Optometric Physician

A weekly e-journal by Art Epstein, OD, FAAO


Volume 20, Number 17

Wednesday, April 15, 2020


Inside this issue: (click heading to view article)
######### Off the Cuff: Contagion

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Off the Cuff: Contagion

Spring is in the air. Not that many years ago my thoughts would be turning to the fresh smells of flowers blooming and freshly cut grass, longer days and getting back on the bike for long rides with friends on country roads. Today, as spring approaches, I am afraid to take a deep breath for fear of what the air might bring with it beyond pollen. I wonder how soon life will start returning to normal, and when we can return to our practices and see routine patients. Unfortunately, I don’t think it will be any time soon.

I am not pessimistic, I am just being realistic. As I think back over the past few months it seems pretty clear that we took a wrong turn a while ago, and finding our way back will not be easy. Truth is, as a country we were not prepared for what should have been obvious. Most of the world wasn’t, but I expected more from us. Feel free to blame whoever you want, but I see this as primarily a major failure of our once top-of-class CDC. China can certainly share in some of the blame, as they clearly buried much of the truth along with their dead, but the seriousness of the situation should have been clearly evident in Atlanta by late 2019. I’ve visited China many times and the well-being of their citizens never struck me as a priority for the Chinese government. Their leadership’s willingness to sacrifice a good part of their economy to stop the spread should have been taken as a chilling warning of what was to come.

Social distancing and largescale closures of schools and businesses have become our new normal, but they are also an economic suicide strategy. It is a last resort that I suspect could have been avoided in the US and many Western countries. Had most of the world outside of Wuhan gotten a jump on COVID-19 and implemented proven infection control strategies like mask wearing, early and extensive testing, and contact tracking protocols, the rapid spread of this very contagious airborne virus could have been limited, and thousands of lives and billions of dollars saved. But the sad and bitter truth is, we were caught with our pants down, and the CDC, FDA and the Surgeon General lied to cover it up. We can’t undo what has already been done. The question is, now where do we go from here?

The answer, oddly, is quite simple. At this point, for us to be totally free of a scourge that cruelly kills 5% or more of those it infects, we have to retrace our steps and get them right this time. If we wait for a vaccine, it will be too late. If we wait for a cure, it may never come. So, for clinicians involved in direct clinical care, interacting with patients with close contact in small rooms, we will need PPE. Start thinking about that now.

While wearing masks and other protective gear will fundamentally change how the profession is practiced, it will likely keep us safe until a more permanent solution is found. Getting it right for us will be an extremely important issue as the consequences are dire. Flattening the curve won’t be enough. We need PPE. We need it now.

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 the editorial board, Jobson Medical Information LLC (JMI), or any other entities or individuals.


News & Notes
Bausch + Lomb Publishes 10-year ARMOR Study Results on Ocular Antibiotic Resistance
Bausch + Lomb announced that JAMA Ophthalmology published 10-year results of the ongoing, multicenter, prospective Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) surveillance study evaluating profiles and trends in antibiotic resistance among common ocular bacterial pathogens across the United States. The analysis of the 10-year results, which evaluated data from bacterial isolates collected from 2009 to 2018, showed that in vitro antibiotic resistance is prevalent nationwide among ocular staphylococci. One in three Staphylococcus aureus and one in two coagulase-negative Staphylococci (CoNS) were methicillin-resistant, and three in four methicillin-resistant staphylococci were multidrug-resistant (to ≥three classes of antibiotics). In total, ARMOR study participants from 88 sites across 41 states collected a total of 6,091 isolates of S. aureus, CoNS, Streptococcus pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae, all organisms frequently implicated in bacterial infections of the eye. Overall, 34.9 percent of S. aureus and 49.3 percent of CoNS were methicillin-resistant and more likely to be concurrently resistant to other antibiotic classes. Read more.


Niswonger College of Optometry Offers ODs Free Webinars on Treating Urgent Eye Conditions
Niswonger College of Optometry’s Dr. Greg Moore and Dr. Richard Hom have launched a weekly webinar sharing best practices for treating patients with urgent eye conditions that cannot wait for care until the coronavirus pandemic ends. This is a public service offered free to any practicing optometrist. Learn more.

BlephEx Announces Appeal Victory in Patent Litigation with Myco Industries
BlephEx announced a victory before the Court of Appeals for the Federal Circuit in its ongoing patent litigation with Myco Industries. The appeal arose from the fact that the Federal District Court for the Eastern District of Michigan previously granted Myco’s motion for a preliminary injunction to enjoin BlephEx from making allegations of patent infringement and threatening litigation against Myco’s potential customers. The appeals court reversed, vacated and remanded the district court’s order, finding that the district court’s claim construction limiting the scope of claims to the treatment of posterior blepharitis was “faulty.” The appeals court held further that vacating the district court’s claim construction necessitated that it also vacated the court’s finding regarding Myco’s likelihood of success on its non-infringement contentions, which in turn required that it vacated the district court’s preliminary injunction with respect to BlephEx’s ability to make generalized allegations of infringement with respect to the ’718 patent. Read more.


Optometric Physician™ Editorial Board

Chief Medical Editor
Arthur B. Epstein, OD, FAAO

Journal Reviews
Shannon Steinhäuser, OD, FAAO

Contributing Editors
• Katherine M. Mastrota, MS, OD, FAAO
• Barry A. Weissman, OD, PhD, FAAO (Dip CL)

Editorial Board
• William Jones, OD, FAAO
• Alan G. Kabat, OD, FAAO
• Bruce Onofrey, RPh, OD, FAAO
• John Schachet, OD, FIOS
• Joseph Shovlin, OD, FAAO



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