EYE DIGEST May 2020
BCDO’S QUARTERLY OPTOMETRIC MAGAZINE
Find our Way Together: New Normal Dr. Mahnia Madan
Financial Wellness Tips for ODs During A Pandemic
Member Spotlight Candorvision and Optometry During COVID-19 Committed to Exceptional Patient Care
12 Tips for Re-Opening Your Practice
info@optometrists.bc.ca 604.737.9907
BC Doctors of Optometry 121 –10551 Shellbridge Way, Richmond B.C, V6X 2W8
CONTENTS
Covid-19 Pandemic Alcon Vision Portal ......................................................................................................................................... 4 Candorvision and Optometry During COVID-19 – Committed to Exceptional Patient Care ...................................................................................................................................................... 6 Fighting Blindness Canada on COVID-19 and Your Eye Health: FAQ's to Help Address Concerns from Your Patients...................................................................................................... 10 Financial Wellness Tips for ODs During A Pandemic............................................................................ 14 Supporting the Role of Optometry In Primary Care ............................................................................ 16 Patients Grateful to Eye Doctors Providing Essential Care During COVID-19 Crisis .................. 20 12 Tips for Re-Srart Your Practice.............................................................................................................. 22 Eyesafe: Eye Protection Guidance ............................................................................................................ 24 HFA Cleaning Quickstart ............................................................................................................................. 26 HFA COVID-19 Guidance ............................................................................................................................ 30 Adapting: Two ODs Reflect on Their Experience.................................................................................. 34
Wellness 5 Tips To Stay Healthy During These Difficult Times ........................................................................... 36 A New Paradigm For Optometry: Natural Disasters And WHO Emergency Medical Teams ................................................................................................................................................ 38 How To Spend Your Days In Self Isolation ............................................................................................. 40
Industry The Waterloo Eye Institute: A resource for Canadian optometry ................................................... 42 Could Mgd (Meibomium Gland Dysfunction) Be the Cause Of Your Dry Eyes? .......................... 45 Rethinking Standard of Care in AMD ..................................................................................................... 46
Programs & Events Introducing EyeLearn .................................................................................................................................. 52 BCDO 2020 Annual Conference & OPTOFAIR ......................................................................................54
Members & Service Member Spotlight: Dr. Mahnia Madan .................................................................................................... 56 Are You Interested in Locum Work? ...................................................................................................... 60
Research The Recent Canadian Council of the Blind Study Reveals the Stark Reality of COVID-19’s Disturbing Impact on Those Canadians Who are Blind, Deaf-Blind or Partially-Sighted ................................................................................................................. 62 Vision 2020: The Importance of Regular Eye Exams ......................................................................... 64
A Letter From Our CEO Dear BCDO members, During these uncertain times, we find ourselves facing a challenging worldwide pandemic. At this moment in time, the work we are doing is vital for the ongoing success of the profession. Our thoughts and hearts go out to anyone directly affected by the virus and to those battling with the uncertainty due to impacts of COVID-19. Over the past several months, BCDO has worked actively to adapt to our new reality and to respond accordingly. In response to the crisis, we adapted and rolled out services to provide our members with real-time, practical and succinct information and support. We continue to offer information efficiently through our member updates, webinar series, various virtual and continued education sessions. Collaboration We have continued to advocate with government and various stakeholders to ensure we have a strong voice for the profession. BCDO remains to work collaboratively with the Ministry of Health, the College of Optometrists of BC, industry partners and other allied health professionals to aid and support our members, clinics and employees. Emerging Priorities We remain focused on four priorities: 1. Advocacy and education; 2. Member value and optometry support in a pandemic context; 3. Financial sustainability; and 4. Readiness for post-pandemic recovery for the “new normal”. BCDO continues to advocate, educate and share resources to ensure we meet the evolving changes to practice and patient management through teleoptometry, e-commerce and other technologies. Furthermore, we have established a new social media strategy to share and promote virtual healthcare and access to care. We will continue to advocate and educate through various public campaigns. Strategic Plan Goals We have established our new Strategic Plan for 20202022. Due to COVID-19, some of the BCDO’s strategic goals and priorities may be impacted but rest assured that we take appropriate measures to safeguard and mitigate
exposure and impact to the association and our members. We continue to adjust our approach as required. To ensure that BCDO and Industry Partners can provide value once clinics reopen and transition back to a “new normal” state of business, BCDO has conducted a post COVID-19 survey to gain an understanding of shared areas of interest to provide ongoing support and value-added resources. Launch of EyeLearn BCDO has rebranded ESEL to EyeLearn, an educational program that will be in favor of a new province-wide approach with a focus on awareness about eye health for children. The new Children's Vision Program will be phasing out of the EyeSee...EyeLearn program. EyeLearn is scheduled to launch alongside our new mascot Opie and BCDO branded items for participating offices starting in August of 2020 in time to promote children’s vision for the fall. The team at BCDO continues to work remotely and are all connected and available to support our members. We will continue to do our best to respond to member enquiries and deliver our services without interruptions. We are continuously working on different aspects, and we thank you for your patience during this time. Thank you for your engagement and support in this unprecedented situation. Please let us know if there is anything else that we can do to support you and we look forward to connecting virtually and in person in the future. We remain committed to you throughout this challenging period. We are confident that the optometry profession will recover from this crisis and come back even stronger than before. Stay strong, safe and healthy. We will get through this together. Sincerely,
Ms. Pria Sandhu BC Doctors of Optometry CEO
Alcon Vision Portal As your trusted partner for more than 70 years, Alcon is sensitive to your needs during this unprecedented time. We know the tremendous impact it is having on your practices and patients, and we want to remind you that we are in this together. Keeping our promise to help people See Brilliantly is now more important than ever. Alcon is dedicated to supporting you, your practice and your patients during these unprecedented times. That’s why we are working alongside other industry and association partners to
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promote the safe wear and care of contact lenses during a time when many of your patients have questions and concerns. We’re extending our support through virtual education for you and your staff at VisionPortal.ca and providing digital tools at AlconVisionBrandLibrary.com so you can continue reaching patients online with important information. Our shared commitment to helping people See Brilliantly remains strong in uncertain times. It connects the eye care community and will help us return to brilliance—together.
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Candorvision and Optometry During COVID-19 – Committed to Exceptional Patient Care This March, the rapidly evolving COVID-19 pandemic meant that everyone had to act swiftly to prioritize health and safety. Our daily routines changed within a matter of days and new processes had to be preemptively adopted to follow federal and provincial regulations in order to help stop the spread of the virus. Eye health professionals and their suppliers faced a series of operational and financial obstacles, ultimately affecting the ability to provide the usual level and range of services for patients. Optometry and ophthalmology clinics experienced a reduction in patient volume, limited working hours leading to staff layoffs, with some practices even having to temporarily close. As a reliable partner for Canadian eye health professionals for more than seven years, we at Candorvision have been in frequent contact with many clinic team members as we processed their orders and checked in to better understand their individual situation, sharing best practices and working together on tailored solutions if any assistance was required.
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We have been excited to hear about their timely response to ensure and adopt safety measures in clinics, their innovative solutions and their victories as they’ve worked tirelessly to meet the needs of patients and communities. At a moment in time where emotions are running high and uncertainty reigns, these outstanding optometrists have risen to the challenge, managing to capture a beacon of light and holding it high to guide others. Here are just a few examples of what we learned from these dedicated teams as a result of their experience and commitment to provide quality patient care: • Doctors and staff personally calling each patient to check in and see how they are coping; • Actively responding to patients’ questions, taking phone orders or setting up online stores so patients can get their dry eye treatments and contact lenses; • Offering personalized home delivery of glasses, contact lenses and dry eye treatments; • Providing quality emergency care while committed to health and safety for both staff and patients;
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• Utilizing telemedicine for patient assessment and non-urgent appointments; • Innovative solutions to adhere to social distancing i.e. curb side pick-up and drop-off with hockey sticks, fishing nets, etc. • Website upgrades, making it a go-to source of valuable information for patients; • Communicating quickly with patient convenience in mind through social media and email i.e. Instagram TV videos explaining telemedicine and showing new in-person appointment procedures, as well as townhall Q&A sessions from doctors. It is heartwarming to see the lengths that optometry clinics are going to, to meet and exceed their patients' needs. By providing very personal, local services, the relationship between the patient and eye health professional can become closer, bridging the temporary gap caused by physical distancing. For those patients who are particularly vulnerable or fearful of leaving their house, the personal care and reassurance or that quick delivery has made the local optometrist their new hero! Supporting local has taken on a new meaning, reminding patients of the valueadded care available to them within their own community. At Candorvision we are proud to be working with such caring and entrepreneurial partners. To all the front-line eye health professionals, we send our deepest thanks and respect for all you have done and continue to do. Candorvision is a Canadian-owned and operated company. Optometry clinics and their teams have always been the main priority for us since the very beginning seven years ago. Working together, we have elevated the standard of care for Canadian dry eye patients to a new level. We are very grateful for your support and loyalty which helped establish HYLO® as the “Gold Standard” in preservativefree, phosphate-free and dry eye treatment and thereby improving the health and well-being of millions of patients. The Candorvision team continues to be here to assist you, our optometry partners, in providing the best-in-class (dry) eye care for patients. Our entire team is working remotely, continuing operations, processing orders and providing clinic and patient assistance during our usual business hours of Monday to Friday, 9 a.m. to 5 p.m. EST. If you have any questions or concerns, please feel free to reach out directly to Jill Davies, our sales representative in B.C. at salesgva@candorvision.com or (778) 833-4956. You can also contact our team by email at info@candorvision. com or by phone at (514) 380-5270. Working closely and communicating openly with amazing eye health professionals like you during this temporary
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crisis, we are optimistic about the future! With the lifting of restrictions being imminent, we look forward to working together with clinics and their patients each step of the way to recovery. With health and safety as THE most recent top patient priority, now is the time for optometrists to remind them: Don’t forget about your eyes, your eyes are everything! [Images supplied: Candorvision logo, Photo of our B.C. representative Jill Davies (Representative Greater Vancouver Area)]
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COVID-19 has presented several uncertainties for everyone, especially those living with vision loss. To support the vision loss community, Fighting Blindness Canada (FBC) has prepared answers to a variety of questions about eye health during COVID-19. This information is not intended to replace medical advice. Patients are advised to contact their health care provider if they have concerns about their eye health. The FBC Health Information Line is also here to help. It can be reached at 1.888.626.2995 or email healthinfo@ fightingblindness.ca.
