EyeDigest Magazine May 2021

EYE DIGEST MAY 2021

BCDO’S QUARTERLY OPTOMETRIC MAGAZINE

PRACTICE MANAGEMENT It's New Era in the Business of Optometry| p. 4

INDUSTRY What's New in Legal Claims | p. 8

MEMBER SPOTLIGHT Meet the BCDO Board of Directors| p. 36

info@optometrists.bc.ca 604.737.9907

BC Doctors of Optometry 121 –10551 Shellbridge Way, Richmond B.C, V6X 2W8

CONTENTS

Practice Management & Industry Salute to Eyecare Heroes ............................................................................................................................. 3 It’s a New Era in the Business of Optometry ........................................................................................4 Candorvision: It’s Intense, Prepare Yourself! ........................................................................................ 7 What’s New in Legal Claims ....................................................................................................................... 8 The Scoatia Professional Plan for Optometrists ................................................................................. 11 Presbyopia… Fast Tips for Multifocal Contact Lens Success ....................................................... 12 Integrating Care1 and Telemedicine Into Your Optometry Practice ......................................... 15 Aequus: Evolve Dry Eye Relief .................................................................................................................. 17 Candorvision: Biofinity XR toric and My Day toric........................................................................... 18 COVID-19 Paid Sick Leave ......................................................................................................................... 19 Member Benefits: Optomart ................................................................................................................... 20 Novartis: Xiidra................................................................................................................................................ 21 Workshop Impact on Optometric Practice in BC ........................................................................... 22 Alcon: Systane ............................................................................................................................................... 24 Alcon DAILIES TOTAL1® Helps Canadian Essential Workers Fight the Fog .......................... 25 2020 BCDO Awards: Call for Nomination ........................................................................................... 27 Serving the Profession of Optometry for 27 Years ........................................................................ 28 AOE: Optometry CE Online ..................................................................................................................... 33 Disease Spotlight: Adult Refsum Disease .......................................................................................... 34

Spotlight on a Member Meet the BCDO Board of Directors ...................................................................................................... 36

Programs EyeLearn 2.0: Children’s Vision Program .......................................................................................... 42 2021 BCDO Events ....................................................................................................................................... 44 Public Education Update .......................................................................................................................... 48 Are You Interested In Locum Work? Let Us Know! ....................................................................... 50

Salute to Eyecare Hereos

May is Vision Health Month and we want to thank you for always being ready, willing and fully able to provide eyecare for our communities.

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It’s a New Era in the Business of Optometry

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By: Sandy Stark Marketing Manager, Sightly For some years now, and most especially in recent months, much coverage has been dedicated to the changes occurring in the field of optometry.

A significant portion of that attention focuses on advancements in technology. By and large, these advancements are widely accepted and promoted as they pertain to in-office investments that offer patients the latest in comprehensive exams and treatments. These changes make sense to practitioners that have spent their careers embedded in older, established business models. In contrast, however, the introduction of e-commerce is one technological advancement that is slow to gain acceptance despite market trends endorsing its application.

The growing demand for purchasing eye care products online has been a trend for some time now, but it has been fast tracked by the global pandemic. In Ontario, for example, when optometrists returned to work in June 2020 with patient volumes reduced by 50 per cent due to strict physical distancing and infection control guidelines, the Ontario Association of Optometrists projected a loss of nearly two million comprehensive eye exams over the following 12 months (Ontario Association of Optometrists, 2020).

The Business of Optometry Optometry practices primarily rely on two revenue streams. The first, naturally, is fee for service.

However, with that stream significantly interrupted by as much as 75–80 per cent during the pandemic, the importance of the second stream, retail sales, has suddenly been propelled into the foreground.

This shift in focus must take into consideration the commoditization of a number of eye care products such as contact lenses, sunglasses, eye drops, and vitamins, to name a few. What this

means is more consumers are seeking goods that are a significant source of an optometry practice’s revenue, through non-traditional eye care retailers where purchasing decisions are driven by price and convenience. Dr. Jeff Goodhew, OD and Dr. Tina Goodhew, OD recognize this: “Consumer behaviour has been changing over the past few years towards purchasing more goods and services online and the pandemic has accelerated this. Ultimately, our patients want convenience, whether it be reordering their contact lenses at 11:00 p.m. or pre-purchasing products and arranging for hassle-free curbside pickup. Our patients want to buy from us and appreciate having multiple channels to do so, including e-commerce.

Sightly has been critical to our success over the past year and we feel it will be a necessity for high performing practices moving forward.”

So imperative now is it to reinvent the business model of an optometry practice that Dr. Arthur B. Epstein, OD, FAOO, based in Phoenix, AZ said, “Optometry has moved on and refractive eye care is rapidly becoming more consumer- rather than profession-driven. Economics will hasten its demise, but automation and technology will surely seal the coffin” (Arthur B. Epstein, 2020).

Consumers to Watch Now, add in the two heavyweight generations that make up a combined total of 55 per cent of the world’s population, Millennials and Gen Z. Together, they currently span an age range of 7–38 years, and have a spending power of nearly three trillion dollars in the US alone (YPulse, 2020). While Millennials are seeking instant gratification and an entertaining, pleasing experience, Gen Z are seeking value and practicality and it is believed they will dominate 40 per cent of consumer shopping.

Seventy-one percent of Millennials consider their phone to be their most important shopping tool Eye Digest Magazine | 5

Seventy-one percent of Millennials consider their phone to be their most important shopping tool (AdWeek, 2019), while Gen Z is two times more likely than Millennials to make mobile purchases (99 Firms). These groups are digital natives that are driven by social responsibility. They want to support local and they are your existing and next patients.

While their behaviours differ somewhat, living up to the expectations of these two dynamic patient groups means meeting them where they are and establishing meaningful relationships.

