DAILY - reviewofoptometry.com · Review of Optometry® partners with Salus University for those ODs who are licensed in states that require university credit. ... keratitis. They

Aaron Bronner, OD, began yesterday morning’s ses-sion, “Managing Uveitis

with Flair,” with a goal of pro-viding “not just facts, but clini-cally useful information on uve-itis you can use today.” He spent the fi rst few minutes dispelling the common mindset that the condition “is no big deal,” with some sobering numbers.

Uveitis is causative in 10% to 15% of total blindness cases in the developed world, he said, and although many gradually regain vision, up to 20% are left legally blind.

Don’t Disrespect the DiseaseSo how do clinicians give uveitis the respect it deserves? By better understanding its sight-threatening

implications, differentials and treat-ment options. Dr. Bronner dove into these topics with a brief primer on how cell and fl are cause vision loss, and the long-term implications of ocular infl ammation, includ-

ing cataracts, glaucoma, cystoid macular edema and, less often, retinal detachment, epiretinal membrane and band keratopathy.

After discussing the many as-sociated conditions, Dr. Bronner provided a few clinical pearls on managing uveitis patients. “If you aren’t comfortable with gonio, you shouldn’t manage uveitis patients,” Dr. Bronner said. “If you aren’t willing to dilate these patients, don’t manage uveitis.”

Therapy RundownDr. Bronner then moved on to

treatment protocols. The ultimate goal—eliminate infl ammation—is simple, and he walked attendees through the common therapy

DAILYFRIDAY , MARCH 2, 2018

On Thursday morning, two leading experts in glaucoma treatment and surgery, James Thimons, OD, and Robert Noecker, MD,

shared the stage to discuss why 2017 was one of the most exciting and innovative years in the recent history of glaucoma care.

In the “Gear Up for Glaucoma” lecture, Dr. Thimons noted that two new drugs came out in 2017, the fi rst time new drugs have been released in 21 years. The discussion delved deep into the next generation of therapeutics, the evolving science of surgical intervention, including mini-mally invasive glaucoma surgeries (MIGS), and the technologies optometrists can use for earlier detection and management of glaucoma.

OCT for the OD“The earlier we can identify it, the earlier we can treat it, and there’s no question that earlier intervention in glaucoma does save sight over time,” said Dr. Thimons, making it essential that

ODs not only have the technology in their offi ces to detect disease early, but that they’re also keen to use it. “OCT is the window to the brain and almost as good as MRI in the early identifi cation of the disease state. It takes us to a completely different level of expertise,” added Dr. Thimons.

Both doctors agreed that ganglion cell analysis through OCT is the frontier of early glaucoma diagnosis. “While it used to be state-of-the-art care, you look at the ubiquity of the OCT machine now—a clinically useful tool that we rely on for our clinical exams and for decision making—so yes, along with visual fi eld testing, OCT testing has become standard of care,” said Dr. Noecker.

Outside Offi ce Hours From there, the discussion turned to a handful of newly approved technologies that are changing the face of glaucoma management, such as add-ing the potential for 24-hour intraocular pressure (IOP) monitoring into the approach to manage-ment. One device, the iCare home tonometer, allows doctors to have IOP data throughout the day, even beyond offi ce hours.

Catching Up to the Silent Thief

WHAT’S INSIDE• The dynamic duo of Melton and

Thomas wowed the crowd .....3

• Olympian Laurie Hernandez opened the exhibits ................3

• How to keep your cool during an ocular emergency .................4

• See what student and resident events are coming up .............5

• Don’t miss tomorrow’s special session on the anterior segment ................................7

• Want to learn about amniotic membranes? We’ve got you covered ...................................8

• These pediatric pearls can make your practice more kid-friendly .................................18

• What OCT can do for your practice ................................22

New drugs, technologies and awareness can bring ODs to higher levels in diagnosing and treating glaucoma.

Drs. Thimons and Noecker discussed innovations

and new directions for glaucoma treatment.

See GLAUCOMA, Page 21

See UVEITIS, Page 21

REVIEW OF OPTOMETRY • SECO SHOW DAILY • MARCH 2, 2018

Topics covered in today’s OD courses, p.6

Special fi ve-page guide to the exhibits, p.10

Tomorrow’s ‘What’s Brewing?’ series, p.18

All You Need to Know About Uveitis Attendees left this course with a comprehensive understanding of the many etiologies of the condition—and how to handle them.

HLA-B27-associated uveitis can sometimes

present with a secluded pupil, which has to

be treated with a peripheral iridotomy (PI).

“While the PI will most likely exacerbate the

uveitis, you have to lower that pressure,”

said Dr. Bronner.

000_sd0318_FRI_final.indd 1000_sd0318_FRI_final.indd 1 3/1/18 5:59 PM3/1/18 5:59 PM

2018MEETINGSNASHVILLE, TNNashville Marriott at VanderbiltProgram Chair: Paul Karpecki, ODwww.reviewofoptometry.com/nashville2018

SAN DIEGO, CA**

San Diego Marriott Del MarProgrom Chair: Paul Karpecki, ODwww.reviewofoptometry.com/sandiego2018

ORLANDO, FLDisney’s Yacht & Beach ClubProgram Chair: Paul Karpecki, ODwww.reviewofoptometry.com/orlando2018

ARLINGTON, VAThe Westin Arlington GatewayProgram Chair: Paul Karpecki, ODwww.reviewofoptometry.com/arlington2018

APRIL 6-8, 2018

APRIL 26-29, 2018

MAY 17-20, 2018

NOVEMBER 2-4, 2018

NEW TECHNOLOGIES & TREATMENTS IN

Eye Care &

2018

REVIEW OF OPTOMETRY® EDUCATIONAL MEETINGS OF CLINICAL EXCELLENCE

Visit our website for the latest information:

www.reviewofoptometry.com/eventsemail: [email protected] | call: 866-658-1772

Review of Optometry® partners with Salus University for those ODs who are licensed in states that require university credit. See Review website for any meeting schedule changes or updates.

*Approval pending

Administered byReview of Optometry ®

OPTOMETRIC CORNEA, CATARACT AND REFRACTIVE SOCIETY

**15th Annual Education Symposium

Joint Meeting with NT&T in Eye Care

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3DAILY


In the second installment of their “Eye Care Update” lecture, op-tometry’s dynamic duo—Randall Thomas, OD, and Ron Melton,

OD—ran through selected hot topics revealed in both recent research and their very own offi ces.

“Our goal is to spend the year looking at the literature, fi ltering through it, incorporating the impor-tant concepts into our clinical prac-tice, trying them, making sure they work, and then bringing them to you so you too can take the pearls back to your practice early next week,” said Dr. Melton in the opening of their second Wednesday course.

The discussion focused on four take-home messages: (1) be prepared and confi dent for anything that may walk through the offi ce door, (2) rely less on antibiotics and referring out for non-surgical procedures, (3) pay attention to infl ammation because it’s telling you something and, (4) when in doubt, use steroids.

Saved by ShingrixThe pair started by addressing the big hitters of these long winter months: herpes simplex virus, herpes zoster

ophthalmicus and herpes simplex keratitis. They touched on Shingrix (GlaxoSmithKline), the new talk of the town in anti-shingle vaccinations. While Drs. Melton and Thomas playfully disagreed on whether the vaccine will truly replace Zostavax (Merck), they warned the audience that “shingles is going to become more and more common for about 20 to 30 more years, until fi nally it will fade away. That’s just the epide-miological reality,” said Dr. Thomas, so ODs “should be prepared.”

Science, Not Habit Building on their earlier morning discussions around the importance of using oral and topical steroids to treat infl ammation, Drs. Melton and Thomas called on new fi ndings from the Antibiotic Resistance Monitoring in Ocular Microorganisms study. As resistance to commonly prescribed antibiotics is an ever-growing con-cern, the doctors announced in no uncertain terms that ODs should be consciously prescribing on a case-by-case basis, rather than by habit.

“Every time you think about prescribing an antibiotic, even topical

ones,” said Dr. Thomas, “we would beg of you to stop because the chanc-es are, you’re wrong.” The epidemi-ology of acute red eye, he explained, “is one of infl ammation, so antibiot-ics will have very little utility here.” Let science guide your care. “Do not do things out of habit; follow the lit-erature and make scientifi cally sound prescribing decisions.”

These sentiments resurfaced as the doctors confronted the next leg of their discussion: differentiating between corneal ulcers and infi ltrates. As infi ltrates are more common and represent an underlying infl amma-tory condition, ocular steroids, often combined with an antibiotic, have become the preferred treatment ap-proach. The fast action of the steroid, Dr. Melton advised, will aid in pre-venting a secondary infection or the much less desirable corneal ulcer.

The Ungrateful DED Threading the theme of prioritiz-ing infl ammation into the second half of their discussion, Drs. Melton and Thomas proposed new ways to target dry eye disease (DED), which has become more widely accepted as

an infl ammatory condition. Dr. Thomas suggested that

everyone fi nd themselves a copy of a comprehensive supplement to the November 2017 Ophthamology, which highlights new global perspec-tives on treating DED. Both agree that the supplement is one of the most innovative pieces of this year’s literature. “Infl ammation is one of the major targets in treating DED,” read Dr. Thomas, “and breaking the cycle of infl ammation is crucial in improving symptoms.” Both doctors continued to cite key publications and case studies released over the last year that list various holistic methods (blinking exercises, warm compresses, fi sh oils, artifi cial tears) that patients can use to better address infl ammation and actively treat DED.

The lecturers concluded the session by reminding all ODs—new to the fi eld and veterans alike—of the great role and responsibility each takes on in their practice. Take a step back from the knee-jerk reaction to refer out, they said. You don’t have to be a genius to do this stuff, “you just have to have the courage to do what you know is right,” urged Dr. Thomas. “Tell your patients, ‘I am your eye doctor; if you ever have a problem, call me fi rst.’ So, now we’re growing instead of referring, and that’s how we grow as a profession.” •

Finding Room to GrowBy sticking to science and practicing with confidence, ODs can deliver for their patients and grow as a profession.

Drs. Melton and Thomas presented

part two of their “Eye Care Update”

series—and encouraged attendees to

ease up on referring. “You just have to

have the courage to do what you know

is right,” Dr. Thomas said.