Covid-19 and Eye Health Frequently Asked Questions How will COVID-19 affect my routine eye exam? Currently, many eye exams and appointments are being delayed or temporarily cancelled to protect the health and safety of patients. Please be patient as offices look to reschedule your exam for a later date or explore an optimal solution based on your personal health needs. Will cancelling my appointment affect my eyesight? Your doctor does not want you to lose vision while you are waiting for your next appointment. If you develop any new or worsening symptoms, please call your doctor. If your doctor’s office is unable to address your concerns, consider going to the emergency room. It is important you keep track of your eye health and notify your doctor of any sudden changes.
What is considered an urgent appointment? Your doctor will decide if your appointment is urgent based on your eye condition and health. Your doctor may choose to keep an appointment for some of the following reasons: Urgent injections or lasers for some patients with age-related macular degeneration, diabetic macular edema, diabetic retinopathy or vein occlusions. • Retinal detachment • Urgent retinal tears • Cancer care involving the eye • Endophthalmitis (infection in the back of the eye) • Uncontrolled pressure in the eye • Uncontrolled inflammation of the eye What if I have an eye emergency? Follow the same protocols as a health emergency. Call your doctor’s office to schedule an emergency appointment. Call 911 or go to your nearest emergency room if you have an emergency and cannot wait to see your eye doctor. NOTE: Emergency rooms may be busier than normal because of the COVID-19 outbreak. If you are vulnerable to severe illness, call your local public health number before you go to the hospital. If I get COVID-19, will my eyesight be affected? COVID-19 is a form of coronavirus that causes respiratory symptoms (access detailed symptom information). Several cases of conjunctivitis (pink eye) have been reported.
Fighting Blindness Canada on COVID-19 and Your Eye Health: FAQ's to Help Address Concerns from Your Patients 10 | Eye Digest Magazine
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NOTE: If you are experiencing any symptoms relating to COVID-19, call your local public health authority. If you experience any symptoms of sight loss, call your eye doctor. What can I do to protect my eyesight during this time? Here are some things you can do to protect your eye health: • Follow the guidelines from Health Canada to protect yourself and others. • If you require eye drops, wash your hands with soap and water for at least 20 seconds before you administer them. • If you are taking medication for your eyes, make sure you have enough medication to last you a 14-day period of isolation. • If you wear contact lenses, try to use your glasses for the next little while. Contact lens wearers tend to touch their eyes more often, which can contribute to the risk of contracting COVID-19. What if I am participating in a clinical trial? Is it still running? Many clinical trials have been put on pause due to COVID19. If you are currently participating in a clinical trial and you have not received information about the status, reach out to your trial coordinator. If you have signed up for a clinical trial but have not yet started your treatment, it is possible your start date may be delayed. Check with your coordinator to find out more. What if I get sick and need assistance? The recommendation from Health Canada is if you become sick with COVID-19 but are not critically ill, stay home and self-isolate until your symptoms are completely gone. Leave home only if you need medical attention. If medical attention is needed, do not use public transportation, call a taxi or your local public health to find out how to get to a medical centre. Some accessibility services will be affected in the next few months. AccessCOVID-19 Health Canada Updates.
Physical Distancing Tips
1. Grocery shop online or select a store pickup option. Prepare in advance as these options may take longer than normal. 2. If you must go to the store; avoid peak hours, wear disposable gloves or gloves you can wash when you get home, wear a mask or scarf to prevent spreading of germs. 3. Stock essential items that could keep your household going for a few months. For example; canned foods,
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frozen vegetables, dried grains, essential household supplies, and essential medical supplies in case you or a household member get sick. Check out the recommended list from Health Canada. 4. Ask your doctor to refill your prescriptions early to avoid going to the pharmacy if you become ill. You may not be able to get larger quantities of your prescription filled as pharmacies manage medication quantities to prevent shortages. 5. Explore new ways of getting active at home (exercise videos, yoga, skipping, stair challenge, and more). 6. Pass the time with some music, podcasts, movies, or favourite television shows. 7. Call friends (and attempt to keep COVID-19 off the topic list). 8. Learn a new hobby that does not require many new materials. For information about the status of COVID-19 in Canada, please refer to federal, provincial, and local government websites.
FBC events and programs have gone virtual! Cycle for Sight Our anticipated annual Cycle for Sight event has gone virtual this June 20th! This annual event brings together thousands of participants each year in support of funding sight-saving research. This year’s virtual Cycle for Sight event provides the opportunity for participants to get involved in any form of physical activity they choose, including biking, running, walking, yoga, and more. Learn more and register at cycleforsight.ca. View Point: FBC Education Series Our nationwide in-person education events have been cancelled due to COVID-19 until further notice. We understand and uphold the importance of providing valuable education experiences to the vision loss community, that’s why over the next several weeks, we are offering a series of education webinars. View Point webinars are free and open to all. To register for an upcoming View Point webinar, visit fightingblindness.ca/ getinvolved. FBC shares regular updates on vision health, research, and news. Follow us on social media @FightingBlindnessCanada and sign up for our monthly e-newsletter to stay up to date: https://www.fightingblindness.ca/enewsletter/
CYCLE FOR SIGHT VIRTUAL 2020
Join Fighting Blindness Canada June 20, 2020 Fighting Blindness Canada's anticipated annual Cycle for Sight fundraising event is going virtual! This event is open for all! Participants can join the fun by doing any physical activity, including biking, running, walking, yoga, and more!
HELP SUPPORT SIGHT-SAVING RESEARCH Eye Digest Magazine | 13
REGISTER AT CYCLEFORSIGHT.CA
Financial Wellness Tips for ODs During A Pandemic
By: Nevasha Naidoo, Education Manager, Financial Literacy Counsel and Stanley Chow, CFP – Financial Literacy Counsel, Financial Advisor
We are living in unprecedented times due to a global pandemic. One minute you have a thriving Optometry practice with a clear view of the road ahead then, suddenly everything comes to a grinding halt and its not so clear anymore. What will happen next? How do I mitigate the financial risk
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to my practice; and once everything opens up, how do I ensure the safety of my patients and rebuild my practice? Although nobody really knows the lasting impact COVID19 will have on the economy, it is important as an OD to shore up your finances against long-term economic instability. COVID-19 has undeniably taught us some
valuable lessons in our personal and professional lives that we will take well into the future and hopefully prepare us for any further unforeseen circumstances. Navigating through the financial fall-out from the pandemic has been stressful. Financial Literacy Counsel understands, and we are here to help you. Therefore, we created a financial guide to navigate the different government measures to help your practice stay afloat as well as answer a few frequently asked questions (FAQs) from ODs across the province. All this in an effort to help you keep your finances in check and make wiser decisions during this unprecedented time. I had the opportunity to interview Stanley Chow who is a Certified Financial Planner specializing in financial planning for optometrist and who is on the frontline of helping ODs get their businesses back on the road to financial recovery. During OPTOFAIR 2020, I had the opportunity to meet many of you and was excited to learn about your practice, listen to your questions and of course, hand out the hedgehog chocolates. We are confident that the following information will be of value to you and your practice. Let us begin…. Nevasha: Stanley, I heard of government measures designed to help small businesses in Canada. Do ODs qualify for them? Stanley: In response to the financial concerns and needs of BCDO members, Financial Literacy Counsel has created a "Guide to Covid-19: Government Relief Programs in Canada”. The guide will help businesses and individuals cut through the noise and make sure they are getting all the help they can receive from the federal and provincial programs. Here is a link to the guide: https://www.flci.ca/ blog/guide-to-covid-19-government-relief-programs-incanada. I hope you find this resourceful. Nevasha: Is now a good time to invest while the stock market is down? Stanley: If you already have investments, this maybe a good time to rebalance your portfolio. Rebalancing is about managing risks and keeping a strategic asset allocation that can help you reach your goals. However, if you have new money to invest, you might want to consider not making a lump sum purchase and instead dollar cost average into the market over 1 year, as we don’t know if the stock market will decline any further.
Nevasha: Should I apply for personal insurances (Life, Critical Illness, Disability) during a pandemic? Stanley: It is always important to have adequate insurances to protect yourself and your family, especially during a pandemic. Considering all that has happened, this would be a good time to re-evaluate your insurance needs. COVID-19 will impact businesses for many years to come. There is a good probability that insurance companies may need to raise rates in the next while to compensate for all the added costs forced onto insurance companies due to COVID-19. Consider applying for personal insurances before a potential increase to insurance rates occur. Nevasha: Why should you have a personal and corporate line of credit as a buffer? Stanley: 2020 will be a year all of us will remember and there will be many lessons learned. Going forward being better prepared for financial emergencies will be important. Consider setting up a personal and corporate line of credit to act as a financial buffer should any unexpected events happen in the future. Also, consider having a home equity line of credit available as it usually has a lower interest rate than a personal line of credit. Thank you, Stan, for addressing these questions and sharing your valuable insights to help bolster ODs financial road to recovery. If you have additional questions regarding your personal or practice finances, please feel free to contact us. I would also like to remind you that as part of your BCDO membership benefits you have access to financial coaching. Contact us to book your session at 604-620-6630 or consultation@ flci.ca. About The Financial Literacy Counsel Financial Literacy Counsel is a boutique financial education and financial planning company committed to “building financially literate generations”. They began serving doctors in 2003 through UBC Medicine and were contracted in 2011 by VCH Employee Wellness to provide financial literacy to healthcare professionals. Their Programs are also delivered through BC Doctors of Optometry, UBC CPD, Vancouver Divisions of Family Practice, Chartered Professionals Association of BC (CPABC) and Continuing Legal Education Society of BC (CLEBC).
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Supporting the Role of Optometry in Primary Care Telehealth has proved to be a crucial tool during the pandemic, making it possible for optometrists to meet their patients’ urgent care needs. And it’s given us the potential to provide eye and vision care to more Canadians, in more communities, than ever before. That’s why it’s been so encouraging to see the BCDO’s success in working with the Ministry to obtain codes for telehealth optometry services. Here in Ontario, we hope to follow BC’s lead to promote access to optometric services that will help people stay home, avoid unnecessary visits to the Emergency
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Department, and ease the burden on the health care system. The OAO is working hard to raise awareness at the Ministry level about the essential role that optometrists can play through telehealth. The OAO urgent care log has seen over 350 optometrists from across the country share their experiences and impact on their communities. The collaboration with the School will enable evidence to be gathered and analyzed with the goal of helping to inform public health policy.