Today’s cancel culture along with more discerning spending habits means these generations are taking their dollars to whomever is answering their call the best. Dr. Ritesh Patel, OD uses his online storefront effectively, stating, "As eye care physicians, we love making connections with our patients but can find time limiting to do so.

With our online presence and e-store, we now have a way to build upon our foundation of this relationship and grow it 24-7. This serves as a huge advantage and allows us to continue to help our patients and grow our practice."

Response For many practices, introducing an online storefront is the next logical step in creating a conduit that marries the needs of both practitioners and their patients. Human contact is essential in maintaining the integrity of patient eye health and protecting the first revenue stream, fee for service. Offering an online storefront is essential to securing the second revenue stream, retail sales, as it eases the tension created by a patient’s conflicting desires to take advantage

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of online convenience but also to support local businesses. Offering an e-commerce solution ultimately makes a patient’s purchasing decision easier which translates into happier patients and stronger relationships. According to Dr. Wes McCann, OD, "Patients’ buying habits, especially during this pandemic, have forever changed. The online retail environment is not only familiar for patients, but a comfortable avenue for patients to purchase from. Patients purchase online due to convenience and with the perception that they are saving money, however, that is oftentimes not the case. Patients want to buy local and support local businesses, but we as business owners need to make it convenient for patients to do business with us. Sightly offers ECPs an opportunity to engage with our patients on their time. While using smart reminders, we can optimally notify patients when we know they will need us for a reorder. Adding a patient-commerce [e-commerce for optometry] option to an optometry office in today's retail environment is unquestionably a necessity to be successful for today and tomorrow's patients."

For BC practices wishing to introduce an e-commerce solution, the Launch Online Grant program has recently received additional funding and has expanded its eligibility criteria (Launch Online).

Sightly is the optometry industry's e-commerce/ patient-commerce solution, designed for your practice's seamless entry into the world of digital commerce. For more information, visit us at getsightly.com or contact us at info@getsightly.com

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What’s New in Legal Claims?

by HR Peninsula Due to the effects COVID-19 has had on our small business clients, the Legal Claims Team has seen an increase in the number of cases throughout the past quarter (Q4). Legal issues relating to unsafe workplaces, human rights, and temporary layoffs are on the rise.

The number of Ministry of Labour claims – Employment Standards claims in Alberta and B.C. – has increased because more workers are asserting their right to refuse unsafe work.

The employer must comply with COVID-19

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preventative measures for the workplace to be considered safe.

More employees are filing applications with their provincial human rights tribunals due to the pandemic. With businesses doing their part to implement distancing and mask policies, some employees who refuse to follow these rules believe they are being discriminated against for not complying.

The number of demand letters has also increased

recently. The rise in letters is due to the high number of employees who have been temporarily laid off and are now claiming constructive dismissal.

Employees have continued to take legal action despite the fact that Alberta, B.C., and Ontario have amended their employment legislation to account for longer layoffs due to COVID-19.

Internal Statistics • In March 2021, there were 31 new legal claims; the highest monthly number since September 2019.

• In Q4 there were 13 legal claims from B.C.; the highest number per-quarter ever.

• There were 5 new in-deals in March 2021; the most in-deals per-month since December 2020.

Ontario COVID-19 Layoff Provisions End July 3rd

Ontario enacted layoff rules for the period of March 1, 2020 to July 3, 2021. These rules say if an employee’s hours of work have been temporarily reduced or eliminated due to COVID-19, they are on a job-protected infectious disease emergency leave. The rules also say that employees are not considered to be laid off or constructively

dismissed during the COVID-19 period.

Sharma v. Toronto (City) This recent decision by the Human Rights Tribunal of Ontario deals with an Applicant who claimed that the City of Toronto discriminated against him because businesses denied him service as a result of By-Law 541-2020. This By-Law states that patrons of businesses must wear a mask. The application was dismissed as the Applicant did not have a protected reason under the Ontario Human Rights Code to not wear a mask.

Changes to Alberta’s OHS Act Amendments have been made to Alberta’s Occupational Health and Safety Act (the new “Act”) and are expected to come into effect September 2021. The new Act changes the right to refuse unsafe work as the description of the type of issue that justifies a work refusal will be altered.

The new Act states that in order to refuse unsafe work, the worker must believe on “reasonable grounds” that there is an “undue hazard” in the workplace.

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Did you know?

These layoff rules also state that any Ministry of Labour claim that was filed for termination or severance (due to reasons related to COVID-19) during the period will be dismissed. These rules expire July 3, 2021 and are not likely to be extended

If a worker believes his/her employer is not taking measures to protect staff against COVID-19, such as physical distancing and mask wearing, he/she can report it to the Ministry of Labor or Employment Standards who will then conduct an investigation into the worksite.

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Integrating Care1 and Telemedicine Into Your Optometry Practice

by Care1

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In a 2016 survey by the American Optometric Association (AOA), 64 per cent of adults reported experiencing eye or vision problems, but only 13 per cent went for an eye exam. Recent statistics reveal that 36 million people worldwide are blind, and 253 million people are visually impaired.

According to the World Health Organization (WHO), 80 per cent of all vision loss cases are treatable or preventable.

Accessibility and convenience play large roles in a patient’s willingness to pursue an eye examination, and many rural areas are underserved by healthcare providers. A majority of these people do not have the time or the means to schedule an eye exam with an optometrist that could take hours to commute to. Additionally, patients with medical conditions that require ophthalmological referral will need to commute even more, which in turn requires additional time commitments and expenses.

As with patients residing in rural areas, senior citizens, those with disabilities, and patients with language barriers could all be more efficiently and cost-effectively managed with telemedicine. These patients often rely on others for transportation to and from appointments, or may require a translator to accompany them. On top of that, critical care for medical cases often adds on further appointments that are difficult to coordinate. And when patients are referred to ophthalmology, wait times can be anywhere from months to even years.

