EYE DIGEST December 2020
BCDO’S QUARTERLY OPTOMETRIC MAGAZINE
Navigating Change: Optometry New Tools and Perspectives
Many Canadians believe COVID lifestyle changes are affecting their eyes Member Spotlight: Dr. Amit Mathur
Genetic Testing for Inherited Retinal Diseases
info@optometrists.bc.ca 604.737.9907
BC Doctors of Optometry 121 –10551 Shellbridge Way, Richmond B.C, V6X 2W8
CONTENTS
Innovation & Technology Many Canadians believe COVID lifestyle changes are affecting their eyes......................................... 5 Adopting Optomap UWF imaging................................................................................................................... 10 Collaboration that Works: TAYE (www.ThinkABoutYourEyes.ca)........................................................... 12 Genetic Testing for Inherited Retinal Diseases............................................................................................ 14 Disrupting the Disruptors: How Will You Respond to Change?............................................................. 16 The Financially Resilient Optometrist............................................................................................................. 20 Change....................................................................................................................................................................... 22 Does this Sound Familiar?................................................................................................................................... 24 Mindset and Product Branding with Anka Eyewear ................................................................................. 26
Programs & Events Children’s Vision Program.................................................................................................................................... 28 2020 Fall Summit Summary ................................................................................................................................30 2021 BCDO Events .................................................................................................................................................32
Members & Services Member Spotlight: Dr. Amit Mathur................................................................................................................ 36 Are You Interested in Locum Work? ............................................................................................................... 40
COVID-19 2020 at its New Normal........................................................................................................................................ 42 BCDO Public Survey Insight................................................................................................................................ 45
Many Canadians believe COVID lifestyle changes are affecting their eyes By: Alcon Canada
- Two-thirds of Canadians say they’re spending more time looking at screens during the pandemic, which can contribute to vision problems –
TORONTO – Thursday, December 3, 2020 – COVID19 has impacted the way we work, learn and socialize, with more Canadians than ever seeking connection and entertainment online. According to a new survey commissioned by Alcon Canada, two-thirds of Canadians requiring vision correction (66 per cent) are spending more time on computer, tablet or phone screens than they did before the pandemic, and nearly one-third (31 per cent) feel their eyesight has gotten worse. The study of 1,000 Canadians requiring vision correction, conducted by research firm Leger, showed that 34 per cent of Canadians requiring vision correction say their eyes feel more tired during the pandemic than they did before, which is a possible sign of digital eyestrain, a condition caused by spending too much time in front of screens. A study found the effects of long-term computer use on the eyes suggest that digital eyestrain is a form of evaporative dry eye. As a result, tears evaporate on the surface of the eye and can cause them to feel dry, tired or irritated. Despite this: • One-third (34 per cent) say they’ve delayed getting new contact lenses while another third (33 per cent) say they’ve delayed getting new glasses, which can further contribute toward worsening vision • Nearly 40 per cent say they’re uncomfortable with the idea of visiting their eye care professional during the pandemic • One-quarter (28 per cent) say they’re actively experiencing symptoms of dry eye “While it’s tempting to turn to streaming services and
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e-books for entertainment after long days of working and learning on screens, I’m seeing patients in my clinic who are suffering from sore, tired eyes as a result, which could be a sign of dry eye caused by digital eyestrain,” says Dr. Shawn Moore, optometrist at Orillia Optometry. “Conditions like dry eye can also present as blurry vision, so if you’re experiencing changes in your eyesight, patients still need to prioritize seeing an optometrist at this time to re-assess their vision care needs. Your eye doctor might recommend using an eye drop with lipids, like SYSTANE® COMPLETE, or switching to a daily disposable contact lens featuring water gradient technology, like DAILIES TOTAL1®.” In addition to dry eye and worsening vision, the survey showed that Canadians are frustrated with the inconvenience and nuisance of foggy glasses caused by wearing a mask and glasses together while running errands. Three-quarters of Canadians who wear glasses say their glasses fog up when wearing masks; 35 per cent say they adjust their glasses more when wearing them with masks; and more than half of Canadians (51 per cent) requiring vision correction wear contact lenses when going outside. Experiencing changes with your vision during COVID-19? The following steps could help: • Give your eyes a rest. When looking at screens, follow the 20-20-20 rule: every 20 minutes, take a 20-second break and look 20 feet away to fight digital eyestrain.
• Find the right eye drop. While dry eye is often a chronic condition that can’t be cured, the right eye drop can provide comfort and help improve symptoms. Lipids found in a drop like SYSTANE® Complete restore the outer layer of the tear film, which helps prevent the tear evaporation often seen with digital eyestrain. • Consider a daily disposable contact lens. If your blurry vision is caused by a changing prescription and not dry eye, consider a daily disposable lens when updating your prescription, which eliminates the need for cleaning and storing your lenses. For those seeking exceptional comfort and additional hydration, DAILIES TOTAL1® features the world’s first and only water-gradient lens technology, which creates a cushion of moisture on the eye that is so comfortable, it feels like you’re wearing nothing at all. • Reassess your set up. Place your screen at an arm’s length away from you and adjust screen brightness to your surroundings, eliminating any harsh lighting near your workspace. • Visit your optometrist. Recognizing the increase in screen time during the pandemic, now is not the time to neglect your eye health. Regular eye exams are critical to ensuring your vision health, and only an eye care professional can diagnose a condition like dry eye or prescribe the right vision corrective device. Eye care professionals across Canada have put in place a number of COVID-19 safety precautions to help protect you while in their clinics. Many offer virtual appointments where appropriate and can provide direct shipping for products like contact lenses and eye drops.
