Volume 6, Issue 43│October 28, 2022
ASSOCIATION NEWS
 
VISION AWARENESS PATCH PROGRAM

Thousands of young people as early as kindergarten are active in scouting programs across Illinois. Many participants continue throughout high school. Hosting scouts at your practice is a great way to connect with your community and increase awareness about optometry and the importance of good vision health.

When scouts earn their Vision Awareness patch, they are also learning about future career opportunities, especially optometry and the numerous possibilities in Science, Technology, Engineering, and Mathematics (STEM).
The patch they receive, created by the New Jersey Society of Optometric Physicians, can help in your outreach to thousands of young people and will help reinforce the importance of clear comfortable vision, with an emphasis on comprehensive eye examinations. During the visits you are also sharing information with parent leaders and volunteers.
One of the first activities for earning the patch is visiting a local doctor of optometry’s office. You can connect with local scout troops by discussing this program with your patients who have children active in scouts or by visiting each organization’s regional/metropolitan council which covers your area. From there, you can work together to identify the closest troops to your office.

Another suggestion for generating awareness of your participation is to add content to your website and social media channels, such as:
·     Attention scout leaders! Find out how your troop can earn a Vision Awareness Free Patch! Email us at [email@domain name].
·     Did you know…your eyes are the size of ping pong balls? If you’re a scout, find out more about your eyes and how you see and earn a Vision Awareness Patch! Find out more by emailing us at [email@domain name].
Questions? Please contact our office at (217) 525-8012


We want to hear your memories of the IOA! In celebration of our 125th anniversary in 2023, the IOA is collecting your stories about the organization.

Please share your thoughts on the importance of IOA membership, favorite memories from IOA, or your thoughts on the history of the IOA.
In Memoriam: Stuart Richer, O.D.

Dr. Stuart Richer, Armed Forces Optometric Society member and frequent speaker at IOA CE events, passed away on Wednesday, October 26.

Dr. Richer earned his Doctor of Optometry degree from the University of California Berkeley in 1981, followed by a low vision residency at the Kansas City DVA Medical Center. Dr. Richer served as the director of ocular preventive medicine at James Lovell Federal Health Care Facility in Chicago. He published numerous papers from his 35 research projects in medical journals and was a sought-after speaker, including at IOA CE events. Dr. Richer had a special interest in aging, nutrients for macular degeneration, low-tension glaucoma, and cataract prevention.

The funeral service will be held Friday, October 28 at 1:00pm at Weinstein and Piser Funeral Home in Wilmette, IL.

Our thoughts are with his family and friends during this difficult time.
ILLINOIS OPTOMETRY STUDENT UPDATES
Chicago College of Optometry
The Chicago College of Optometry held its White Coat Ceremony for the Class of 2026 on October 1, 2022.
Call for Courses - 2023 Annual Meeting

The IOA has opened the Call for Courses for the 2023 Annual Meeting in Schaumburg, IL on September 28-October 1. Lecturers are invited to submit their lecture(s) and workshop courses in the online portal at the link below. All courses must be submitted online by December 16, 2022.
2022 Medicare Fee Schedules

Locality 12: Excel or PDF

Locality 15: Excel or PDF

Locality 16: Excel or PDF

Locality 99: Excel or PDF
Report illegal and unsafe contact lens sales to the FDA & FTC
Labor Law Poster 2022
Check out the newest IOA classifieds here!

Looking for a motivated and energetic OD to join our Tinley Park Target Optical team! Friendly, helpful staff and overall healthy patients. (Read more)
SAVE THE DATE
BUSINESS TIP OF THE WEEK
EMAIL SERIES PART ONE:
Email is one of the most powerful marketing channels when it comes to driving patient engagement and improving the bottom line. The best way to create an immediate connection with your new patients is to send a welcome email. Whether they came in for a pair of glasses or an emergency appointment, letting them know you appreciate them can go a long way. You can be creative with these emails and consider adding visuals or links to audio and video content.
INDUSTRY NEWS
Don’t Miss the Signs of Thyroid Eye Disease (TED)