This is where Care1 comes in.

Care1 was founded in 2011 by ophthalmologist Dr. Kenman Gan and optometrist Dr. Trevor Miranda, who, at the time, were both practicing in Victoria, Canada. When Dr. Miranda had patients that required an ophthalmological consult, he would refer them to Dr. Gan for evaluation. Like most cities in Canada, the demand to see an OMD in Victoria is high while the availability is low, thus creating long waitlists. Dr. Miranda already had access to

an OCT, a fundus camera, and a perimeter in his practice. It didn’t make sense for patients to wait six months to have these tests done at Dr. Gan’s office before they could be diagnosed when they could be taken in Dr. Miranda’s office any day of the week.

A simple website was created for Dr. Miranda to upload diagnostic images along with preliminary diagnoses. Dr. Gan could then review and confirm the diagnoses, and the two doctors would then collaborate on patient treatment and care. This dropped patient wait times for diagnosis and treatment from an OMD down from 6-12 months to 1 week.

When the cost of accessing vital health care is reduced, patients become more proactive about their eye health. Care1 allows optometrists to tap into the telemedicine market and expand their practice, while also contributing to the health and wellness of the general public. An optical telemedicine practice enables optometrists to reach more patients and provide services that are often limited by the practice’s physical location.

With shortened wait times, urgent care can now be better prioritized, leading to a lessened load on both optometrists’ and ophthalmologists’ schedules.

With the concept proven, Care1 began to grow by adding one OD and OMD at a time. Today, over 100 eye doctors use Care1, and we are the largest teleophthalmology program in Canada by patient volume. The software is powered by DeepMD, an artificial intelligence platform that analyzes patient data and images, and makes a recommended diagnosis which is then confirmed by an OMD. Integrating Care1 into an optometry practice is one of the most rewarding decisions an optometrist can make.

Optometrists are generally the first to diagnose eye diseases and are capable of managing the Eye Digest Magazine | 15

healthcare needs associated with those diseases.

With Care1, a patient’s case history and digital imaging uploads can be instantaneously sent to a local ophthalmologist and a consultation report with treatment recommendations can be received in a matter of days. It is an easy-to-use, single page, drag-and-drop dashboard interface that allows ophthalmologists to easily view a patient’s progression.

Of course, there are technical requirements.

Good digital imaging and visual field equipment is a must, as well as an internet connection and an electronic medical records system that allows for easy transition between in-house patient care to Care1 telemedicine. Dr. Miranda explains

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the biggest benefit of Care1 in his practice: “We don’t have leakage of these patients. In fact, it is the opposite. We are now getting referrals from ophthalmology through Care1. The bucket is getting filled up rather than leaking patients away when they have pathologies.”

We are proud that this company that was founded by eye doctors, for eye doctors, is still owned and run by eye doctors. While COVID-19 brought telemedicine in the eye care field into the mainstream, we look forward to continuing to grow with our OD and OMD partners around the world and see huge potential for our platform post-pandemic.

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COVID-19 paid sick leave Workers can take 3 days of paid sic k leave if they need to stay home because of COVID-19. The program is in place until December 31, 2021 .

I'm a worker

to stay home because of d nee you if s day k sic d pai 3 to up e You can tak COVID-19. note is not required.

To take a COVID-19 sick day, a doctor's

I'm an employer

You are required to offer employees 3 days of paid sick leave if they need to stay home as a result of circumstances related to COVID-19.

For more information, visit https://www2.gov.bc.ca/gov/content/covid-19/info/paid-sick-leave

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OPTOMART As a valued member of BC Doctors of Optometry, you have access to a variety of services and resources provided to help support you in practice. We invite you to take advantage of your Optomart benefits.

Optomart is the Association’s online listing service for employment, business opportunities, and the sale of optometry equipment. Listings are available for the general public to browse on the BC Doctors of Optometry public-facing site.

To submit a job posting or to sell/buy optometry 20 | EyeeDigest Magazine quip ment, please visit the Optomart Page.

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Workshop Impact on Optometric Practice in BC

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The TFOS DEWS II® has redefined Dry Eye Disease (DED) as a multifactorial disease of the ocular surface that is chronic, progressive, and inflammatory in nature.1 For most patients, the therapeutic journey for DED involves long-term commitment and an ongoing partnership with their optometrist.

For optometrists, active, two-way communication is key to cultivating successful, long-term therapeutic relationships with patients and optimizing treatment outcomes.2 Good communication between a patient and their eye care provider can facilitate coping, self-care management, and an optimal quality of life.2 Strategies for optimizing communication with patients were presented on February 17, 2021 by Dr. Rana Taji, an optometrist from Toronto and a member of the Faculty behind the VerbalEYEs educational program. A working checklist grid was provided to the participants as a leave-behind tool to use after the workshop.

Some of the key patient communication strategies included were: • Presenting a shared agenda for the consultation • Inviting the patient to take an active role in the discussion and their treatment plan • Being open to questions using an “Ask-TellAsk” approach - Ask the patient what they already know or want to know about their condition - Tell the patient what they need to know - Ask or ascertain whether the patient understands the information or has additional questions • Assessing readiness to change on a regular basis • Setting self-management goals • Correcting misunderstandings of the treatment plan Of the 168 optometrists that attended the webinar, 71 participants (42%) responded to the post-workshop survey. The majority (70%) found

the workshop valuable and indicated that they were planning to alter the methods in which they care for patients (58%). Some mentioned that they were planning to share their takeaways with colleagues (40%) and would be looking for additional information on the topic (28%). Many participants responded that they really enjoyed the format of the program, especially when dealing with COVID-related virtual meeting fatigue. "Dr. Taji was very personable and I enjoyed her style of ’lecture,’ or rather it was more like a chat. Much better than talks that seem so cold and remote."3 In addition, some participants mentioned wanting to introduce significant changes into their practices by including more time for communication as well as explaining dry eye disease in more depth during appointments. Some will be using the DEQ5 questionnaire on a more frequent basis with patients, and others plan to be more upfront with pricing and with procuring commitment from patients.

