Optometric Physician

Vol. 22, #28   •   Monday, July 26, 2021


Off the Cuff: Thank You

This past Wednesday started like any other Wednesday. It is supposed to be our day off, but like most Wednesdays, we were anything but off. I was up late Tuesday night finishing up a project and got up a bit later than usual—no, I am not a morning person. Shannon was up and about first, and headed to a dentist appointment and then to the office to set up our new Eaglet Eye profilometer. I got up a few minutes later, woken by my face being licked by George, our new alarm dog. I made myself a latte and downed a couple of frozen waffles.

I started catching up with emails, but was interrupted as a new one popped in from my old friend Bob Colucci, the COO of Regener-Eyes. The subject was “Newsweek – America’s Best Eye Doctors 2021.” The email contained one line: “CONGRATS!! No. 1 in the Nation. See below.”

I clicked on the link at the bottom of Bob’s email – I didn’t notice the second link below it, and up came a list of America’s Best Ophthalmologists 2021. At the top of the list was Eric Donnenfeld, an old friend who I worked closely with for many years. Since I serve on the Regener-Eyes advisory board with Eric, I assumed that was why Bob sent me the link. I emailed back how happy I was for Eric and noted that the list was filled with ophthalmologists who were friends. I was happy for all of them.

Two minutes later I get a text from Phil Pivnick, now a senior surgical academic manager at Alcon. Phil was one of my first reps when I started in practice, and over the years has become one of my dearest friends. His text was a screen grab of the Newsweek list, and I quickly scanned past it to see the message below—that my phone must be ringing off the hook. Perplexed as to why my phone would be ringing off the hook, I scanned back up and realized that that my name was at the top of the list Phil sent. I stared at it totally flummoxed. How could I be number one when Eric was number one. Why was I on an ophthalmology list? It then sank in. There were two lists. One for ophthalmologists and one for optometrists.

Those of who know me know that I am uncomfortable with accolades. I even wince a bit at introductions preceding lectures. I have always done what I do, and I never expect recognition or even a thank you. It is the way I was raised, I guess. Staring at my screen, I was numb, but one thing I knew was that I wanted to share this with Shannon. As I called her I started to scroll down the list until I got to number 9. There was Shannon! Shannon was number 9! My eyes welled with tears as I told her. One of the most difficult things for me is knowing that I cast a big shadow, and Shannon is often covered by it. My wife is one of the most capable and brilliant clinicians I’ve ever met. While she never complains, I have long realized that she never gets the credit she deserves. Finally, here she was in the top 10, at last getting recognition for the amazing person and clinician that she is.

After many phone calls, texts and emails from friends across the country and around the world, Shannon and I are both overwhelmed. Newsweek “surveyed over 10,000 ophthalmologists, optometrists, clinic managers and other health care professionals who recommended the best eye doctors in the U.S.” They searched for “the doctors who had earned the most respect from their peers in three categories: the quality of care they provide, the continuity of care and the quality of the technology they use in their practices.” The list is filled with some of the most amazing ODs that we know. We realize that neither of us would have made this list if not for the trust, confidence and connection with our colleagues that we have. We were chosen by you, and for that we are incredibly humbled and honored by your recognition.

Newsweek’s recognition of our profession and its important role as primary providers of eye care in the US is an important milestone for optometry, one that should not be underestimated. Like many of you, I have long been frustrated by our profession’s second-class treatment. Change has come slowly, but it continues. My work with the AOA during the Fusarium keratitis outbreak of 2006 directly led to the Associated Press Stylebook finally recognizing ODs as doctors. That accomplishment was memorable. Shannon and I being part of Newsweek’s recognition of our profession will always be among the most gratifying achievements of our lives. Thank you for the honor from the bottom of our hearts.

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.




Patient Adherence to Glaucoma Treatment During the COVID-19 Pandemic

In medicine, patient adherence refers to the degree to which a patient correctly follows medical advice, and it most commonly pertains to medication or drug compliance. Patient adherence to glaucoma treatment has been a frequent and serious issue that is associated with adverse long-term outcomes. The purpose of this study was to determine the factors that are associated with adherence to glaucoma treatment among patients during the ongoing coronavirus disease 2019 (COVID-19) pandemic. This was a cross-sectional study involving 100 consecutive glaucoma outpatients who were interviewed based on the modified version (ARMS2-COVID) of the original Adherence to Refills and Medications Scale 2 (ARMS2) that examined adherence to medication. Length of treatment and disease onset along with basic demographic details (gender, age, socioeconomic status, and educational levels) of the patients were also recorded.