to learn more about DAILIES TOTAL1® or SYSTANE® COMPLETE. Study Methodology An online survey of 1,000 Canadians who wear corrective eye wear was completed between September 22 and September 27, 2020, using Leger’s online panel. For comparative purposes, a probability sample of 1000 respondents would have a margin of error of ±3.1%, 19 times out of 20. About Alcon Alcon helps people see brilliantly. As the global leader in eye care with a heritage spanning more than seven decades, Alcon offers the broadest portfolio of products to enhance sight and improve people’s lives. Alcon’s Surgical and Vision 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. More than 20,000 Alcon associates are enhancing the quality of life through innovative products, partnerships with eye care professionals and programs that advance access to quality eye care. For more information, visit www.alcon.ca. For more information, contact: Viktoria Kiely, Cohn & Wolfe vkiely@cohnwolfe.ca 647.259.3273 ©2020 Alcon Inc. 11/20 CA-DT1-2000097
For more information, talk to your eye care professional
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Adopting Optomap UWF imaging By: Dr. Shiv Sharma, OD Supported by Optos®
Ultra-widefield (UWF) imaging has increasingly become an essential tool for optometrists and ophthalmologists alike. Recently defined by the International Widefield Imaging Study Group as images that include retina “beyond the vortex vein ampullae in all 4 quadrants”(1), UWF images allow for increased detection of peripheral retinal pathology. This is significant for a number of disease states, including diabetic retinopathy (DR), as research has shown predominantly peripheral lesions (PPLs) to be associated with a greater than 4-fold increased risk of DR progression.(2) After considering adopting UWF for some time, I purchased an Optos device for our practice in early June of this year. At that time, most offices in Canada, including ours, had been closed to routine care for nearly two months, which may make this sound like a risky investment. However, adopting this technology benefited our practice almost immediately in several ways. Detecting More Pathology First and perhaps foremost, UWF imaging has allowed us to detect more pathology, faster. In a single capture taken in less than ½ a second, the Optos device images more than 80 percent, or 200 degrees, of the retina. Using optomap images, I have identified more retinal holes, tears and areas that can be lasered preventatively, often in patients who are not the usual suspects. This has been surprising, as I consider our typical dilated fundus exam to be quite thorough, but the evidence is clear. This is also consistent with what has been shown in the literature about the device’s ability to identify more pathology compared to binocular indirect ophthalmoscopy.(3)
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The autofluorescence feature has also proved to be an invaluable tool for enhanced imaging of common conditions such as ARMD by highlighting RPE damage. (4) Improving the Patient Experience Having UWF imaging has created the opportunity for better patient education. Patients can sometimes have difficulty understanding their diagnosis or condition without the ability to see an image with their own eyes. Having a UWF image to show and review with them not only contributes to greater understanding, it also may serve as motivation for greater compliance with treatment and follow-up recommendations. Enhancing Practice Reputation and Driving Growth Improving the patient experience also creates an opportunity to enhance your practice’s reputation and drive growth. Patients are often impressed by their experience with the Optos device, which in turn enhances their perception of the practice as one that offers the latest technology and thus provides high quality care. This has given our practice a competitive edge that has led to increased referrals, a measure that we are able to assess quantitatively. An enhanced reputation and commitment to having up to date technology can also help when trying to attract and hire staff and associates, as new graduates will often gravitate toward clinics that have the latest technology.
Easy Integration Optos UWF devices are very user-friendly, making the learning curve minimal and staff training easy. At our practice, we trained staff members in 10 minutes – some of them remotely. This is impressive considering the fact that some other devices require specialized training.
or contacts. In many cases, the extra time has allowed for discussion of other revenue-generating items, such as contact lenses and eyeglass lenses or specialty services like myopia control, dry eye treatment, and more,” which I might not have had time to address previously with a busy patient schedule.
Improving Efficiency While practice efficiency is always important, it has become even more so as a result of the pandemic. The ability to capture 80 percent of the retina in less than ½ a second in a single capture not only allows for faster and easier detection of retinal conditions, it has also allowed us to increase the number of patients that we see per day.
In addition to these revenue-generating opportunities, this approach also leads to more positive word of mouth, as patients appreciate the opportunity to have their questions and concerns addressed thoroughly and learn about new technologies that could improve their quality of life.
Documentation of pathology is also more efficient and effective with UWF. The ability to compare an image from a previous visit instead of having to develop and rely on drawings is not only less time consuming, it also makes a patient’s record much more thorough. Opportunities for Increasing Revenue Typically, optometry practices follow one of two models for patient flow when adopting UWF. The first is “selling” an optomap to each patient as an additional service. This option did not appeal to me, as it seemed inefficient given the staff time and training required and the potential for the result to be less impactful than the alternative approach of simply incorporating it into a slightly raised basic exam fee. The later approach, for which we’ve opted, ensures that the device is being put to good use on a consistent basis and maximizes the potential for word of mouth. While the raised exam fee and increased patient volume will lead most practices to quickly recoup their investment, it is important to look beyond the exam fee itself. Quality time with the patient is perhaps the biggest benefit UWF has to offer. UWF is now part of our pretest protocol. Before I even see a patient, a staff member captures an optomap image and completes autorefraction, auto tonometer, pachymetry, and OCT if applicable. Having this data collected before I even enter the exam room allows me to have a higher quality visit with the patient, during which I can spend more time educating, discussing treatment options, and answering questions. In cases where there is no retinal pathology to address, I have more time to address the reason for the patient’s visit, such as purchasing glasses
CSR
Peripheral Tear
Conclusion Purchasing capital equipment is a significant investment and thus requires the consideration of multiple factors before making a decision, particularly under the current circumstances. The Optos [California] UWF imaging device is one that, in my experience, has helped our practice provide better patient care, and created new opportunities for growth.
