Volume 8, Issue 26 │June 28, 2024

Editor's Note: the IOA office will be closed on Thursday, July 4th in observance of Independence Day, we hope you have a safe holiday!

Breaking News: FTC Updates Federal Eyeglass Rule📢

Yesterday evening, the U.S. Federal Trade Commission (FTC) released its once-per-decade update to the federal government’s eyeglass sales requirements (known as the “FTC Eyeglass Rule”). Noting 10 years of advocacy and active efforts seeking to moderate the agency’s harsh approach toward small and mid-sized health care practices, the AOA issued an analysis of the rule changes and pointed to two harmful proposals that now have been officially abandoned by the agency.  

To ease the practice burdens connected to the FTC’s rule update, the AOA announced that it will be providing member doctors with compliance tools before the rule is enforced. The AOA will also continue its work with the FTC and other federal enforcement agencies to spur a crackdown on illegal medical device sales and internet scams.  

Click here for an in-depth AOA.org article and to enlist in AOA advocacy efforts.  

Questions about compliance and the new rule can be directed to askaoa@aoa.org.

The Illinois Optometric Association was awarded the 2024 AOA State Advocacy Award for exemplary dedication to optometry and the advancement of optometry. The award was received at this years Optometry's Meeting. The IOA was largely awarded this for the efforts in passing SB764, the Vision Care Plan Regulation Act that underscores its commitment to advancing optometry and safeguarding public health.

Dr. Angie Oberreiter representing Illinois at House of Delegates

Dr. Oberreiter & Dr. Forzley photographed together representing Illinois

Dr. Sam Forzley addressing the House of Delegates

Dr. Joan Stelmack, OD, MPH was recently recognized at Optometry's Meeting for the Dr. Jerry P. Davidoff Vision Care Award. Dr. Stelmack actively provides services in a clinical vision rehabilitation practice setting, gives back to optometry through education, and sharing knowledge with fellow practitioners for betterment of vision rehabilitation eyecare.

Dr. Joan Stelmack is director of low vision service at the University of Illinois Department of Ophthalmology and Visual Science. Dr. Stelmack has collaborated on 23 funded research studies and in the role of principal research investigator, she has received over $4 million dollars in research funding. She has authored more than 47 journal articles and presented more than 155 scientific papers, posters and lectures. Congratulations Dr. Stelmack!

Congratulations to Dr. Louise Sclafani, OD, FAAO, FSLS who was the recipient of the AOA Contact Lens & Cornea Dr. "Uncle Frank" Fontana Award. This award is given in honor of Frank D. Fontana, O.D., a founder of the CLCS, contact lens pioneer, and friend and mentor to many.

Dr. Sclafani received this award for her passion in educating patients and colleges about contact lens technology. She is also an advocate for healthy contact use and strives to give back to optometry through the education of other practitioners.

Member Dr. Paul Velting, OD has recently completed his term as Immediate Past Chair on the AOA Contact Lens & Cornea Section Council for 2023-2024. Congratulations on your valuable time as a council member!

Dr. Jennifer Harthan, OD, FAAO, FSLS was also recognized during the AOA's annual Optometry's Meeting this past week. Dr. Harthan was awarded with the Contact Lens & Cornea Section Achievement Award. The Achievement Award is given by the AOA CLCS in recognition of outstanding contribution to the optometric profession in the area of contact lenses and eye care. Congratulations Dr. Harthan!

Congratulations to Student Karli Clark (pictured on the left), for proudly representing ICO at Optometry's Meeting by participating in the Optometry Student Bowl and becoming the national runner-up. Great work Karli!

IOA member Dr. Ansel Johnson, OD along with Nikita Mokhashi, MD took time on June 18 to speak about eye conditions and maintaining healthy vision at UChicago Medicine Urban Health Initiative. The Urban Health Initiative is a benefit program to improve population health and community benefit programs for the South Side of Chicago.

Mark your calendar for the IOA Annual Meeting which will take place from October 3-5 in Springfield, IL. This gathering serves as a platform for professionals to come together, exchange knowledge, and foster meaningful connections within the industry. Registration will open in July, offering you the opportunity to join us for an enriching experience filled with insightful discussions, innovative ideas, and networking opportunities. We look forward to welcoming you!

Now Accepting Student and Paraoptometric of the Year Nominations

The IOA Paraoptometric of the Year Award recognizes a deserving individual paraoptometric who has made outstanding contributions to the profession of optometry, patients, and the public. This individual must be employed by an IOA member doctor.

A paraoptometric is one who works under the direct supervision of a licensed doctor of optometry, collects patient data, administers routine and technical tests of patient’s visual capabilities, and assists in office management. A paraoptometric may assist the doctor in providing patient care, examination and treatment services, including, but not limited to, contact lenses, low vision, vision therapy, ophthalmic dispensing, and office management.

The Para of the Year will be awarded free registration to the IOA Annual Meeting and will be recognized at the IOA Annual Meeting.

Nominations are due July 15.