Laurie Hernandez, 2016 Olympic gold medalist, addressed the crowd at

yesterday’s grand openng of the exhibit hall (top). She was then joined

by outgoing SECO president Lynn Hammonds, OD, for the ribbon cutting

ceremony (right). Ms. Hernandez is a spokesperson for Alcon’s Dailies

AquaComfort Plus contact lenses and its #InvisibleEdge campaign.

EXHIBIT HALL OPENING CEREMONY


Black humor enthusiasts are well aware of the Darwin Awards—an unoffi cial listing of the

dumbest ways people have injured themselves each year. Rich Mangan, OD, kept the crowd of his pre-lunch presentation “Be Prepared! Handling Ocular Emergencies” engaged with reminders that people often make risky choices; photos of ladders propped up on wheeled garbage cans, motorcyclists treating their moving vehicle like a La-Z-Boy and even a video of a marksman checking the barrel of his fi rearm only to have it nearly blow his nose off.

Dr. Mangan, who writes Review of Optometry’s Urgent Care column, even offered a collection of cases he’s witnessed that may offer an optomet-ric analog to the Darwins, such as patients who have stored soft contact lenses in pond water, shot themselves in the eye with paintball guns and even enucleated their own eyes. Call them the “Mangan Awards” per-haps, but the speaker also offered careful guidance on how attendees can treat these patients.

The fi rst step, Dr. Mangan said, is identifying whether or not your patient has a true ocular emergency, and if it needs to be treated immedi-ately (within a matter of hours), ur-gently (within a day), soon (within a week) or on an elective basis (within a month). Making that call begins with training staff to understand “the art of triage,” Dr. Mangan said. “It’s defi ned as sorting patients ac-cording to the urgency of their need for care.”

The presentation consisted of a

number of case examples to demon-strate how ODs can manage ocular emergencies.

You’re So Vein Patients with ocular trauma may not realize it, but some of their symptoms may indicate that they’re experienc-ing a central retinal artery occlusion. Fundus imaging, however, will reveal the damage to their vascular system. Be on the lookout for superfi cial opacifi cation or whitening of the retina in the posterior pole with a cherry-red spot in the center of the macula, Dr. Mangan said, and if you suspect it, act immediately. “When you go outside a four-hour win-dow, your prognosis is really, really poor,” he explained, but “it’s still recommended, even within a six- to eight-hour time frame, that you try to re-perfuse the eye.” Dr. Mangan said not to spend precious time taking a complete family history in these cases—treat fi rst. That intervention can include anything from orbital

massage to anterior paracentesis to a special Nd:YAG laser application. The goal here is to reduce the pres-sure on the eye.

Burn, Baby, Burn“There are some chemicals that can eat through a cornea, or the eye, in only fi ve minutes,” he warned. Alkali-based chemicals are more severe than acid-based ones, but Dr. Mangan said all contingencies, such as how much of the chemical got in the eye and how long ago it hap-pened, play a role. Sixty percent of these types of burns occur at work, but plenty of household items contain dangerous chemicals, and children are especially prone to this type of injury. For these cases, manage-ment needs to begin over the phone because “you want to start irrigation right away,” he said. Instruct the patient to fi nd a shower or even an outdoor hose. Don’t even try to take contact lenses out, he noted. Just keep irrigating. Also, don’t forget to ask patients to bring the container that held the chemical if they’re not sure what it was.

Once they arrive at the offi ce, refer to the Roper-Hall classifi cation of ocular surface burns to judge how to start treatment. “If it’s a basic substance or an alkali burn, you may want to avoid a topical glaucoma drop and use an oral instead,” Dr. Mangan said. And “if there’s any kind of limbal blanching, I think the patient will benefi t from a Prokera amniotic membrane (Bio-Tissue). Sometimes I’ll wait until three to fi ve days out from the burn and assess the

healing. If the healing is a little slow, I’ll turn to the Prokera.”

Not-so-gentle GiantIn cases of giant cell arteritis, if they’re in your chair, chances are they’ve already lost vision in at least one eye. “Clearly, if they’ve already had vision loss in one eye, this is a true ocular emergency,” Dr. Mangan said. And if there’s any doubt, get a blood test. “It’s urgent we get these patients started on steroids right away,” he said. Other treatments include obtaining a biopsy, but even that’s not 100% reliable. The Ameri-can College of Rheumatology offers a fi ve-point scoring system. If your patient has any three of these, you’re justifi ed in starting steroids:

• Older than 50 years of age.• A Westergren ESR greater than

50.• Temporal artery tenderness or

abnormality on exam.• New-onset headache.• Positive temporal artery biopsy.

Soft CellOne patient presented to Dr. Mangan complaining of a “pulling” sensation in his left eye when looking superior temporal. The diagnosis turned out to be periorbital cellulitis, an infec-tion usually caused by Staphylococ-cus or Streptococcus.

For patients with tenderness, proptosis and blurred vision, he said, ask if they’ve had any surgeries, such as lid and sinus surgeries (or a history of trauma), because patients who’ve undergone these can get infections even months to years later. Unlike with chemical burns, “you want to get as much of a history as you can” to uncover the cause of the infection.

Initial treatment will include an-tibiotics, but if the problem persists, patients may need to undergo a par-ticularly gory procedure that requires a surgeon to “push out the pus.” A video of this elicited uncomfortable groans, even from this room full of doctors. •

Emergency Protocols in OptometryWhen patients stick their noses—or eyes—where they don’t belong, ODs must act fast.

DAILY4


Dr. Mangan presented urgent

cases from the strange to the scary

in yesterday’s course on ocular

emergencies.

‘Immediate Care’ Examples

• Chemical burn• Acute ocular trauma • Sudden vision loss• Severe pain• Brow pain with nausea/

vomiting

‘Urgent Care’ Examples

• Corneal abrasion • Foreign body• Flashes and fl oaters plus

vision change• Monocular patients• Postoperative patients

‘Obtain Care Soon’ Examples

• Recent-onset diplopia• Recent-onset ptosis• Distorted vision for less

than two weeks• Photophobia• Mild pain for 2-3 days

‘Elective Care’ Examples

• Dry, itchy, watering• Fluctuating vision for

weeks• Broken glasses• Mild redness• Lumps and bumps



5DAILY

SECO Welcomes Students and ResidentsAbundant opportunities for the next generation of optometrists to learn and connect.

SECO is committed to the training and education of the next generation of opto-

metric professionals, and our growing student program show-cases that commitment.

Students and residents get free access to SECO’s world-renowned OD continuing education program, including Special Sessions and MedPro360. Residents may reserve space in courses ahead of time, and stu-dents may attend as long as space is available. Learning Labs are not included.

The Student Lunch Symposium on Saturday from 12–1:15pm is your chance to enjoy a free lunch while you hear from industry leaders Alcon, Johnson & John-son Vision, CooperVision and Hoya. You could win a $1,000

scholarship courtesy of SECO International just by attending.

The Student Party this year is joining with another exciting event at SECO, The Bad Habits–Eye Docs of Rock Charity Event benefi tting Optometry Cares. Students will have a special VIP Lounge area at the party with special seating, games and drink tickets courtesy of Hoya. The party is Friday from 9pm to midnight at the College Football Hall of Fame.

Pick up your $100 cash sti-pend, courtesy of SECO Interna-tional, on Saturday from 3–4pm in the student lounge inside the exhibit hall. You must bring your SECO badge and photo ID with you. Don’t be late!

Be sure to check out the new Student Escape Room Adventure

presented by VSP Global. Test your optometry knowledge as you work together searching the room to fi nd clues, solve riddles and crack codes to escape the room within the hour. Sign up in advance in the student lounge in the exhibit hall or at the link on AttendSECO.com.

Be sure to check out the return of SECO’s Multimedia Poster Presentations in the exhibit hall throughout the show.

Student-focused practice man-agement courses will be available on Saturday, March 3 at the Practice Management Education Theater brought to you by VSP Global in the exhibit hall. The topics are: Starting Cold Versus Buying a Practice and Student Debt: The Numbers Actually Work in Your Favor. •

SECO is happy to bring 2019’s conference to New Orleans Febru-

ary 20-24 for the fi rst SECO congress held outside of Atlanta in 60 years! Don’t miss out on this exciting new chapter. Visit booth #1633 to learn about everything there is to do in New Orleans. You can fi nd out about all of the great hotel options the city has to offer and book your room today.

We’ll be giving away New Orleans-themed prizes throughout the show, including a Grand Prize Giveaway for those who book their 2019 hotel reservations that includes:

• Two-night hotel stay from Star-wood

• $400 Delta airline voucher• $150 gift card to Arnaud’s Res-

taurant• All-inclusive Package Registration

for SECO 2019.The grand prize winner will be an-

nounced on Saturday at 4pm with free Bloody Marys. You must be present to win, so be sure to join us at booth #1633.

SECO Welcomes Students and ResidentsAbundant opportunities for the next generation of optometrists to learn and connect.

SECO is happy to bring 2019’s conference to New Orleans Febru-

ary 20-24 for the fi rst SECO congress held outside of Atlanta in 60 years! Don’t miss out on this exciting new chapter. Visit booth #1633 to learn about everything there is to do in New Orleans. You can fi nd out about all of the great hotel options the city has to offer, and book your room today.

We’ll be giving away New Orleans-themed prizes throughout the show, including a Grand Prize Giveaway for those who book their 2019 hotel reservations that includes:

• Two-night hotel stay from Star-wood

• $400 Delta airline voucher• $150 gift card to Arnaud’s Res-

taurant• All-inclusive package registration

for SECO 2019.The grand prize winner will be an-

nounced on Saturday at 4pm with free Bloody Marys. You must be present to win, so be sure to join us at booth #1633.

SECO Moves to New

Orleans for 2019

Learn more, book your hotel

and win prizes at booth #1633.