As you work to return to practice to serve your patients, we wish you the very best in adapting to a new normal. One silver lining from the crisis may be the catalyst to explore new ideas for practice. The School will strive to do its part and work with you to identify key questions, and explore and disseminate research-based evidence that will inform public health policy, encourage the responsible advancement of telehealth and other technology, and guide new paradigms for patient care. We want you to know that the School is heartened by your effort and perseverance, and supportive of our profession. Please let us know if we can be of assistance.
Stanley Woo, OD, MS, MBA, FAAO Director, School of Optometry and Vision Science University of Waterloo
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Patients Grateful to Eye Doctors Providing Essential Care During COVID-19 Crisis By Josh Robinson
vice president of licensing and development at Pearle Vision.
Eye doctors and optical stores have been deemed essential during the COVID-19 crisis for good reason. Everyone — including those who are providing essential services themselves — needs to be able to see clearly while they are working. Vision care providers have found themselves on the front lines this spring, continuing to see patients for critical or urgent care appointments throughout the crisis. Most optical stores remain open to fix or replace broken glasses and contact lenses. That dedication to serving patients has not gone unnoticed. Notes of heartfelt gratitude are pouring in to eye doctors, including this one from a first responder: “I needed a pair of glasses for work. Your staff was so attentive and willing to help during these trying times — even opening their doors during off-hours. Thank you for the perfect pair of glasses!” Industry for All Seasons Vision needs such as eye exams and corrective lenses do not waver as the economy ebbs and flows, and they certainly do not disappear during a pandemic. The optical industry is considered sustainable as well as essential, because it remains necessary through all seasons. Eye care is also important for all ages. Regular eye exams and corrective lenses are especially crucial to maintain vision, overall health and independence as the population ages. Baby boomers are now 56 to 76 years old, and Gen X is 41 to 55. Millennials, who make up the largest generational group in history, are closing in on their 40s. “We provide a service that customers and patients want and need, even during an economic downturn or a global health crisis,” said Alex Wilkes, general manager of Pearle Vision. “And we have the added bonus of being able to help patients see better and live fuller lives, which is very rewarding.”
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Five-Star Reviews Even as they deal with the challenges of a global health crisis, eye doctors, opticians and other optical industry employees are earning high praise for being available to care for patients while many other businesses have closed: • One man brought in the broken glasses of his wife, a nurse, and was grateful to find an optical store open. “You’re my last hope,” he said, adding that she needed the glasses for work. • A nurse who saw flashes of light and spots to the right of her eye was quickly seen by the doctor at her neighborhood optical store. “I’m relieved that I am okay and can return to work. I received excellent care,” she wrote. • A patient who requested an eye exam for contacts was relieved to see the doctor the same day. She was a member of the National Guard Reserves and expected to be deployed that week, and she needed her contact lens prescription updated before she left. Pearle Vision’s Wilkes said that the optical industry can be proud of how vision care providers have continued to serve their communities during the COVID-19 outbreak. “We are honored to be designated an essential service and to continue to go about the business of caring for patients every day,” he said. “The unprecedented times in which we are living have demonstrated how essential high-quality eye care is and how appreciative people are to have access to it.”
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12 Tips for Re-Opening Your Practice
By Dr. Pavan Avinashi
At this point, you have likely embraced the Phase II “green light” and have re-opened your practice, or are planning to do so shortly. In turn, you’ve put a lot of effort into establishing appropriate measures and protocols, including procuring all the necessary PPE and sanitization products. Here are some tips to help you get back on track, and friendly suggestions of things that you should be mindful of:
1. Don’t hesitate to re-start all your marketing efforts. Yes, being closed for a few months has hurt, and the gradual opening isn’t filling the bank accounts, but make yourself relevant again to your patients and local community. Marketing shows your confidence and strength in fighting this tough time. 2. Plan to have enough PPE and cleaning products for at least 2 weeks. With supplies such a commodity, assign the process to a staff member as it can be timeconsuming. Calculate your burn rate of PPE (masks, gloves, etc.) and forecast accordingly. As an example, we are going through 65 masks per day between staff, doctors and patients. 3. Consider adjusting your service fees slightly to compensate for the notable increase in expenses required to open in a safe and appropriate manner.
This is happening in many industries, from healthcare to hair salons. In our practice, we have increased our exam fees by $6. 4. It’s never too late to properly train staff on new measures and protocols. It is critical that all members of your team feel confident donning and doffing PPE, comfortable watching each other (including the doctors!) and calling out mistakes, and understand any new safety measures. It is equally important to check-in with your entire team on how they are doing, and how comfortable they are with the new-normal and interacting with patients. In our office, we do one-on-one check-ins, as well as team surveys, to get feedback on happiness and comfort levels. 5. (Re-)Train your staff on triaging appointments. A 6 year old emmetrope for a routine exam and a 45 year old emerging presbyope that is motivated to purchase eyewear should be prioritized differently. Fill your schedule with more “strategic” appointments for the upcoming weeks, and delay others for late summer or early fall. Ensure you are also prioritizing patients with ocular health concerns while being mindful that some of these patients (seniors, diabetics) may be at higher risk for an in-person exam see the next tip!
6. Continue (or start) telemedicine. Here in BC, we have been gifted with this MSP privilege; incorporate this patient care approach into your practice and daily schedule as part of your new-normal. Consider how a blended model of in-person and telehealth exams could look in your practice. 7. Look for areas of your business that needed a “reset”. This time is a great opportunity to implement adjustments in patient flow, business ideas and/or new protocols. Examples may include expanded evening hours, screening all routine exams for dry eye (OSDI, meibography, etc.), co-pays on urgent care visits, or other ideas you have had on the back-burner. 8. Utilize e-commerce. If business closure didn’t force you to look into and introduce e-commerce options for your practice, do it now! Canadians have become more comfortable and savvy with buying everything they need online over the past few months. If we can’t provide the same solutions, you will become increasingly less relevant to them for products. Two great Canadian options are www.Lensboxpro.com and Getsightly.com 9. Hire new or extra staff if needed. There is currently the largest pool of applicants in decades; use this opportunity
to enhance your team or replace underperformers. 10. Establish your maximum patient capacity. The Government of BC has a suggested venue capacity of 5 square metres/person for Phase II. Using this as well as your comfort level, establish a patient capacity within your practice and have your team enforce it. Patients understand that coming alone and waiting in their cars or outside is part of the new-normal. As your flow gets better and restrictions ease, adjust the capacity accordingly. 11. Implement curb-side pick-up. This is possible for contact lenses, some glasses orders, or dry eye products. It is highly appreciated by patients and limits congestion within your office. You can offer payment options online or over the phone, have the order fully packed, and ask patients to call when they are arriving or are outside your clinic. 12. Have proper signage. Whether it’s window clings, floor stickers, and/or desktop signs, make sure you are communicating clearly to patients what you expect of them in your practice and efforts being made by your team. Many industry partners are now offering complimentary templates or pre-designed options for various signage.
Eyesafe: Eye Protection Guidance
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Eyesafe By Phil Trickett, Eyesafe Manager Together, we are facing a truly unprecedented situation. The global coronavirus pandemic is affecting all our families, our businesses, our communities, and our way of life. During this time, we wanted to reach out and update you on how we are approaching the situation at Eyesafe. First and foremost, our hearts go out to anyone who has been impacted by the virus, either directly or indirectly. Our thoughts are especially with those who are sick, to whom we extend our heartfelt wishes for a full recovery. And we are truly inspired by the selfless healthcare workers around the world who are on the front lines working tirelessly to care for people in need. As of this writing, many of you are having to pivot and make rapid decisions about how to manage through this fast-evolving crisis. It may be opening for pick-up or delivery-only, finding new ways to serve patients who need essential optometry services, or trying to maintain workers’ wages through hardship and uncertainty. As a participating Eyesafe Member, you play an important role in preventing working place accidents and injuries as well as promoting eye health and safety during these challenging times. Currently there is no standard explicitly for eye protection against biological hazards, such as Covid-19. Normal dress wear glasses by nature, only offers limited coverage and especially from the side will not provide adequate protection. Goggles or face shields are proposed as appropriate protection for the eyes. However, as the primary method of infection is droplet rather than airborne transmission, closely fitted wraparound safety glasses that comply with minimum coverage requirements for eye protectors, CSA Z94.3 and ANSI Z87 could be used in circumstances when there is no aerosol generation. The specification of CSA / ANSI safety glasses requires lateral protection be part of their compliance protocol. Using this type of Eye and Face protection should be prioritized during occasions that generate splashes and sprays or when prolonged face to face proximity is unavoidable. We have also been hearing from you that front-line workers urgently need prescription safety eyewear. Eyesafe and the BC Optimum Program are continuing to operate and
provide prescription safety eyewear through our partner lab, Cascade. We have introduced a “COVID-19 Package” to help frontline workers with access to these supplies through our members. As we enter this next phase in our battle with the virus, Eyesafe will continue to prioritize: 1. Providing a full service of all Eyesafe prescription safety eyewear 2. Continuing customer service to all Eyesafe & BCDO members 3. Introduction of COVID Package for the supply of PPE 4. Assist with design and marketing images to promote prescription safety eyewear especially during these current times. (See example) We are focused on the health and safety of our members, their patients, families, and communities. Eyesafe is exploring ways to support your practice to be sustainable, productive, and thriving post COVID-19. If you have any questions regarding the supply of any protective eye equipment, please don’t hesitate to contact Phil Trickett, Eyesafe Manager at info@eyesafebc.ca or call 604-7379947. As we go forward, we will be sure to keep you updated, and know that we always value your questions, ideas, and feedback.