October 23, 2022

Optometrists are well-positioned to detect the early warning signs of debilitating eye conditions, helping patients avoid long-term damage and changing the trajectory of their care. One such condition is Thyroid Eye Disease (TED) – a chronic autoimmune condition that can worsen over time and lead to potential vision loss in severe cases.1,2
I would bet that when most optometrists think about TED, proptosis comes to mind. Though proptosis is an obvious symptom of the condition, it is not the only one we should be looking out for. In fact, other symptoms can be so subtle, they are unfortunately easy to miss.
One such symptom is dry eyes. In one study, seventy-two percent of TED patients say dry eyes are their most frequent source of eye discomfort; however, this symptom is often misdiagnosed as allergies or conjunctivitis.3,4 Other common symptoms of TED include diplopia, pain or pressure behind the eyes, eyelid retraction, photophobia and redness, swelling, and excessive tearing.1
To help determine if my patients have TED, I typically start with a few questions and exams:
  • Medical history: Ask if they have been diagnosed with a thyroid condition. Up to 50% of people living with Graves’ disease may develop TED.5
  • Eyelid retraction: Examine the tone of the eyelids, as well as the blink anatomy.2
  • Eye symmetry: Look for a variance in symmetry between the right and the left eye. If you do see an asymmetry, ask about it and if it is longstanding or something of more recent onset. With most patients having cell phones with them in the exam room, oftentimes it is easy to see previous pictures of them to compare against their current appearance.
  • Slit lamp: Perform a slit lamp exam; the image below shows a patient who presented with a chief complaint of dry eyes. The symptoms were present because of ocular surface exposure which may be secondary to TED.
TED is commonly a manifestation of a systemic condition called Graves’ disease. Although it is critical to identify and diagnose patients with TED at the early signs or symptoms, it is also critical to understand appropriate care to help these patients. Oftentimes this involves oculoplastic or TED specialist referral for further analysis, which may include MRIs, CT scans or orbital imaging to help determine next steps. If it is TED, there are treatment options available that may help.
TED patients often go several years without a proper diagnosis, leading to significant delays in treatment and ultimately affecting their physical and psychological wellbeing. TED can have a profound impact on some patients’ lives, negatively impacting the ability to do daily tasks that we take for granted such as driving or reading.
As optometrists, we can play an important role in the early identification of TED, ultimately helping to get our patients the care they deserve.
For more information about the signs and symptoms of TED, visit TEDImpact.com.
The Presbyopia Conversation: Start Early, Individualize Message

Outside of eye care, the term “presbyopia” is not commonly used or well understood — and it’s one that can be tricky to explain.
Many doctors avoid the topic altogether until a patient brings it up. But with myriad options for today’s presbyopes, including new topical drops now entering the market, it might be time to up your game.

It is important to be proactive when talking about presbyopia so patients understand what is normal and what to expect. I start planting the seeds when patients are 35 years old, letting them know that within the next 3 to 5 years they will likely see some changes in their vision. Once a patient becomes presbyopic, it’s important to recognize that presbyopia isn’t a one-time conversation. Their concerns and visual needs will change as they continue to lose accommodation.
Fortunately, technology is changing too. Lately, I’ve been talking to patients about opportunities with pupil-modulating presbyopia-correcting drops like Vuity (pilocarpine HCl ophthalmic solution 1.25%, Allergan/AbbVie), which is available now, and pipeline drugs such as Brimochol PF (carbachol/brimonidine tartrate, Visus Therapeutics) and others.
In talking to patients, I rarely use the term “presbyopia.” Instead, I talk about the focusing system becoming less flexible. I also try to describe what is happening functionally. Instead of using clinical terms like “near vision” or “intermediate vision,” I mention specific tasks like seeing the computer screen or car dashboard.
The range of options for correcting presbyopia is wide — from over-the-counter readers to bifocal or progressive spectacles, monovision, multifocal contact lenses, surgical options and eyedrops. Reviewing the pros and cons of each could overwhelm patients, so I focus on what I think will be best for that patient’s vision and lifestyle, and I keep the conversation simple. With multifocal contacts, for example, I don’t get into a lot of detail about the modulus or toricity, although those details factor into my lens choice. Similarly, with all the presbyopia-correcting drops in the pipeline, I expect that eventually I’ll choose a starting drop based on the mechanism of action, duration and side effect profile, and then adjust as needed.
ILLINOIS NEWS
How Concerned Should You Be About Covid-19 ‘Scrabble' Variants? Here's What We Know So Far
By Renée Onque,CNBC • Published October 25, 2022 • Updated on October 25, 2022 at 3:58 pm