7DAILY


Contiuned | FRIDAY, MARCH 2 OPTOMETRIC EDUCATION

SURGICAL PROCEDURES AND COMANAGEMENT

1–4pm Laser Learning Lab Lighthizer, Lewis, Walker Room A310

3–5pm Wet, Dry and Painful Eye Learning Lab Pate, Than, Elder, Clore Room A407

5–7pm High Tech Cataract Care Woodard Room A312

TEAM-CENTERED LEARNING (FOR ODs AND AOPs)

7–8am What’s Brewing? Controversies in Ocular Nutrition Gerson Room A311

10–11am MRSA: A Cause for Concern Mangan Room A313

10–11am Scleral Lenses Shovlin Room A311

1:30–2:30pm Managing Millennials in the Workplace Burns Room A315

2:30–3:30pm The New Customer Experience King Room A315

5–7pm Through the Eyes of Women: Caring for the Female Patient Than, Sclafani, Pate Room A311

5–7pm Seeing Stars: Concussions in Sports Weise Room A313

TECHNOLOGY

7–8am What’s Brewing? OCT Angiography Rixon Room A312

5–6pm 3D Printing in the Modern Dispensary Parker Room A304

Looking to brush up on your anterior seg-ment disease management skills? Then clear some space in your schedule for “Anterior

Segment Solutions.” In this Saturday morning Special Session course, Zaina Al-Mohtaseb, MD, assistant professor of ophthalmology at Baylor College of Medicine, will engage attend-ees in a detailed exploration of the ins and outs of the various anterior segment cases seen in clinical practice.

“The goal of the discussion is to make optom-etrists and ophthalmologists more comfortable when that corneal ulcer walks through the door

at 5pm on a Friday,” says Dr. Al-Mohtaseb.She will start things off by discussing infec-

tious keratitis, including bacterial, fungal and parasitic forms. The talk will focus on diagnostic and treatment modalities used in these cases. “I will use a case-based approach to depict how to manage corneal ulcers,” says Dr. Al-Mohtaseb. “In addition, I will discuss the differentiating features of bacterial vs. fungal vs. parasitic infec-tions.”

Not All Ulcers Are Created EqualDr. Al-Mohtaseb will also address the fact that not all corneal ulcers actually represent an infectious process. Identifying sterile infi ltrates is an important distinction. She will review the use of steroids and where it fi ts into the management of these patients. To illustrate her points, Dr. Al-Mohtaseb will share her own research on anterior segment topics.

Next up, the course will shift gears to cover some special considerations for cataract surgery in patients with corneal disease. Here, Dr. Al-Mohtaseb will walk attendees through what they should be educating referring optometrists and ophthalmologists about for these patients.

To cap things off, Dr. Al-Mohtaseb will talk about a new way of fi xating intraocu-lar lenses (IOLs) in patients with absence of capsular support. She will also go over newly available types of presbyopia correcting IOLs. “It is exciting to be discussing all these cut-ting edge technologies and changes,” says Dr. Al-Mohtaseb, as they allow better care and postoperative vision than ever before. •

Master the Anterior SegmentManaging the many presentations of this area can be diffi cult, but this special session course has you covered.

Corneal ulcer diagnosis and management will be a focal

point of tomorrow morning’s course.

SATURDAY: 8:30–10:30am AMPHITHEATER A3

The Symfony IOL is a newer intraocular lens that

allows greater post-op visual independence for

many patients.

Photo: D

erek Cunningham

, OD

, and Walter W

hitley, OD

Time Course Presenter(s) Location


7DAILY


Continued | FRIDAY, MARCH 2 OPTOMETRIC EDUCATION

SURGICAL PROCEDURES AND COMANAGEMENT

1–4pm Laser Learning Lab Lighthizer, Lewis, Walker Room A310

3–5pm Wet, Dry and Painful Eye Learning Lab Pate, Than, Elder, Clore Room A407

5–7pm High Tech Cataract Care Woodard Room A312

TEAM-CENTERED LEARNING (FOR ODs AND AOPs)

7–8am What’s Brewing? Controversies in Ocular Nutrition Gerson Room A311

10–11am MRSA: A Cause for Concern Mangan Room A313

10–11am Scleral Lenses Shovlin Room A311

1:30–2:30pm Managing Millennials in the Workplace Burns Room A315

2:30–3:30pm The New Customer Experience King Room A315

5–7pm Through the Eyes of Women: Caring for the Female Patient Than, Sclafani, Pate Room A311

5–7pm Seeing Stars: Concussions in Sports Weise Room A313

TECHNOLOGY

7–8am What’s Brewing? OCT Angiography Rixon Room A312

5–6pm 3D Printing in the Modern Dispensary Parker Room A304

Looking to brush up on your anterior seg-ment disease management skills? Then clear some space in your schedule for “Anterior

Segment Solutions.” In this Saturday morning Special Session course, Zaina Al-Mohtaseb, MD, assistant professor of ophthalmology at Baylor College of Medicine, will engage attend-ees in a detailed exploration of the ins and outs of the various anterior segment cases seen in clinical practice.

“The goal of the discussion is to make optom-etrists and ophthalmologists more comfortable when that corneal ulcer walks through the door

at 5pm on a Friday,” says Dr. Al-Mohtaseb.She will start things off by discussing infec-

tious keratitis, including bacterial, fungal and parasitic forms. The talk will focus on diagnostic and treatment modalities used in these cases. “I will use a case-based approach to depict how to manage corneal ulcers,” says Dr. Al-Mohtaseb. “In addition, I will discuss the differentiating features of bacterial vs. fungal vs. parasitic infec-tions.”

Not All Ulcers Are Created EqualDr. Al-Mohtaseb will also address the fact that not all corneal ulcers actually represent an infectious process. Identifying sterile infi ltrates is an important distinction. She will review the use of steroids and where it fi ts into the management of these patients. To illustrate her points, Dr. Al-Mohtaseb will share her own research on anterior segment topics.

Next up, the course will shift gears to cover some special considerations for cataract surgery in patients with corneal disease. Here, Dr. Al-Mohtaseb will walk attendees through what they should be educating referring optometrists and ophthalmologists about for these patients.

To cap things off, Dr. Al-Mohtaseb will talk about a new way of fi xating intraocu-lar lenses (IOLs) in patients with absence of capsular support. She will also go over newly available types of presbyopia correcting IOLs. “It is exciting to be discussing all these cut-ting edge technologies and changes,” says Dr. Al-Mohtaseb, as they allow better care and postoperative vision than ever before. •

Master the Anterior SegmentManaging the many presentations of this area can be diffi cult, but this special session course has you covered.

Corneal ulcer diagnosis and management will be a focal

point of tomorrow morning’s course.

SATURDAY: 8:30–10:30am AMPHITHEATER A3

The Symfony IOL is a newer intraocular lens that

allows greater post-op visual independence for

many patients.

Photo: D

erek Cunningham

, OD

, and Walter W

hitley, OD

Time Course Presenter(s) Location



DAILY8

The misunderstanding with amniotic membranes is the perception that “you

only use it on trainwrecks,” says Greg Caldwell, OD, of the bio-logic technology that eye care professionals can actually use for a variety of ocular wound healing purposes. By “trainwrecks,” he’s referring to corneas with severe conditions such as microbial ulcers or chemical burns. While amniotic membranes are highly regarded for their ability to treat these conditions, Dr. Caldwell

hopes this early morning course—“Get Comfortable With Amniotic Membranes in an Hour”—will dispel the myth that they’re limited to severe cases. “Amniotic mem-branes should be in every optom-etrist’s offi ce to rehab the cornea,” he says. Yes, they are useful for severe corneal defects, but they can also be used for conditions as common as dry eye.

In tomorrow morning’s course, Dr. Caldwell will talk about the differences between the two main types of amniotic membranes,

cryopreserved and dehydrated, the pros and cons of each, and how to identify when to use which type. He’ll explain the science behind the biological scaffolding that facilitates cellular adhesion and assists in cell migration and proliferation.

Amniotic membranes—which are derived from the submucosa of the placenta—provide an impres-sive regenerative platform. Their therapeutic capabilities include promoting stem cell expansion, suppressing pain and promoting cellular migration—all while ex-pediting recovery. The technology possesses natural growth factors and optimal scaffolding proper-ties within a complex extracellular matrix that are:

(1) Anti-scarring(2) Anti-angiogenic (3) Anti-infl ammatory That last point is key because, as

Dr. Caldwell’s course will explain, infl ammation is the “hallmark of all ocular surface disease.” If left uncontrolled, ocular infl ammation can lead to chronic pain and ir-ritation, delayed healing and more extensive tissue damage that may cause scarring and, eventually, even threaten the patient’s vision.

In addition to updating attend-ees on the benefi cial properties of amniotic membranes and the conditions they can be used to treat, the lecture will provide an overview of the various products available, tips on inserting and removing each one, a discussion of patient expectations and strategies to help attendees better under-stand the patient’s experience.

“It can be used on a herpes ulcer. It can be used for recurrent corneal erosions,” Dr. Caldwell explains. “This is an awareness lecture and, for those alreadyaware, it’s got tips to help doctors feel more comfortable with the procedure and helps guide them around any pitfalls they might en-counter.” As the procedure is rela-tively new to optometry, and not all states allow its use, it is prudent to be conservative until you gain confi dence and experience

The course will also review how to partner with a lab and a com-pounding pharmacy to develop the autologous serum.

Finally, the course will review the cost of and billing tips for the ProKera (BioTissue), AmbioDisk (IOP Ophthalmics) and BioDOptix (BioD) graft products. •

Get on Board with Amniotic Membranes This overview covers all you can do with this versatile technology.

SATURDAY: 6:30–7:30AM ROOM A313, LEVEL 3

Special Event Benefiting Optometry Cares - The AOA Foundation

SEE THE OPTOMETRY STARS AT SECO 2018SEE THE OPTOMETRY STARS AT SECO 2018

Friday, March 2 | 9:00 PM - MidnightCollege Football Hall of Fame

EYE DOCS OF ROCK

Thank You SponsorsPlus, a special lounge just for

optometry students,

presented by

Special Guest

Performers to be

announced!

Purchase raffle tickets for a chance

to win an iScan system courtesy of

Optovue!

Photos: Nathan Lighthizer, O

D

Amniotic membrane grafts (such as the Prokera Slim shown here) promote

epithelialization, decrease infl ammation and scarring, prevent new blood vessel

growth and improve comfort.



Eye Care

2018


OPTOMETRIC CORNEA, CATARACTAND REFRACTIVE SOCIETY

**Additional CE fees if attending both meetings. Agenda subject to change.See website for details: www.reviewofoptometry.com/SanDiego2018

Administered by

Review of Optometry®*Approval pending

Review of Optometry® partners with Salus University for those ODs who are licensed in states that require university credit

SAN DIEGOAPRIL 26-29, 2018

We invite you to attend a unique joint meeting

held at the San Diego Marriott Del Mar.

Review’s New Technologies & Treatments in Eye Care and

Optometric Cornea, Cataract and Refractive Society’s annual

meetings are combined to provide you with up to 29* COPE CE

credits in one weekend.