Strong listening skills are required, and with today’s reality of wearing masks, the need to be on the lookout for patients’ body language, especially eye expression, is key to creating and cultivating close and trusting relationships with patients.

As we all know, patients may have various reasons for not following a treatment plan—the dropout rates for many treatment plans show that. Therefore, more and more often these days, treatment decisions are made collaboratively within the partnership between patient and health care professional.2 Adopting adapted and patient-centric communication strategies has thus become a key factor for success in any treatment plan.

1. Craig, J.P., et al. Ocul Surf. 2017 Oct; 15(4):802-812.

2. Mastrota, K. Optometry Times. 2020 Nov; 12(11).

3. BCDO VerbalEYEs workshop post-survey results

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Alcon DAILIES TOTAL1® Helps Canadian Essential Workers Fight the Fog

By Alcon Alcon DAILIES TOTAL1® is helping Canadian essential workers fight the fog by giving 100 deserving workers a one-year’s supply of DAILIES TOTAL1® lenses. The brand recognizes that on top of everything else, the last thing essential workers should have to deal with is the daily annoyance and interference of fogged-up glasses caused by constant masking-wearing.

“With masks mandatory, foggy glasses are just part of the daily routine for so many Canadians.

This reality is even more difficult for our essential workers who are out on the frontlines every day,” said Nelson Da Silva, senior brand manager, “We’re pleased to be able to ease this one challenge for a number of Canadian essential workers, so they can safely and more comfortably do the important things that keep us all going.”

Based on over a thousand submissions, 100 deserving essential workers have been selected to receive a one year’s supply of Alcon DAILIES TOTAL1® lenses. Additionally, in a time when supporting local is so important, Canadian essential workers can receive an enhanced rebate Eye Digest Magazine | 25

of $150 off a one-year supply of DAILIES TOTAL1® lenses when purchased through their local optometrist or optician until the end of the year.

As the world’s first water gradient contact lenses, Alcon DAILIES TOTAL1® lenses feel like nothing on your eyes, offering unsurpassed comfort while eliminating the issue of fogged-up glasses.

SmarTears Technology releases a component found in natural tears throughout the wearing day to keep eyes hydrated all day long. Alcon DAILIES TOTAL1® lenses are offered in both spherical and multifocal lenses, with a silicon hydrogel core that offers outstanding breathability.

About Alcon Alcon helps people see brilliantly. As the global leader in eye care with a heritage spanning more than seven decades, we offer the broadest portfolio of products to enhance sight and improve people’s lives. Our Surgical and Vision

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Care products touch the lives of more than 260 million people in over 140 countries each year living with conditions like cataracts, glaucoma, retinal diseases and refractive errors. Our more than 20,000 associates are enhancing the quality of life through innovative products, partnerships with Eye Care Professionals and programs that advance access to quality eye care. Learn more at www.alcon.ca. You can also connect with us on Instagram and Facebook.

About DAILIES TOTAL1® Contact Lenses DAILIES TOTAL1® contact lenses are designed for people with presbyopia and are intended to be used on a daily disposable basis. The contact lenses are available with a power range of – 6.00 to + 3.00D and three ADD powers (Low, Med, High). DAILIES TOTAL1® contact lenses are medical devices that must be prescribed by an eye care professional. See product instructions for complete wear, care, and safety information.

2020 BCDO AWARDS

CALL FOR NOMINATIONS Nominations will be accepted until June 30, 2021.

Click Here to Nominate

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Serving the Profession of Optometry for 27 Years

By Academy of Opthalmic Education

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How a Canadian Company Forged the First TPA Course for Optometrists in Ontario In 1991, the Regulated Health Professions Act came into effect in Ontario. Twenty-two health professions—optometry and opticianry among them—were included. Recognizing that healthcare profecpessions constantly evolve, from new treatments to the interplay between technology and pharmacology, mandatory continuing education became a cornerstone of the Act. Not only do optometry and opticianry both have a health science component within their scopes, but a common overlap in eyeglass and contact lens dispensing as well.

Enter The Khan Group.

Ali Khan, a first-generation immigrant, passionate Canadian, experienced educator, and established Ontario optician, was approached by many with requests to support the health professions by providing CE opportunities.

The first live seminar offered under the banner of The Khan Group Inc took place in September 1994. In conjunction with the outstanding support of Dr. Barbara Caffery, OD and Dr. Marvin Cooper, OMD, the lectures were meticulously selected and presented by stalwarts of the optometry and ophthalmology communities.

High calibre education with fair pricing built the solid foundations of The Khan Group’s reputation as an official optometry educator. After achieving formal CE provider status with ARBO/COPE to provide accredited “Class A” lectures, the Academy of Ophthalmic Education Ltd., or AOE, was born.

One of AOE’s founding principles is collaboration between ophthalmology, optometry, and opticianry to not only uplift all eye care professionals, but to facilitate better vision care for patients.

This has not always been easy. At the time, optometry was actively lobbying lawmakers to expand their scope of practice to include the prescribing of therapeutic pharmaceutical agents.

AOEworkeddiligentlytoacquirerenownedToronto ophthalmologists that believed in collaborative eye care with well-educated primary care providers— optometrists. This expanding faculty included noteworthy names such as Dr. Raymond Stein, Dr. Ike Ahmed, Dr. Alan Berger, Dr. Allan Slomovic, and many more. Now equipped with prominent educators from Canada and the United States, both in ophthalmology and optometry, AOE was able to bring quality COPE-accredited education to all provinces at a reasonable price.