References 1. Choudhry, N. Classification & Guidelines for Wide Field Imaging: Recommendations from the International Wide Field Imaging Study Group. Poster session presented at: 51st Annual Retina Society Meeting; 2018 Sept 12-15; San Francisco, CA. 2. Silva PS et al. Automated Hemorrhage and Microaneurysm Counts on Ultra-widefield Images Predict Increased Risk of Diabetic Retinopathy Progression Over 4 Years. Paper presented at The Association for Research in Vision and Ophthalmology Annual conference; 2018 Apr 29- May 3; Honolulu, HI. 3. Brown K, et al. Comparison of Image-assisted versus Traditional Fundus Examination. Eye and Brain. 2013; 2013(5):1–8 4. Ly, Angelica et al. “Fundus Autofluorescence in Age-related Macular Degeneration.” Optometry and vision science : official publication of the American Academy of Optometry vol. 94,2 (2017): 246-259
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Collaboration that Works: TAYE (www.ThinkABoutYourEyes.ca)
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It seems like only yesterday that the BCDO and other provincial associations and industry leaders partnered to establish the successful TAYE (ThinkAboutYourEyes. ca) campaign in Canada. Like today, those were very challenging times, but the collaborative and entrepreneurial vision that was shared has more than proven itself over time. As the charts below show, the last TAYE campaign delivered across Western Canada in 2019 provided a lift in comprehensive eye exams (CEE’s) for families of between 14 and 34% over the course of the year. Importantly, the research data also validated that TAYE is significantly supporting Optometrist visits and supporting industry sales. TAYE correlated to a lift in Optometrist visits of between 13 and 28%. Table 1
Table 3
While it was hoped that a fully bilingual national campaign for 2020 would be possible the COVID-19 pandemic provided for a “stutter step”. Undaunted, the collaborative not-for-profit organization which organizes TAYE each year, the Council for Healthy Eyes Canada (CHEC), remains committed to its inclusive and important mission; knowing that millions of Canadians will benefit from professionals supporting proper correction for their vision. Together with an expanding group of partners, including BCDO, CHEC is very excited for the national TAYE campaign in 2021, which is focused primarily on supporting comprehensive eye exams (CEE’s) for Canadians.
Table 2
By any measure TAYE has been an enormous success: There are clearly tangible results from every TAYE campaign since inception, there has been amplification that is achieved for scant marketing dollars, but it’s also important to note how the leadership from Optometrists and industry alike has truly helped to create something extraordinary and special. Beyond improving awareness Canadians have for their vision and encouraging meaningful action, a unique collaborative effort has been supported in a win-win paradigm between industry and Optometrists. Through TAYE, CHEC has created a cooperative community that provides a coordinated, effective and measurable message for Canadians.
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Genetic Testing for Inherited Retinal Diseases By: Fighting Blindness Canada The popularity and utility of genetic testing for inherited retinal diseases (IRD) has significantly grown in the last decade. Advances in the genetics of IRDs, coupled with development of gene-specific treatments, have increased individuals’ interest in discovering their genes. The first gene-replacement therapy for an IRD was recently approved by Health Canada. Voretigene neparvovec (Luxturna®) is a one-time gene therapy treatment that can prevent vision loss and even restore some vision for individuals with retinitis pigmentosa or Leber congenital amaurosis caused by biallelic mutations in RPE65. This is a historic moment, bringing to fruition the promise of the genetic revolution and giving hope to the IRD community that other treatments are coming. Over the past 40 years, scientists have discovered over 300 genes that cause IRDs. Alongside these developments, genetic testing quality and speed has improved, while costs of testing have reduced in the past two decades. For many years, genetic testing for IRDs was not prioritized and was limited to academic centers. However, as new and often gene-specific treatments are coming to human trials, provincial governments have recognized the importance and value of genetic testing for IRDs, which is why all provinces now provide funding for IRD genetic testing. At Fighting Blindness Canada, we receive many inquiries on how to get genetic testing done. We always advise interested individuals to work with a vision care team and a genetic counsellor to navigate this process. Successful genetic testing may help: • Confirm a diagnosis. Sometimes it is hard to definitively
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confirm an IRD through eye tests alone. Some IRDs cause similar symptoms and retinal damage. Genetic testing may help vision care providers understand a diagnosis and how vision loss might progress. • Understand inheritance. Gene mutations have specific inheritance patterns such as dominant, recessive, or x-linked. Knowing more about the inheritance pattern of a gene mutation can be helpful in determining how the mutation is passed on and if other family members should get tested for the mutation. • Determine next steps. Many clinical trials and treatments currently available are gene specific. For those interested in participating in a clinical trial, a first step to determining eligibility may be genetic testing or knowing their gene mutation. Despite these benefits and great advances in genetics over the past 20 years, many genes that cause IRDs have not been found yet. As many as 30% of IRD patients who get genetic testing will get a negative result. There is also a chance that the laboratory will identify a genetic mutation that has not been previously shown to cause a disease. This result is known as a variant of unknown significance (VUS). This does not mean an IRD is not present, rather that the genetic mutation that was identified has not yet been connected to a specific disease. It is possible that in the future, the variant may be identified in other people or shown to cause an IRD. In the case of a variant of unknown significance genetic test result, an IRD diagnosis may be confirmed using other information, like medical and family history. The importance of proper diagnosis and genetic testing is growing as treatments are getting closer to market availability.
Each province has different steps for getting genetic testing. We have made provincial guides to genetic testing that are available on our website. To access the guides and learn more about genetic testing, visit fightingblindness. ca/resources/genetic-testing-for-inherited-retinaldiseases Fighting Blindness Canada’s IRD Patient Registry is a secure clinical database where information about an individual’s clinical and genetic information is collected, providing opportunities to be connected with clinical trials that may be appropriate. Individuals can enrol anytime, and once genetic test results are received, information can be updated. To learn more about registering, contact Fighting Blindness Canada’s Health Information Line at healthinfo@fightingblindness.ca or call 1.888.626.2995.
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Disrupting the Disruptors: How Will You Respond to Change? By: Sandy Stark Marketing Manager, Sightly "People are very open-minded about new things - as long as they're exactly like the old ones." – Charles F. Kettering During his lifetime, Charles Francis Kettering was a holder of over 180 patents and was the inventor of some of the most commonplace devices and tools we use in modern society, perhaps most notably within the automotive industry. When we think of pioneers in the automotive industry, many people think of Henry Ford. Yet, one can argue that it was Kettering who had the greatest influence on securing the automobile's success. After all, among other things, Kettering is credited with inventing the electric ignition system. Can you imagine still having to hand crank our cars to get them started?