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Adapting: Two ODs Reflect on Their Experience Dr. Shiv Sharma In his 2007 book, author Nicholas Taleb expanded his metaphor to define a black swan event: First, it is an outlier, as it lies outside the realm of regular expectations, because nothing in the past can convincingly point to its possibility. Second, it carries an extreme 'impact'. Third, in spite of its outlier status, human nature makes us concoct explanations for its occurrence after the fact, making it explainable and predictable. The COVID-19 pandemic can be considered a black swan event on a global scale, which of course includes a dramatic effect on both optometry and the eye care industry. While the immediate impact resulted in the unforeseen closure of our clinics to routine patient care, the ripple effects permeated throughout the eye care world with contact lens, frame, lens, and eye care product sales greatly reduced in our clinics almost overnight. However, adaptation began to take place immediately. Tele-optometry, which was recently added to our scope of practice by the College of Optometrists of BC, became a new MSP benefit after successful emergency negotiations
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with the Ministry of Health that were initiated by BCDO. This allowed an avenue for continuity of safe patient care as the pandemic took grasp. Meanwhile, industry partners shifted their strategy to help expand upon direct to patient delivery and e-commerce solutions to maintain patient access to eye care products. Now that our province enters Phase II of the COVID-19 Recovery Plan and we have started our return to routine patient care, albeit in a very different looking way, it would be reasonable to assume that both our practices and the industry may have permanently been changed. Fortunately, there are ways that we can learn from the changes which have been forced upon us and turn them into advantages moving forward. Tele-optometry has now been successfully tested in a real life environment and will continue to be an effective tool for many patient care situations once the pandemic is over. It can greatly improve access to eye care in the rural and remote areas of the province and be an effective tool for our local patients - increasing quick access to care in emergency situations, follow-ups, and even routine care as technology develops. E-commerce can be used as a way to efficiently deliver eye care products to our patients and to perhaps broaden our reach to a much wider audience than what we have traditionally had in our practices. Which begs the question - why didn’t we just implement this all sooner?
Dr. Sascha Verdi One day we are in the office, business as usual, and the next we are left struggling to adapt under the global pandemic. This unprecedented time left health care professionals questioning how we could continue to provide care to our patients while adhering to the provincial guidelines to minimize risk. Thankfully, the tele-optometry platform emerged and provided a space for optometry professionals to provide urgent care services to those in need. I welcomed this opportunity as an innovative way to provide care to my existing patients. Additionally, I found it to be a great opportunity to expand our network over a larger geographical area that we wouldn’t have reached otherwise. Although this was foreign terrain, I was pleasantly surprised at how positive my experience was. While I was isolating, I designated blocks of time each week for patients to book appointments. When they entered my virtual waiting room they were asked to fill in a consent form. From there, via a secure online web camera, I was able to address the patient’s chief complaint and further discuss with them our course of action. In
certain circumstances, I performed diagnostic testing to aid in my diagnosis such as guiding patients through amsler grid testing. In cases where a therapeutic agent was required, it was as simple as faxing the prescription to the patient’s pharmacy of choice. I arranged follow-ups to ensure their condition was improving and referred any cases that needed further investigation to the appropriate ophthalmologist. As we all know how worrisome acute or chronic ocular symptoms can be for our patients, they often expressed gratitude for there being an avenue that enabled their concerns to be addressed and managed in a convenient, timely and safe manner. As we transition back into the office, I plan to continue to use tele-optometry in my practice. The world around us is rapidly evolving and by adding this platform to our toolbox, we can further enhance patient care. I look forward to continuing to care for my patients through the best means possible, which I believe includes telehealth.
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5
TO STAY HEALTHY DURING
TIPS
THESE DIFFICULT TIMES
Due to the COVID-19 outbreak, most of the population is self-isolating and working from home. Eye Care Professionals have had to close-down their clinics, and in many cases, lay-off employees. There is no doubt that this pandemic has caused enormous stress, both financially and personally for these doctors, their employees and the patients that they provide care to. An obvious result of being forced to stay home is an increased exposure to computers, televisions, laptops, tablets and cell phones for everyone. We are all undoubtably spending many more hours during the day on technology, and our eyes may feel more uncomfortable than usual, with dry eye symptoms being exacerbated. With Optometry and Ophthalmology clinics being closed across the country, eye care professionals should take some much needed time to focus on themselves, and make their own health a priority.
HERE ARE 5 TIPS TO STAY HEALTHY DURING SELF-ISOLATION: 1- STAY ACTIVE
4- ALLEVIATE STRESS
Give your eyes a much-needed break from focusing on a screen - and get moving! It is finally Spring, and the weather is improving. That is a great reason to put on your favorite running shoes and go outside for some fresh air. Walking, running or engaging in a workout are all great activities to incorporate into your daily routine. Not only will you be doing something good for your body, exercise is a great stress reliever and is good for your mental health.
Take a nice warm bath, cook one of your favorite recipes or simply unwind with a glass of wine or a good book. It is important to slow down and relax during stressful times. Your mind and body will thank you for it.
2- EAT NUTRITIOUSLY It may be very tempting to order food delivery at this time, however, be mindful to eat a balanced, nutritious diet as often as you can. You will feel better and more energized! Incorporate Omega-3s into your daily diet, either by eating fresh fish or by taking a nutritional supplement containing EPA, DHA & DPA. 3- FOLLOW THE 20-20-20 RULE
5- KEEP YOUR EYES WELL HYDRATED AND LUBRICATED
Long periods of screen-use can cause eye strain and increase your dry eye symptoms. For every 20 minutes you spend looking at a screen, take a break and look at something 20 feet in the distance, for 20 seconds. Doing this throughout your day can help with eye fatigue, and forces you to blink more often, which is beneficial for dry eye sufferers.
Being on the computer for long periods of time can lead to your eyes feeling irritated, dry and itchy. Keeping your eyes well-hydrated with preservative-free artificial tears can relieve these uncomfortable symptoms, while offering instant comfort and long-lasting hydration.
On behalf of I-MED Pharma, we hope all Canadian eye care professionals and their patients remain safe and healthy during these unprecedented times. It is our sincere hope that we can all get back to a normal way of living very soon.
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©2019 | I-MED Pharma Inc.
A New Paradigm For Optometry: Natural Disasters And WHO Emergency Medical Teams Dr. Marina Roma-March President, Third World Eye Care Society
The rapid deployment of a mobile optometric team as an emergency medical team (EMT) is now recognized by the World Health Organization. In response to natural disasters the Geneva based WHO EMT Working Group coordinates the immediate deployment of international emergency medical teams. After the 2010 Haiti earthquake, NGOs and well-meaning individuals descended on the country ill prepared for the conditions and depleted food and water supply. Because of this haphazard international response WHO restricted access to future disaster zones. Eyesight is a critical determinant in the recovery of a community from a disaster but it is often overlooked by humanitarian responders. Government employees, hospital staff, and essential workers cannot function and complete necessary daily tasks required for repair and reconstruction without eyesight correction. Capacity building measures led by the local community can be hampered and delayed not only through lack of food, lack of shelter and the collapse of infrastructure but also by functional blindness created by uncorrected refractive error (URE). Functional blindness due to lost or destroyed spectacles is a potential life threatening condition for many survivors during the acute phase of a disaster and can lead to a higher secondary mortality and morbidity rate especially for myopes. We must address the loss of not only life and limb but of eyesight in disaster management. This vision crisis unknown in a healthy community prior to a disaster can be addressed post disaster by deploying emergency optometric teams trained in rapid response working with a substantial library of spectacles covering the spectrum of diopter powers. The Third World Eye Care Society (TWECS) mobile disaster team was the only WHO approved EMT allowed to provide acute eye care to survivors after Typhoon
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Haiyan destroyed cities and villages on the island of Leyte Philippines killing over 8000 people and leaving 4 million homeless on November 8th, 2013. NGOs willing to work in the devastation zone required strict approval from WHO before authorities allowed them into Tacloban City. The TWECS EMT specialized cell of 11 optometrists and 7 other specialists from the US, Canada, New Zealand, and Australia immediately embedded with a local medical facility as the disaster began to transition into an acute recovery phase. The team deployed on day 56 and spent 13 days conducting rapid mobile eye clinics with handheld optometric equipment, medications and an inventory of 12,000 prescription spectacles ranging in powers from +20 diopters to -20 diopters. In the first week the TWECS team performed acute optometric care from eye examinations to foreign body removals and surgical referrals on 4,200 survivors and replaced over 3,800 prescription spectacles lost in the Typhoon’s storm surge. First responders that included doctors, nurses, hospital staff, local EMTs and personnel from the mayor’s office were immediately seen by the TWECS recovery team. During the second week 3,600 more ambulatory patients, many of whom were referred by other WHO EMTs, received acute optometric care and spectacles. During this deployment over 8,106 people were examined by TWECS optometrists and had eyeglasses replaced. Of the 8106 patients seen, 940 (11.6%) needed myopic correction, 1151 (14.2%) hyperopic correction and 5,998 (74%) needed presbyopic correction. This successful rapid deployment of a mobile optometric response is an example of a developing role for highly trained mobile acute optometric specialists carrying a prepared spectacle library. It is a new paradigm in the field of optometry, solidifying optometry as first responders in eye care and the acute visual crisis created post natural disaster.
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How do you spend your days in self isolation? BY WESTGROUPE
As we find ourselves trying to adjust to the new normal, the days seem to drag out as boredom sets in. Our routines have been interrupted, as we wait to resume back to life as we used to know it. However, life is not on pause, during this downturn here are some steps to follow that are beneficial for mental, physical and emotional health, all while keeping us motivated and productive. KEEP YOUR ROUTINE According to experts, sticking as closely to your daily routine as possible is key. Go through the same motions as you would if you were going to your office. This includes getting up at the same time, taking a shower, getting dressed and making breakfast. Plan out your day to ensure to get through your task list.
SET BOUNDARIES Dedicate an area of your home to become your office space that is free from distractions. This will help you compartmentalize and associate work tasks to this area of the house. Separate other areas of the house for family time, exercising, meals and relaxation. By keeping areas dedicated with specific purposes, it will help you focus and keep you in a routine. SCHEDULE BREAKS & STAY ACTIVE Breaks are important to keep you moving and nourished. Working from home requires a lot less movement and it is easy to get stuck in the same spot for the entire day. It is recommended to schedule breaks into your calendar like you would a meeting. Allocate the time for exercising, meals and to stretch . Many local gyms are streaming free classes online with Instagram “Live Stories”. If the time of the class doesn’t work for you, the great feature about “Live Stories” is that it stays online for 24 hours. This way you can schedule it into your day that works best for you. TRY SOMETHING NEW Take this opportunity to do the things that you have been putting off. Our industry experts have put together a number of resources online so you don’t miss a beat. There are various courses you can take and receive CE credits for. Or you can embrace the opportunity to learn new skills such as social media, marketing workshops, photography, telehealth, etc. that can help you prepare to adapt your business during this changing landscape.
