Practice Management

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Updated Dell questionnaire takes a closer look at patients visual needs

May 25, 2017

Not too many years ago, there was a clear separation between refractive surgery and cataract surgery. Refractive surgery was limited to modification of the cornea, while successful cataract surgery was typically followed by a new bifocal glasses prescription. Early pioneers such as Robert Osher began advocating combining astigmatic keratotomy with cataract surgery to reduce spectacle independence in the mid-1980s, but this was not widely adopted at that time. It took many years for the combination of improved biometry, modern IOL formulae, small-incision surgery, astigmatic keratotomy and toric IOLs to allow surgeons to routinely achieve good uncorrected distance vision after IOL surgery. The advent of multifocal, accommodating and extended depth of focus IOLs has essentially transformed cataract surgery into a form of refractive surgery. These new options have created a complex array of choices for the surgeon and the patient. And with multifocal IOLs now available in several add powers, the choices have become even more complicated. This trend will continue as new technologies emerge.

As a participant in early clinical trials for presbyopia-correcting IOLs, I was excited when we received approval for these lenses in 2004. But I soon found that a problem was brewing in my clinic. Suddenly, I was spending a huge amount of time explaining all the various IOL options to cataract patients. Sometimes after a long discussion, the patient would state that he had no interest in spectacle independence. Educational videos and surgical counselors helped, but I needed a way to quickly assess what my patients wanted their vision to be like after surgery, what compromises they would be willing to make to achieve those goals, and whether they would be willing to pay for this result. The result was a Cataract and Refractive Lens Exchange Questionnaire, which I first published in 2004. The questionnaire was helpful in streamlining my clinic, and other surgeons found it useful as well.

Perspective

Prescription drug prices rose nearly 10% in 2016

May 24, 2017
The cost of prescription drugs increased by 8.77% last year, the fourth consecutive year drug prices have gone up, according to data from the Truveris National Drug…
In the Journals

High-risk pools may raise health care costs for all Americans

May 24, 2017
Reinstituting high-risk pools as a state option as part of the American Health Care Act that was recently passed by the U.S. House of Representatives would move health…

ACP offers recommendations to Congress for health care reform

May 23, 2017
Today, the ACP released a new policy agenda containing several recommendations for Congress to improve American health care. The paper, titled A Prescription for a
Clinical Science

Evisceration and Enucleation: A National Survey of Practice Patterns in the United States

Ophthalmic Surgery, Lasers and Imaging Retina, September 2012, Volume 43 Issue 5
The management of evisceration and enucleation has changed over time. The authors assessed the practice patterns…
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COPE CME CE

Ocular Surface Diseases, Disorders, & DysfunctionsTM: Volume 2, Number 1

This activity is supported by an educational grant from Shire.

Maintenance of the health of the ocular surface is complex due to numer-ous potential challenges, including dry eye…
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Meeting News

VIDEO: Speaker advises how to navigate transition from fee-for-service to value-based health care systems

January 15, 2017
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Updated Dell questionnaire takes a closer look at patients visual needs

May 25, 2017
Not too many years ago, there was a clear separation between refractive surgery and cataract surgery. Refractive surgery was limited to modification…

Perspective

Prescription drug prices rose nearly 10% in 2016

May 24, 2017
The cost of prescription drugs increased by 8.77% last year, the fourth consecutive year drug prices have gone up, according to data from the…

In the Journals

High-risk pools may raise health care costs for all Americans

May 24, 2017
Reinstituting high-risk pools as a state option as part of the American Health Care Act that was recently passed by the U.S. House of Representatives…

ACP offers recommendations to Congress for health care reform

May 23, 2017
Today, the ACP released a new policy agenda containing several recommendations for Congress to improve American health care. The paper, titled A

Cybersecurity expert: 5 things physicians should consider to help protect data

May 22, 2017
In this guest commentary, Zuly Gonzalez, co-founder and CEO of Light Point Security and former cybersecurity expert at the National Security

Q&A: Why health care remains a target to cyberattacks like WannaCry

May 22, 2017
Earlier this month, hackers executed a worldwide ransomware attack that has impacted more than 100 countries and infected tens of thousands of…

Most doctors disapprove of Trump approach to health care

May 19, 2017
A new survey shows that the majority of U.S. doctors do not like President Donald J. Trump’s job performance when it comes to health care…

Meeting News

Speaker discusses opioid crisis through a population health perspective

May 17, 2017
PHILADELPHIA — The key issue in opioid abuse is that addiction thrives among populations marked by violence, homelessness and employment…

Perspective

House hearing opens with support for NIH funding, criticism of proposed cuts

May 17, 2017
Today, the U.S. House of Representatives held a hearing on funding for the NIH. In opening remarks, the Subcommittee on Labor, Health and Human…

AMA urges Senate to sustain insurance coverage

May 16, 2017
AMA recently penned a letter to Senate leaders advocating protection for patients at risk of losing health insurance coverage as the Senate begins…

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