San Diego Marriott Del Mar11966 El Camino Real

San Diego, California 92130Phone: 858-523-1700

A limited number of rooms have been

reserved at $165 per night.

Please make reservations with the hotel

directly at 858-523-1700. For group

rate, mention “New Technologies and

Treatments in Eye Care”.

David Friess, OD, FAAOPresident, OCCRS

Paul M. Karpecki, OD, FAAOReview Program Chair

Program Chairs:

Three Ways to RegisterOnline: www.reviewofoptometry.com/sandiego2018Call: 866-658-1772 • E-mail: [email protected]

Convenient opportunities to register for one or both meetings.**

REGISTER ONLINE: WWW.REVIEWOFOPTOMETRY.COM/SANDIEGO2018

Earn up to

29 CE Credits*

10


DAILY

FREE CE IN THE PRESENTATION THEATERSIndustry support allows ODs and AOPs to earn credit for free!

Space is limited and participation is on a fi rst-come, fi rst-served

basis. Today’s schedule:

11am–12pm: • Workshop: Sutureless Amniotic Membranes How to Properly

Insert and Remove Them (Katena)

• The Evolution of Lenses – The Importance of Blocking Blue

Light (Essilor

1–3pm: • Cracking The Code: Clinical Case Management & Medical

Record Compliance Part 1

2–3pm: • Blue Light (Essilor)

4–5pm: • Winning the Online Game: Any Practice Can Be #1 Online

(iMatrix)

• Procuring Practice Buyers and Sellers (VSP)

• Practice of the Future (Essilor)

SHOW SPECIALSMany exhibitors are offering special deals. Check out the list in

the mobile app or on page 14.

EXHIBIT HALL IN-BOOTH EVENTSBe sure to visit these companies for special events today:

AcuityPro Software: Showing off a totally redesigned booth,

the company will also be randomly handing out International

Space Station hats while supplies last.

EyeMed Vision Care: Free charging pad for the fi rst 100

attendees to take a survey.

MacuLogix: Offering free copies of the most recent AMD

diagnostic and treatment guidelines, along with patient

management recommendations. Stop by and ask for the AMD Knowledge Base, a

collection of reading

essentials for the diagnosis

and treatment of AMD.

TLC Laser Eye Centers:

TLC will be hosting a

LASIK Wet Lab each

day. Today’s takes place

1–4pm. Attendees can

create a LASIK fl ap on a pig’s eye using the Alcon laser suite,

have Pentacam scans performed on their eyes and learn how to

interpret the results. Lecturers will review pre- and post-op care

protocols for LASIK and PRK. Upon completion, participants can

sign up for a chance to win a Fitbit.

NEW! STUDENT ESCAPE ROOM1pm, 2:45pm, 4:30pmStudents, test your optometry knowledge as you work together

searching the room to fi nd clues, solve riddles and crack codes

to accomplish the goal of escaping within the hour. Three rooms

will be running simultaneously with groups of 10 students each.

LEARNING LOUNGE, POSTERS & GOOGLE TALKSIn this informal educational environment, you can hear from

industry leaders on the latest in exciting trends. Plus, experience

the new Google Talks! Liz Austin from Google shares cutting-

edge strategies for fi nding new patients and growing your

business with Google. You can also fi nd the return of our

multimedia Poster Presentations.

EYESTYLES FASHION SHOW, 11:15–11:45amSee the latest eyewear trends and gain insight on how

showcasing the latest trends in frames can help maximize ROI

and customer experience in your practice. Experience it in the

Focal Point lounge this morning.

THE VIEWSee some of the world’s most exclusive frames in THE VIEW,

SECO’s Luxury Eyewear Pavilion.

EXHIBIT HALL EVENTS FOR FRIDAY, MARCH 2

OPENS: 10:45am CLOSES: 5pm

DAILY10



DAILY


11DAILY

Exhibitor Listing for SECO 2018 (as of February 26, 2018)

Attendees can visit Optometry’s Marketplace at SECO™ for free just by mentioning an exhibiting company they intend to visit during SECO 2018.

EXHIBITOR .............................. Booth EXHIBITOR............................... Booth EXHIBITOR .............................. Booth EXHIBITOR............................... Booth

4ECPs, a Preferred Premier Google Partner ............................1300A&A Optical ..................................1200ABS Smart Mirror ..........................1111ABB Optical Group ...........................332Acuity Pro/VisionScience Software ..1113Akorn .............................................800Alcon ..............................................429Allergan ........................................1220Allied Powers ..................................404Allure Eyewear ................................714American Academy of Optometry ....1725American Academy of Orthokeratology

and Myopia Control .....................1726American Board of Opticianry – National

Contact Lens Examiners ...............1718American Board of Optometry .........1724Applied Medical Systems .................301Art Optical Contact Lens ..................603Article One ....................................1337Aspex Eyewear Group ....................1201Association of Schools and Colleges of

Optometry ....................................127Avalon Eyewear ...............................437Avesis ..........................................1532Baumvision ...................................1137Bausch + Lomb ...............................818Beaver Visitec International ..............737Binocleuses ..................................1330Bio-Tissue ......................................310BlephEx ........................................1500Bruder Healthcare Company .............327Bushnell Outdoor Products .............1431CareCredit ....................................1600CatarActive3 ...................................235Centervue .....................................1619Chadwick Optical ............................209Clearlens ......................................1536ClearVision Optical/BluTech ...........1005Coburn Technologies .......................321Color My World by EyeChroma ..........504Community Low Vision Center ..........131Compulink Business Systems .........1313Contact Lens Spectrum (Pentavision) ..512CooperVision ...................................513Costa Sunglasses ............................627Crystal Practice Management ...........330Demandforce ................................1629Design Eyewear Group ...................1422DGH Technology ..............................320Digital Healthcare Professionals .......313Digital Heat Corporation ...................241Diopsys ..........................................633DM Med Group ..............................1614

Ear Technology Corporation ...........1625Eastern Ophthalmic Supply & Repair ..701EdgePro by GPN Technologies ..........715Edison Optics ................................1436E-Dr. Network/New Era ....................408Energeyes, the Association of Corporate-

Affiliated Optometrists .................1604Eschenbach Optik ..........................1115eSee Acuity...................................1528Essilor Instruments ..........................420Essilor of America ...........................419Eye Designs ....................................921Eyecare Business (Pentavision) ........514EyeCor by Nteon/Nteon Practice

Consultants ..................................506Eyefficient ......................................300EyeMed Vision Care .........................538EyePromise/ZeaVision ......................605Eyes of Faith Optical ......................1412Faniel Eyewear ..............................1328Fashion Optical Displays ..................507Gazal Eyewear ..............................1241Good-Lite .......................................401Hai Laboratories ..............................711Harvest Acuity .................................311Healthpod .......................................704Heidelberg Engineering ..................1505Heine USA.......................................611Hoya Vision Care ...........................1013Icare USA .......................................432i-dealoptics ..................................1427Identity Optical Lab .........................412IDOC ..............................................405iMatrix ................................ 1307, 1533ImprimisRx ...................................1428Innexus by Innereactive ...................308Integra Life Sciences .....................1401Interstate Optical .............................802Invision Magazine ..........................1723J & M Distribution .........................1615Jeunesse Innovations ....................1511Johnson & Johnson Vision..............1019Kasperek USA Optical ....................1405Katena ............................................533Keeler Instruments ........................1101Kentucky College of Optometry .........121Kingdom Eyewear ..........................1228Kio Yamato Optics .........................1340Konan Medical ..............................1207LA Eyeworks .................................1141Lacrivera ........................................609Lafont ............................................812LasikPlus ......................................1522Life Without Color ............................211

Lombart Instrument .........................738Luneau Technology USA (AIT, Briot,

WECO, LPO, Visionix) ............. 424, 426Luxottica Group ...............................621M&S Technologies ...........................414MacuLogix ....................................1515Mad Vision ....................................1139Marco Ophthalmic .........................1029Marcolin USA Eyewear .....................913Maui Jim Sunglasses .......................833MaximEyes by First Insight .............1331MaxiVision (MedOp Health) .............1325Medi Lazer ......................................215Modern Optical International ............500Morel Eyewear ..............................1432My Vision Express ...........................326MyEyeDr .......................................1327National Academy of Opticianry ......1720National Board of Examiners in Optometry ..................................1513National Vision Retail .....................1507National Vision ..............................1304Natural Ophthalmics ........................315NCI Vision Systems ..........................536Nerdwax .........................................245New York Eye ..................................713Nidek ...........................................1215Nouveau .........................................931Nova Southeastern University College of Optometry .................................123NovaBay Pharmaceuticals ................438Novartis Pharmaceuticals .................137Oasis Medical ...............................1214Oculus ............................................836Ocusoft ........................................1109Optical Academy Alliances ...............440Opticwash ......................................339Optikam Tech..................................328Opto Multimedia ..............................400Optometric Architects ......................607Optometric Management (Pentavision) .................................510Optometric Protector Plan ................410Optometry Times (UBM) .................1729Optos ...........................................1301Optovue ........................................1521Orgreen + Goldsmith .....................1240Orion Vision Group .........................1610Ottica Veneta ................................1229OWP USA ......................................1430Passion to Heal, Me to We ................128Patch .............................................645Pharmanex ...................................1310Practice Director EHR ....................1621

Presenta Nova .................................338Professional Eye Care Associates of

America ........................................304Proof Eyewear .................................322Quantel Medical ............................1433Quidel Corporation...........................641Q-Vision Optics ...............................407Reichert .......................................1419Remote Area Medical .....................1737Review of Optometry .....................1411RevolutionEHR.................................411RightEye .........................................220Santinelli International ...................1204ScienceBased Health .....................1414Shire ..............................................501Shwood Eyewear ...........................1426Signet Armorlite ..............................314SingleCare ......................................305Solutionreach ..................................323Southern College of Optometry .......1210State Optical Co. ...........................1321Studio Optyx .................................1437Sun Ophthalmics .............................201Suppleyes .......................................309TearScience ....................................433TelScreen .......................................318The Gideons International ................739The Lens Butler ...............................205The McGee Group ............................827TLC Laser Eye Centers .....................537Topcon Medical Systems .................727US Optical ....................................1501UAB School of Optometry .................120Ultra Palm Optical (Cazal, Caviar, Goliath) ......................................1329United States Air Force ....................129Uppercut Consulting ........................303Villa Eyewear ................................1338Vital Tears ......................................838Vmax Vision ....................................601Volk Optical ..................................1103VOSH International ........................1727VSI, a division of Enhanced Medical

Services .....................................1525VSP Global/VSP Optics Group/Eyefinity/

Marchon/Altair ..............................805Walman Instruments ........................927Walman Optical .............................1026Wal-Mart Health and Wellness ........1212Weave ............................................639Williams Group ................................706Wolters Kluwer ................................543X-Cel Specialty Contacts ................1032Zeiss ..............................................700


12


ocal Point Loung :Fashio

Presentation Theater #1

Learning Lounge

Exhibits InfoBooth

PosterPresentations

SECO 20199

1005

20'

30'

ClearVisionOptical /BluTech

1013

20'

20'

HOYAVisionCare

1019

40'

40'

Johnson &Johnson

Vision

1026

30'

Wal

man

1029

20'

30'

MARCOOphthalmic 1032

X-CelSpeci10320

1101

KeelerInstru

1103

1109

OCuSOFT

1111

A.B.S.Smart

1113

AcuityPro /

1115

Eschenbach

1200

20'

A&

A O

ptic

al

1201

30'

Asp

ex E

yew

ear

Gro

up0'

1204

Santitinelli

1207

Kon

anM

edic

al

1210

Southern

1212

Wal-Mart

1214

OASIS

1215

NidekInc.

