Optometric Physician



Vol. 23, #14  •   Monday, April 11, 2022


Off the Cuff: The Importance of Role Models in Optometry

Earlier this week I received sad news from my old dear friend Paul Farkas that his partner of many years, Ted Kassalow, had passed away. Together, Ted Kassalow and Paul Farkas created what was, and arguably remains, one of the most significant professional optometric practices in the history of our profession. Paul remains active in optometry. Many of you know him from his continued leadership on ODWire, and his son, Dr. Adam Farkas, for the creation of CEwire.

During their many years in practice, Paul and Ted were a perfectly matched set. Ted was a tall handsome and charming fellow with many contributions especially in the early days of the contact lens field. He was a founder of the "Dirty Dozen" practice management group, which has been copied by many others wishing to share insights and success strategies. Paul always seemed to be the quiet brains behind the operation except that he quickly figured out that fitting sharp, uncomfortable pieces of hard plastic on patients’ eyes took a bit of magic. As I recall, he became a licensed hypnotist and would give masterful demonstrations. I attended one of them with my ex-wife. I think she was never the same.

Emailing Paul about Ted’s passing brought me back to my beginnings practicing in the New York City area. After graduating from SUNY, I knew what I wanted to be and how I wanted to practice, but back then, optometry was becoming more and more commercial, something I was increasingly uncomfortable with. I shared with Paul, “I'm not sure you realize just how much influence you and Ted had on my career. You were the first ‘real doctors’ I met who were ODs who comported themselves like true professionals, in fact at a higher level than many of the MDs that were around back then. You created what I thought was the perfect practice, and although I knew we could never duplicate it, we certainly did learn from what you and Ted did.”

Paul and Ted were role models for me and my then partner Joe Freedman. They proved that optometry could not only survive, but thrive, in professional settings even as more and more ODs were opening up storefront practices or in strip malls in the NYC area. With the confidence Paul and Ted inspired, I connected with local MD colleagues like Eric Donnenfeld and eventually got on staff at our local university hospital. That eventually led to sharing what I was constantly learning in hundreds of papers and articles, and more than a thousand lectures around the world. Ultimately it led to opening Phoenix Eye Care with Shannon, which is cross between a MASH eye unit and a series of university hospital specialty eye clinics.

I am convinced that I could have accomplished little of this if not for the vision of Paul and Ted in building our profession’s future and serving as role models for me and many others.

Ted Kassalow, MS, OD, FAAO, is survived by three children—many of you know his son, Dr. Jordan Kassalow, as well as eight grandchildren. My sincere condolences to the family.



Arthur B. Epstein, OD, FAAO
Chief Medical Editor

Want to share your perspective?
Write to Dr. Epstein at artepstein@optometricphysician.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.




Trends in Myopia Development Among Primary and Secondary School Students During the COVID-19 Pandemic

A cross-sectional study was conducted to evaluate the development of myopia among students in Shenzhen, China, during the COVID-19 outbreak to evaluate myopia development among primary and secondary school students during the coronavirus 2019 (COVID-19) pandemic.

The study included 1,472,957 and 1,573,824 students in 2019 and 2020, respectively. The prevalence of myopia was 46.9 and 50.5% in 2019 and 2020, respectively. The prevalence of myopia among students in the former Shenzhen Special Economic Zone (SEZ) was higher than that in areas outside the former Shenzhen SEZ (2019: 47.0 vs. 43.7%; 2020: 50.5 vs. 47.3%). The prevalence of myopia among girls was higher than that among boys (2019: 50.4 vs. 44.0%; 2020: 54.0 vs. 47.6%). The 50th percentile (P50) of spherical equivalent refraction (SER) in the right eye among girls was lower than that in boys. The prevalence of myopia continued to increase as the grade increased, with the greatest annual increase observed in grades 2 to 5 (3.4 to 3.9%). The P50 of SER in the right eye of students decreased as the grade increased.

The prevalence of myopia among students increased during the COVID-19 pandemic, especially in primary school grades 2 to 5.

SOURCE: Mu J, Zhong H, Liu M, et al. Trends in myopia development among primary and secondary school students during the COVID-19 pandemic: a large-scale cross-sectional study. Front public health. 2022; Mar 22;10:859285.




A Prospective Comparative Study Between Implantable Phakic Intraocular Contact Lenses and Implantable Collamer Lenses in the Treatment of Myopia in Adults

Researchers initiated a prospective, randomized comparative study with phakic intraocular lenses (IOLs) for the treatment of myopia to compare implantable collamer lenses (ICLs) and acrylic implantable phakic contact lenses (IPCLs) in the treatment of myopia in adults, and looked at refractive outcomes and adverse effects. Patients were randomized into two groups: one for ICL and the other for IPCL. Preoperative assessments included a full examination, Pentacam evaluation, endothelial cell count, and biometry. Researchers compared the adverse effects and refractive outcomes between both groups. The study was registered in clinical trials (NCT04624035).