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Still, with all of Kettering's success, he uttered that quote. Given the sentiment, we can assume that he had his battles getting others to buy into his vision, as many disruptors do. Kettering was a disruptor in his time, and his invention was such that other companies had three choices - either get on board, disrupt and innovate, or become extinct. To achieve that last option you just need to keep the status quo. In the eye care industry, we have seen disruptors emerge over the past two decades, with Clearly and Warby Parker to name but two. Surprisingly, by and large, the optometry industry has been slow to respond. Or perhaps not surprisingly, when you consider that quote once again, by Charles Kettering. It is in our nature to resist change. Then
comes a year like 2020, and businesses start scrambling to catch up. However, to claim COVID-19 as the reason for the change and quickly dismiss the need once the perceived threat is behind us could be a costly mistake. The disruptive force to the eye care industry started long before we ever heard of COVID-19 and will be forging ahead at an accelerated pace long after. Regardless, we still have the same three choices when faced with a disruptive change to our industry: we can either get on board, continue to innovate, or become extinct. DISRUPTING THE DISRUPTORS How we view disruptors says a lot about how we adapt and succeed in the face of change. Do we see them as an attack on our industry, a catalyst for positive change, or do we dismiss them altogether? At Sightly, we believe disruptors bring positive change, but not everyone has the resources to innovate. Our primary mission is to create a patient-commerce platform that will allow practices not just to disrupt the disruptors of the eye care industry but to be disruptors in their own practice, leading their change rather than reacting to someone else's. Here are some ways you can take advantage of the work disruptors have done for you, improve the quality of life for your patients, and improve your practice's workflow: 1. Disruptors have done a lot of research and invested a lot of resources into discovering what customers want. Use their research and ideas to improve your own patient experience and develop efficiencies within your practice. 2. Drive the change in your practice and lead by example. Enforce your new technology by using it yourself. Demographics shift, and younger generations now are the not-so-distant patients of the future. Some already are your patients, and they drive the
change the disruptors are bringing to the table. These patients do not resist technology; they demand it. They will not know a world without online convenience. 3. Modernize your website. Having an online presence with your contact information and an 'About Us' blurb will not cut it. First impressions matter, and the visual appeal is king. It takes less than one second for a visitor to your site to form an opinion about you and your practice. 4. Be mobile – use an app like Sightly to bring your products and services to your patients, when and where they want it. 5. Patients want to see an Optometrist for their eye care, and they want to buy from experts. Bring your unique expertise and areas of specialization to the patient-commerce storefront. You can use virtual chat technology and recommend products you know they need based on their personal medical history. 6. You have the advantage of personalizing the online experience with patient profiles, reminder notifications to re-order lenses, and booking appointments. Using these steps, along with becoming a trusted and knowledgeable partner in your patients' care, will help mitigate your risk of stagnating in the status quo. You will make great strides toward controlling your practice's success and longevity. With or without COVID-19 change is happening. You choose how you will respond to that change. You can crank out the next few years, or you can ignite your engines. Sightly is the optometry industry's patient-commerce solution designed to make your practice's entry to the world of digital commerce seamless. For more information, visit us at getsightly.com or contact us at info@getsightly.com
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The Financially Resilient Optometrist By: Alphil Guilaran Financial Literacy Counsel Inc.
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The pandemic has proven Optometrists are resilient. From rethinking how to do in-person appointments using PPE to providing virtual based meetings, they have proven they can overcome adversity to deliver essential eyecare to patients. However, can the same be said when it comes to financial resilience? As an Optometrist, if you are concerned about your financial situation during the pandemic, you are not alone. Stress, due to economic uncertainty and fear of the unknown, is making it more challenging for Optometrists to plan and reach their financial goals. The good news is, there are three ways you can increase your financial resilience. Consider these tips to help you take control of your finances and improve your financial well-being. 1. Increase your financial literacy One of the simplest ways to improve financial resilience is by increasing your financial literacy. Reading a book on finances, watching a course online or listening to a money podcast, are great places to start. Being a financially literate Optometrist begins with having a basic understanding in a few core areas: setting personal and business financial goals, cashflow management, as well as understanding debt, insurance and investing. To elevate your financial literacy, you need to take the next step of applying what you learn into your daily life. Whether you do it yourself using online financial tools or reach out to trusted professionals, the power is in your hands to elevate your financial literacy.
unexpected. If your spending plan reveals you have a shortfall, look at ways you can adjust your expenses to meet your obligations. If you are incorporated, reach out to your accountant or financial planner to determine how much to draw out in salary and/ or dividends based on your regular monthly expenses. 3. Act like an Optometrist, Think like a business owner Business owners prioritize protecting their profit centers because they know their financial resilience depends on how quickly they can bounce back from setbacks. They invest in insurance programs to protect against risks that threaten their ability to work, such as a disability or a critical illness. As an Optometrist, do you have adequate insurance coverage to protect against the loss of your income? We recommend you review your disability, critical illness and life insurance needs at least once a year. This will improve your financial resilience, knowing that you have protected your income, your family and your practice. Concerns over money during the pandemic is top of mind for many professionals. In addition to the tips we shared, it is important to communicate with your partner and family about your financial priorities. If needed, reach out to a trusted financial professional for their insight and advice so you can improve your financial resilience and well-being. If you have additional questions regarding your finances, your BCDO membership benefits includes two financial coaching sessions. Contact the Financial Literacy Counsel to access your benefit at 604-620-6630, email: consultation@flci.ca or click the QR code
2. Create a spending plan Creating a spending plan strengthens your financial resilience as it empowers you to make choices based on what is important for you and your family.
below:
ABOUT THE FINANCIAL LITERACY COUNSEL
Make a detailed list of your regular monthly expenses such as mortgage, rent, loan payments, utilities, food, income taxes, etc., and compare that with your monthly income after clinic and business overhead expenses. If you have more than what you need, prioritize increasing your rainy day/ emergency fund to be prepared for the
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 Accountants of BC (CPA-BC) and Continuing Legal Education Society of BC (CLE-BC). FLC is the winner of the 2020 IFSE Institute Financial Literacy Champion of the year award.