Though BA.5 still accounts for most U.S. Covid-19 cases, percentages are rising for the other omicron variants circulating throughout the country, per the CDC.
"The ones that are particularly concerning are BQ.1 and another related one called BQ.1.1. Those are two that are expanding fairly rapidly in the United States," according to Roy Gulick, chief of the division of infectious disease at Weill Cornell Medicine and NewYork-Presbyterian Hospital.
Internationally, another concerning variant, XBB, which first emerged in Singapore and hasn't been detected in the U.S., is being closely watched worldwide as it spreads quickly in other countries.
The new variants were coined the "Scrabble" variants by Peter Hotez, co-director of the Center for Vaccine Development at Texas Children's Hospital, during an interview with the Houston Chronicle.
The nickname refers to the letters that are used to define the variants like B, X and Q, which would rack up many points in a game of Scrabble.
Here's what we know about Covid 'Scrabble' variants
Health professionals are keeping a close eye on BQ.1, BQ.1.1 and BA.4.6, says Gulick.
"What these three variants have in common, so the two BQs plus the 4.6, and a couple of others, is that they are more resistant to the monoclonal antibodies that we've been using," he says.
The "Scrabble" variants are very resistant to Bebtelovimab, a therapy that is commonly used and recommended as a treatment for Covid-19, especially in patients who cannot take antivirals like Paxlovid or remdesivir, according to Gulick.
Their evasive nature will likely make Bebtelovimab ineffective in patients with Covid-19 infections from those variants, he adds.
Simultaneously, monoclonal antibodies, like Evusheld, that are used as prevention for people who can't take or don't respond well to vaccines, including highly immunocompromised people, are losing "all efficacy against these more recent variants," says Gulick.
"Both of these pose threats either to people who are being treated with Covid today or where we're trying to prevent Covid today," he notes.
How you can protect yourself against 'Scrabble' variants
Thankfully, antivirals, including Paxlovid and remdesivir, still provide full protection against these variants at this time, says Gulick. "They're powerful tools that people who are at risk really should make use of," he says.
A few preventative measures to consider are getting a bivalent booster, which may offer some level of protection against the newer variants, and wearing masks in public places, he says.
"We are concerned that these new variants, because they will render some of the monoclonal [antibodies] not effective for prevention or treatment, that this could lead to increased cases," he says.
"Unfortunately, as people keep saying, the virus is not over us. The virus is not done."
NATIONAL NEWS
 
NIH Researchers Home In on a New Cause of Stargardt Disease
Study may help lead to gene therapy for rare inherited blinding disease.

Using a new stem-cell based model made from skin cells, scientists found the first direct evidence that Stargardt-related ABCA4 gene mutations affect a layer of cells in the eye called the retinal pigment epithelium (RPE). The discovery points to a new understanding of Stargardt disease progression and suggests a therapeutic strategy for the disease, which currently lacks treatment. The study took place at the National Eye Institute (NEI), part of the National Institutes of Health. The findings published online today in Stem Cell Reports.
“This new model will accelerate development of therapies for Stargardt disease,” said NEI Director Michael F. Chiang, M.D. “We lack a therapy for this disease in part because it’s rare. This model theoretically creates an unlimited supply of human cells for study.” Stargardt affects about 1 in every 10,000 people in the U.S.
Stargardt disease causes progressive loss of central and night vision. The vision loss is associated with the toxic build-up of lipid-rich deposits in the RPE, whose main job is to support and nourish the retina’s light sensing photoreceptors. Under normal conditions, the ABCA4 gene makes a protein that prevents this toxic build-up. Prior research showed that Stargardt disease is caused by a variety of mutations in the ABCA4 gene. More than 800 ABCA4 mutations are known to be associated with a broad spectrum of Stargardt disease phenotypes.
One way the RPE supports photoreceptors is by ingesting their spent outer segments, which keeps the cell pruned and healthy. In Stargardt disease, many scientists believe that RPE cells die after they acquire toxic byproducts when they ingest outer segments, and that this in turn leads to photoreceptor death and vision loss.
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