Optometric Physician



Vol. 24, #33 •   Monday, August 21, 2023


Off the Cuff: Parched in a Desert

So we have water delivered to the office every other week by one of the large water delivery companies in the southwest. We love our water cooler. Not only does it have the typical hot and cold water dispenser, it has a K-cup coffee maker on the top. We have a bit of a coffee culture in the office, and this coffee maker is really good and gets put through its paces daily, not only for my staff but for patients as well.


Lately, though, our water deliveries have been postponed two or three days. Not a big deal…until it became one. Our last delivery was in July, and we were supposed to have received our next on August 8th. That morning I got an automated email that said, “Sorry, we’re going to miss your scheduled delivery.” This came in at 6:30am. No biggy. But then I received the same message the next day, and the next day, and so on. Now it’s been 10 days, we’re totally out of drinking water, and they’ve rescheduled us to next week assuming that doesn’t get bumped back also. The subsequent lack of coffee is the least of our issues (although it definitely doesn’t help). Arizona set record highs last month and staying hydrated is a major concern.

I dread calling customer service lines. My experience yesterday calling the water delivery company was no different. The voice that answered was so blasé and disinterested, I could hear the flat affect I am sure graced her face. I was amazed she managed to speak at all. She told me they are short on drivers and don’t have anyone to service our route. “Sorry.” If I want to cancel service, no one can come until next week to pick up the equipment. If I don’t want to cancel service, no one can come to bring water until next week. I don’t want to lose our awesome water cooler, but this experience has not fostered a positive opinion of this company.

As a layperson I know this one individual's lackadaisical attitude should not influence my opinion of the whole company. I can’t be the only one calling with these issues that she’s had to field that day. As a business owner, though, I know this is a sign of a larger problem. Supply chain issues aside, my interaction with their customer service representative shows they may need to overhaul their entire customer service process or need to improve employee training. Of course all the training in the world cannot fix an attitude that seemingly does not care about the customer or her employer. This interaction definitely made me look at my own staff, the customer service we provide, and really appreciate their efforts to keep our patients happy and loyal to the practice.

Shannon L. Steinhäuser, OD, MS, FAAO
Chief Medical Editor


Want to share your perspective?
Write to Dr. Shannon L. Steinhäuser, OD, MS, FAAO at ssteinhauser@gmail.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.



Comparison of Visual Performance and Image Quality Between aMyopia-Control Contact Lens and a Single-Vision Contact Lens

This study aimed to evaluate the visual performance and image quality of concentric dual-focus-designed contact lenses (CLs) compared with single-vision CLs in myopic Chinese people. Twenty myopic volunteers between the ages of 18 and 26 years were recruited at a university eye hospital to wear both defocus-incorporated soft contact (DISC) lenses and single-vision CLs for 1 week in random order. High- and low-contrast visual acuity (VA), contrast sensitivity (CS), ocular higher-order aberrations (HOA), Strehl ratio and the Quality of Vision (QoV) questionnaire were assessed with each type of CL at weekly follow-up.

Distance VA was not affected by DISC lenses compared to single-vision CLs in either high or low contrast. However, there was a significant reduction in low-contrast near VA with DISC lenses compared with single-vision CLs. The differences of CS between DISC lenses and single-vision CLs were significantly associated with lighting conditions and spatial frequencies (F=128.81). Compared with single-vision CLs, wavefront aberrations of DISC lenses were significantly increased in total HOA, trefoil, and spherical aberrations for either 3.0 mm or 6.0 mm pupil size. The Strehl ratio wearing DISC lenses reduced significantly compared to the single-vision CLs at a pupil diameter of 6.0 mm. QoV scores were higher overall and frequency with DISC lenses than with single-vision CLs, indicating poorer visual performance.

Researchers wrote that the DISC lenses provided satisfactory distance VA. However, the higher scores of the QoV questionnaire with DISC lenses may be related to decreased CS at medium or high spatial frequencies and increased higher-order aberrations.

SOURCE: Han D, Zhang Z, Li B, et al. Comparison of visual performance and image quality between a myopia-control contact lens and a single-vision contact lens. Cont Lens Anterior Eye. 2023 Aug 11. Epub ahead of print.