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Change By: Dr. James Thompson Class of 75 - Waterloo
We have always experienced change. It is part of human nature. Today I am going to go over the optometry version of change that has occurred in my lifetime. Change that is happening now. And a guess for the future. In the last century when I graduated there were no cell phones, no internet, no digital cameras, no OCT, no disposable contact lenses, no Auto refractors, no perimeters, no IOLs, no refractive laser surgery, and no BIO. I had to learn these technologies. The concept of washing hands between patients was being introduced. Tonometry was being introduced as a regular test. No diagnostic drugs allowed including fluroscein. If you referred a patient to an ophthalmologist they never returned. The BC College of Optometry told us not to prescribe vitamins as this was outside our scope of practice. This 21st century comes along and we had to deal with added scope of practice with therapeutic drugs - More learning. Myopia has changed from uncontrolled genetic problem to something that we can contain. The advent of on-line glasses. At the time on-line change was considered so devastating that optometry students were considering quitting. Yet we survived. Today things are changing faster. Last year’s cell phone
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has changed. Alexa is changing with new algorithms. These are all the positive changes. Luddites feel these are negative changes. The other mostly negative change is the elephant in the room, COViD 19. So how do we deal with it? A few simple rules. 1. Change is overwhelming, so keep it simple. 2. Look at the facts. Be aware of emotions & emotional language. 3. Examine and re-examine your procedures and policies. 4. Listen to your employees and their needs. 5. Embrace different styles and be patient. 6. As an optometrist you are the leader in the office and your community. There will not be a new normal. There never has been a normal. There has always been change. The change is just occurring faster. Have we had pandemics? Yes. It just has been - not in our lifetimes. Look at facts. It is a virus. What do you know about virus? Look at history for guidance to the future. Use the knowledge and technology that we have. Put them together. I am impressed how fast we have moved forward. Genes were sequenced. Machine intelligence reduced the number of vaccine trials.What used to take years now takes months. The ability to produce billions of vaccines in such short order is outstanding.
Patients and optometrists are dealing with information overload from traditional and social media. The increasing stress on individuals is driving up the sympathetic nervous system. For us optometrists, the visual components, accommodation, pupil response, blink rate, lacrimation, convergence, (conjunctivitis). How can we calm them down? Traditionally it has been plus lenses; calming tints eg G15, photochromic; some vision therapy: conversation; social interaction; going for a walk in daylight; antiinflammatory diets; the reading/computor rules of Breath/ Break for 20 seconds every 20 minutes; palming. More myopia control. More dry eye therapies. All of these, we can counsel ourselves and our patients.
patients will have multiple diagnoses. We will need to know more about what our referral sources can do.
I believe that we have just arrived at the point that macular degeneration is no longer the leading cause of blindness in Canada. It will continue to be an annoyance.
Future research will be looking at COViD 19 effects. The use of lenses and/or vision therapy will be used to help treat mental illness. Patients and doctors will continue to need human interaction for empathy and understanding as well as how to deal with of information overload. The understanding of numbers will become more important than ever. Masks will be a fashion accessory? Finally the number one treatment option for the optometrist for the next 40 years will be glasses.
The future will be extremely interesting. New disinfectant systems will be invented. Disinfection of frames will continue. I am surprised that we hadn’t done frame disinfection earlier. Masking will be standard. Virtual telemedicine will be greater. We will be using newer versions of Facetime rather than telephones. Dr. Google will get better and will take away our simpler diagnoses. Consequently patients in the office will get harder. We will be used for second opinions when Dr. Google fails. More
Myopia control will look very different. Plus lenses will be built into every pixel of the computor. The power of the pixel will be changed by software We will be doing gene sequencing in the office. Sequencing to decide upon to tailor the best drug for the best bug. Sequencing to decide on preventive measures based upon the human genome eg glaucoma, AMD.
Change is inevitable. Re-read the rules. How we meet these challenges is up to You. And You can do it.
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Does this sound familiar?
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By: Phil Trickett Eyesafe Manager
“I value my eyesight too much not to wear safety glasses but fogging on the lenses drives me to distractions. Do you have any recommendations for keeping the fog at bay”? Fogging is the number one problem faced by safety eyewear users and now with COVID this seems to affect all spectacle wearers using face masks. Once you understand why the fogging is happening, solving the issue becomes an attainable goal. Let us look at the reasons why this annoying occurrence happens. • Ambient Heat: The temperature of the surrounding environment • Tight Eyewear: Usually associated with snug fitting frames such as wrap and goggle style frames • Increased Humidity: The more moisture in the air, the more likely the lens will fog • Human Exertion: Working hard causes the body to heat up and produce sweat. The added heat and moisture contribute to lens fogging • Lens Washing: Washing most anti fog coated lenses erodes their anti fog properties. • Not to raise glasses up to your forehead. When you do this, water vapour from your sweat will phase change to the inside of the lens.
ways, with varying levels of success and longevity. Todays advanced anti fog technologies actively manipulate moisture through surface acting agents, chemicals designed to move to the lens surface as needed to prevent fogging. The most reliable coatings employ dual – action properties. • Hydrophilic: That absorb moisture into the lens • Hydrophobic: That spread excess condensation in a clear film across the lens surface and ultimately shed moisture off the lens.
Maintaining a fog free view is vital, workers whose vision is obscured by fog can not clearly see hazards around them or worse still remove their eyewear completely, directly compromising compliance and exposing themselves to possible eye injuries.
Applying dual action anti fog properties so it goes on and stay on even after repeated washings and wiping is key to the coating durability and longevity. Whether it be coating manufacturers that bond anti fog agents permanently to the lens or those that rely on controlled application methods and vigorous monitoring such as sprays or wipes.
With so much at stake, it is easy to see why safety managers need effective anti fog solutions and until now products with anti fog solutions did not necessarily stand up to the demands of the workplace.
The need for effective anti fog performance on safety eyewear is clear. Look for proven technology that delivers lasting fog free vision and durable staying power that stands up in the harshest of working environments.
Anti Fog Solutions Differ Widely.
By selecting the effective anti fog properties, workers benefit from a safe, productive, and compliant workforce which supports a healthy bottom line.