Capitol Connection: Health Insurance Industry Plans for Incoming Reforms

WCIA | By Cole Henke

June 25, 2024

There are a number of reforms on the way for the health insurance industry. Governor Pritzker made it a top priority this legislative session, and now health insurance companies are preparing to make the changes.

The plan prevents health insurance companies from using a process called step therapies, where they require a patient to use a less expensive option, even if their doctor prescribes something different. It also bans prior authorization for mental health treatments, and it requires health insurance companies to regularly audit their directories.

Laura Minzer with the Illinois Life and Health Insurance Council joined Capitol Connection to talk about how the health insurance industry is adapting.

Check out the newest IOA classifieds here!

ODs Wanted:

Central IL:

OD needed in Champaign, IL offering highly flexible, family-friendly scheduling arrangements (Read more)

Chicago IL:

Optometrist Needed at University of Chicago's Department of Ophthalmology and Visual Science (Read more)

Immediate need for short and long term needs for optometrist in Chicago area (Read more)

Chicago Suburbs:

Part-Time transitioning to Full-Time optometrist needed on the North Shore of Chicago at an established private practice (Read more)

Part-Time optometrist needed to provide exceptional, comprehensive eye care to our family practice patients (Read more)

Southern IL:

Optometrist needed for community health in Southern IL locations including Robinson, Lawrence, Ina, Shawnee, Hillsboro, Vandalia (Read more)

Part-Time optometrist needed at a clinic in Benld, IL. Conveniently located half-way between St. Louis, MO and Springfield, IL near I-55 (Read more)

Optometry's Meeting 2024 Wraps Up Four Days of Education, Governance and Networking in Nashville

Vision Monday | By Staff

June 24, 2024

Last week, Optometry’s Meeting 2024 welcomed more than 4,500 doctors, students, paraoptometric staff and industry supporters to Nashville. Marking the 127th Annual American Optometric Association (AOA) Congress and 56th Annual American Optometric Student Association (AOSA) Conference, the annual four-day education, governance and networking event focused on optometry’s essential and expanding role in health care and saw its largest gathering of AOA doctors since 2018, the organization announced. The show attracted 4,674 attendees, the AOA said. Eye Care Square opened on Wednesday evening and featured 159 exhibitors and a sold-out exhibit floor, numbers not seen since before the COVID-19 outbreak, according to the group.

During his opening address, AOA president Steven T. Reed, OD, celebrated the organization's successes of the past year, including the advocacy for coverage and reimbursement fairness, which resulted in more than 10,000 meetings and interactions with policymakers, the group said. Additionally, Dr. Reed shared that through the AOA’s public awareness campaign, Eye Deserve More, more than 600,000 patients are actively seeking out AOA doctors.

“This is what I know will be a powerful week, filled with world-class continuing education, opportunities to connect with colleagues, conduct the business of our association, and reenergize ourselves for the work we want to accomplish together,” Dr. Reed said.

Leading artificial intelligence (AI) transformation advisor Tom Lawry helped kick off Optometry’s Meeting with a message about AI and the evolving impact on optometry. “AI is an opportunity, not a threat,” Lawry told the audience. “Leverage AI as part of your practice. Understand what AI can do and don’t worry about how it works. Understand what AI is good at and what it’s not. And practice responsible AI in service to all. It’s in your hands. Nobody is more qualified to drive it than you.”

Optometry’s Meeting kicked off day two with a report on the strength of the association, citing more than 500 new doctors joining AOA in the first six months of 2024, pushing membership to more than 50,000. Executive director Jon Hymes also shared that 75 percent of Americans indicate trust in an AOA-member doctor of optometry, a finding from a recent survey indicating that the AOA’s brand is stronger than ever.

“We are growing in size, clout and effectiveness, and are well prepared to continue to do all that it takes to safeguard optometry’s essential and expanding role in health care and support the practice success of our doctors,” Hymes told attendees during the House of Delegates session.

Two events brought together paraoptometric attendees at Optometry’s Meeting. The Paraoptometric Awards Luncheon Celebration, supported by Alcon, is the annual celebration of AOA associate-member paraoptometrics, honored for their outstanding and significant contributions to the profession, the AOA said.

AOA also observed Juneteenth, a federal holiday, with a panel discussion celebrating the collaboration between Black EyeCare Perspective, the AOA, and Johnson & Johnson Vision, which is aimed at boosting Black representation in the eyecare sector to better mirror the demographics of the United States. This partnership demonstrates a joint dedication to fostering diversity and inclusivity in optometry, according to the AOA.

This year’s Paraoptometric Award winners were recognized for their outstanding dedication to the profession. Following the celebration was the Paraoptometric Idea Exchange, where attendees networked and discussed practice challenges and opportunities, and generated ideas on how to grow AOA associate membership.

On Thursday evening, Tyson Montgomery of The Ohio State University College of Optometry took home the trophy after another AOSA Optometry Student Bowl, powered by EssilorLuxottica. The high-speed, high-stakes test of optometric knowledge pits one champion from each school against all others. Michigan College of Optometry received the competition’s Spirit Award, the AOA said.