The success of the education events did not go unnoticed by industry vendors and pharmaceutical companies. It wasn’t long before they too wanted to be part of the CE conferences.

Dr. Bouma Willem, MPP with Mr. Yavar Ali Khan, RO

While protecting the integrity of the courses, it became obvious that AOE would need to find a 30 | Eye Digest Magazine

way for ECPs to interact with industry vendors.

This led to the creation of Optifair Canada, an eye care industry trade show that runs parallel to the optometry and opticianry CE tracks. Boot camps are also offered for optometric assistants and ancillary staff for hands-on training in dispensing glasses and contact lenses.

Up until COVID-19 arrived, the AOE conference and Optifair Canada were offered twice a year and the joint event was the hallmark of AOE’s success. In October 2005, Optifair Canada hosted its largest conference to date, with all 120 available booths sold out to industry partners and more than 1200 optometrists and opticians gathered within the Toronto Congress Centre.

The event caught the attention of the national media, and was even covered by a special report in Hello Magazine. This was the beginning of a culture of giving back, and AOE would go on to help form the Canadian Society of Eye Health Practitioners, or CSehp, a non-profit organization dedicated to supporting eye care charities, educating the general public, sourcing insurance for ECPs, supporting students through free education, and fundraising for students at risk.

The primary mission of AOE always remained focused on serving the profession of optometry by providing high quality and fair priced CE, but AOE was also quickly building bridges between ECPs, industry leaders, and lawmakers.

Lawmakers noticed that by collaborative learning and training, issues of scope overlap were leading towards resolution. Trust was building and camaraderie was on the rise.

In 2009, the government of Ontario decided to move forward with stakeholder input to revisit scope of practice issues in vision care. In particular, the long-overdue issues of TPAs and tertiary eye surgery wait times and care.

Optifair Canada Tradeshow

Knowing that success without charity is not truly success, Mr. Ali Khan founded “The Eye Ball,” a major charity fundraising event, in 2013. From that event, nearly $100,000 was raised for ORBIS, an international organization that offers tertiary eye care all over the world through their flying eye hospital.

The event drew more than 500 black tie-attired guests showing solidarity as ECPs, dedicated to eradicating preventable blindness around the world. Special guests and speakers included the National Minister of Health at the time, the Honourable Tony Clement, and former First Lady Mrs. Margaret Trudeau.

AOE and its sister organization, CSehp, were invited to provide input as recognized CE providers and stakeholders. AOE and CSehp’s recommendation in strong support of TPAs became part of the final HPRAC recommendation document A Report to the Minister of Health and Long-Term Care on Interprofessional Collaboration Among Eye Care Health Professionals.

After the HPRAC recommendation, the Ministry of Health finally granted optometrists the ability to prescribe TPAs to treat non-surgical, medical eye conditions, including common eye infections as well as a relatively extensive scope for treatment of glaucoma in comparison to the rest of the country.

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The College of Optometrists of Ontario then issued a new directive for optometrists to re-certify themselves by taking additional, formally structured courses on TPAs. Optometrists who graduated before 1990 were required to complete a 100-hour TPA course that consisted of 60 hours of didactics, 20 hours of wet lab, and 20 hours of clinical rotation with an ophthalmologist.

Optometrists who graduated after 1990 were required to complete a 20-hour refresher course on pharmacology.

At that time, the only formally structured course on TPAs was expensive and required a disruptive two-week trip to a school of optometry in Oklahoma.

With the approval of the College of Optometrists of Ontario, AOE rose to the occasion, developing and offering a structured TPA course in collaboration with Nova Southeastern College of Optometry.

The didactics course was presented over three weekends at Toronto Congress Centre and the wet lab was conducted over one weekend in the state-of-the-art ophthalmology clinic at the Bochner Eye Institute.

In keeping with AOE’s theme of supporting the evolving needs of optometry, they reached out to ophthalmologists who were willing to accept optometrists for clinical rotations, as per the requirements of the 100-hour TPA course. This course, along with the 20-hour pharmaceutical update course for those who graduated after 1991, enabled many optometrists to acquire their certification to use TPAs in compliance with the College of Optometrists of Ontario’s practice guidelines. AOE, in collaboration with New England College of Optometry, offered an additional course as well to accommodate those left behind.

This was the landmark effort by the AOE to serve the educational needs of the profession of optometry. As important as these TPA courses were, they were not provided by any other Canadian CE provider or school of optometry.

From a 100-hour structured course in vision therapy to entering the online arena with webinars and video on demand, continue following AOE’s journey in the next issue of Eye Digest.

AOE's 25th anniversary seminar. One of two rooms that ran in parallel

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Disease Spotlight: Adult Refsum Disease

by Fighting Blindess Canada

DISEASE SPOTLIGHT: ADULT REFSUM DISEASE With a prevalence of one in one million, adult Refsum disease (ARD) is an inherited metabolic disorder that is one of the rarest causes of retinitis pigmentosa. People with ARD have a genetic mutation that prevents them from breaking down a fat called phytanic acid found in many foods, including some dairy, red meat, and fish.

Individuals with this genetic mutation will build up

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phytanic acid in their bodies over time, leading to symptoms such as vision loss.

ARD usually begins in childhood or early adulthood, although some individuals may not develop symptoms until their 40s or 50s. The disease can be difficult to diagnose because of its varied symptoms and rare incidence. Diagnosis is based on blood levels of phytanic acid and

confirmation through genetic testing.

Common symptoms of ARD include: • Night blindness and peripheral vision loss caused by retinitis pigmentosa (often one of the first symptoms) • Hearing loss • Ichthyosis (dry or scaly skin) • Peripheral neuropathy (numbness in the hands and feet) • Loss of sense of smell • Joint pain • Cardiac arrhythmias (heartbeat abnormalities) The main treatment for ARD is to avoid foods that contain phytanic acid. Research has identified the following foods as being high in phytanic acid: • Full-fat dairy products • Some red meats (specifically beef) • Most fatty fish • Products that include any of the above in their ingredients Other treatments involve avoiding fat-burning activities like exercise, weight loss, stress, and illness. Minimizing these activities lowers the

amount of phytanic acid released into the blood.