1220

30'

20'

Allergan

1300

20'

4ecp

s, A

Pref

erre

d

1301

20'

20'

Optos,Inc.

1304

30'

Nat

iona

l Vis

ion,

Inc.

1307

20'

20'

iMatrix

1310

1313

Com

pulin

kB

usin

ess

1321

SEC

OIn

tern

a1325

MaxiVision

1327

MyEyeDr

1329

UltraPalm

1331

20'

Max

imEy

esby

Firs

t

1337

SECOIntern

1401

Integra Life

1405

20'

20'

KasperekUSA Optical

1411

20'

30'

Review ofOptometry

1412

Eyesof

1414

ScienceBas

1419

Rei

cher

t, In

c

1422

Des

ign

Eyew

ear

1426

Shwood

1427

1428

ImprimisR

1430

OWPUSA

1431

Bushnell

1432

MorelEyew143241433

Quantel

1436

Edison

1437

STUDIO

1441

51'2''Remote Area Medical

1500

BlephEx

1501

U.S.Optica1 01

1505

Heidelberg5055

1507

National

1511

Jeunesse

1513

National

1515

MacuLogix

1518

Visioneering

1520

Ophthalmic

1521

21'2''Optovue

1522

1525

VSI, adivision ofEnhanced

1528

1530

FoxFire

1532

Avesis

1533

1536

CLEARLEN

1600

CareCredit

1604

20'

Ener

geye

s,Th

e

1610

OrionVision

1612PatientPop6122

1614

DMMed

1615

J & MDistri

1619

Centervue

1621

Practice

1625

EarTechn

1627

1629

Demandfor

17141715

1718

American

1719

AirForce

1720

National

1721

ArmedForce

1723

INVISION

1724

American

1725

American

1726

American

1727

VOSHIntern

1728

FirstVision

1729

Optometry17299

913

23'

20'

MarcolinU.S.A.

Eyewear Corp.

921

23'

20'

Eye Designs,LLC

927

20'

Wal

man

Inst

rum

ent

931

20'

Nou

veau

1129

1131

1133

FACEA

1137

Baumvision

1139

MADVision

1141

L.A.EYEW

1228

Kingdom

1229

OtticaVenet

1240

Orgreen +

1241

GazalEyew12412

1328

FanielEyewe13283

1330

Binocleuses

1338

VillaEyewe

1340

KioYamat

SECO 2019Find out about our move to New Orleans for next year’s conference. Register today! Prizes will be given out, too—ask for details at the booth!

DAILY12

Today’s Free CE in Theater 1 11am–12pm: Workshop: Sutureless Amniotic Membranes How to Properly Insert and Remove Them (Katena)

1–3pm: Cracking The Code: Clinical Case Management & Medical Record Compliance Part 1

4–5pm: Winning the Online Game: Any Practice Can Be #1 Online (iMatrix)

ENTRANC

E X H I B I T H A L L M A P A N

Industry’s PerspectiveStop by the Learning Lounge to hear industry executives discuss trends in eye care.




DAILY

ounge::o

EscapeRoom Adventure

9137

20'

20'

NovartisPharmaceuti

cals

201

20'Su

nO

phth

alm

ic20

'2

205

TheLens

209

Chadwick

211

LifeWitho

213

TalentCare

215

MediLazer

219

Miraflex

220

RightEye200221

Kentucky21

222

Global expo

223

UABScho

226

Adit

227

NovaSouth

228

Passion to

229

United

230

Associatio

231

Communit

233

235

CatarActiv

241

245

Nerdwax

300

20'

Eyef

ficie

nt,

LLC

301

Applied

303

Uppercut

304

Professional

305

SingleCare

308

Innexus by308309

Suppleyes,

3090

310

20'

Bio

-Tis

sue

311

Harvest

313

DigitalHealth

314

SignetArmor

315

Natural

318

TelScreen

320

DGHTechn

321

Coburn

322

ProofEyewe

323

20'

Solu

tionr

each

326

MyVision

327

Bruder

328

OPTIKAM

330

Crystal

332

ABBOptica3323

338339

opticwash

344

400

20'OPT

OM

ultim

edia

401

20'

Goo

d-Li

te

404

AlliedPower

405

IDOC407

Patch408

E-dr.Netwo

410

SECOIntern

411

30'

Rev

olut

ionE

HR

412

Identity22

414

M&STechn

419

Essilor ofAmerica

420

20'Es

silo

rIn

stru

men

ts

424

Luneau

426

429

Alcon

432433

20'TearScience

437

Avalon

438

NovaBay

439

440

21'2''Optical

441

Wolters

500

20'Mod

ern

Opt

ical

0'

501

20'

20'

Shire

504

ColorMy044

506

EyeCOR by

507

20'

20'

FashionOptical

Displays

510

Optometri

512

Contact513

CooperVision 514

Eyecare

533

20'Katena

536

NCIVision537

20'20

'TLC Laser

Eye Centers 538

20'

EyeM

edVi

sion

Car

e

601

VmaxVision

603

ArtOptica

605

EyePromise/

607

Optometric

609

Lacrivera

611

621

31'4''

20'

LuxotticaGroup

627

20'

20'

CostaSunglasse

s

633

21'2''Diopsys

639

Weave

641

QuidelCorpo641

700

20'Ze

iss

701

East

ern

Oph

thal

mic 704

Healthpod040

706

Williams

711

HAILabo

713

NewYork

714

AllureEyewe

715

EDGEPro by

727

20'

40'

TopconMedicalSystems

737

Beaver

738

20'

Lom

bart

Inst

rum

ent

739

TheGideo

800

Akorn, Inc.

802

805

20'

60'

VSP Global /VSP Optics

Group /Eyefinity /Marchon /

Altair 812

20'La

font

818

40'

30'

Bausch +Lomb

827

20'

20'

TheMcGeeGroup

833

20'Maui Jim

836

Oculus

838

VitalTears

2020

20

13

Today’s Free CE in Theater 211am–12pm: The Evolution of Lenses – The Importance of Blocking Blue Light (Essilor)

2–3pm: Blue Light (Essilor)

4–5pm: Procuring Practice Buyers and Sellers (VSP)

NCE

A N D S P E C I A L E V E N T S

Today’s Free CE in Theater 34–5pm: Practice of the Future (Essilor)

Escape Rooms Students, test your optometry knowledge as you work together searching the room to fi nd clues, solve riddles and crack codes within one hour. Three rooms will be running simultaneously with groups of 10 students each.


EyeStyles Fashion ShowToday at 11:15am, see the latest eyewear trends and gain insight on how showcasing the latest trends in frames can help maximize ROI and customer experience in your practice.


Ear Technology CorporationBooth 1625

New-to-the-industry hearing products designed for the optical channel include TuneAmp, which is affordable, easy to use and easy to sell. TuneAmp is already sold by many opticians in Europe, but SECO is the fi rst showcase for our products in the US. Great opportunity to add revenue and profi t to the practice. Stop by and let us show you how it easy it can be!

Eyes of Faith OpticalBooth 1412

New styles: Integrity and Trust (both available in ophthalmic and sun). New colors: hickory smoke (for the Honor line), scarlet (for the Beauty line), choc-full-of-color (for the Alive line).

Villa Eyewear Booth 1388

The Blackfi n Spring/Summer 2018 collection includes the new Bonita Bay, Ocean Ridge, Elliott Key and Marrowstone frames.

CooperVisionBooth 513

CooperVision Introduces MyDay toric daily dispos-able contact lenses that incorporate the Biofi nity toric design and material, offering the healthy advan-tages of silicone hydrogel, uncompromised comfort and handling, and excellent lens stability and visual acuity.

EyeChromaBooth 504

EyeChroma is a brand new company. SECO is our fi rst trade show. We are bringing the fi rst profes-sional kit of color-enhancing glasses to help color-blind patients see a much more vibrant world The kit includes our fi ve most successful lens coatings proven to be successful for the vast majority of color blind patients.

ImprimisRx Booth 1428

Preservative-free cyclosporine 0.1%/chondroitin sulfate compounded ophthalmic emulsion is now available for only $99.99 for your patient’s fi rst three bottles. No prior authorizations, no coupons and no pharmacy callbacks to deal with.

LacriveraBooth 609

The new FlexFit punctal occluder by Lacrivera offers a fresh approach in bringing greater value to your dry eye practice. The FlexFit nose technol-ogy, designed to collapse when inserted, allows for simple sizing, easy insertion, superior retention and excellent patient comfort. Available in four sizes and in sterile preloaded or non-sterile bulk packages.

MarcoBooth 1029

Visit Marco to see our newest products: TS-310 refractive tabletop workstation, LM-7 Series lens-meters and the new Ultra M Series slit lamps.

Kingdom EyewearBooth 1228

We are pleased to debut the Casanova Occhiali, Taxi and Dolce Vita collections of hand-enameled and cloisonné eyewear designs for the fi rst time at SECO, only in the VIEW.