Sixty eyes of 60 patients (28 in the ICL group and 32 in the IPCL group) with a follow-up period of 12 months. The mean preoperative spherical equivalent was -12.7 ± 3.4D and -13.6 ± 4.4D in the ICL and IPCL groups, respectively. The mean postoperative spherical equivalent value was ±0.4 ± 0.2D and ±0.6 ± 0.1D in the ICL and IPCL groups, respectively. Uncorrected visual acuity (UCVA) improved from 1.3 ± 0.06 to 0.15 ± 0.02 LogMAR in the ICL group (p<0.001) and from 1.3 ± 0.02 to 0.15 ± 0.01 Log MAR in the IPCL group (p<0.001). The mean endothelial cell count was reduced by 3.3% in the IPCL group and by 3.2% in the IPCL group.

Researchers concluded that both ICL and IPCL are effective methods to correct high myopia in adults, with no statistically significant differences in adverse effects between the lenses.

SOURCE: Rateb M, Gad AAM, Tohamy D, et al. A Prospective comparative study between implantable phakic intraocular contact lens and implantable collamer lens in treatment of myopia in adults. J Ophthalmol. 2022; Mar 28;2022:9212253.



Efficacy, Safety, and Treatment Burden of Treat-and-Extend vs. Alternative Anti-VEGF Regimens for nAMD

This study aimed to compare efficacy and treatment burden of treat-and-extend (T&E) anti-VEGF against fixed and pro re nata (PRN) regimens for neovascular age-related macular degeneration (nAMD). MEDLINE, CENTRAL, and EMBASE were searched. Randomized-controlled trials and observational studies comparing T&E to PRN or fixed dosing for treatment-naïve AMD patients were included. Mean difference (MD) for visual acuity (VA) and number of injections were presented. Risk of bias was assessed according to Cochrane guidelines. The methodology was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

VA improvement was similar with T&E and fixed dosing at one (MD, -0.08 letters; p=0.95) and two years (MD, 0.58 letters; p=0.62). In contrast, VA improvements were significantly greater for T&E when compared against a PRN regimen at one (MD, 3.95 letters; p<0.0001) and two years (MD, 4.08 letters; p<0.001). Significantly fewer ranibizumab injections were administered in the T&E arm at one (MD, -2.42 injections; p<0.0001) and two years (MD, -6.06 injections; p<0.00001) relative to fixed dosing. Fewer aflibercept injections were likewise administered to patients on a T&E regimen vs. fixed dosing at one year (MD, -0.78 injections; p<0.0001).

Investigators wrote that their findings, though lacking confirmation, indicated that T&E preserved VA similar to fixed schedules with significantly fewer injections at one and two years. Also, patients with T&E dosing achieved better VA outcomes than those on a PRN regimen, but T&E dosing was associated with more injections.

SOURCE: Rosenberg D, Deonarain DM, Gould J, et al. Efficacy, safety, and treatment burden of treat-and-extend versus alternative anti-VEGF regimens for nAMD: a systematic review and meta-analysis. Eye (Lond). 2022; Apr 8. [Epub ahead of print].






Industry News

Haag-Streit Introduces Slit Lamp Imaging System

Haag-Streit announced its Imaging Module 910, designed to generate high-quality images while enabling clinicians to concentrate on examining their patients. Imaging is ready with the turn of a knob, requires no software and needs only the press of a button to capture images. The module is equipped with an improved camera sensor and optics, features that ensure high illumination and an image selection algorithm that chooses the best image possible. Learn more.






Alcon Introduces Systane iLux² MGD Thermal Pulsation System

Alcon introduced the Systane iLux2 Meibomian Gland Dysfunction Thermal Pulsation System with new imaging technology to capture infrared photos and HD video of the meibomian glands. The handheld device enables patients to view their meibomian glands and treatment through infrared imaging and HD video of the procedure. ECPs can customize heat and compression across each treatment zones. Learn more.

Allergan Announces Positive Topline Phase III Results for Vuity Twice-daily

Allergan announced the Phase III VIRGO trial evaluating the safety and efficacy of investigational twice-daily administration of Vuity (pilocarpine HCl ophthalmic solution) 1.25% in adults with presbyopia met its primary efficacy endpoint, improving near vision without compromising distance vision on day 14. Read more.

Upneeq Wins Best in Innovation Award from New Beauty

RVL Pharmaceuticals announced its FDA-approved acquired blepharoptosis (ptosis) drug Upneeq (oxymetazoline hydrochloride ophthalmic solution) 0.1% was selected as the winner of a "Best in Innovation" award at the 12th Annual Beauty Awards. Learn more.

Quest Adds DR Screening in Collaboration with IRIS

Quest Diagnostics announced a collaboration with IRIS (Intelligent Retinal Imaging Systems) to deliver diabetic retinal imaging services through designated Quest patient service centers across the United States. Read more.













Journal Reviews Editor:
Shannon Steinhauser, OD, MS, FAAO

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