The COVID-19 pandemic has disproportionately impacted patients of older age and lower educational levels with regard to their ability to follow their treatment plan regardless of the duration of previous treatment.

Researchers wrote, based on their findings, in order to ensure higher levels of patient adherence among patients of older age with limited education, more planning will be required, aided by appropriate educational interventions and proactive patient follow-ups.

SOURCE: Mylona I, Dermenoudi M, Glynatsis NM, et al. Patient adherence to glaucoma treatment during the COVID-19 Pandemic. Cureus. 2021 Jun 9;13(6):e15545.



Reported Patient Satisfaction and Spectacle Independence Following Bilateral Implantation of the PanOptix Trifocal Intraocular Lens

To assess the spectacle independence and satisfaction of subjects after bilateral implantation of the PanOptix® trifocal intraocular lens (IOL) at the time of cataract surgery, eligible subjects interested in a trifocal IOL were enrolled and followed for three months after the second eye surgery. Visual acuity and refractive data were collected one month and three months postoperative, including the uncorrected and best distance-corrected binocular visual acuities at distance (4m), intermediate (60cm) and near (40cm). A patient satisfaction and spectacle independence questionnaire were administered at the three-month visit.

A total of 30 subjects successfully completed the study. Eighty-five percent of eyes (51/60) had a refraction within 0.50D of plano with ≤0.50D of refractive cylinder. One subject (3%) reported needing glasses for distance work, three (10%) reported needing them for for intermediate work and four (13%) reported needing them for near work. Ninety percent or more of all subjects reported never wearing glasses, or wearing them only a little at all working distances. Ninety percent or more were able to function without glasses at all three working distances all or most of the time. More than ninety percent of subjects reported being "completely" or "mostly" satisfied with their vision without glasses or contact lenses at all three distances and overall.

Investigators wrote that a high percentage of patients are likely to achieve spectacle independence for distance, intermediate and near vision with this trifocal IOL.

SOURCE: Blehm C, Potvin R. Reported patient satisfaction and spectacle independence following bilateral implantation of the PanOptix® trifocal intraocular lens. Clin Ophthalmol. 2021; Jul 6;15:2907-12.



Switch to Autophagy the Key Mechanism for Trabecular Meshwork Death in Severe Glaucoma

The key differences in cell death mechanisms in the trabecular meshwork (TM) in adult moderate and severe primary glaucoma remain unanswered. This study explored key differences in cell death mechanisms in the trabecular meshwork (TM) in adult moderate and severe primary glaucoma. Select cell death-related proteins differentially expressed on mass spectrometric analysis in ex vivo dissected TM specimens from patients with severe adult primary open-angle (POAG) or angle-closure glaucoma (PACG) compared to controls (cadaver donor cornea) were validated for temporal changes in cell death-related gene expression on in vitro primary human TM cell culture after 48 hours (moderate) or 72 hours (severe) oxidative stress with H2O2 (400-1000uM concentration). These were compared with histone modifications after oxidative stress in human TM (HTM) culture and peripheral blood of patients with moderate and severe glaucoma.

Autophagy-related proteins seemed to be the predominant cell-death mechanism over apoptosis in ex vivo dissected TM specimens in severe glaucoma. Analyzing HTM cell gene expression at 48 hours and 72 hours of oxidative stress, autophagy genes were upregulated at 48 to 72 hours of exposure in contrast to apoptosis-related genes, showing down-regulation at 72 hours. There was associated increased expression of H3K14ac in HTM after 72 hours of oxidative stress and in peripheral blood of severe POAG and PACG.

A preference of autophagy vs. apoptosis may underlie stage transition from moderate to severe glaucoma in the trabecular meshwork or peripheral blood, which may be tightly regulated by epigenetic modulators.

SOURCE: Rao A, Sahay P, Chakraborty M, et al. Switch to autophagy the key mechanism for trabecular meshwork death in severe glaucoma. Clin Ophthalmol. 2021; Jul 14;15:3027-3039.





Industry News

Dr. Epstein Named America’s Top Optometrist by Newsweek

Newsweek’s ranking of America’s Best Eye Doctors 2021 was released July 22, and it named Arthur B. Epstein, OD, Phoenix Eye Care, and chief medical editor of Optometric Physician, the No. 1 optometrist in the country, with a score of 92.6%. Shannon L. Steinhäuser, OD, also of Phoenix Eye Care, and Epstein’s wife, was ranked No. 9, with a score of 89.1%. The publication looked at the 20 most populous states in the US and selected the 300 best optometrists and ophthalmologists, in a separate ranking. Researchers began with a survey of more than 10,000 optometrists, ophthalmologists, clinic managers and other healthcare professionals. “What we were looking for were the doctors who had earned the most respect from their peers in three categories: the quality of care they provide, the continuity of care and the quality of the technology they use in their practices,” wrote Nancy Cooper, Newsweek Global Editor in Chief. View the list.