A treatment called plasmapheresis may be used if levels of phytanic acid in the blood are too high and are causing severe symptoms (requiring hospitalization). Plasmapheresis directly removes phytanic acid from the blood in a process like dialysis.

Such forms of treatment often reduce or even stop many of the symptoms of ARD, including peripheral neuropathy and ichthyosis. Vision and hearing loss may not improve, although it is suspected that treatment can slow further progression.

If you have questions about adult Refsum disease, please contact FBC’s Health Information Line at 1.888.626.2995 or healthinfo@fightingblindness.ca This Disease Spotlight article was developed by Fighting Blindness Canada (FBC). FBC is the largest charitable funder of vision research in Canada, offering hope to Canadians by funding the best, most promising research that is driving treatments and cures for blinding eye diseases.

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Meet the BCDO Board of Directors Dr. Bligh is the current President of BC Doctors of Optometry. She advocates for equity, innovation, and the continued positioning of optometrists as trusted primary eyecare providers in BC. Dr. Bligh sits on the MSP Negotiations Committee and serves as a BCDO Liaison with the Ministry of Health.

She studied Genetics at the University of Western Ontario before completing her Doctor of Optometry degree at the University of Waterloo, graduating as class valedictorian. Dr. Bligh practices full-scope optometry in New Westminster and Vancouver, with a special interest in pediatrics. She has volunteered internationally with Volunteer Optometric Services to Humanity.

Dr. Errin Bligh President

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She is a foodie and creative type. When not in the office, Dr. Bligh likes staking out new dining options (and mourning those that have closed), making art at home, and indulging her husband in extremely specific and remote architectural site visits.

She is the proud mom of the cutest baby in the whole world.

Dr. Madan received her Doctor of Optometry from Pacific University College of Optometry in Portland, OR. Following optometry school, she did a residency in ocular disease and surgical co-management at the Eye Center of Texas in Houston.

After her residency, Dr. Madan practiced in large OD/OMD practices as a medical optometrist before returning to Canada. Dr. Madan practices in Vancouver, where she splits her time between an ophthalmology practice and an optometry practice. Her practice focuses on innovative treatment for dry eyes and glaucoma management.

She is a fellow of the American Academy of Optometry and has lectured on the management of ocular diseases. She also currently serves as Vice President for the BC Doctors of Optometry in BC. Dr. Madan says, "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." She also encourages other optometrists to get involved with BCDO as the work that the association does helps progress our profession forward, and this is very important in our province.

Dr. Mahnia Madan Vice President

Dr. Lam was born and raised in Nanaimo, did his undergraduate studies at Simon Fraser University, and studied optometry at the University of Waterloo.

He worked at clinics in 100 Mile House and Williams Lake for his first two years after graduation, and has been working at his current clinic in Nanaimo for the past 20 years. He has also visited many remote rural communities to provide eye care, and now helps coordinate the BCDO Rural Access Initiative. Dr. Lam also has a keen interest in volunteer eyecare missions, having participated in eight trips to various parts of Mexico, Nicaragua, Ecuador, and the Philippines.

Dr. Johnathan Lam Past President

As the Past President of BCDO, Dr. Lam is the chair of the Stakeholder Relations Committee, and a member of the Executive Committee, MSP Negotiations Committee, and the Patterns of Practice Committee. He is also a member of the CAO Teleoptometry and AI Task Force.

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Dr. Shiv Sharma graduated with a Bachelor of Science degree majoring in Molecular Biology and Biochem from SFU with particular interest in genetics and protein structures. He went on to obtain his Doctor of Optometry degree from the Southern College of Optometry and completed clinical rotations through the Eye Center at SCO, the John- Kenyon American Eye Institute, as well as the Novamed Eye Surgery Center. These rotations gave him the opportunity to provide care for pre and post-operative cataract, retina, and LASIK patients. After completing his studies, Dr. Sharma became the owner of the Optiview Eye Clinic - a progressive, full scope private practice in Surrey, BC which he has owned and operated since 2013.

Dr. Shiv Sharma Treasurer

He has consulted for several eye care industry partners on the research, development, and application of new products in addition to technology and innovation in optometry practice. Dr. Sharma is also a current Board Member and Treasurer of BCDO and is a strong advocate for the advancement of optometry through advocacy to government, industry, and regulatory stakeholders. Dr. Sharma hopes to help optometry evolve into the future and for optometrists to be able to excel and provide effective health care in a fast-changing environment.

Dr. Lili Liang graduated with a Doctor of Optometry and a Master of Public Health from Salus University. She completed her training throughout the US from private practices in North and South Carolina, IHS in New Mexico to VA in San Francisco. Part of her public health training brought her to Malawi in East Africa working at the Mzuzu Central Hospital. It was in between those mountains, Dr. Liang learned the true meaning of providing healthcare. Since university, she has dedicated herself to global health from working with organizations in Liberia to mission trips to Haiti and Peru. She now brings that experience to Vancouver.

Currently, Dr. Liang serves the communities of Gastown and Mount Pleasant out of her boutique offices where all services are accompanied with a side of jazz notes. She has laughed, cried and most importantly, dreamed with her patients.

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Dr. Lili Liang Director

Dr. Evelyn Lo obtained her Bachelor of Science at Simon Fraser University. She then pursued her Doctor of Optometry degree at Pacific University in Portland, Oregon. In her final year of studies, she completed an intensive ocular disease rotation at the Bascom Palmer Eye Institute. She graduated with distinction and was awarded the Outstanding Graduate Award for her exceptional service and commitment to optometry.