Acuity Pro SoftwareBooth 1113

Offering several specials on software, including $100 off Acuity Pro Version 9 license key ($995) or $50 off Version 9 upgrade licenses. Included is a USB Acuity Pro license key and installation, remote control/receiver, mouse pad, HOTV/hot key card and pair of red/blue glasses. You can also place orders directly from the website and take advantage of the show specials by using coupon codes UPGRADE2018 or LICENSE2018.

eSee Acuity Booth 1528

Stop by booth 1528 to enter a raffl e for a free all-in-one digital acuity chart. Just drop on by with no purchase or gimmicks!

Eschenbach Optik Booth 1115

Buy three, get one free—a $1,595 value! Our new Visolux Digital XL FHD is an advanced portable video magnifi er that features a 12-inch touch screen display. With magnifi cation from 2x to 22x, dynamic line scrolling, FHD camera and HDMI and USB ports, it’s ideal for patients who need extra magnifi cation.

EyeMed Vision Care Booth 538

Stop by booth 538 to see for yourself how being part of our net-work leads to profi t potential and loyalty from EyeMed members. On Thursday from 1–4pm, speak one-on-one with EyeMed’s president Lukas Ruecker.

Eyes of Faith OpticalBooth 1412

Receive a 30% discount on your 30-piece order and keep your boards refreshed. Fifteen ready-for-spring styles ship in March, 15 sizzling styles for summer ship in May.

Kasperek USA OpticalBooth 1405

Leave the booth with your premium in hand! Mix and match from the following collections: Glen Lane, Pure-T, Pure-T Max, Camelot, Pure Color, Cc: Two is One or Pure Comfort. Five frames earns you a $100 Visa gift card. For 17 frames, receive an iPad or Apple Watch. And pick any 28 frames to receive an iPad Pro.

LacriveraBooth 609

• FlexFit punctal plugs: sterile preloaded $49/pair & nonsterile bulk $265/10 pair box.• VeraPlug punctal plugs: sterile preloaded $40/pair & nonsterile bulk $250/10 pair box.• Vera90 Extended Wear (60 to 180 days): $100/10 pair box. • VeraC7 collagen plugs: $45/60 plugs.

Lombart InstrumentBooth 738

• Haag-Streit BI 900 slit lamp $11,599 (was $13,691) and free BC/BD tonometer!• Haag-Streit Octopus perimeter: up to $15,000 trade-in.• Topcon 3D OCT-1 Maestro: Up to $15,000 trade-in, free Lombart table and large table top, free remote installation of review software, free ongoing remote training. Limited offer: fi ve-year leasing special $1,099/mo for 60 months, includes fi ve-year service coverage.• Topcon Aladdin HW 3.0 biometer: up to $12,500 trade-in, $2,000 mail-in rebate, free CAS training ($1,500 value), free Lombart table and small top, free IOL confi guration setup.• Reichert Ocular Response Analyzer G3: 0% fi nancing for 24 months; monthly payment $677.• Lane promotions (incl. 2nd-year warranty): premium lane pack-age $28,990 ($3,277 savings), digital refraction package $29,485 ($4,595 savings), value lane package $13,995 ($2,585 savings).

Natural OphthalmicsBooth 315

Ongoing education plus 15% show discount promo on all orders. Natural products for dry eye and allergy will increase revenue, bring referrals to your offi ce and meet patients’ needs.

MaximEyes, by First Insight Booth 1331

Attend a 10-minute MaximEyes EHR demo in Booth 1331 and get a $10 Starbucks gift card. Must be a practicing doctor or practice decision-maker.

Modern Optical International Booth 500

Buy 20 frames, get 20 free! Modern Optical is family owned and has been a proud supporter of independent eye care since 1974. Restrictions apply on free frames.

Professional Eye Care Associates of America Booth 304

Promotion for new members: join by March 15, 2018 and your next three months of PECAA membership are free!

New Product Launches

Exhibit Hall Show Specials

DAILY14



15DAILY


The fi elds of low vision and vision rehabilitation have remained a misunderstood

niche for years. For patients, the term low vision opens a Pandora’s box of emotions, send-ing fear, confusion and even panic into the exam room; for optometrists, the extensive time investment and management pro-cess of low vision patients is often daunting.

While ODs seek comfort in know-ing they can refer these cases to the nearest low vision specialist, that

luxury cannot last. The growing num-ber of those in need of care from such a small number of specialists is simply unsustainable.

In his course, “Low Vision Care for the Primary Care Practitioner,” Scott Gartner, OD,

provides a glimpse into the current state of low vision care and what optometry needs to do to ensure all Americans in need of low vision exams, management and assistive devices receive them—their daily independence often depends on it.

“I want to communicate how and when the primary care optometrist can perform many of the basic low vision needs, like prescribing higher power reading lenses and a few special low vision devices, allowing a patient to function and perform their daily living tasks better,” says Dr. Gartner.

During the course, he will walk through the array of testing nec-essary to choose the best device for correction, and will discuss the abundance of new technolo-gies available for everyday use. He will also touch on new clini-cal procedures available for some outstanding cases. He says he hopes it becomes easier to identify those who are in need of moderate man-agement, as opposed to those who should be referred to a specialist.

This past year, the AOA released several articles and statements that serve to emphasize the importance of integrating vision rehabilitation into your practice.

“That understanding is a big milestone for the entire eye care fi eld,” says Dr. Gartner. “It reveals

that low vision and vision rehabili-tation should be on every doctor’s mind when taking a patient’s his-tory.”

His lecture touches on the ques-tions that all ODs should be asking patients—and how to interpret the answers.

“I never want to hear that patients with macular degeneration or glaucoma are being told that

there is nothing left to do to save their eyesight, because it’s not true,” says Dr. Gartner. “For low vision specialists, those diagnoses, for example, are just the starting point for low vision rehabilitation.”

Knowing what to ask, what to look for, when to refer and to whom are skills all ODs should learn, refi ne and regularly integrate into their practices. •

High Hopes for Low VisionHold up your end of the bargain for these patients.

SATURDAY: 3:30–5:30pm ROOM A304, LEVEL 3

Andrew Bartlett, MDAlabama Vision Center, Birmingham, Ala

In his SECO 2018 Special Session, “Cornea Update,” Dr. Bartlett will

be teaming up with Joseph Shovlin, OD, to give attendees a refresher

course on all things cornea. “I’m hopeful attendees will take away the

signifi cant advancements that modern corneal transplantation techniques

can offer,” says Dr. Bartlett. “I also promise to do my best to keep people

from falling asleep and to be as entertaining as the SECO ethics commit-

tee allows.”

Dr. Bartlett comes from a family legacy of medical vision achievements

and currently practices at the Alabama Vision Center in Birmingham, Ala.

After receiving his undergraduate degree from the University of Alabama,

he attended the University of Alabama at Birmingham School of Medicine.

For his ophthalmology residency, Dr. Bartlett went to Texas Tech

University. He also completed a Cornea and External Disease fellowship

at Eye Consultants of Atlanta.

His specialties include cataract surgery, LASIK and corneal transplan-

tation (specifi cally, Descemet’s membrane endothelial keratoplasty and

Descemet’s stripping automated endothelial keratoplasty).

SPEAKER SPOTLIGHT

Dr. Bartlett’s SECO course schedule includes:

• Cornea UpdateSunday 9–11am, Amphitheater A3

• View the complete Schedule of Events, explore all of the offered courses and get a detailed map of the exhibit hall.

• Keep your pulse on the most popular sessions and events by accessing the Activity Feed which will highlight photos, ratings, comments and more.

• Receive announcements and obtain the most up-to-date event information.

• Get your course handouts at your fi ngertips.

• Tap into your competitive side! Earn points and achievements to win prizes.

WHY USE THE SECO 2018 MOBILE APP?

Visit the Apple App

Store or Google Play

store and search for

SECO 2018.

“I never want to hear

that patients with

macular degeneration

or glaucoma are being

told that there is nothing

left to do to save their

eyesight, because it’s not

true,” says Dr. Gartner.


DAILY16



Eye Care &&

E

2018


NashvilleApril 6-8, 2018

Paul Karpecki, OD, FAAO Program Chair

Eric Schmidt, OD, FAAO

Doug Devries, OD

Alan Kabat, OD, FAAO

Nashville Marriott at Vanderbilt University2555 West End Avenue Nashville, TN 37203 Reservations: 615-321-1300 DISCOUNTED RATE: $249 per night

Program Faculty

Earn up to

19 CE Credits*

Administered by

Review of Optometry®*Approval pending

Review of Optometry® partners with Salus University for those ODs who are licensed in states that require university credit.

THREE WAYS TO REGISTER online: www.reviewofoptometry.com/nashville2018 email: [email protected] phone: 1-866-658-1772Registration cost: $495

See event website for agenda and up-to-date information.

Continuing Education with Examination (CEE/TQ) Courses at SECO 2018Date Start End Course # Title COPE

Friday, March 2 1:30pm 3:30pm 139 OCT in Glaucoma - Green Isn't Always Clean 20-609693

Friday, March 2 1:30pm 3:30pm 141 Referral Center Grand Rounds 20-609695

Friday, March 2 1:30pm 3:30pm 143 AMD - Current Concepts and Future Directions 20-637056

Friday, March 2 5pm 7pm 146 Narrow Minded: The Management of Angle Closure 20-610353

Friday, March 2 5pm 7pm 149 Modern Day Diabetes 20-609703

Friday, March 2 5pm 7pm 515 Seeing Stars: Concussions in Sports 20-609717

Saturday, March 3 6:30am 8:30am 154 The Pressure is On: Managing Challenging Cases in Glaucoma 20-638342

Saturday, March 3 6:30am 8:30am 156 "What's Brewing?" All About Dry Eye & MGD 20-609705

Saturday, March 3 12:30pm 2:30pm 159 Get Going with Glaucoma 20-638344

Saturday, March 3 12:30pm 2:30pm 161 Neuro-Ophthamology of MS 20-609699

Saturday, March 3 12:30pm 2:30pm 162 New Drugs and Bugs 2018 20-609697

Saturday, March 3 3:30pm 5:30pm 164 Glaucoma Update: New Tools and Treatment Options 20-609709

Saturday, March 3 3:30pm 5:30pm 166 Anterior Segment Surgery Update 20-638460

Saturday, March 3 3:30pm 5:30pm 169 From Outdated to Updated: A Review of Key Clinical Trials in Eyecare 20-609713

Saturday, March 3 5:30pm 7:30pm 529 Digging Into Dry Eye 20-609723

Sunday, March 4 12pm 2pm 530 Lunch Course: How Do You Mend a Broken Cornea? 20-609725


17DAILY


Prepare Your Practice for Red EyeDetermining if a case is urgent and knowing what to do is imperative.

