Today's Spotlight

Home on the Range

Optometric educators may have noticed a disturbing trend developing. It seems optometry students are under the misconception that a single, ideal refraction—the refraction, let’s call it—exists for each individual, and that the goal of what we teach students is to find it. Once found, the refraction can be prescribed with impunity. If the patient has trouble with their glasses, it is assumed, the refraction could not be blamed.

How many times have we heard, “These are the wrong glasses” or “Who thought this prescription would be right for you?” In fact, refractive procedures should not spit out a single ‘correct’ number, but rather, a range of lenses. The key is recognizing what to do with that range.

Today's Spotlight

Sure I’m Sure, Aren’t You?

Are you one of those annoying doctors who is always sure? Well, me too, and that’s why I know the only thing sure docs can be sure of is that we are mostly just pretending.

But, since we are the doctors and it all flows from the top, we ODs have to pretend to be sure so the rest of the office and all of the patients don’t burst into flames at any given moment. I want to help you by reminding you of some things that we can be sure about and some things that we can be sure we should not be sure about. Here goes.
Today's Spotlight

Clear the Air—and the Vitreous

By far, floaters are the most common complaints in a retina practice. Chronic floaters may significantly impact a patient’s quality of life, affecting everything from reading to driving. Their causes can include any number of processes, such as posterior vitreous detachment (PVD), myopic vitreopathy, vitritis, vitreous hemorrhages, retinal detachment, retinal breaks and vitreous liquefaction.

Managing these underlying causes remains the primary treatment approach for the associated floaters. Still, most floaters are benign and are treated simply with observation, which does not always address the patient’s symptomology.
Today's Spotlight

Busted Barriers: Triaging Retinal Hemorrhages

Retinal hemorrhages, often first diagnosed in the primary eye care setting, can be a presenting finding in many ocular and systemic disease states. Because of the blood-retinal barrier, which aids in isolating blood from the retina to avoid retinal toxicity, hemorrhages within the retina are rare unless there is insult to the ocular or systemic vasculature. Such damage can be caused by vascular disease, hematologic disorders and dyscrasias, infections, trauma or hypoxia. In addition, they can be idiopathic. A look at the clinical presentation of retinal hemorrhages and the pathophysiology that leads to their correct identification and classification can help you work through the differential diagnoses and decide whether to monitor or refer.
Today's Spotlight

Mixed DED: A Chimera in Your Chair

Caring for patients with dry eye disease has always been a complex process that begins with a search for the underlying etiologies at play. Whether a patient has aqueous-deficient dry eye or evaporative dry eye is a crucial distinction for management purposes, yet they are not mutually exclusive. Research now suggests 30% to 70% of dry eye patients may have a hybrid of both forms. This article explores the new understanding of mixed dry eye presented by the Tear Film and Ocular Surface Society’s Dry Eye Workshop II, and how to manage it in your clinic.
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The News Feed

Look Inside The Current Issue

June 15, 2018


Busted Barriers: Triaging Retinal Hemorrhages

While uncommon, this clinical finding can be a harbinger of bigger issues. Here’s what you need to know.

Prepping Your Diagnostic Toolbox

Caring for this population takes more than an IOP check these days. Here are some must-have diagnostic strategies.

The Bugs Behind Infectious Retinitis

Be prepared to find the etiology behind a patient’s inflamed retina.

Warding off the Blues

Blue light has its pros and cons. Here’s how to help your patients manage it for the best systemic and ocular outcomes.


A Coding Crystal Ball

The comprehensive error rate testing program can provide valuable claims data to help you stay ahead of the game.

Clear the Air—and the Vitreous

PPV for floaters is controversial. But maybe it’s time to take a closer look at this management strategy.

Fend Off the Supervillain

Here’s how to protect a vulnerable cornea from opportunistic threats that might make a bad situation even worse.

Home on the Range

There’s no one ideal refraction. Prescriptions are as diverse as the patients in your chair.

If It’s Not One Thing It’s Another

When a cataract patient presents with unexpected DME, the case becomes a balancing act. Here’s how to handle the situation.

MIGS: Getting Better All the Time

Studies show these techniques are evolving and leading to improved outcomes.

Missed Connections

A carotid cavernous fistula can present with a number of ocular findings—be ready to refer and follow.

Pressure Watcher

Worried about glaucoma, a patient presents with complaints of visual disturbances.

Sherlock Holmes With a Lab Coat

Put your thinking cap on—it’s time to solve some ocular mysteries.

Snip and Squeeze: Canaliculitis

Surgery may be the best option for patients with this condition.

Sure I’m Sure, Aren’t You?

As docs, we have to at least pretend we know what’s going on around here.

Welcome to the Jungle

The contact lens market is growing again! But newbies are beset by conniving retailers. Look out for them.

White: Not Just for Brides

The FDA recently approved a new over-the-counter alpha-adrenergic receptor agonist designed to clear your patients’ red eyes.


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.

Continuing Education

June 2018 • 2.00 Credits

Warding off the Blues

April 2018 • 2.00 Credits

Frontline Ocular Surface Disease Care


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Review of Cornea & Contact Lenses

May/June 2018
  • Get Started with Sclerals

    If you’re new to sclerals, don’t worry. This start-up guide can help you learn how best to approach a scleral lens fitting.
  • Foggy with No Chance of Moisture

    This article discusses the causes of these two frustrating complications in scleral lens wear—and how you can combat them in your practice.
  • Post-keratoplasty: Consider Sclerals

    Many post-keratoplasty patients experience issues with soft or GP contact lens options. In these cases, scleral lenses may be able to help.
  • Why Contact Lens Care Still Matters

    We can serve our contact lens patients best by understanding the spectrum of lens care options and how to educate wearers.
  • Lend Color to the Fit

    This case highlights one of the common challenges associated with switching a soft lens aphakic patient to GPs: comfort.
  • CXL: A First-line Therapy for Keratoconus

    Today’s access to CXL shatters the binary treatment path and opens the door to a whole new mindset and therapy regimen.

Women in Optometry

Women in Optometry - March 2018
  • All Eyes on Cedar Park Vision

    The artsy downtown of Austin, Texas, provided endless inspiration for Kim Wampler, OD, as she and her husband relocated their practice Cedar Park Vision earlier this year.

  • POP-UP POLL: The Debt Load

    The Association of Schools and Colleges of Optometry says that the average educational indebtedness for optometry school grads with debt was $174,165 in 2016-17.

  • Financially Stressed? Make a Plan for the Future

    Where's the money? Dr. April Jasper shares some strategies for those who feel overwhelmed and under-reimbursed.