Dr. Lo enjoys all aspects of optometry but has a special interest in the treatment of dry eyes, myopia management and ocular disease. She volunteers her time with AMIGOs Eye Care, serving as a supervising doctor on mission trips overseas. Internationally, she collaborates with the Zhongshan Ophthalmic Center in Guangzhou, China to provide continuing Optometric education to doctors, students, and their patients.

Dr. Evelyn Lo Director

Locally, Dr. Lo is an advocate for the advancement of the optometric profession to better serve patients. Her active involvement on several BCDO committees helps her recognize the value of a network of supportive colleagues and industry partners. As colleagues, Dr. Lo strongly believes in optometric mentorship and encourages fellow BCDO members to become more involved with the association to collectively further the profession. She looks forward to meeting everyone in person again someday!

As an optometrist, Ivan lives for the days where he can make a meaningful impact on the lives of patients and the communities he works in. Whether it’s giving an amblyopic child their first pair of glasses to prevent permanent vision loss; treating an individual’s glaucoma to mitigate damage to their visual system; or comanaging a patient’s cataract surgery to give them the best vision they’ve had in decades, Ivan is passionate about the ability optometrists have in enhancing the wellbeing of people through optimizing their sight. After graduating from NECO, in order to both maximize his ability to care for patients to the highest level and to provide eyecare to lower socioeconomic communities in need, Ivan went on to complete his residency at the Bronx-Lebanon inner city Hospital Centre. During his time there, he held the position of assistant clinical instructor at SUNY College of Optometry and spent many of his nights on-call dealing with ocular emergencies, consulting with other hospital subspecialities, and co-managing trauma cases through the hospital's emergency department. Ivan wants to say thanks to all optometrists for the hard work you do to make a positive impact on the people of BC – you’re making a difference!

Dr. Ivan Prpic Director

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Dr. Petar Prpic’s involvement and service towards the profession of optometry started while he was still a student at NECO. His hard work and contributions outside of the classroom were recognized by the faculty and staff at NECO. Upon graduating in 2013 he had been awarded the NECO Alumni Scholarship, Dr. Hyman R Kamens Achievement Award and NECO Presidential Medal.

Shortly after returning to BC, Dr. Petar Prpic got involved with the CE Committee and has held the position of Co-Chair for many years. Education is a passion of his and he is often seen spending extra time teaching his patients or support staff in the office. He also spends countless hours listening to podcasts or reading articles, having a special interest in contact lenses and practice management.

Dr. Petar Prpic Director

His most recent accomplishments include being named the Young Optometrist of the Year at the last Annual Conference, and now being voted on to the Board of Directors. Dr. Petar Prpic is extremely excited to be joining the Board at what is such a strong time for the association and profession in BC. He encourages all BCDO members to continue pushing themselves, and their peers, towards clinical excellence and continued growth of the profession.

Originally from small-town Saskatchewan, Dr. Brittany Rollett began her optometry career in Newfoundland before moving to British Columbia in 2013 with her husband Paul, also an optometrist.

Dr. Rollett works in private practice, as well as at a laser surgery centre. She is particularly interested in binocular vision, and loves the satisfaction she receives at uncovering BV diagnoses that can be remedied, profoundly improving the quality of a patient’s life. Dr. Rollett feels very fortunate to have been a part of sustainable eye care missions throughout her career, and hopes to return to these once her small children are older (and we are able to travel again!).

Being a part of the BCDO board has opened Dr. Rollett’s eyes to the amount of work and advocacy that occurs behind the scenes. She will forever be grateful for her time on the board and highly recommends any interested members get involved, be it through joining the board or simply sitting on a committee. It is inspiring to be surrounded by optometrists who so tirelessly work to advance our profession.

Dr. Rollett feels incredibly lucky to do what she does in this beautiful province we call home, in such a collaborative and supportive professional community.

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Dr. Brittany Rollett Director

Dr. Surjinder Sahota graduated from the Illinois College of Optometry in 2000, and then she did a residency in Chicago in primary care and ocular disease. Upon completion, she returned to practice in British Columbia. Originally, she worked in rural BC for 5 years, and has since been practicing in a group practice in the Fraser Valley. In her practice, she enjoys seeing patients of all ages, but has a special interest in ocular disease and dry eyes.

Dr. Sahota has been a member of BCAO since 2001, and been on the board since 2008, serving on various committees, and then as president form 2011-2013. After 2015, she took a short leave from the BCDO board and is now back on as the BCDO representative on the Canadian Association of Optometrist’s board. She has a strong passion for government advocacy and public education to help forward the profession of Optometry.

Dr. Surjinder Sahota CAO Representative

Dr. Sahota encourages all members to get involved, to whatever capacity available, whether it is local advocacy in your office or community. Taking the time to join an association committee or board, will help grow you professionally in your own office and beyond.

As the CEO of BC Doctors of Optometry, Pria Sandhu is a dedicated, result-driven visionary with over 20 years of experience in operations, leadership and executive health management. Pria enjoys leading organizational change and increasing membership engagement. She is motivated with servant and value-based leadership approach with focus on members, community and patient-centered care. Pria enjoys negotiations and fostering stakeholder relations through collaboration and engagement. She values learning and development, through education and networking opportunities.

Pria is a Chartered Professional in Human Resources (CPHR) who holds a master’s degree in Leadership and Healthcare Management (Royal Roads University), a Geography - Urban Planning and Economics degree (UBC) and a post-graduate certificate in Human Resources and Labour Relations (BCIT).

Pria is passionate about technology, innovation and the advancement of scope of practice. She is motivated by the pursuit of improving access to healthcare, the promotion of educational and research excellence and empowering diversity and inclusion. Pria loves to travel, mountain bike and design and decorate homes.