While anti fog solutions differ widely, from coatings to sprays and wipes to home remedies such as applying soap or shaving cream to the lenses, they all work in different
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Mindset and Product Branding with Anka Eyewear By: Anka Eyewear
Have you realized that you or your kids are able to instantly identify a business by looking at its logo, even if its name isn’t a part of the logo? In our digitized world where consumerism has evolved at a mind-blowing pace, today’s consumers can describe products from a copious number of businesses based simply on their logos, MORE than the indigenous plants in their own backyards. We live in a world that is hyper-connected digitally. Since the beginnings of Facebook, Youtube, Twitter, Yelp and Google, people have become increasingly overwhelmed with superficial communication, funneled into automated email sequences, and tracked by data collectors. The harsh truth is that investing more resources in tech is not going to make your business marketing more effective. During these unprecedented times, consumers need something that will fulfill them emotionally. They want authentic trustworthy connections with others who share values that will benefit the future. Consumers are seeking PURPOSE more than products and services. Purpose drives happiness and building meaningful relationships with the businesses from which they buy will be key moving forward. Coupling your company logo with quality eyewear that instills trust that their needs are your priority, and builds confidence for a healthier, happier experience will poise your company to dominate the competition.
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Your business logo is often the first thing a customer will notice about your business. It is more than just an image. Symbols are succinct and an efficient way of communicating information about your business. A logo is an important part of your company’s brand and makes a significant impact on public perception. In fact, a logo is one of the most important branding investments a business can make. Your logo is how people recognize you, and it helps express how you’re different from your rivals – greener, kinder, more trust-worthy and so on. A logo is a simple functional signpost to help people identify your business. Market trends are showing brand loyalty has elevated to new heights, and this pandemic has magnified global need for sustainability. This is a time of renaissance for innovation that demands our balance sheets to include more than monetary credits and debits. Now is the time to revamp your business to convey a stronger, fresher identity. Can We Help You? The team at Anka Eyewear would be delighted to work with you towards a finished product customized with your logo that you can be proud of. Please your inquiries to info@ankaeyewear.com
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We are excited to officially launch the New Children’s Program in
2021
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A survey of members showed that a narrow majority of respondents preferred to delay the distribution of EyeLearn materials in their offices because of the COVID-19 pandemic. In response, we have delayed sending merchandise and have pivoted our strategic messaging to focus on relevant topics including screen-time recommendations for school aged children.
STAY TUNED! Eye Digest Magazine | 29 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
The 2020 Fall Symposium occurred on October 2-4, 2020, hosted as a virtual conference. Over 400 doctors attended over the weekend. Over 430 BCDO and CAO members registered to attend the conference, with 24 students and 24 non-member optometrists. The weekend had a total of 10.5 COPE CE credits available. The Symposium was supported by 10 corporate partners, who provided a total of $20,000.00 to support the event and the continuing education courses. Education The Fall Summit provided 6 CE courses (1 course was COPE approval pending), and 6 non-CE courses featuring innovative products and services from industry partners. This year, the fall conference did not feature a Peer Circle. Fall Summit Course Program: CE Courses ARE YOU IN?: How to reach the impossible - Mr. Martin LespĂŠrance COPE: 69577-PM, 1.5 COPE CE Credits The Future of Dry Eye Disease is NOW - Dr. Richard Maharaj
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COPE: 66480-PM, 1 COPE CE Credit (Supported by Labtician Thea) Emerging Technologies, Advances in Laser Refractive Surgery, and Managing the Challenges of COVID - Dr. David Lin and Dr. Simon Holland COPE: 69500-PB, 2 COPE CE Credits (Supported by Novartis) Building a Specialty Contact Lens Practice with Corneal Topography and Imaging Tools - Mr. Randy Kojima COPE: 69315-CL, 1.5 COPE CE Credits (Supported by Medmont and Precision Technology Services) What’s next for eyecare in BC? Innovation and collaboration during COVID-19 and beyond Panel: Drs. Zaid Mammo, Alfonso Iovieno, and Sonia Yeung COPE: 69553-PB, 1.5 COPE CE Credits New Advances in Myopia Management - Dr. Sherman Tung COPE: 69345-GO, 1.5 COPE CE Credits (Supported by Hoya)
Agents of Change in the Health Care Industry - Dr. Sam Daher COPE: Approval Pending, 1.5 COPE CE Credits
Lensbox Session - Dr. Pavan Avinashi An introduction to the contact lens/retail management services offered through the Lensbox platform.
Dry Eye Management in Glaucoma and Cataract Surgery Patients - Dr. Kulbir Gill COPE: Approval Pending, 1.5 COPE CE Credits (Supported by Allergan)
Lunch & Learn: ABB Optical Group-Canada An introduction to the contact lens/retail management services offered through the ABB Optical platforms (a company newly branching into Canada).
Non-CE Courses Lunch & Learn: Get Sightly An introduction to the Get Sightly platform and services.
The PRECISION1ÂŽ Canadian Launch - Dr. Shaun Golemba (with Dr. Mira Acs) Sponsored by Alcon An introduction to new contact lens technology by Alcon.
Changing the Conversation: Contact Lenses for Presbyopic Astigmats - Dr. Harbir Sian Sponsored by Bausch + Lomb An introduction of a new contact lens by Bausch + Lomb. Contact Lens Subscription Session - Dr. Trevor Miranda Sponsored by Avocado Lenses An introduction to the contact lens subscription services offered through the Avocado Lenses platform.
Evaluations Overall, the event feedback was positive and attendees appreciated the ease of access that the online conference format offered. A number of survey respondents suggested to continue hosting one conference virtually. Respondents also noted the appreciation of the variety of topics, and provided suggestions for future topics they would like to see.
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2021 BCDO EVENTS 32 | Eye Digest Magazine
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WEBINARS 2021 Course: Extending Patient Outcomes in Cataract surgery Date: Thursday, Jan 28, 2021 Presenter: Dr. Steven Schendel Time: 6:00 pm Platform: Zoom Course: VerbalEYEs – workshop on optimal communication strategies for DED management Date: Wednesday, Feb 17, 2021 Presenter: Dr. Rana Taji Time: 6:30 pm Platform: Zoom
FEATURE MONTH INDUSTRY PARTNERS In 2021, stay tuned for exciting announcements and informative, engaging CE sessions from our feature month industry partners! January – Alcon February – Novartis March – Johnson & Johnson Vision April – Labtician Thea May – Allergan (an AbbVie Company) and more!