B+L to Present 14 Scientific Posters at ASCRS Annual Meeting

Bausch + Lomb announced the presentation of 14 scientific posters involving the company’s ophthalmic surgical technologies at the American Society of Cataract and Refractive Surgery annual meeting, July 23-27 in Las Vegas. Ten presentations will discuss the clinical performance of one or more of the company’s enVista, Crystalens and Trulign intraocular lens platforms. Two posters will highlight the results of studies in which investigators used the cloud-based eyeTELLIGENCE clinical decision support software, available exclusively on the Stellaris Elite vision enhancement system, to evaluate energy and fluidics metrics and analyze the impact of COVID-19 on ophthalmic surgeries. View the schedule of presentations.

J&J Vision to Present Data on Latest Cataract Innovations at ASCRS Annual Meeting

Johnson & Johnson Vision announced that 21 company-sponsored studies supporting cataract surgery outcomes will be presented at the 2021 American Society of Cataract and Refractive Surgery and American Society of Ophthalmic Administrators Annual Meeting. A complete listing of abstracts related to Johnson & Johnson Vision can be found on the ASCRS website. Read more.

Allergan to Present Data from Eye Care Portfolio at ASCRS Annual Meeting

Allergan will present new data from its portfolio of eye care medicines at the American Society for Cataract and Refractive Surgery Annual Meeting. Presentations will include new data on AGN-190584 (pilocarpine 1.25%), an investigational presbyopia treatment, and updated analyses on Durysta (bimatoprost intracameral implant). View the schedule of presentations.

Alcon to Present 70 Abstracts at ASCRS Annual Meeting

Alcon announced it would have approximately 70 abstracts highlighting the benefits of the Alcon cataract and refractive suite at the American Society for Cataract and Refractive Surgery Annual Meeting. A few highlights of the company’s data include: a high level of patient satisfaction and increased spectacle independence with PanOptix and Vivity; the ARGOS Biometer with Image Guidance delivered substantial time efficiencies for cataract surgery practices, surgeons and patients; and the NGENUITY 3D Visualization System Heads-Up Display increasing surgical ergonomics. Learn more.

Allegro Ophthalmics to Present Results of ALG-1007 Ex-U.S. Phase II Trial at ASCRS Annual Meeting

Allegro Ophthalmics announced the results of the company’s second ALG-1007 ex-U.S. clinical trial for the treatment of dry eye disease will be presented during the American Society of Cataract and Refractive Surgery and American Society of Ophthalmic Administrators Annual Meeting. On July 22, Allegro President and CEO Vicken Karageozian, MD, will present at Eyecelerator during its “Dry Eye: The Need for Innovation” session. On July 24, Eric D. Donnenfeld, MD, will present full study results of the company’s second ALG-1007 ex-U.S. clinical trial for DED. View the schedule of presentations.

NovaBay Partners with ImprimisRx to Promote Prescription Avenova

In addition, NovaBay Pharmaceuticals, a pharmaceutical company focusing on commercializing Avenova for the eye care market, is partnering with ImprimisRx, a wholly owned subsidiary of Harrow Health, to promote prescription Avenova. ImprimisRx will provide NovaBay with national sales, marketing and distribution support for its FDA-cleared 0.01% hypochlorous acid Avenova in 40 ml bottles. Avenova is a clinically proven antimicrobial lid and lash solution for the management of numerous chronic eye conditions. Read more.

Nanodropper & Unite For Sight Announce Global Health Partnership

Nanodropper is joining forces with Unite For Sight to launch a global health initiative aimed at providing better access to vision-saving medications in Ghana. The initiative will allow the public to donate Nanodroppers to Unite For Sight partner clinics in Ghana at $9 per adaptor, a substantially lower price than retail value. The Nanodropper easily twists on to eyedrop bottles and reduces the waste from a typical eyedrop. Learn more.

Surface Ophthalmics Announces $25 Million Private Round of Fundraising

Surface Ophthalmics secured gross proceeds of approximately $25 million in a private placement of preferred stock. The proceeds from this round of capital raising will be used to complete the ongoing Phase II clinical trial of SURF-100, an innovative head-to-head study comparing SURF-100 against leading on-market competitors lifitegrast ophthalmic solution 5% and cyclosporine ophthalmic emulsion 0.05% along with the Phase II clinical trial of SURF-200, being studied as a potential treatment for acute dry eye disease. Read more.










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