FRIDAY: 1–2pm ROOM A403, LEVEL 3

If your staff seems to panic every time a red eye emergency calls the offi ce, this Friday afternoon course

will help ease everyone’s minds. In “Red Eye Emergencies: What Do You Do?” Kris Kerestan-Garbig, OD, of Garbig Family Eye Care in Wilder, KY, will teach attendees about the crucial role front offi ce staff and optometric assistants play in managing red eye-related emer-gencies. Additionally, she will go over the most common presenting signs, symptoms, causes and treat-ment options for red eye cases.

Dr. Kerestan-Garbig will start things off by going over how to properly train your staff to begin these evaluations during the initial phone call. Here, she will go over some common things patients will

say, including “I’m afraid I have pink eye,” and “My eyes are so red and itchy, I can hardly stop rubbing them.”

Next, she will list what to look for in urgent cases that need immedi-ate attention and differentiate them

from cases that can wait. According to Dr. Kerestan-Garbig, must-see patients include those with redness associated with:

• Sudden or severe pain and discomfort

• Bleeding in or around the eye• Ocular trauma from:

– Sports injury– Auto accident– Blow to the eye– Fingernail scratch– Paper cut– Curling iron burn– Chemical burn

• Foreign body in the eye• Extreme discomfort and sensi-

tivity to light• Sudden change in vision or loss

of vision• Copious matter or discharge

Non-urgent cases, meanwhile, include redness not associated with ocular trauma or foreign body injury, involve mild pain or discom-fort that has been present for several days to a week, have no bleeding and little to no light sensitivity, change in vision or discharge.

Beyond that, Dr. Kerestan-Garbig will cover the signs, symptoms and treatment of many of the most com-mon red eye lid conditions, including internal and external hordeolum, chalazion, blepharitis, meibomiani-tis, trichiasis and eye lid trauma.

To fi nish things up, Dr. Kerestan-Garbig will bring things full circle with a quiz for attendees. Here, participants must identify a number of cases based on clinical images and the list of associated symptoms. •

After attending this course, blepharitis

mangement will be a breeze.


Caring for Her EyesLearn about the ocular differences that may affect the care of female patients.

Tonight, Tammy Than, OD, Louise Sclafani, OD, and Caroline Pate, OD, will teach

attendees about sex-related differenc-es in patients’ ocular structures and functions in their lecture “Through the Eyes of Women: Caring for the Female Patient.”

The development and severity of many ophthalmic conditions can vary between sexes, ranging from ocular surface disease to optic neuropathies, the presenters say. To help attendees better prepare for this, the presenters will go over the specifi c ocular needs of the female patient at different life stages—all the while placing empha-sis on the diagnosis and management.

First up, Dr. Sclafani will begin with basic statistical differences be-tween female and male eyes, as well as some conditions women common-

ly present with, including macular holes, Graves’ disease, myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus, Sjögren’s syn-drome and rosacea.

After this, she will touch on some complications that could affect this patient population. Eating disor-ders and ocular complications such as episcleral capillary aneurysms, subconjunctival hemorrhages, night photosensitivity and decreased tear production are all issues to consider here, and Dr. Sclafani will go over each in detail.

Next, Dr. Pate will address how to best care for pregnant patients. Top-ics pertaining to this patient popula-tion will include corneal changes, dry eye, refractive changes, intraocular pressure, optic nerves, central serous retinopathy, hypertension, pre-

eclampsia and diabetes. Dr. Pate will cover what to look for in these cases and how to approach treatment before wrap-ping things up with some case examples.

The discussion will then shift back to Dr. Sclafani, who’ll address hormonal infl uences on the glaucoma popula-tion. This section will start off with several case examples leading into key consid-erations to answer the question, “Is there a difference in the prevalence of glaucoma between men and women?” To get to an answer, Dr. Sclafani will cover glaucoma and pregnancy, the protective role of endogenous estrogen, exogenous hor-

mones and the maturing patient. The session will conclude with a

talk on systemic medications with oc-ular side effects and how they affect female patients. Here, the presenters will discuss the possible ocular side effects of drugs such as hydroxychlo-roquine/chloroquine, topiramate, tamoxifen and more. •

Sex can infl uence the severity of various ocular

conditions. Tonight’s presenters will let you in on

the etiology of this patient’s ocular concern.


DAILY18


Head-borne Low Vision Devices6:30–7:30am, room A304

This course provides an overview of the newest low vision technology for head born display devices which enable the legally blind to actually see and/or hear their visual world. These devices empower individuals with various eye conditions to become more independent as they engage in their various activities of daily living. The benefi ts and disadvantages of each will be discussed. Case studies will be used to demonstrate the device including patient videos. Scott Gartner, OD

Vision Therapy: The Top 10 Tools in Action6:30–7:30am, room A316

Vision therapy has the power to change a patient’s life for the better. Vision therapy can be used to treat issues with binocular vision, accommodative, strabismus, amblyopia and acquired brain injury successfully. While there are upwards of 200+ therapy activities, this lecture will focus on the most common, the top 10. Marc Taub, OD

Get Comfortable with Amniotic Membranes in an Hour6:30–7:30am, room A313

In offi ce and sutureless amniotic membrane (AM) is emerging as an excellent alternative due to promising clinical outcomes to treat a variety of ocular surface conditions rapidly and effectively. This course will review what is an amniotic membrane, the various types of AMs, clinical applications, patient experience, insertion and removal.Gregory Caldwell, OD

Creative Techniques for Finding Your Next New Team Member6:30–7:30am, room A315

When adding to your team it is more important to determine if the new addition will fi t into the offi ce culture than for them to have optometric skills. How do you fi nd the best candidate for the position? Where do you fi nd the best candidate for the position available in your offi ce? This course will help you locate hire and keep the best person for your establishment. Carole Burns, OD

All About Dry Eye & MGD6:30–8:30am, room A312

We hear a lot about the new “disruptive” technology. Does disruptive equal better? Some topics discussed: meibography, intranasal stimulation, tear osmolarity, risk assessment. DEWS II: disruptive or disrupting? Milton Hom, OD

What’s Brewing? CoursesSATURDAY SATURDAY: 8–9am ROOM A403, LEVEL 4

Pediatrics PearlsKids can be tricky to examine and treat. This session will give advice you can integrate today.

Not every OD is used to a squirming, curious six-year-old in their chair. So, when a pediatric patient walks through the door, how can you be prepared? Katherine K. Weise, OD, director of pediatric optometry

service at the University of Alabama at Birmingham, will provide Saturday morning’s attendees with a roadmap for success with these patients.

To begin her 8am lecture, “I’ve Got a Kid In My Chair…Now What?” Dr. Weise will discuss the main differences between an adult and pediatric visit, starting with techniques on taking the history. Unlike an adult patient, kids should generally follow a developmental curve, and abnormal development is a red fl ag. Other pediatric-specifi c history questions include prenatal, delivery and perinatal risk factors, family and school placement and guardianship. Each one of these can impact the child’s visual development, and Dr. Weise will share how to record the history and sleuth out what is at play.

Children may not have an extensive history but, Dr. Weise says, they won’t sit still for long, so the trick is getting to the point quickly.

Dr. Weise will then delve into conditions more common in the pediatric population that might be infl uencing any suspicious fi ndings. Cerebral palsy, for example, has a high rate of secondary eye problems, according to Dr. Weise. Other developmental delays, such as Down syndrome, often have asso-ciated eye signs, including poor accommodation, eye lid abnormalities, retinal disorders, optic atrophy and media opacities.

Finally, with the history out of the way, Dr. Weise will turn her attention to testing. She will cover visual acuity, alignment, strabismus screening with both an ophthalmoscope and with a cover test, stereo testing, pupil testing, extra-ocular muscles and confrontation visual fi elds—all with a pediatric twist.

For fundus exams, Dr. Weise doesn’t mess around. “If you go to a doctor who doesn’t use dilating drops on kids, you need to choose another doc-tor,” she emphasizes. Of course, you should consider skipping it if the drops will harm the child (i.e., subluxated lens, narrow angles or systemic or neuro condition that would contraindicate drops); if the child is tired and would per-form better when fresh; or if parents refuse. For the last one, it’s the clinician’s job to convince them with education, according to Dr. Weise.

No pediatric discussion is complete without a refresher on myopia, and Dr. Weise will spend a few minutes discussing myopia risk factors, prevalence and control options. She will wrap up the session with a brief look at an OD’s worst nightmare: pediatric ocular emergencies. Attendees will walk away with a comprehensive understanding of how to take a pediatric history, what to look out for, and how to handle the most common pediatric conditions. •

A child in the chair can be a real challenge. For one, they rarely stop moving.

Dr. Weise will share some tips on getting a good look at this patient’s eyes

even as he squirms and fi dgets.


19DAILY


Published in partnership with Allergan.

SECO CHAMPION SPOTLIGHT

© 2018 Allergan. All rights reserved. All trademarks are the property of their respective owners. AOT72080_v2 01/18 180013


Orlando, FloridaMay 17-20, 2018

Join Review of Optometry’s New Technologies & Treatments in Eye CareMay 17-20, 2018 in Orlando at Disney’s Yacht & Beach Club. Earn up to 18* COPE CE credits including interactive workshops!**

TQ/CEE approval is pending for optometrists licensed in Florida or other states requiring “Transcript Quality” courses for re-licensure. Please see agenda on event website for specifi c courses.

EARLY BIRD SPECIAL: $495

Registration cost: $595 after March 23, 2018.

Get your discounted park tickets by Friday, March 9 th.

DISNEY’S YACHT & BEACH CLUB1700 Epcot Resorts Boulevard

Orlando, Florida 32830Phone: 407-934-7000

See website for updated hotel accommodations.


Eye Care &

2018


Paul Karpecki, OD, FAAOProgram Chair

Douglas Devries, OD Mark Dunbar, OD, FAAO Murray Fingeret, OD, FAAO

FACULTY

g

3 3 WAWAYS TO REGISTERYS TO REGISTERonline: www.reviewofoptometry.com/Orlando2018

email: [email protected] | phone: 866-658-1772

Earn up to

18 CE Credits*

**Separate registration required. Review of Optometry® partners with Salus University for those ODs who are licensed in states that require university credit. See event website for complete details.