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CONNECT Despite these uncertain and stressful times, connecting with people is exceedingly important. Social isolation brings a longing for human connection. With the public safety measures being put in place, people have had to adapt and become creative in their approach to socializing. Connecting digitally with video chat has become the main source of communication. There are many free services you can utilize to stay with your team, family, friends and patients. Video chat is a great digital platform that allows you to see, connect and interact with people while maintaining necessary precautions. It is important to stay connected with patients, to see how they are doing, to let them know you are here for them and inform them how they can get in contact with you.
STIMULATE YOUR MIND It is just as important to stay active mentally as it is physically. Rest your eyes to avoiding screen time by switching out watching TV for listening to music, a podcast series or audio books. Music is not only therapeutic but mentally stimulating . Listening to music, depending on how you listen to a playlist or different genres, triggers the production of various hormones in the brain to stimulate specific areas. Studies show that music can help reduce anxiety, blood pressure, pain and stress. It can also improve sleep quality, mood, mental alertness and memory . RELAX It is equally as important to take your mind off the stress of things that are beyond our control. Find ways to relax and have fun. Don’t let self isolation stop you from having a social life. You can enjoy most of the activities you would do normally, now from the comfort of your own home! What is most important at this time is to stay positive, work together and keep busy. They key is to maintain a routine while keeping healthy physically, mentally & emotionally. Change can be scary, especially when it is unfamiliar. As things shift, we need to embrace, evolve and learn to adapt in order to move forward. Take this time to learn new skills or programs that will be beneficial for your business or career. Remember to stay connected to friends, family, team members and patients. Engage with the people around you to include them in your virtual social life. There is an unlimited amount of resources available online to stay healthy, have fun and relax. Together we will get through this. Stay home and stay safe. FULL ARTICLE: https://blog.westgroupe.com/how-to-spend-your-days-in-self-isolation/
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The Waterloo Eye Institute:
A resource for Canadian optometry The Waterloo Eye Institute As an optometrist, what keeps you up at night? Is it rising rates of myopia in children or age-related conditions that are becoming more prevalent as our population ages? Is it the ongoing need to keep up with new clinical practice? Or government policies that don’t always recognize (or adequately remunerate) the services you provide? At the University of Waterloo’s School of Optometry & Vision Science, we believe we can help address these issues through a bold new initiative, the Waterloo Eye Institute. Through advances in vision research, optometric education and patient care, the Waterloo Eye Institute will help you stay ahead of the growing demand for eye and vision care and better leverage your expertise. Here’s how: • The Waterloo Eye Institute focuses on inter-professional collaboration to provide seamless patient care. Care coordination among family physicians, optometrists,
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•
•
ophthalmologists and other healthcare professionals will create a pathway that is not only less stressful for patients but more efficient as well. Through research conducted at the Waterloo Eye Institute, we will develop new treatments and techniques for clinical practice. We will also provide governments with evidence-based information to inform policy change and ensure that optometrists are both recognized and remunerated for the vital role they play in health care. The Waterloo Eye Institute will create new continuing education opportunities for all Canadian optometrists. We’re working on a new web-based platform incorporating the latest in instructional design to deliver content when you need it and where you want it. Evidence-informed approaches to clinical practice, hot topics in health care like cannabis, and specialty practice are just a few examples.
• While the School already trains students for the
• Harness the power of AI for clinical decision support
practice of optometry, the Waterloo Eye Institute will take optometric education to the next level. Earlier contact with patients, exposure to a wider variety of eye conditions, and opportunities to learn from other health care professionals will create a new generation of ODs who are well prepared to meet Canadians’ growing eye and vision care needs. There’s never been a greater need for the eye and vision care services you provide. The Waterloo Eye Institute will help you meet the demand through innovation, education and research. But we need your help to make it a reality.
not replacement Clinical Programs/Services • Leverage our expertise and breadth of services to increase patient access and expand educational opportunities. • Reimagine the patient pathway to improve experience and efficiency for patients and students
•
The Waterloo Eye Institute This $35M investment in Canadian optometry will include: An ambulatory surgical Centre • Collaborate with ophthalmology to promote seamless patient care and provide unique clinical training opportunities. • Increase patient access, decrease wait times and promote interprofessional models of care including pre- and post-op co-management. Diagnostic Imaging and Reading Centre • Embrace telehealth technology to expand access to eye and vision care to underserved populations • Create a resource for clinical education and professional development. Ocular Imaging Research Centre • Bring new techniques and treatments from the lab to the clinic. • Use the eye as the window to the brain to understand, diagnose and treat conditions like Parkinson’s, diabetic retinopathy, AGM and stroke.
The time is now Through a five-year pledge equal to just one eye exam a week to the Seeing Beyond 2020 campaign, you can help build Canada’s premier eye and vision care centre. You’ll be making an investment that will benefit not only your patients, but your profession as well. If 200 optometrists across Canada make this pledge, we will be able to raise more than our $5M goal for 2020 which is critical to beginning construction in 2021. So whether you pledge one exam, two or three a week or a month. Are just starting out and can give $20.20 a week your gift is truly appreciated. The most important thing is that you participate, at any level – because as a collective, you can make a difference. There are also naming opportunities available to recognize your support. We have donors who have already made a pledge to name an exam room! Gifts of any size qualify for a tax receipt. You can make your gift once a year or give monthly. Gifts of securities are also an excellent way to meet your philanthropic goals with favorable tax advantages. Learn more about what the Waterloo Eye Institute means for BC optometrists and how you can get involved or how to make a gift - please contact Andrea Carthew at acarthew@uwaterloo.ca.
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I-MED Pharma products help patients manage their dry eye disease symptoms from mild to more serious conditions like MGD and Blepharitis Preservative-free, viscoadaptive tears Convenient, one-step ocular hygiene solutions Safe, rapid and reliable diagnostic tools Nutritional vitamins to balance out ocular health Therapeutic accessories to complete existing DED treatments
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Your eyes are precious. From the moment you wake up in the morning to the moment you go to bed at night, you rely on your eyes to accomplish many routine tasks and help you do the things you love. It is important to keep them at their best because when symptoms of dry eye disease start surfacing, such as red, itchy, swollen, stinging or burning eyes, this can have a serious impact on your quality of life. Thankfully, with a little attention, there are many things you can do to keep your eyes healthy and pain-free. DED: A Growing Prevalence Simply stated, dry eye disease (DED) happens when the surface of the eye doesn’t produce or retain enough lubrication and moisture. When eyes are healthy, our meibomian glands release oil into our tears which helps to keep the eyes hydrated. If we don’t blink enough, or we don’t blink fully, these glands can become clogged, which can lead to a condition known as Meibomian Gland
our teeth and gums need regular brushing and flossing to remain healthy, our eyes need some attention and care to be at their best. The first line of defence is to schedule routine eye exams with your eye care professional who can assess the health of your eyes and determine if you suffer from dry eye disease. If a diagnosis of dry eye is determined, there are effective management solutions that they can recommend. I-DROP® MGD: Protection and Hydration in one drop! When it comes to relieving dry eye symptoms, I-MED Pharma has the most effective management solutions that offer unparalleled comfort and relief to patients. Our newest addition to our I-DROP® product line is I-DROP® MGD, the most-advanced artificial tear on the market today. I-DROP® MGD is a premium, preservative-free artificial tear that helps relieve symptoms of evaporative dry eye. It is formulated with 0.20% viscoadaptive hyaluronan, as well as superior osmoprotectants and bioprotectants that help
Could Mgd (Meibomium Gland Dysfunction) Be the Cause of Your Dry Eyes? Dysfunction (MGD). MGD is one of the leading causes of evaporative dry eye. In today’s world, the increased use of computers, TVs and smartphone screens strain our eyes daily, for hours on end. This tends to make us blink less often and to not close our eyes completely when we do blink. This prevents the meibomian glands from secreting oil into the tear film, which is necessary to properly lubricate and hydrate the cornea. When the meibomian glands do not work as they should, the result can be dry eyes. Caring for Your Eyes We so often hear about the importance of eating well and exercising, but what are we doing to improve the health of our eyes? If left unchecked, dry eye symptoms can worsen over time and become more difficult to manage. This can lead to irreparable damage to the ocular surface. Just like
stabilize and restore the lipid layer. I-DROP® MGD offers enhanced relief for severe chronic dry eye symptoms. For a comprehensive strategy to combat Meibomian Gland Dysfunction and the irritating symptoms of dry eye disease, I-MED Pharma is proud to offer a wide range of effective products that also include I-LID ’N LASH® ocular hygiene cleansers, the I-RELIEF™ Hot & Cold Therapy Eye Mask and our I-VU® line of nutritional supplements. Take the time to focus on what’s important and your eyes will soon be thanking you!
