Volume 6, Issue 45│November 18, 2022
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Congratulations to Dr. Ansel Johnson of Blue Island, IL for Being Featured for his Work During World Diabetes Awareness Day by the AOA.
Photography by Nate Smith
Successes in diabetes care
NOVEMBER 14, 2022
This World Diabetes Day, the focus is on access to education. Living with diabetes himself, one AOA member is passionate about caring for and educating patients with diabetes.
Excerpted from page 56 of the November/December 2022 edition of AOA Focus.
Ansel Johnson, O.D., is eager to talk about his vision for caring for patients with diabetes. It is rooted in a holistic approach: the latest technology (OCT); a standard of care informed by his training and the latest research (such as the AOA diabetes guideline); collaboration with a patient’s primary care physician, a dietician and a pharmacist; and patient education.
Patients can even learn from each other, says Dr. Johnson, who practices in Illinois.
His philosophy? It all works together.
What is crucial is being in a patient’s corner with all those tools at his disposal.
A member of the Association of Diabetes Care & Education Specialists (ADCES) for more than two decades, Dr. Johnson says: “You’ve got to be patient-centered and see what their barriers are.”
Dr. Johnson is one of only six doctors of optometry among ADCES’ 12,000 members.
You and Paula Newsome, O.D., started a program a few years ago called KNOCTM (Knowledge-Nutrition-Ocular Health-Coaching). Describe this holistic philosophy.
Even professional athletes, who may know what drills they need to do, have their trainers. They have a strength coach. They may have a speed coach. They may have a psychologist to talk to. They have different people to help them be better.
From where does your passion for providing diabetes care derive?
Family. I have family living with diabetes. I have family members who passed away from complications from diabetes. I am a poster child for Type 2 diabetes because I am living with diabetes myself. Like most people, I ignored the warning signs. I’m a busy professional, running my own practice, with a high stress level, until I had a catastrophic health incident and had to be hospitalized because it had gotten out of control.
Does your own diabetes story help you relate to your patients with diabetes?
Professionally, in practice every day, I see people living with diabetes. I am able to relate my own story to them. I talk to them about my own struggles and day-to-day decisions I have to make to live a better-quality life. I am also really big on patient education.
You’ve talked about providing patients with “nuggets” of education. What are those?
We all know, intellectually, how to take care of ourselves if we’re prediabetic or diabetic. But we also have our own human frailties and struggles. I ask patients, “What’s your plan?” I challenge them to be specific. If they mention their diet, I ask them “How are you going to eat differently?” Are they going to start eating from smaller plates, decreasing the amount of meat they eat? I try to give people specifics or tips that are motivational and achievable.
What kind of commitment does it take to provide this level of care?
Not every doctor can be out of their office for a prolonged period. But I am certified by the Centers for Disease Control and Prevention in diabetes prevention. That’s a two-day seminar—Diabetes Prevention Program lifestyle coach—which is a much lower bar to manage. Optometry can make a big difference in terms of public health and health care disparities.
Access AOA’s valuable diabetes resources
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AOA-PAC Plays Outsized Role in 2022 Midterm Elections
Despite shifting political winds and the lasting disruption caused by the pandemic and economic downturn, the AOA-PAC continues to play a decisive role in hundreds of congressional races, nationwide.
As the 2022 midterm election closes with most races now called, the AOA-PAC backed more than 91% of winning candidates this cycle by reinvesting over $2 million back into the campaigns of hundreds of pro-optometry U.S. House and Senate incumbents and candidates. Below, view the AOA-PAC’s interactive map with a full list of endorsed candidates and incumbents, and see optometry’s advocates in action throughout the past year.
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7 Takeaways from the 2023 Medicare Physician Fee Schedule Final Rule
The CMS finalized several policy recommendations put forth by the AOA, yet the 2023 physician fee schedule conversion factor still spells payment cuts without immediate Congressional action.
Medicare finalizes its annual physician fee update with several changes affecting optometry, yet physicians’ attention remains largely focused on sizable payment reductions looming.
On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) published its final rule that includes updates and policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, come Jan. 1, 2023. Broadly, the PFS reflects the administration’s effort to promote accessibility, quality, affordability, empowerment and innovation, while specifically, outlines policy changes that affect billing and coding, reimbursements and participants in the Merit-based Incentive Payment System (MIPS).
While the 2023 PFS final rule contains much of the feedback and recommendations shared by optometry’s advocates during a public comments period in July, the AOA continues to review and evaluate the final rule’s effect on optometry. Notably, the final rule heaps urgency in the waning days of this congressional session to avert ballooning cuts to Medicare physician payments slated for 2023.
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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.
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IOA/AOA Membership Renewal Update
2023 membership invoices have been mailed out, so members should begin receiving invoices soon! Those on a recurring monthly or quarterly payment do not need to respond as your payment schedule will be automatically renewed.