Administered by

Review of Optometry® *Approval pending

21DAILY


escalation of a strong steroid, periocular injection, vitreal steroid implants and, for severe cases, im-mune modulators. “When Humira was fi rst approved for uvieitis, everyone was excited and wonder-ing if they should add it to their common therapy,” he said. “But we shouldn’t. It’s a very powerful drug, and should only be for severe cases. It comes with a lot of side effects.”

Clinicians can also consider nonsteroidal anti-infl ammatory drugs (NSAIDs), which research now shows may be useful for some recurrent acute anterior uveitis cases, he said.

Dr. Bronner concluded the treat-ment portion of the lecture noting three common treatment errors to avoid: “not using cycloplegics in anterior disease, not fully control-ling infl ammation and being impa-tient with steroid taper,” he said. “These will get you into trouble.”

Diagnostic TroubleWhile treatment is straightforward,

Dr. Bronner said, diagnosing is not. “Really, you need to rely on the intersection between the clinical picture and patient setting,” he said. “Labs just aren’t sensitive enough.” On the other hand, the patient’s age, sex, race and other medical diagnoses are crucial to understanding their uveitis presen-tation and can go a long way to whittling down the differential list to make testing more useful.

“Uveitis can present with a laundry list of clinical fi ndings,” Dr. Bronner added. “Not all fi ndings present with each etiology. Knowing what is common for each etiology is the key to honing the differential.”

Differentials GaloreDr. Bronner then spent the second half of the lecture running through those many etiologies, careful to include the usual clinical fi ndings.

Everything from juvenile idiopathic arthritis, Behcet’s disease, herpetic disease and postoperative retained lens fragments to sarcoidosis tattoos

and tuberculosis are all on the uveitis differential list. Dr. Bronner helped attendees get through the material by providing clinical pearls after each etiology. He concluded the lecture with an etiology “that’s mostly discussed as a curiosity, but it’s not all that uncommon,” he said. He sees as many as one patient a year with Fuchs’ heterochromic iridocyclitis—

and he can’t treat them with steroids as you would a usual uveitis patient. “You have to treat the hypertension here, and then the cataract as soon as it forms.”

Dr. Bronner provided a fi nal reminder before dismissing the lecture: “Don’t rely on labs—the clinical picture and patient setting are more helpful every time.” •

All You Need to Know About Uveitis

NSAIDs in Uveitis Treatment For clinicians looking for a therapy that bridges the gap between peri-ocular agents and long-term immune modulators, research suggests oral nonsteroidal anti-infl ammatory drugs (NSAIDs) may be surprisingly useful. Although NSAIDs have never been a part of the uveitis treatment protocol, Dr. Bronner discussed a small study from Massachusetts Eye and Ear that showed a reduction in uveitis episode recurrences by more than 63% in 44 patients with recurrent acute anterior uveitis.

The patients were on the maximum dose for each specifi c NSAID trialed for a at least six to 12 months prior to showing any reduction, and periocu-lar steroid was used to control acute fl are-ups. The researchers preferred COX selective celecoxib, unless cost was an issue for the patient.

While this is an off-label use, it may actually be very useful in optometric practice, Dr. Bronner said. “Of course, as with all long-term medications, controversy still exists, given the risk and reward balance of long-term NSAIDs in these eyes.”

Continued from Page 1

OD and MD Experts Address How to ‘Gear Up for Glaucoma’Continued from Page 1

Knowing that peak IOPs do not occur between the hours of 9am and 5pm, optometrists can now tap into possible missing links that could radically alter the management approach, the speakers said.

Dr. Thimons, who has rented the home tonom-eter to more than 45 of his patients since its FDA approval last spring, has found the data output for late evening and early morning pressure read-ings to be fascinating. “I’d say 30% to 40% of these patients have a 5mm Hg difference between my highest IOP recording and what they found off-offi ce hours from the device,” he said. Dr. Noecker said he does receive the occasional late-night call from patients who panic after seeing a high reading in the middle of the night; however, he said this can be avoided by simply engaging in a few extra minutes of patient education around IOP results.

Hysteresis Hysteria For the last fi ve years, Drs. Thimons and Noecker

have been using the Ocular Response Analyzer (Reichert) to assess corneal hysteresis to further inform the direction for glaucoma management. “This provides the type of information that really yields high return in looking at prediction for progression within existent glaucoma patients,” said Dr. Thimons.

According to Dr. Noecker, when he doesn’t have the corneal hysteresis reading, he really misses it. “It’s a step up from pachymetry, a more sophisticated measure and more reliable, so in some ways, I use it to see how good a job we’re doing; you can see the hysteresis rise when you treat appropriately,” said Dr. Noecker. Because visibly positive feedback can be rare in many of these interventions, this data adds a necessary slice of positivity to the process.

New Digs: MIGS In the fi nal part of the presentation, Drs. Noecker and Thimons explored some of the latest, real-time results trickling in from the use of the newest

drugs on the market—Rhopressa (Aerie Pharma-ceuticals) and Vyzulta (Bausch + Lomb)—as well as the newest frontiers in MIGS. Dr. Noecker said that in combining two or three MIGS for one patient, he has come across impressively positive results. And while he’s seen varying success with lowering IOP across these procedures, the greatest triumph lies in the breadth of options.

According to Dr. Thimons, glaucoma treatment was once “drops and laser and then trabeculec-tomy, with a gigantic space in between.” Now, however, we “have minimally eight, maybe 10 procedures in the middle of that, each of which gives you a different risk pattern, a different IOP endpoint that you can drive to, and we’re seeing remarkable results, like patients dropping into the low teens and staying there for years without drops.”

In closing, the message was clear: thanks to new technologies and surgical procedures, we are on the horizon of revolutionizing the course of glaucoma. •


DAILY22


Chances are, you’ve had patients ask you about their headaches. These can include migraine, facial pain syndromes and pain

related to cranial neuropathies, orbital and ocular disease and sometimes, they can be indicative of bigger medical emergencies, so diagnosis and man-agement become crucial.

In tonight’s course (part of the Snap Chat series), attendees will learn about the most common head-ache cases as well as some of the most troubling. Richard B. Mangan, OD, will be looking for heavy audience participation while providing clinical pearls that will aid in the differentiation of benign head pain disorders and more serious disorders.

Name that HeadacheThroughout the course, Dr. Mangan will address the many different types of headaches, including tension headaches, cluster headaches, migraines,

rebound headaches, infl ammatory headaches, sinus headaches and brain tumor headaches.

Within each section, he will start with a review of the headache’s typical presentation. For ex-ample, tension headaches are “characterized by gradual onset, bilateral, non-throbbing, aching pain over the frontal and temporal regions, which often spreads to the occipital,” says Dr. Mangan.

Finding ReliefManaging headaches can be tricky, as it usually calls on the practitioner to decide whether behavior modifi cation or abortive or prophylactic treatment would be more appropriate.

In addition to the many types of headache pre-sentations that exist, Dr. Mangan will discuss what each could indicate, including giant cell arteritis, infectious meningitis, pseudotumor cerebri, brain tumors and stroke.

Finishing up, Dr. Mangan will give attendees a crash “Radiology 101” course for headache cases. “Computerized tomography is today’s preferred imaging modality to exclude intracranial patholo-gy, especially in acute cases,” says Dr. Mangan. •

The speakers in “Understanding and Interpreting the OCT in Retina and Glaucoma”

on Thursday morning made a con-vincing case for the importance of using optical coherence tomography (OCT) in clinical eye care practice for diagnosing, following and man-aging retina and glaucoma-related conditions.

Noting the fi rst scientifi c description of OCT in the Journal of Science in 1991, the speakers said OCT is now widely embraced by optometrists and ophthalmologists. Its widespread use is being driven by increased demand for eye care due to an aging population, yielding a growing number of cases involving macular degeneration, diabetic retinopathy, retinal vascular disease and glaucoma.

“What an opportunity for optometry to get involved in medical eye care,” said Mark Dunbar, OD, director of optometric services at Bascom Palmer Eye Institute, “by having an OCT to keep these patients in your chair longer.”

Qualities of a Good OCTDr. Dunbar said his experience with various retinal OCT devices and software packages revealed that they all were “very good.” He pointed out that “a B-scan is a B-scan” and that—on both ends of the economic spectrum—all OCT offerings he has tried offer high defi nition, three- to fi ve-micron images that pick up key features of

abnormality and pathology. Though OCT software programs for glaucoma

are unique, Dr. Dunbar said the differences boil down to subjective factors and personal prefer-ences. But he pointed out that all the devices do a “great job” of detecting retinal nerve fi ber layer thinning and evaluating the ganglion cell complex. Since the hardware is similar across platforms, software that is patient friendly, com-petitively priced and fi ts the needs of clinicians are important purchasing considerations.

When it comes to OCT selection, Jeffry D. Gerson, OD, an optometrist at Grin Eye Care in

Leawood, Kan., compared the process to buying different tiers of contact lenses from companies offering “good, better and best” options. “For most patients, the ‘good’ works out just fi ne,” Dr. Gerson said.

Confi dence FactorDuring the comprehensive presentation, featuring 245 slides, in which Drs. Dunbar and Gerson gave tips for OCT interpretation of retinal and glauco-ma conditions, the speakers urged clinicians not to make OCT interpretation more complicated than it needs to be. With any kind of imaging technol-ogy, especially when dealing with anatomy, there can be an “intimidation factor,” they noted. Dr. Dunbar told the story of a friend and colleague who purchased an OCT several years ago.

“He went through all of those insecurities: ‘Is this technology too advanced for me? Am I smart enough to fi gure it out?’” Dr. Dunbar said. A year later, the friend’s confi dence with OCT was high. “It really changed his life and how he practices,” Dr. Dunbar said. “So don’t get caught up in the minutia.”•


Making a Case for OCT How imaging technology can change the way you practice.

Take the Pain Out of Managing HeadachesPractitioners should be prepared to get to the bottom of these cases. This course can help.

This CT scan shows a parietal ischemic stroke.

“What an opportunity for optometry to get involved in medical eye care,” said Dr. Dunbar, “by having an OCT to keep these patients in your chair longer.”


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DAILY - reviewofoptometry.com · Review of Optometry® partners with Salus University for those ODs who are licensed in states that require university credit. ... keratitis. They

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