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Rethinking Standard of Care in AMD
2020 Vision and the Future of the Profession By Albert Ng, OD, FAAO, FIOA Last year, in an effort to safeguard my patients’ vision and grow the AMD specialty in our medical optometry practice of nine doctors, I made the decision to invest in a dark adaptometer. Today, I can’t imagine care delivery without this technology. The AdaptDx® is a diagnostic tool that’s given me and my aging patients peace of mind that I never thought possible until now. As one of more than 1,000 eye care professionals who have used the AdaptDx to identify and monitor AMD, I am excited to make 2020 the year that I join the growing movement to spread the word to my colleagues about the benefits of dark adaptation testing and the indisputable reasons why this technology should be formally declared standard of care. Why We Need to Measure Dark Adaptation We don’t have to count exclusively on what we can see through a Volk 90D lens, OCT or other imaging. There are easier ways and more accurate methods of detecting early disease and monitoring for change. In fact, a large peer reviewed study revealed that subjective dilated fundus exam testing and photography cannot reliably
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enable detection of AMD—even in patients who have large drusen. What about the cases that we miss? How many times have one of your patients presented with unexpected CNV? It’s hard to erase the memory of the patient in tears in your chair because she’s losing vision that may have been prevented—if only we had known sooner or set closer exam intervals. With the AdaptDx, I can potentially detect AMD disease development three years before it can be observed clinically. That means I am going to be on top of that patient’s care, following it treating it early and offering early advice for prevention. And with a definitive diagnosis, the patient will also be more likely to comply with my recommendations and participate in his or her care. How and Why Dark Adaptation Works Functional changes are present in AMD prior to even the earliest clinical indicators. We now know that impaired dark adaptation is the first detectable consequence of AMD and it can be used to identify patients with subclinical disease. In fact, functional changes presenting as impaired
dark adaptation take place several years before clinically evident damage to the eye has occurred. We can use dark adaptometry to detect this functional indicator. The AdaptDx is currently the only commercially available dark adaptometer. It measures a patient’s Rod InterceptTM (RITM) time - the number of minutes it takes for the eye to adapt from bright light to darkness at a standard threshold stimulus level. The test delivers a simple output that provides clinicians a clear and objective measurement of retinal function, with 90% sensitivity and specificity for the presence of AMD. • An RI time less than 6.5 minutes indicates normal dark adaptation consistent with healthy photoreceptor function. • An RI time greater than 6.5 minutes indicates impaired dark adaptation, most often due to AMD in patients over age 50, unless there is a pre-existing hereditary retinal degeneration or significant vitamin A deficiency, which is rare. The AdaptDx test is indicated for patients with symptoms or risk factors. It is also used to monitor disease progression. For example: • Patients with issues seeing or driving at night: Since night vision difficulty is the first symptom of AMD, all patients who have issues seeing or driving at night should be tested for dark adaptation impairment. • Patients who are at risk of AMD: Patients over 50 who are at high risk of developing AMD should be tested on an annual basis, even if they do not experience night vision problems. Risk factors include age, family history, smoking, obesity and overall cardiovascular health (heart disease, high blood pressure or high cholesterol). • Patients with AMD to monitor disease progression: Patients with diagnosed AMD should take the AdaptDx Extended Test every six months or more to monitor disease progression. A change in the RI of three or more minutes is considerate substantial and should result in more frequent testing and closer monitoring. Declaring Standards in AMD In “Practical Strategies for Preventing Blindness Caused by AMD,” the third in a series of annual reports aimed at reducing avoidable vision loss, 27 members of the AMD Speakers Alliance released the “AMD Manifesto,” which includes five essential practice guidelines for modern AMD management. These are as follows: 1. The goal of managing AMD is to preserve visual function—not to wait until vision has already been lost. As many as 78 percent of AMD patients seek their first
treatment after having already suffered irreversible vision loss in one eye, and nearly half of them have an acuity of 20/200 or worse. There is currently no cure for AMD, but with proper care, significant visual acuity loss may be prevented in many patients. 2. Dark adaptation testing can overcome the practical challenges associated with diagnosing AMD using only traditional subjective clinical assessment. As mentioned above, observing the macula and evaluating fundus photos for small drusen and pigmentary changes isn’t easy. A study of 1,288 eyes (644 adults) published in JAMA Ophthalmology revealed that doctors are missing AMD about 25% of the time—even when the doctors were aware that their findings would be double-checked by trained graders. Conversely, dark adaptation is a simple functional test that enables eye care professionals to diagnose AMD with 90% accuracy. 3. Optometrists must establish improved practice protocols to proactively identify early disease and monitor it on a regular basis to ensure that CNV is detected as soon as it occurs. Once AMD is diagnosed using dark adaptation, optometrists can closely monitor progression on a regular basis, giving patients as much as a three-year head start. If a patient progresses to advanced AMD while being closely managed, the optometrist has a much better opportunity to save both eyes with a timely referral to a retina specialist at the first signs of CNV. 4. Optometrists can, and should, recommend treatments that make a meaningful difference. Optometrists can help AMD patients by prescribing lifestyle changes, diet and exercise modification, systemic disease management, nutritional supplementation, retinal light protection, and more careful follow-up. While these treatments will not cure AMD, they have each been shown to slow or even halt the progression of the disease. Doing this will allow patients to enjoy additional years of high-quality central vision, enhancing the odds of a better quality of life. 5. The treatment of AMD should be initiated at first detection, regardless of the stage. Based upon our current understanding of AMD pathogenesis, the stages of subclinical, early, and intermediate AMD all represent different clinical manifestations of the same underlying disease process. Care Delivery That Matches Technology Availability In short, the AdaptDx lessens our reliance on clinical signs and risk assessment and removes the guesswork
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from diagnosing AMD early in the disease process. As such, from a clinical perspective, why wouldn’t every optometrist aspire to adopt this technology when making plans for the promising new decade ahead? Macular degeneration is the worst thing that can happen to a patient. If you have a cataract, we can restore vision with surgery; but if you have AMD and the macula bleeds, the patient can get anti-VEGF injections to slow down the disease, but the damage is done. Let’s keep our patients out of the hospital for as long as possible. They don’t want to spend an entire day waiting for injections every one to three months. If we can initiate early treatment and slow down the disease process, every month and year matters— in terms of time, vision, cost and quality of life. The population is aging, but they want to remain independent. If we can preserve our patients’ eyesight, we can give them the freedom they want, so they’re less dependent on their adult children. We need to be wellness doctors, so let’s not allow our patients to become victims of preventable vision loss. Instead, let’s test them with a dark adaptometer, follow them closely, and prescribe strategies intended to preserve their sight for as long as possible.
in the office, in any light. Meanwhile, Theia takes over to facilitate a reliable, consistent test by using automated instructions and adaptive feedback spoken directly to the patient, making it easier than ever to fit dark adaptation testing into any practice workflow. The AdaptDx Pro is truly a revolutionary way to quickly and effectively measure dark adaptation in virtually any clinical setting. Dr Albert Ng is a Fellow of the American Academy of Optometry serving his community in Toronto for more than 36 years. He is the founding Clinic Director of a multi doctor Medical Optometry Practice that specializes in Ocular Wellness, Vision Therapy, Myopia Control and Dry Eye Management. Dr Ng is blessed to be a father and husband of a loving family. His motto: “To serve is a Privilege”
Related Links: Neely DC, Bray KJ, Huisingh CE, Clark ME, McGwin G, Owsley C. Prevalence of undiagnosed age-related macular degeneration in primary eye care. JAMA Ophthalmol. 2017;135(6):570-5. Owsley C, Jackson GR, White M, et al. Delays in rod-mediated dark adaptation in early age-related maculopathy. Ophthalmology. 2001;108:1196–202. Jackson GR, Scott IU, Kim IK, et al. Diagnostic sensitivity and specificity of dark adaptometry for detection of age-related macular degeneration. Investigative Ophthalmology & Visual Science. 2014;55(3):1427-31. Karpecki P, Ferrucci S, Dierker D et al. Practical strategies for preventing blindness caused by AMD. Review of Optometry, October 15, 2019.
The New AdaptDx Pro Makes Dark Adaptation More Accessible In 2020, MacuLogix introduced the AdaptDx ProTM, the next generation of dark adaptation testing featuring a wearable headset and an artificial intelligence-driven onboard technician named TheiaTM. The new headset requires no table-top space, external computer or dark room, ensuring that this critically important technology is accessible and there are few, if any, obstacles to adoption. The AdaptDx Pro includes all of the functionality of the company’s table-top dark adaptometer but is selfcontained in a wearable headset that was customdesigned and tested for patient comfort. This personal dark room allows you to administer the test anywhere
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Olsen TW, Feng X, Kasper TJ, Rath PP, Steuer ER. Fluorescein angiographic lesion type frequency in neovascular Age-Related macular degeneration. Ophthalmology. 2004;111(2):250-255. doi:10.1016/j.ophtha.2003.05.030. Cervantes-Castañeda RA, Banin E, Hemo I, Shpigel M, Averbukh E, Chowers I. Lack of benefit of early awareness to age-related macular degeneration. Eye. 2007;22(6):777-781. doi:10.1038/ sj.eye.6702691. Neely DC, Bray KJ, Huisingh CE, Clark ME, McGwin G, Owsley C. Prevalence of undiagnosed age-related macular degeneration in primary eye care. JAMA Ophthalmol. 2017;135(6):570-5. AdaptDx Pro is available in Canada through Clarion Medical Technologies.
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The Children’s vision program is now progressing to the new targets and priorities for this year, which include phasing out of the EyeSee...EyeLearn program and launching of the new EyeLearn program. EyeLearn is scheduled to launch alongside our new mascot Opie and BCDO branded items for participating offices starting in August of 2020, and efforts will be ongoing after that.
Will there still be free eyeglasses?
Is there any cost to participate in Eyelearn?
Eyelearn will focus on outreach and education of key stakeholders with an objective of increasing the capture rate of young children having a com-prehensive eye examination with a Doctor of Optometry. Free eyeglasses will no longer be a feature of the program; rather there will be items available for all children including* stickers, toys, activity books, and sunglasses, as well as eye-catching posters and brochures with a focus on modern children’s vision needs.
Outreach and distribution of materials to family doctors and the education system, as well as direct-to-public marketing, will be done by BCDO as a member benefit. We look forward to working with industry partners to strengthen the reach of the campaign.
*subject to change, prototypes and cost analyses are in the works
What do I do with my current ESEL frame kit? Your current ESEL frame kit is yours to do with as you please.
What is the timeline for this change? The official transition to Eyelearn will occur in August 2020. Efforts of the campaign will be ongoing after that time and will evolve as we determine the efficacy of particular strategies.
Can I still use ESEL in the meantime? When will I no longer be able to access ESEL?
Analysis of capture rates by ODs of children of various age groups will be conducted by BCDO using MSP billing data, to ensure that the program is achieving its desired outcome of increasing the percentage of children receiving comprehensive eye examinations by a Doctor of Optometry. Within your office, if you sign up prior to the official program launch in August 2020, you will receive a drop shipment for free with items that can be distributed to patients and parents. If you wish to restock on any of these items after August, they will be available for purchase directly from BCDO. It is our intention to keep costs as low as possible to encourage participation. You can tailor your level of involvement based on your prac-tice needs and community by deciding what to purchase and in what quantities.
You may continue to use ESEL for now. Orders will be accepted until August 2020, coinciding with the launch of Eyelearn.
JOIN US! Be the be Digest notified when EyeLearn launches, for updates on the program, and to receive a complimentary shipment 50first | to Eye Magazine of merchandise in late-summer 2020. For more information and to get on the list, please email info@optometrists.bc.ca
Introducing EyeLearn to ODs What?
EyeLearn will focus on outreach and education of key stakeholders regarding the importance of vision for learning, the value of a comprehensive eye examination, and modern children’s vision needs including screen time recommendations. The objective is to increase the capture rate of young children having a comprehensive eye examination with a Doctor of Optometry.
Why?
