patient would be referred to a glaucoma surgeon to consider more aggressive filtration surgical procedures such as trabeculectomy or tube shunts. However, the majority of glaucoma patients in the average practice have neither completely mild nor advanced disease; rather, they lie somewhere in the middle. These patients are often taking multiple medications, are not ideally controlled and could benefit from a treatment modality more aggressive than topical medication, but less so than filtration surgery. This is where MIGS fit in.
Today's Spotlight

Lymphocytes on the Loose

We all know the classic presentation of uveitis: cells and flare, pain, photophobia and reduced vision. But because a multitude of events can trigger such a response, we sometimes lose sight of how these processes occur and what they signify about our patient. The patient’s systemic and ocular health rely on you, the optometrist, to carefully and strategically undertake a systemic review and work-up of anterior uveitis (AU) patients, to investigate and potentially uncover, an infectious, autoimmune or inflammatory underlying etiology.

We now know that a properly executed work-up, combined with more recent and advanced diagnostic techniques, yields an underlying systemic diagnosis in 70% of cases. The need is clear for a careful ocular evaluation and review of histopathological and immunological mechanisms to further narrow down the systemic work-up.
Today's Spotlight

Looking to the Future of Glaucoma Treatment

As far as we know, intraocular pressure (IOP) is the only modifiable risk factor with respect to altering glaucoma’s characteristic death of retinal ganglion cells. IOP quantifies the balance between aqueous humor secretion by the ciliary body epithelia and its drainage through the conventional, pressure-sensitive pathway and unconventional, pressure-insensitive or “uveoscleral” pathways. IOP will increase along with any resistance to aqueous outflow. This can result from age-related cellular dysfunction in the conventional outflow pathway or a normal outflow system unable to handle overproduction. Since altering other mechanisms in the pathophysiology of the disease is not possible without profound risk to the patient, lowing IOP is the only means of arresting disease progression. In the United States, the current guidelines for the initial intervention of newly discovered cases of primary open-angle glaucoma recommend a first-line approach with topical ocular hypotensives. To that end, three new agents that are under investigation aim to decrease IOP without upsetting the physiology. If successful, these medications could help keep the primary outflow pathway functioning.
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Look Inside The Current Issue

July 15, 2017


10-2 Visual Field Testing: A Tool for All Glaucoma Stages

This diagnostic tool is a must for detecting paracentral and visual field defects close to fixation in glaucoma, even the early-moderate stage.

Be a Hero to Your HSVK Patients

It is important for ODs to have a thorough understanding of this sight-threatening disease.

Caring for Patients With Brain Injury

More often than not, TBI affects a patient’s vision, and ODs must be prepared to evaluate and manage this population.

Glaucoma Surgery: Are You Ready to Refer?

Surgery is inevitable for many patients with glaucoma. These tips can help you refer when the time is right—and comanage after the fact.

Looking to the Future of Glaucoma Treatment

A trio of new therapies is poised to change how ODs fight the disease.

Mastering MIGS: Today and Tomorrow

These procedures have changed the glaucoma treatment landscape—and more are on the way. Here’s a primer for ODs.

2017 Office Design Contest

Your new high-tech and eye-catching office could be a winner. Enter today!


5 Steps to Better Glaucoma Care

Optometry has to take the lead with glaucoma, especially with recent advancements.

Decoding MIGS Coding

Clinicians must know how to code for these novel additions when comanaging glaucoma surgical patients.

Every Picture Tells a Story

Studies suggest imaging is fruitful in cases of isolated palsies, regardless of whether neurological symptoms are present.

Hitting a Nerve

Here’s what you need to know about the newest technology approved for dry eye disease therapy.

Lymphocytes on the Loose

Most anterior uveitis arises from systemic causes. Make the connection and you’ll be better equipped to quickly and accurately distinguish etiologies.

News Review

AMD | Cognitive Decline | Contact Lenses | Pediatrics

Not Just Another Headache

Migraine is the most common disabling brain disorder. Are you ready to help these patients?

Prescribe with Laser Focus

Know how to pair drugs with associated procedures.

The More Things Change…

Glaucoma care has flourished in recent decades, but still can’t crack its toughest challenge.

What a Pain!

The profession fights to expand and maintain its privileges at every turn—they’re vital to providing care. Don’t take your DEA license for granted.

Who’s the Boss?

Spoiler alert: it isn’t you. So tread carefully.


Practice Pearls

Expert clinician Paul Karpecki, OD, provides practical insights and management strategies for a wide array of ocular conditions.

RCCL e-News

A quick read of the best pearls from the current issue of Review of Cornea & Contact Lenses, with links to full articles.

Optometric Retina Society E-Newsletter

Keep up to date on the latest research and clinical findings in retinal disease care with this quarterly publication from the ORS.

Optometric Physician E-Journal

A weekly e-journal edited by Art Epstein, OD, featuring incisive commentary, timely research summaries and late-breaking news.


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Review of Cornea & Contact Lenses

May/June 2017

Women in Optometry

Women in Optometry - June 2017