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BCDO Events
GOVERNMENT RELATIONS WEBINAR BC Lieutenant Governor Janet Austin opened the first session of the 42nd Parliament of British Columbia on December 7, 2020. The BC Legislative Assembly is back in session for the first time since Premier John Horgan’s BC NDP won a majority government on October 24, 2020. As such, elected officials are now accepting meetings with constituents and stakeholders. In January, BCDO will launch a comprehensive initiative aiming for members in all ridings to contact their local MLAs. Grassroots outreach with a consistent message will be invaluable in supporting the ongoing and centralized work we do to educate the government on how optometry serves our communities. This will be particularly impactful for those members who live and work in the same riding. We will be providing template letters and talking points for your reference. To help you prepare to meet with your MLA, BCDO will be hosting a Government Relations webinar on Jan 12, 2021. Whether you are experienced in this area with an existing relationship with your MLA, or new to this realm, your participation is encouraged. Date: Tuesday, January 12, 2020 A link will be shared in advance. Thank you for supporting this important work!
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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BC Doctors of Optometry Member Spotlight: Dr. Amit Mathur 36 | Eye Digest Magazine
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behalf. Over the last 20 years, my core practice in Burnaby has been our model of an integrative health unit. We work collaboratively with pediatricians, family doctors, internal medicine, cardiology and pharmacists under one roof. It really allows us as optometrists to be an integral health provider in the care delivery of patients, especially those suffering from chronic diseases. Working in northern communities really gave me a chance to understand the issues of access to care. I really feel that being in remote indigenous communities made me aware of the challenges that still exist and the lack of continuity of care models. This experience continues to inspire me in the work I do today.
Dr. Amit Mathur BC Doctors of Optometry Member
About me: Today I spend almost all of my time as the President of CloudMD Software and Services Inc. (TSXV:DOC) and managing my optometry clinics - but I always start defining myself with my childhood in a small northern BC town of Kitimat. To this day, I find many of my core values stem from this rural, small town upbringing. I studied General Science with pharmacology studies at UBC for 3 years and then attended the University of Waterloo. This was a great experience for me, I was able to collaborate with my professors in research and was first published in an international journal on the topic of reverse geometry contact lens design. I graduated in 2000 from UW with the Ontario medal of Proficiency and started my first job in Windsor, Ontario at a busy refractive eye centre. It wasn’t long that I began to miss beautiful BC, the mountains and returned to work in North Vancouver with Dr. James Thompson. He was a great mentor, and I was able to participate in VT and all the facets of and independent practice. Alongside of this work, I began to start clinics and acquire clinics with partners in a group practice. This was a great, fast paced experience. With larger patient numbers, I was able to participate in product research, advise some of the eyecare pharma/product partners and lecture on their
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I had a “TSN turning point” after a motor vehicle accident in 2011. I was forced after struggling with concussive symptoms to slow down and limit my practice and clinical work for several years. But as this aspect of my work slowed down, I was able to explore other opportunities and co-founded a telehealth company called Livecare. This venture allowed me to use my clinical knowledge in developing models for virtual care that are used to this day. Today, I continue eyecare in Burnaby and Squamish at our Omni Eye and Vision clinics and have the privilege to continue to advance virtual care and digital health solutions as the President of CloudMD Software and Services Inc. alongside a management team of health care leaders in Canada. Who would have ever forecasted a pandemic? It has been rewarding to work with CloudMD to assist clinicians, counsellors, family doctors, allied health providers and optometrists continue services virtually in these unique conditions. Our product Livecare Connect is used North America wide as a secure solution to serve our patients with built in workflow, payment solutions, and the ability to have patients fill in and sign consent forms etc., all while being compliant for healthcare. I am excited about the future of eyecare, and how technology will disrupt and improve the delivery of eyecare.
How do you define success? Success for me is being able to create work-life balance. I’ve always worked very hard, and although financial security is important, the ability to affect the lives of people positively to me is paramount. I am a family man, being a good husband, father, son, son-in law, brother taking care of your loved ones is success. As I get older
(and wiser) its family, health, and this balance that I would say defines my success.
What inspired you choosing optometry as your profession? When deciding on a my professional path, I was lucky to have many mentors and family surrounding me that were “ologists” in the family. I was an extravert, liked connecting with people and wanted to be challenged while working in healthcare. I was also not interested in being on call and really wanted a work-life balance. The search of careers that met these requirements is Optometry. I really enjoyed business and was always inspired by entrepreneurship and felt that Optometry encompassed it all. After 20yrs now, this initial research has to proven to be pretty accurate.
the health ministry to ensure our work is recognized and remuneration advocacy continues.
What are the most rewarding aspects of your job? Optometry offers the opportunity for patients to be instantly treated and assisted – like removing a foreign body or treating an abrasion as examples. But still I find it rewarding to see how a child reacts when they put on their first pair of glasses and notices a world that is so much better, clearer than they could imagine. That smile and excitement that we have all felt, is truly rewarding. I also find it very gratifying to practice as a part of a greater health team. Working with pediatricians, family doctors and internists together to help patients with their vision disorders and systemic condition as a whole is very rewarding. Also, today as the president of a public company, it has been great to see our technologies and the CloudMD virtual physicians app be of real service in a holistic, patient centric offering during Covid conditions.
What new direction would you like to see happen in Optometry?
What would you like to see BCDO accomplish in the next few years? I think the BCDO has done a wonderful job in taking a lead and embracing concepts of technology and innovation. Leadership has worked very hard to educate and expose membership to solutions, options and trends that continue to affect our profession. I have had the opportunity as President of a digital health provider (CloudMD) to study and contribute to global trends in healthcare delivery. Patient centric models of delivery that are enabled by virtual care, in my opinion, are going to continue their growth. I hope that the BCDO continues it’s focus in educating and exposing our colleagues to these solutions, trends, and opportunities that come with the changes in practice and care delivery. I also hope the BCDO continues to work with our healthcare colleagues to ensure we are seen as key providers in the circle of care as new health delivery models are launched in BC. It is integral for us to continue the excellent work engaging
I think the trends that I’m seeing in general health care delivery lend to practice adaptation. Many of us have had to embarks under pandemic response situations. The adoption of virtual care and more patient centric models of care including care at home has been sped up these last several months. I hope Optometry is able to keep pace and use technology, alI supported devices to expand our reach to patients. With these coming solutions, I feel we will be better engaged in preventative care as well as better ongoing care and monitoring of disorders than ever. I also hope that we continue to see closer and more integrative models of care with primary care and ophthalmology both.