On September 30, 2022, the IOA Board of Directors voted to keep IOA membership dues at the same rate as 2022. Likewise, the AOA Board of Directors did not issue a dues increase, so IOA/AOA membership fees will remain the same in 2023.
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2023 Dues Contest
Pay membership dues in full by 1/31/2023 and be entered into a drawing to win FREE registration to the 2023 IOA Annual Meeting in Schaumburg, Illinois! This includes your registration for the meeting and all CE testing fees associated with your registration but does not include hotel reservations.
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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.
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2022 Medicare Fee Schedules
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Report illegal and unsafe contact lens sales to the FDA & FTC
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Check out the newest IOA classifieds here!
Rosin Eyecare is seeking candidates for a full time position in Orland Park, Illinois. We are looking for an energetic, team-oriented, positive individual (Read more)
Shopko Optical is currently seeking an Optometrist to join our team in Taylorville, IL and Jacksonville, IL! ( Read more) |
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EMAIL SERIES PART FOUR:
Emails announcing a product or service are important for getting the message out to patients. The purpose of these emails is to inform existing patients about specials you are running or new services that are available at your office. Grab the interest of your recipient with attractive graphics and bold images, then provide interesting and informative content that details the new product or service. Share this same updated information on your social media.
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IL GOP Elects New Leadership, Democratic Leadership Remains in Place
Politico reports that Republican state senators and representatives have elected new leaders for their caucus. State Senator John Curran (R-Lemont) secured unanimous support from Senate Republicans to take over leadership from current Senate Minority Leader Dan McConchie. State Rep. Tony McCombie (R-Sterling) won 31 to 8 to become House Minority Leader. Current Minority Leader Jim Durkin announced that he was stepping down from the position last week. The new leadership “is an indication that Republicans want to expand their reach.” House Speaker Emmanuel “Chris” Welch also secured the necessary votes to remain speaker. Senate President Don Harmon likewise received enough support from the Senate Democratic Caucus to retain his position.
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Rep. Mazzochi's House Race Still Too Close to Call
CBS News reports that the race for the 45th House District in the western Chicago suburbs is still too close to call. State Rep. Deanne Mazzochi (R-Elmhurst) is currently trailing her opponent Democrat Jenn Ladisch Douglass by less than 250 votes. Mazzochi recently filed a lawsuit against the DuPage County Clerk for improperly verifying mail-in ballot signatures. On Tuesday, November 15, Judge James Orel sided with Mazzochi and ordered the Clerk's office to change their ballot counting methods as they continue counting mail-in ballots.
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Amoxicillin Shortage Hits Northern Illinois
Alternatives are OK, Northwestern Medicine specialist says
November 14, 2022 at 5:00 am CST
Amoxicillin, the form of penicillin many doctors turn to and parents expect when their children are sick, is in short supply across the country, including in northern Illinois.
The Food and Drug Administration listed amoxicillin on its page of drug shortages beginning on Oct. 31.
On a local Facebook page, McHenry Moms, some parents reported being either unable to get the widely prescribed antibiotic from McHenry County pharmacies for the past few weeks or having to go to more than one pharmacy to fill the prescription.
The good news, said Michael Postelnick of Northwestern Medicine’s McHenry County hospitals, is that there are other antibiotics doctors can prescribe. Postelnick is the antimicrobial stewardship practice coordinator for health care system’s locations in the region.
In simple terms, Postelnick helps ensure doctors are not overprescribing antibiotics, including amoxicillin.
It appears that the drug is suffering from the same supply chain issues, “which we have heard about post-pandemic, ad nauseam,” Postelnick said.
A few of the manufacturers are having issues supplying the drug and one manufacturer was shut down by the FDA, Postelnick said.
The drug is not totally unavailable, but supplies are limited, he said.
There are good alternatives, Postelnick said, and doctors prescribing antibiotics should check with pharmacies and consider those if amoxicillin is not available.
“They cover the same bacterium as amoxicillin,” he said of the alternatives. Doctors prefer amoxicillin, however, “because it covers a narrower spectrum and is less likely to cause problems down the road.”
Families that cannot find a pharmacy with it in stock should not get old drugs from friends or family, he said.
“That is bad. Antibiotics are prescribed for a course of therapy, and you should finish the course,” he said.
Keeping that antibiotic around “just in case for the next time is a great way to make bacteria resistant” to drugs, he said. Those leftover pills are not enough to complete a course of treatment, he said.
If someone is taking an antibiotic for five of their seven days, for example, and feel better, they may ask their doctor if they can discontinue the treatment, he added.
Overall, he said, doctors have gotten better about not prescribing the bacteria-killing drugs when not necessary. But collectively, “30% to 50% of antibiotic use for outpatients is unnecessary,” he said.
In pediatrics, Postelnick calls it a “balancing act” when deciding what to prescribe.