Ten-Year Real-World Outcomes of AntiVEGF Therapy in Neovascular AMD Using Pro Re Nata Regimen

All patients receiving intravitreal injection (IVI) for neovascular age-related macular degeneration (nAMD) between January 1, 2008, and December 31, 2020, were searched in electronic medical records to analyze long-term outcomes of anti-vascular endothelial growth factor (anti-VEGF) therapy for the treatment of nAMD using a pro re nata (PRN) regimen in a single-center clinical practice. All 3844 treatment-naïve eyes of 3008 patients were included, with a total of 50,146 IVIs (87% bevacizumab) administered. Main outcome measures were mean change in visual acuity (VA) from baseline, proportion of eyes within 15 letters of baseline, proportion of eyes with VA ≥20/40 Snellen and ≤20/200 Snellen, number of annual visits and number of annual IVIs.

The mean baseline VA was 55 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, and the mean change in VA from baseline was +2, +2, ±0, -2, -2 and -4 ETDRS letters at year 1, 2, 3, 5, 7 and 10, respectively. Proportions of eyes within 15 letters of baseline were 88%, 87%, 82%, 80%, 76% and 72% at the end of years 1, 2, 3, 5, 7 and 10, respectively. The median number of annual IVI was 6 at years 1 to 7, and 5 at year 10. The median number of annual total visits was 10 at year 1, 9 at years 2 to 7, and 8 at year 10, respectively.

VA was maintained short-term and long-term with anti-VEGF therapy using PRN treatment regimen.

SOURCE: Hujanen P, Ruha H, Lehtonen E, et al. Ten-year real-world outcomes of antivascular endothelial growth factor therapy in neovascular age-related macular degeneration using pro re nata regimen. BMJ Open Ophthalmol. 2023 Aug;8(1):e001328.

Effect of Asanas in Yoga on Intraocular Pressure of Practicing Healthy Individuals

One aspect of yoga practice is focused attention by breath and mantra. This was the basis for a scientific investigation of its effect on various physiological functions such as intraocular pressure (IOP). The objective of this study was to evaluate the effect of asanas in yoga on the IOP of practicing individuals. A prospective, observational study was performed on 107 volunteers practicing the asanas such as the Sun Salutation exercise (Surya Namaskar), Skull Shining Breath (Kapalabhati pranayama), Downward Facing Dog (Adho Mukha Svanasana), Standing forward bend (Uttanasana), Legs Up the Wall pose (Viparita Karani), alternate breathing technique (Anulom Vilom), deep meditation (dhyana), bellows breath (Bhastrika pranayama), Yoga headstand (Shirshasana) and control of breathing exercise (pranayama) each for five minutes/day (40-60 minutes) for at least five days in a week for 12 weeks. The IOP measurement was performed for each asana (before and after) at baseline and every four weeks. The primary outcome was the change in IOP.

The mean age of the participants was 42.64±7 years, and the male to female ratio was 1.2:1. Skull Shining Breath, Sun Salutation, Downward Facing Dog, Standing Forward Bend, Legs Up the Wall pose, deep meditation and alternate breathing techniques showed a significant mean reduction in IOP at baseline, followed by every four weeks, till week 12, while yoga headstand, bellows breath and control of breath led to a significant increase in IOP.

Yoga headstand, bellows breath and control of breathing technique worsened IOP transiently.

SOURCE: Morya AK, Shrivastava AK, Janti SS, et al. Effect of asanas in yoga on intraocular pressure of practicing healthy individuals: a prospective observational study. Maedica (Bucur). 2023 Jun;18(2):238-45.



Industry News

Optometric Researcher Receives $2.04 Million Grant to Study Link Between Myopia & Glaucoma

SUNY College of Optometry’s Dr. Alexandra Benavente-Pérez was awarded a $2.04 million grant from the National Eye Institute that will explore the relationship between myopia and glaucoma and their effect on the ganglion cell complex at the genetic, cellular, structural and functional levels. Read more.

NCCVEH at Prevent Blindness Names Recipient of the Bonnie Strickland Champion for Children’s Vision Award

The National Center for Children’s Vision and Eye Health at Prevent Blindness announced the recipient of the ninth annual Bonnie Strickland Champion for Children’s Vision Award is optician Danielle Crull, ABOM, author, owner of A Child’s Eyes, organizer of The Pumpkin Patch Project, and founder of the Truffles the Kitty Organization. Read more.







Journal Reviews Editor:
Shannon L. Steinhäuser, OD, MS, FAAO

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