The AOA’s Research & Information Committee (RIC) conducted the survey this past summer, with findings published in the AOA Health Policy Institute brief: 93% of doctors who provide myopia management work in cities, with 71% working independently. Before beginning myopia management protocols, 73% believe an annual progression of 0.5 to 0.75 diopters is required. The most important risk factor for myopia management was determined to be refractive error. Soft (contact) lenses approved by the FDA were the preferred treatment method. 33% of myopia management candidates postpone treatment; 80% of these patients postpone treatment due to financial constraints.

The most difficult aspect of epiretinal membrane (ERM) peeling may be the timing — early removal allows the membrane to reappear, whereas later surgery may impair restored visual acuity. An analysis published in BMC Ophthalmology evaluates clinical outcomes for patients with diffractive multifocal intraocular lenses (MIOLs) and compares how changing levels of ERM affect recovery.

Researchers used retinal imaging to examine the eyes of 200 people with age-related macular degeneration (AMD) to see who had subretinal drusenoid deposits (SDDs). Patients were asked to fill out a questionnaire about their family history of cardiovascular disease. There were 97 SDDs and 103 drusen only among the 200 patients. 47 of the 200 patients had severe heart disease, and 40 of the 47 (86%) had SDDs. In comparison, 57 (43%) of the 153 AMD patients who did not have these severe diseases had SDDs. According to the researchers, AMD patients who had these severe cardiovascular diseases and strokes were nine times more likely to have SDDs than those who did not.

This technique for placing an IOL without capsular support has a steep learning curve, but once mastered, it should take only 15 to 20 minutes to complete. The most difficult aspects of this technique are measuring for needle insertion sites and lacing the trailing haptic into the needle lumen. Lacing the trailing haptic is probably the most difficult intraocular maneuver. This is a difficult task, but with the right approach and equipment, unnecessary complications can be avoided.

This physician’s surgical video demonstrating the management of a symptomatic dislocated posterior chamber intraocular lens (IOL) with a Siepser slipknot suture technique is an oldie but a goodie, as many eye care specialists have commented.

Change is difficult, and it usually necessitates effort, struggle, and the challenge of those who are dragging their feet around us. Annual reflection is a good way to stay current, push the boundaries, and provide better patient care. Try these tips to help your practice thrive, whether you have a long-standing specialty contact lens practice or are looking to expand into more specialty areas.