What advise do you have for new graduates? As new grads, I think it’s very important to find meaningful work that allows them to truly develop their own style of practice. In every profession, the first few years is such a learning curve, and ours is no different. The skills if not utilized in early years become harder and harder to use later on. This leads me to encourage new graduates to take meaningful continuing education courses and engaging with their local family doctors to promote themselves and the profession as part of the patients holistic care team.
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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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2020 at its New Normal By: Syrine Podadera The past months drastically changed our daily routine and have stripped us of unnecessary activities. We were left with little to no option on how to go through our days. The things that we thought were important suddenly turned into activities we can live without. We started this year with lots of goals in mind. For some, it might be the year of saving money, getting that license, finding a new job, or maybe traveling the world. But as it turned out, 2020 became the year where most of us just wanted to stay alive. Because in the first place, isn’t that what matters most? On our quest for greatness, we have forgotten how to breathe. Our past daily routines used to revolve around rushing to work, skipping meals, and staying up late. We missed out on family dinners to attend to work matters. We forgot birthdays, reunions, and anniversaries. Our minds were everywhere and nowhere at the same time. That was the old normal and we thought we had everything under control. Then the plot twist happened.
We were all caught off-guard. The tourism industry came to a halt. Airlines have shut down and millions have lost their jobs. Economies in both first world and developing countries have suffered. Health care systems have been overwhelmed and millions of people have been infected with COVID-19. We have spent the entire year trying to accept and live the new normal way of living – face masks, social distancing, and swab tests. Nobody saw it coming and until now, we cannot see where this is going or when this is ending. But one thing is for sure, what we hated about the outside before also turned out to be the things we are missing the most. The places that were bustling with tourists are now eerily quiet and the cities that didn’t sleep are now having the rest they deserve. Perhaps it is in our innate nature as humans to keep on working until we have no choice but to stop. This is what this year is about because in one snap, the world came to a stop. We are now confronted with the reality that we are never
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the masters. We thought we had things under control but we have been slapped with the truth that we are merely inhabitants on this planet. We are temporarily here and it’s not up to us to decide until when we’re staying. We can develop the most sophisticated technology but at the end of the day, the works of nature and the invisible will always be more powerful. However, there’s no doubt that we will get through this dark phase. Vaccines have now been developed and tested on humans and it’s only a matter of time until we find the perfect cure. This is not the first pandemic and this will surely not be the last. But it’s important to remember that we have always survived and we will continue to exist until we cannot anymore. But instead of fearing the unseen and the unthinkable, it is better to be grateful for just being
here. As what we have witnessed from the tragic deaths of more than 1.5 million people in less than a year, life is so precious and short. This pandemic taught us a lot of things especially the truth about our mortality, our responsibility, and the fact that this is all temporary. We are stewards of everything that is around us and that includes taking action for the protection of our environment, the improvement of our health care systems, and the development of a universal vaccine for different viruses in the near future. It is high time for us to reflect what COVID-19 has brought us especially when it comes to taking care of our health. Otherwise, history always repeats itself and the price is always expensive.
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BCDO Public Survey Insight By: BC Doctors of Optometry and Edelman
Overview As British Columbians navigate a fall/winter season during this second wave of COVID-19, Phase 2 of the BCDO Telehealth Campaign will leverage the BCDO survey about attitudes and perceptions towards eye health and optometry care during COVID-19 to continue to raise awareness of the importance of maintaining eye health during the pandemic. Against the backdrop of this information, BCDO will continue to use this data to provide British Columbians with information about optometry services, treatment options and regular information about eye health. Background BC Doctors of Optometry survey reveals 1 in 2 British Columbians are concerned about increased screen time and its impact on their eye health since COVID-19. The most common eye conditions during the first 6 months of the pandemic include dry eye and headaches; nearly a third of British Columbians (30%) did not take action to address eye health concerns . A research survey released by BC Doctors of Optometry (BCDO) reveals that most British Columbians (73%) have experienced at least one eye symptom or condition during the pandemic and 30% of those who experienced eye conditions did not take any action to address their concerns. The survey also showed a concern about screen time since COVID-19 - nearly half (48%) of British Columbians are worried about their increased screen time and its impact on their eye health during the first 6 months of the pandemic, and the most common eye symptoms or conditions experienced by British Columbians include itchy or irritated eyes (31%), dry eye (26%), headaches
(24%) and eye floaters (20%). Perceptions that eye health concerns did not require medical attention (55%), concerns related to COVID-19 (39%) and lack of knowledge of available online or phone services (20%) are the three major reasons why people didn’t see an optometrist or a doctor to address their eye symptoms in the past few months, according to the survey. There are plenty of resources to ensure that British Columbians can receive proper eye treatment without putting their safety at risk. For example, people can use the Find a Doctor tool on the BCDO website to locate an optometrist in their area or arrange a virtual appointment over the phone or using secure telehealth platforms to determine if an in-person eye exam is required. “All the open clinics in B.C. are complying with the guidelines to ensure visitors’ safety and the safety of others in the clinic,” said Pria Sandhu, CEO of BC Doctors of Optometry. “Your eye health should not be ignored even in the middle of a pandemic. BC Doctors of Optometry are committed to the safety and wellbeing of our communities, patients and staff, while delivering care to British Columbians for their eye care needs.” The survey generated responses from 1,000 British Columbians representative of the population across the province from August 7 – 11, 2020. BCDO is using the survey results to develop key messages, designed to guide all media and public facing communications from BCDO and its members to reinforce the availability of telehealth services during the pandemic; the steps being taken by BCDO and its members to keep British Columbians safe; and ensure eye health remains a priority even during this challenging time.
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