As ODs, we all know that children’s vision is key for learning: we want to enhance all children’s eyes, helping to unlock their potential for learning and social integration, and help to increase awareness of this among the public, teachers and GPs. Currently, the capture rate for children’s eye exams in BC is at <10% for children under age 4, and <40% for children between the ages of 5-14. The primary metric of success for EyeLearn is a meaningful increase in these numbers. We also hope as many ODs as possible will participate by reducing barriers to involvement.
How?
Outreach and distribution of materials to family doctors and the education system, as well as direct-to-public marketing, will be done by BCDO as a member benefit. We look forward to working with industry partners to strengthen the reach of the campaign. Optional perks of purchasing items that can add value to your office will be available.
Where?
Province wide. Any office can participate. Any child in BC can participate. Marketing will be done face-to-face with BCDO staff and volunteer OD’s in schools, in GP offices, at public health fairs, and online to all.
Who?
All children, ages 0-19 years.
When?
EyeLearn is scheduled to launch alongside our new mascot Opie and BCDO branded items for participating offices starting in August of 2020, and efforts will be ongoing after that. Orders for Eye See…Eye Learn will be accepted until August 2020.
How to participate in EyeLearn?
If you would like to receive a complimentary shipment with our new mascot Opie and BCDO branded items, as well as marketing materials for our new program, please sign up at the Optofair on the sign up sheet. Alternatively, please email info@optometrists.bc.ca to provide this information to get on the list. Only those who Eye Digest Magazine | 51 sign up at the Optofair will be entered to win a $200 cash prize! BC Doctors of Optometry Tel: 604.737.9907 Toll-free (BC): 1.888.393.2226 Fax: 604.737.9967 Address: 121–10551 Shellbridge Way, Richmond, BC. V6X 2W8
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The 2020 BCDO Annual Conference & OPTOFAIR held at Hyatt Regency Vancouver from February 28 to March 1, 2020, was once again a roaring success. Over 337 Optometrists, 102 Optometric Staff and 68 different exhibitors from BC and the rest of Canada came together to join and support the conference.
This year’s conference featured 71 speakers, offered 43 OD CE credits, 18 OA CE credits, and 53 sessions; including the new courses such as MSP Billing and the Cultural Safety and Humility course presented by Jenn Smith and Connie Chong of First Nations Health Authority. The keynote speaker was Nikolas Badminton, a worldrenowned futurist, researcher, and media celebrity. Mr. Badminton spoke about how exponential technologies are disrupting how we live our lives and redefining what vision is. It also highlights the exponential technologies that will change the world and show signals of change relating to how humans use their eyesight, and how medicine is being changed with big data and artificial intelligence.
Over 430 delegates attended the “Focus on the Future” OPTOFAIR to visit 68 different vendors while enjoying variety of prize draws and specialty themed cocktails.
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The chocolate passport, which we launched last year, was once again a success as the delegates have enjoyed the opportunity to fill a box with gourmet chocolates from Daniel Chocolates. Everyone has enjoyed taking pictures with the iconic James Bond lookalike with his Bond girls and was mesmerized by the Strolling Lady dressed like a cupcake stand—filled with give away edible cupcakes. The BCDO OPTOFAIR prize draw winners are: • Dr. Sara Kirby, winner of free 2020 BCDO Membership • Robyn Jonson, winner of Apple TV 4 The cocktail reception hosted by Johnson and Johnson Vision was attended by a large number of delegates. Everyone loved the J&J Vision photobooth, and their signature drink. As the Gala evening rolled on, the night evolved into even better things with superb foods, tantalising cocktails and champagne, entertainment, and great company and conversations with many. There was lots of mingling, re-discovery of former colleagues, and connecting with some new ones. It was indeed a great crowd, with a lot of interesting, intelligent and talented health professionals.
The night was filled with iconic 007 James Bond music by the live band, KokoSoul. DJ Kyboom played 80s music for the evening while Strolling Champagne Ladies were roaming around the ballroom. Adoremi Dancers hit the night with show-stopping dance moves. One of the highlights of the night was the ice sculpture pouring the signature drink of this year’s Gala theme— the Martini. The place was also buzzing with excitement as we brought in everyone’s all-time favorite casino games. The Annual General Meeting were attended by wide array of stakeholders, BCDO board members, directors, guests, non-members, and CAO representatives. Headed by President, Dr. Johnathan Lam, the discussions were about the accomplishments, strategic priorities, treasury report, member engagement projects, partnership, public awareness initiatives, and next this year’s mission and goals. The Awards Luncheon hosted by BCDO President, Dr.
who has contributed to the advancement of optometry in a meaningful way over the past year or cumulatively over many years.
Johnathan Lam, was also a success as we recognized and celebrated members, optometric staff and industry who have made extraordinary contributions to the optometry profession. Once again, congratulations to our 2020 Award Recipients:
• Young Optometrist of the Year | Dr. Petar Prpic This Young Optometrist of the Year Award recognizes a member with less than 10 years in the field and has demonstrated outstanding leadership skills both within their profession and in their community.
• President's Award | Dr. Barry Lester The President’s Awards is BCDO’s top award for our profession and has been developed to recognize the exemplary and outstanding professional and community contributions made by a member of the British Columbia Doctors of Optometry.
• Optometrist of the Year | Dr. Shaun Golemba
• Optometry Industry Representative of the Year | Mr. Errol Camacho The Optometry Industry Representative of the Year award honors a person who has provided exceptional services to our doctors. A big thanks to our Corporate Partners, for your generous support of our Annual Conference and OPTOFAIR. Thank you to the Board of Directors, CE committee, exhibitors, speakers, and the BCDO Team for delivering this incredible Conference & OPTOFAIR. We couldn’t have done it without you. Lastly, thank you to all who attended this year’s conference. We look forward to seeing you at the 2021 Annual Conference & OPTOFAIR!
The Optometrist of the Year award honours a member
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BC Doctors of Optometry Member Spotlight: Dr. Mahnia Madan Eye Digest Magazine | 57
lectured on management of ocular diseases at various state optometry meetings throughout North America, and at the American Academy of Optometry. I moved back to Vancouver in 2013, however, finding a similar way to practice here in Vancouver was extremely difficult. Nonetheless, I was determined to work as a medical optometrist and create a similar OD/OMD model that is available in the USA. I approached several ophthalmologists and I was fortunate to join Dr. Kevin Wade’s practice in Kerrisdale. For the past few years, we have been working side by side creating our own integrated model. We collaborate on patient care, treatment modalities, and are progressing to begin research and innovative endeavours. I have found in my career, combining the services of ophthalmology and optometry is not only an effective way to deliver quality patient care but it is also efficient and gratifying as it allows us all to focus on what we do best. I hope to see more OD/OMD integration in the province.
What inspired you choosing optometry as your profession? Dr. Mahnia Madan, FAAO Vancouver, BC BC Doctors of Optometry Member
About me: I am an optometrist, practicing in Vancouver. I went to UBC for my undergraduate degree and received my Doctor of Optometry from Pacific University College of Optometry in Portland, OR. Following optometry school, I moved to Minneapolis with my husband and worked as an associate at a great private practice in the area. Although, I loved working there, I desired to work in an integrated clinic with OMDs and ODs where we would be treating ocular diseases and have the opportunity to be involved in educating other clinicians. Therefore, after working for two years, I decided to go back to school and do an optometric residency. I did my residency in ocular disease and surgical co-management at the Eye Center of Texas in Houston. The clinical experience and exposure that I received working alongside ophthalmology has been an influential experience for me and has changed the way I practice. I moved back to Minnesota and practiced at a large OD/OMD practice as a medical optometrist. I served as Director of Optometric Services at the clinic being a liaison between ophthalmologists and optometrists in the community and had the opportunity to teach optometric externs. I became a fellow of the American Academy of Optometry and have
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I can’t say I wanted to be an eye doctor for as long as I can remember. Being an emmetrope, I had never visited an eye doctor until I was applying to optometry schools! In my second year of undergrad, I had the opportunity to travel to India and volunteer at an eye camp there and I was immediately hooked!
Why is being a member of BCDO important to you? Being a BCDO member is extremely important. The meetings provide a huge opportunity for me to network with my peers and stay on top of the changes in optometry. I feel the work that the association does, helps progress our profession forward, and this is very important in our province.
What has been your experience being Vice President for BCDO? It has been a very rewarding yet humbling experience representing my colleagues and learning about the needs and challenges of optometrists across the province. I am grateful to have the opportunity to be on the board as it has broadened my knowledge of the optometric profession as a whole and has allowed me to connect with amazing leaders across Canada. I am humbled to see the amount work and effort that goes on behind the scenes to provide cutting edge education to the members and continuously advocating for our profession.
Do you have a specialty? If so, what made you choose it? I have always had an interest in ocular disease management and dry eyes treatment. I enjoy educating patients about the surgical and medical options available for their condition. I try to read as much ocular disease literature as possible so I can continue to stay update on what is changing in eye care. Since my residency, I have worked at OD/OMD integrated practices in the USA and in Vancouver. Today, I am fortunate to be practicing at Lynn Valley Optometry along side Drs. Shajani and Sodhi, and at Dr. Kevin Wade Inc. where I can focus on ocular disease treatment and surgical co-management with my ophthalmological colleagues. I enjoy seeing patients for comprehensive care and patients referred by other optometrists, ophthalmologist or GP for medical eye care or dry eye treatment.
optometrists in North America. There is also a need for larger collaboration with our physician colleagues so that optometrists are seen as primary health care providers. I would also like to see ODs and OMDS working together in an integrated model. Traditionally, optometrists have concentrated on vision care needs while ophthalmologists have been the sole providers of medical specialty eye care. But, during the last 30 years, there has been a significant change in the scope of optometric practice with the expansion into medical eye care as well as the development of multiple optometric subspecialties. I believe this will not only improve patient care but also will help to reduce back logs in ophthalmological care in BC.
What are 3 pieces of advice you have for new grads entering the workforce? As a new grad, I think it is very important to expose yourself to as many aspects of optometry as possible. This involves being open to different practice models and locations, taking various CE courses, attending large ocular international meetings and symposiums. Getting involved with the optometric association and networking with your colleges as much as possible. I would highly encourage
What are some new innovations in the field of eyecare that are exciting in 2020? No other group was more excited about 2020 than perhaps us. And then COVID-19 hit and things changed in an instant. Telehealth is more important than ever and I expect we will see a blended model of in-person and virtual care continuing into the future. Despite the challenges, I believe our profession will adapt to a new model and continue to provide eye care. In terms of innovations in the field, I am looking forward to better presbyopia IOL solutions, such as Light-AdjustableLens. Glaucoma management has been rapidly changing with MIGS surgeries on the rise and new drug delivery systems on the horizon. Dry eye treatment is also continuing to evolve, with so many more tools than ever before. We are excited at our clinic to be one of the 1st clinics to compound Autologous Platelet Rich Plasma (PRP) eye drops as treatment for dry eyes and corneal epithelial defects.