“You have to rely on your physician on when it should occur and when it shouldn’t,” he said of the prescription. Just because a child has an ear infection does not mean it is bacterial, he said.
“That is where your pediatrician becomes very important,” Postelnick said.
According to the websites Northwestern Medicine uses to track drug availability, it is thought supplies will rebound in November or December.
In the meantime, parents or adults who need an antibiotic should speak to their doctor about those alternatives, Postelnick said.
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Paul Olsovsky Discusses Recent Tech Advancements in Optometry
Paul Olsovsky is an optometrist with close to 30 years of experience in the field. In the following article, Dr. Olsovsky discusses the technology advancements in optometry, and how they are benefiting both patients and providers.
Technology is advancing in all fields, but none quite as rapidly as the seemingly futuristic innovations seen in the world of optometry. With new devices and software coming to the sector at unprecedented paces, it’s a profession ripe with possibilities for patients with a wide range of eye conditions.
And as all industries shift into an ever-digital space, Paul Olsovsky of Oregon expects this rapid evolution to continue bettering optometrists’ diagnoses and patient outcomes.
The New Technology Is Set to Change Optometry for The Better
Technological advancements are hitting the optometry field all the time. But Paul Olsovsky of Oregon says that practitioners consider these to be the most effective and exciting:
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Fitting and Troubleshooting Tips for Scleral Lens Success
November 14, 2022
Increasing scleral lens use can benefit a larger patient base.
In 2021, eye care practitioners estimated scleral lenses accounted for approximately 14% of the gas-permeable (GP) lenses they prescribed, according to the Contact Lens Spectrum’s GP and Custom Soft Annual Report 2021.1 Although corneal lenses remain the dominant GP lens design, scleral lenses are becoming increasingly more popular among practitioners for a variety of corneal conditions.
Because scleral lenses are fitted to vault over both the cornea and limbus and land on the sclera, the resultant tear reservoir provides a plethora of advantages over traditional corneal lenses. These include superior vision, improved comfort, and greater ocular surface protection. Scleral lenses are usually considered as an option for patients with irregular corneas; however, they are also excellent options for patients with high ametropia and dry eye syndrome.
As scleral lenses have become commonplace in many practices, manufacturers have created simple fitting guides. When fitting empirically—regardless of the manufacturer—all scleral lenses follow the same 4 basic guidelines.
1. Choose a diagnostic lens
Choosing the correct diagnostic lens is crucial and includes 2 key steps: selecting proper design and selecting diameter. A prolate design is ideal for regular corneas or patients with corneal ectasias (eg, keratoconus and pellucid marginal degeneration). An oblate design is ideal for patients who have had refractive surgery (eg, LASIK, photorefractive keratectomy, or radial keratotomy). On occasion, topography reveals a corneal pattern that does not clearly fit into either category (eg, post transplant). In this case, try both designs and determine which is a better overall fit based on fitting guidelines 2 through 4.
Choosing the appropriate diameter should be guided by the patient’s horizontal visible iris diameter (HVID). This can be measured manually with an HVID ruler or slit lamp beam or obtained from metrics provided by a topographer. Once the appropriate diameter and design have been selected, choose a starting lens recommended by the manufacturer based on the patient’s corneal condition or keratometry values. When in doubt, choose a lens from the middle of the fitting set.
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House Speaker Nancy Pelosi Stepping Away from Leadership Position
The New York Times reports that Speaker of the House Nancy Pelosi announced on Thursday that she will be leaving House leadership in January. She plans to remain in Congress but will not seek the role of minority leader after Republicans secured control of the House. “For me the hour’s come for a new generation to lead the Democratic caucus that I so deeply respect,” Speaker Pelosi said from the House floor on Thursday. Shortly after Speaker Pelosi’s announcement, the number 2 Democrat, Steny Hoyer of Maryland announced that he too will not seek a leadership position next term. Representative Hakeem Jeffries of New York is now expected to become the next Democratic leader. |
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AEYE Health Gets FDA Approval to Screen Diabetics to Prevent Blindness
JERUSALEM, Nov 15 (Reuters) - Israeli digital health firm AEYE Health said on Tuesday it received clearance from the U.S. Food and Drug Administration (FDA) to market its screening system to detect damage to the retina of the eyes in diabetics.
Screening diabetics for retinopathy, or damaged retinas, has recently become reimbursable in the United States.
The FDA approval follows positive Phase III clinical trial results from last February.
Using a special desktop camera, AEYE takes images from each eye and through artificial intelligence it captures and analyses data of the retina that helps diagnose diseases, including diabetes, that could lead to blindness.
It noted that diabetic retinopathy is a leading cause of blindness in the working age and that 90% of such vision loss could be avoided with early detection and treatment.
AEYE added it was advancing a follow-on program for the screening of glaucomatous optic neuropathy and expects to initiate FDA pivotal trials soon.
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