Dr. Timothy Petito shared his thoughts on telemedicine in eye care in the latest issue of Advances in Ophthalmology and Optometry.
- Telemedicine is here to stay, and its use will increase into the future.
- The existence of telemedicine creates a challenge for the health care system in defining its appropriate use.
- The use of remote data gathering should be included in the care of patients as indicated on a case-by-case basis and at the direction of the practitioner ordering the test or responsible for the care of the patient, just as all other testing approaches would be in the office or clinical setting.
- The prevailing standard of care should be adhered to regardless of whether the health care services are provided via in person interactions, telemedicine, or any combination thereof.
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Dr. Garrett Wada of Wada Optometry has a unique optometric practice. You notice it as soon as you step inside - it's like stepping into another world, or more appropriately, out of this world. Dr. Wada's practice is Star Trek themed. From the waiting area to the exam room to the Dispensing area, it's like boarding a starship.
"I've always been a Star Trek fan and I've always wanted to do something different for my office. Initially, I started hanging starship models in my practice and I put Star Trek photos up. It gave patients something to talk about," says Dr. Wada. One of his patients turned out to be a set builder for Hollywood movies and he offered to build a small Star Trek set for the office. "I was able to expand on the theme by finding props online and was fortunate to find two expert wood craftsman who put the final touch to my starship. I'd like to think this office is one-of-a-kind," Dr. Wada adds.
His futuristic practice is completed with high-tech optometric equipment including the EPIC-5100 workstation, Tonoref M3 autorefractor/keratometer/tonometer, and LM-1800 autolensmeter from Marco. They not only provide the technology that goes with Dr. Wada's theme, it's made his process efficient by quickly bringing all the data pulled from the TRS-5100 digital refractor, M3, and autolensmeter into his EMR system.
"The EPIC is a wow factor. Patients see the arrangement from where the doctor sits and where they sit - it's completely different from what they're used to," says Dr. Wada. His EPIC is modified to hold a slit lamp for easy patient transitioning. "Patients are in a great mood when they come in and see all the technology," says Dr. Wada. "People really are impressed by technology and I really recommend doctors to pursue that. Especially the EPIC and M3 because they make our lives easier and they make the exam process quicker and more accurate."
You can see more of Wada Optometry at www.wadaoptometry.com.
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In a recent article by Lou Catania, OD, FAAO, he discusses the historical fact that there has been vigorous debate regarding the “need” or practicality for ¼ D endpoints as opposed to ½ D endpoints in refractive care. He then examines whether it's time to reduce that endpoint determination to the level of ⅛ D.
Dr. Catania discusses the relevant science surrounding the theoretical capabilities of the human visual system to respond to changes, and recognizes the visual effects a difference ⅛ D represents. Wavefront aberrometry has the ability to predict for clinicians which patients will be able to discern differences of ⅛ D (and which will not) based on the level of high order aberrations their system includes. Finally, he touches on the considerations of prescribing lenses based on the 1/8 D endpoint and whether they can be reliably fabricated.
If adopted, this new standard would result in better outcomes for our patients, and improved standards of care, based not on an arbitrary “norm” but on individualized “maximum performance”.
“The highly precise measurement of higher (3rd and 4th) order aberrations with modern wavefront aberrometry can now identify and accurately measure a patient’s irregular astigmatism and spherical aberrations. At the “clinical awareness threshold” these “higher order” aberrations (HOAs) begin to decrease the “quality of vision” and undermine the likelihood of ⅛ D sensitivity.”
“The increasing understanding of optical, retinal and neural vision components and the development of advanced refracting technologies and correcting lens materials and designs makes the ⅛ D refraction and correction a reality.”