What new direction would you like to see happen in Optometry in BC? I would definitely like to see scope expansion for optometrists in BC so that we are on par with rest of the
new graduates to consider doing an optometric residency; the clinical experience and exposure one receives during this one year is invaluable to your life long career. My second piece of advice would be to continue to read as much optometric and ocular literature as possible and continue a life-long pursuit of learning. And lastly, I would encourage you to find something you are truly passionate about in the field of eye care. Whether it is providing specialty contact lenses care or teaching at a university or providing third world eye care. Focus your time and efforts on this passion, whatever it may be, so that you can have a truly fulfilling career.
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Are you interested in Locum work? Let us know! BCDO has a “Locum List� of members interested in locum opportunities to assist members looking for short term work coverage. If you are interested in locum opportunities, please provide us with your contact information: name, email, and phone number. When an opportunity becomes available, we will email our list of locum doctors with the details and those interested can connect directly with the member who posted the ad. Please email info@optometrists.bc.ca if you would like to be added to the Locum List or if you are looking for locum coverage.
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The Recent Canadian Council of the Blind Study Reveals the Stark Reality of COVID-19’s Disturbing Impact on Those Canadians Who are Blind, DeafBlind or Partially-Sighted
By Keith D. Gordon Ph.D. And Michael Baillargeon
It goes without saying that at this time of crisis for the world, we are all feeling more stress than usual. Now imagine how much more stress you might be feeling if you were facing the dreaded COVID-19 with the additional challenges associated with those living with blindness or vision loss. We, at the Canadian Council of the Blind (CCB) became aware very early on in the pandemic (late February to early March) that many Canadians who are blind, deaf-blind or partially sighted were being heavily impacted by COVID-19. At the same time it was acutely apparent to the CCB that the many government initiatives and programs being announced in response to pandemicrelated challenges were, for the most part, not taking into account what we see as the fundamental needs of not only our community, but all people with disabilities. We perceived the need for all levels of government to provide support and solutions to help those living with disabilities and by extension vision loss, get through these stressful times. We saw it as being necessary to provide the factual support required by governments to act. Working in cooperation with Louise Gillis, CCB National President, we determined that our best course of action would be to survey the vision loss community and report our findings. The survey was designed to specifically identify what impact COVID19 was having on those living with blindness or vision loss.
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We wanted to know their current circumstance and daily experiences due to the pandemic, and what their specific concerns and needs were. The survey, conducted electronically during the week of April 7th to April 14th, attained a robust sample of 572 responses with respondents representing all provinces. We promised to let their voices be heard so that they would not be left behind, or forgotten. Our goal, then and now, was to make sure that the members of the vision loss community would be provided with the support needed, both socially and economically, to weather the COVID19 pandemic. The results are a call to action and paint a disturbing picture of the experiences Canada's vision loss community are confronted with, on a daily basis, during this COVID-19 crisis. Key results of the study showed high levels of stress in the vision loss community. Respondents are very concerned about social distancing – they’re unable to see how far they are from others and are concerned that others don’t realize that they have vision loss and tend to come too close. Respondents feel unsafe when going out. Those living with vision loss are particularly concerned that the effect of the added stress from the pandemic on their mental health may cause them to become overwhelmed.
Sgt Johanie Maheu, Rideau Hall © OSGG-BSGG, 2017
Her Excellency the Right Honourable Julie Payette, Governor General of Canada This was re-enforced Thursday May 7, during a virtual conversation live streamed on YouTube, between Her Excellency the Right Honourable Julie Payette, Governor General of Canada and Dr. Mona Nemer. Canada’s Chief Science Officer, discussing the importance of research and science in the times of global pandemic. When the conversation turned to a discussion on our vulnerable population and people with disabilities, the Governor General remarked as to having received a communication from the Canadian Council of the Blind; “that was alert particularly to the fact that people who are vision impaired are quite anxious in the time of the pandemic and that it was affecting them in many different ways.” Survey respondents are stressed about their inability to access a doctor or health care practitioner and to meet their financial obligations, and about their ability to maintain their present standard of living. They’re further stressed due to their already-fragile economic status. Respondents also expressed concern about having transportation and finding someone to accompany them should they have to go to the doctor or hospital. Shopping is a concern as plexiglass shields make it difficult to negotiate payment and those with seeing disabilities are uncomfortable interacting with staff. About half of the respondents indicated that they had a personal care worker entering their home, about half of whom weren’t wearing proper personal protective equipment. Respondents are concerned that when the COVID-19 pandemic is over, they’ll discover that their job no longer exists. Many who were asked to work from home have discovered that they don’t have the proper accessible
devices and technology necessary to do their jobs from home, and that their employers have refused to provide or fund them. The survey succeeded at identifying the challenges confronting those living with vision loss during the COVID19 crisis. As Respondent 211 commented, “What’s affecting my mental health is this prolonged and extreme isolation. As a blind person, I already live a fairly limited life when referring to freedom of movement and independence and now even that small wedge of my active life has been completely eradicated.” It’s clear that the vision loss community is being heavily impacted by the pandemic. It’s further evident that there’s a need for immediate action from all levels of government to provide support and solutions to help those living with vision loss get through these stressful times. The CCB’s resulting report includes detailed recommendations for all levels of government to consider. In open-ended questions we discovered that there were a number of respondents who were concerned about their ability to see their eye doctor and that they might lose vision as a result. They also expressed a concern about not having an accompanying person with them when they went for their eye appointment and concern over maintaining social distancing in the doctor’s waiting room. The following are typical responses we received: Respondent No.444: “I’m worried how long the pandemic and restrictions will last, and the impact on my appointments with doctor and optometrist.” Respondent No. 441: “I am not able to get my monthly shots in my eyes, vision is going down.” Respondent No. 547: “Can't see my eye doctor. I need a new prescription and would like glasses instead of contacts.” Respondent No. 465: “…my fear is having to do things like my eye appointment by myself when I am used to having my daughter with me to guide me and point out hazards in my way.” Respondent No. 462: “Concerned about maintaining social distance in eye doctor's waiting room.” The Survey Report on the Impact of the COVID-19 Pandemic on Canadians Who Are Blind, Deaf-Blind, and PartiallySighted is fully accessible and available on the link above and on the CCB website at www.ccbnational.net. Editor’s Note: Both Keith D. Gordon, Senior Research Officer and Michael Baillargeon, Senior Advisor Government Affairs and Special Projects are colleagues at the Canadian Council of the Blind, advocating on a daily basis, for Canadians who are living with blindness or vision loss.
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Vision 2020: The Importance of Regular Eye Exams I-MED Pharma, Inc.
When the World Health Organization (WHO) published its recent World Report on Vision, employers, governments and eye care professionals around the globe took notice. Noting an increase in myopia cases and the problems caused by undiagnosed vision issues in children, the report has become part of a changing global conversation about visual health. Thanks to new information and advances in science, as well as shifts in how we work, and the treatment options available, employers and policy makers are realizing that quality vision care needs to be an integral component of a comprehensive healthcare system. For eye care professionals and consumers, this means a new view on ocular health. Changing Views: A New Conversation About Vision Both the WHO’s “World Report on Vision” and Essilor International’s “Vision Report”, show how poor vision can impact a child’s development. In fact, uncorrected
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sight problems can affect a child for years. Such studies, and efforts like the American Optometric Association’s Eye Exam Awareness Campaign (#2020EyeExam), raise the importance of ocular health and regular eye testing among consumers. Eye care professionals are noticing how this new awareness is bringing the subject of eye health into focus for many Canadians. New government policies propose earlier and more frequent eye testing for children, and new innovative therapies are in development for pediatric-specific issues. In addition, employers are becoming increasingly aware of how elongated screen-time use by employees can negatively affect their ocular health, and how many office environments can contribute to conditions that lead to dry eye disease. As attitudes change, and comprehensive eye exams become more routinely covered by workplace benefits, Canadians will enjoy a more holistic approach to
eye health. Eye Care Options for Canadians As Canadian policy makers and employers bring about positive changes, consumers need to make their eye health a priority to ensure good vision for their future. This starts with booking yearly exams with an eye care professional. An eye exam can check for early stages of eye disease, as well as other conditions that may affect not only a person’s vision, but their overall health. I-Med Pharma has a wide range of management solutions available to help patients who suffer from dry eye disease and other ocular surface disorders. Tips for Canadians to Help Manage their Dry Eyes Use Viscoadaptive Artificial Tears: Get immediate comfort and long-lasting relief with I-MED Pharma’s I-DROP® PUR, I-DROP® PUR GEL, and the new I-DROP® MGD. These blink-activated, preservative-free drops offer excellent hydration and lubrication of the cornea and contain a superior quality hyaluronic acid. Carry Hydrating Wipes: I-MED Pharma’s convenient I-LID ’N LASH® wipes are used to clean and remove ocular debris and makeup, while hydrating the delicate skin around the eyes. A regular ocular hygiene regimen helps to maintain lid and lash health and enhances the effectiveness of
artificial tears. Try a Therapeutic Eye Mask: Eye care professionals recommend moist heat therapy for a range of eye conditions. I-RELIEF® Hot & Cold Therapy Eye Mask, from I-MED Pharma, relieves symptoms associated with meibomian gland dysfunction, blepharitis and other ocular surface disorders. Nutrition from the Inside-Out: I-MED Pharma’s I-VU® OMEGA-3 PLUS daily nutritional vitamins provide Omega-3 fatty acids in the re-esterified triglyceride form. Taken daily, these vitamins help to improve symptoms of dry eye syndrome. A Vision of Eye Care for All Canadians Many factors are contributing to our changing attitudes regarding eye health, such as advancements in the field of eye care, recognizing the symptoms that can cause vison problems, as well as understanding the importance of early eye exams for children. As employers and policy makers adapt to a new view of vision care, Canadian consumers will hopefully become more aware of their eye health and make it a priority. For more information about I-MED Pharma’s products, please visit imedpharma.com and osdcare.com.
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