Ms. Pria Sandhu Chief Executive Officer

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EyeLearn: Optometrist Toolkit EyeLearn is BCDO’s newly revamped children’s eye health program, rolling out in urban and rural communities across BC. EyeLearn raises awareness of the importance of eye exams for infants and those under 19 years of age and highlights eye exams for this group are fully or partially covered by MSP.

HAVE YOUR KIDS SEEN

THIS YEAR?

To accompany the EyeLearn program, we have created the following suite of materials for our members to help promote children’s vision health, all featuring the mascot, Opie.

Within the toolkit, there are several pieces to help promote children’s vision health: Social Media Posts To promote children’s vision health through your optometry clinic’s social channels, we have created four images for use on Facebook and Instagram, with accompanying copy and messaging.

Opie Posters Opie posters are available in three different sizes 8x11, 11x17, and 18x24.

HEALTHY EYES CAN HELP

MSP WILL COVER EITHER

YOUR KIDS DO BETTER AT

ALL OR A PORTION OF

SCHOOL AND SPORTS!

THE EXAMINATION COST.

Book an appointment today. www.bc.doctors ofoptrometry.ca

301814-11-Opie In-store Poster-18x24.indd 1

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Email Template To remind parents and guardians about the importance about children’s eye health, an email template is available for Doctors of Optometry to customize and share with patients. Doctors of Optometry also have the option to include an Opie banner below their signature, which links to the EyeLearn page on BCDO’s website.

To download the EyeLearn Optometrist Toolkit, please click here. EyeLearn merchandise is coming SOON, please stay tuned!

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2021 BCDO EVENTS Eye Digest Magazine | 45

WESTERN PROVINCES CE BC Doctors of Optometry invites you to attend the first ever Western Provinces CE session!

BCDO has teamed up with the Alberta Association of Optometrists, Saskatchewan Association of Optometrists, and Manitoba Association of Optometrists to host a unique and engaging presentation from Dr. Justin Schweitzer, “Managing Your Patient’s Glaucoma: From the Classic Case to the Conundrum”. This interactive course will equip attendees with knowledge on the options available to diagnose, treat, and manage glaucoma patients ranging from classic to complex cases.

Be sure to take this opportunity to learn alongside your colleagues from various provinces!

For more information, click here

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2021 BCDO ANNUAL CONFERENCE & OPTOFAIR BC Doctors of Optometry’s 2021 Annual Conference & OPTOFAIR is a three-day continuing education, networking and professional development event for doctors of optometry and optometric staff. This is your opportunity to gain valuable and relevant insight and education into the optometric field.

Date: Friday, September 17 – Sunday, September 19, 2021 Please stay tuned for more details!

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Public Education Update

By BC Doctors of Optometry and Edelman Over the past few months, we have kicked off two public awareness and education campaigns — Telehealth (“Your Eye Health Matters”) and EyeLearn with Opie!

In 2021, we will help British Columbians move into a new reality as more and more British Columbians are vaccinated and begin to navigate the summer and fall months.

BCDO EyeLearn Program Opie is back! The BCDO EyeLearn Program, which raises awareness of the importance of eye exams for infants and those under 19 years of age, is now live on Facebook and Instagram, website banners and using Google search. By creating and publishing interactive videos, GIF and images of BCDO mascot Opie — all with real-life scenarios and fun eye health facts — we are inviting parents and children into Opie’s world. Opie is talking about the impacts of screen time and the importance of seeing your Doctor of Optometry for information and guidance in a fun and engaging way.

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We launched an earned media campaign about the BCDO EyeLearn program just before the Vision Health Month in May, to reach out to a wider audience through traditional media. Part of the coverage includes interviews with CTV Vancouver, CTV Vancouver Island, Sing Tao Daily, Omni TV and Fairchild. We designed a toolkit for members, including social media posts, email templates, as well as visit stickers, posters and window decor of Opie that BCDO members can use all year long to help promote children’s eye health and engage with their patients.

In addition, we will further bolster our EyeLearn campaign to promote children’s eye health through the creation of a video that will be used across all channels, including website, Facebook and Instagram. In this video, a Doctor of Optometry will ask children questions about their eye health and then provide the right information.

of this year. This year, BCDO will continue to lead the conversation around eye health with research and surveys, earned media, social media, paid ads and SEM.

BCDO Telehealth Campaign The BCDO Telehealth Campaign kicked off in March and will stay in market until the end of May, but the messaging about the availability of Telehealth will continue to be shared with British Columbians. In this campaign we published an engaging videography and photography series featuring Dr. Sandy Johal and Dr. Helon Law to educate British Columbians about access to eye care services, both in-person and virtually, during COVID-19, and to direct people to BCDO’s Find a Doctor tool.

We will continue to spread the message about the availability of MSP coverage for children and the importance of eye health to British Columbians’ overall health. Since the Telehealth BCDO campaigns targets a broader range of British Columbians, this campaign will focus on a group that has the most need and potential to engage in eye care – B.C. parents.

The videos and images are now live on BCDO’s Facebook and Instagram, and are being optimized through paid ads, to reach the largest number of British Columbians. We have also launched the SEM (Search Engine Marketing) campaign to direct people who are searching eye healthrelated keywords to the BCDO website and the Find a Doctor page.

Coming soon: 2021 Public Education Campaign Following the Telehealth and EyeLearn campaigns, an integrated public education campaign will kick off in June, and stay in market throughout the rest

COVID-19 has changed everything. From homeschooling to worries about the long-term impacts of COVID-19, parents’ plates are full. Often parents put themselves and their well-being last. As we pivot into the recovery phase of the pandemic, we want busy parents to understand they must look after themselves if they’re going to look after everyone else.

The campaign will aim to bring comprehensive eye exams to the top of parents’ ever-expanding “have-to-do” lists and encourage them to book an appointment with a Doctor of Optometry. Stay tuned, more details to come!

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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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Stay Safe & Healthy

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