Friday was highlighted by the 2024 National Optometry Hall of Fame Induction & AOA Advocacy Awards ceremony, the EyeTalks series of panel-style discussions on cutting-edge trends and clinical solutions for every office, and the Celebration of Optometry closing party, the AOA said.

Optometry’s Meeting will be held in Minneapolis, Minn., next year at the Minneapolis Convention Center from June 25-28, 2025, in partnership with the World Council of Optometry to host the 5th World Congress of Optometry, according to the AOA.

Most Ocular Injuries Related to Nerf-type Gun Projectiles Have Favorable Prognoses

Healio | By Kate Young Fact checked by Heather Biele

June 26, 2024

Although most ocular injuries from Nerf-type gun projectiles are limited to the anterior segment and have good long-term visual outcomes, researchers strongly advise safety eye wear during use.

“As Nerf-type guns are widely used by children and adolescents, the public must be made aware of potential for serious ocular injuries,” Julia Maida, a student at Illinois College of Optometry (ICO), said in an online poster presentation as part of Optometry’s Meeting.

With limited data on prevalence, ocular findings and visual outcomes associated with these injuries, Maida and colleagues conducted a retrospective chart review of electronic medical records from 35 patients aged 3 to 56 years (average age, 24 years) at Illinois Eye Institute. None of the patients were wearing protective eye wear when they sustained their injuries, all of which were unilateral.

According to results, 70% of patients were diagnosed with anterior uveitis, 14% with corneal abrasion and 10% with edematous adnexa or eyelids. Other injuries included subconjunctival hemorrhage and hyphemia.

All 21 patients with anterior uveitis were treated with a topical steroid, and 11 were also given a cholinergic antagonist for comfort and pain relief.

The average best-corrected visual acuity at baseline was 20/30, ranging from 20/20 to 20/150, and all patients who attended their follow-up visit eventually returned to 20/20.

“Reports on this topic in the past have looked at individual cases, which typically led to worse ocular injuries with worse prognosis,” Samantha Rivet, study author and ICO student, said in the presentation. “In contrast to this, we noted that when looking at a larger patient pool, most of the injuries were limited to the anterior segment with a good overall visual prognosis and no long-term complications.”

She added, “With this being said, we’d like to advise consumers to use safety eye wear when using this product.”

Tear Evaporation Plays Role in Dry Eye Disease

— Perfluorohexyloctane may slow evaporation to reduce dry eye.

Optometry Times | By Mile Brujic, OD, FAAO

June 25, 2024

Dry eye is a common disease. National statistics suggest that anywhere from 5% to 15% of the general population has some form of dry eye disease.1 These are simply estimates; it is very likely that the incidence of dry eye is greatly underestimated.

Of those living with dry eye, approximately 9 in 10 are experiencing evaporative dry eye.2 If not addressed, excessive tear evaporation may lead to worsening of the condition. It can trigger a cycle of inflammation and ocular surface damage that is not only painful but expensive; the annual cost of dry eye to the US economy was estimated at approximately $55 billion.3



Several factors contribute to the increasing prevalence of dry eye disease. As eye care providers, we are seeing the impact of increased screen time, as computers have become the default way of working and spending leisure time for millions of people. Use of desktops, laptops, iPads and tablets, smartphones, and nearly every other digital device has a potentially important effect.

Climate change, taking the form of extreme weather and other environmental factors, also likely plays a role in the recent pervasiveness of dry eye disease.4 Relative differences in humidity levels, some based on normal seasonal changes, can exacerbate the condition by increasing tear evaporation and decreasing the stability of the tear film. Even something as simple as a patient going from warm air to cold or cold to warm, quite common in the extremes of summer and winter temperatures, will affect the ocular surface. But these factors alone do not explain the prevalence of dry eye disease.

I have been practicing optometry for 22 years. When I graduated from optometry school, we thought that insufficient tear production caused most dry eye symptoms. That belief led to the widespread practice of lubricating the eye with artificial tears. If a patient did not improve with one type of artificial tear, we gave them another to try.

However, a concept started to gain currency over the next 2 decades, championed by Korb and Blackie, among others.5 They believed dry eye might not necessarily be caused by the eye’s failure to produce enough tears; instead, the condition may be due to an imbalance of the tears being produced. They theorized that the tears produced in patients suffering from dry eye might not be held on the eyes appropriately.

As a result, optometrists started examining how tears are maintained on the ocular surface via the eye’s lipid layer. This led to the realization that dry eye might be based on the health of the meibomian glands, which produce the outermost layer of the tear film: the lipid layer.

One of the most common etiologies of dry eye that we encounter in our practices is evaporative dry eye, which we know is caused by meibomian gland dysfunction. Although not all the cases we see in patients are evaporative dry eye, most dry eye cases have an evaporative component.

Around 1 billion people globally have meibomian gland dysfunction, which often impacts the composition and thickness of the lipid layer.6 When a patient’s lipid layer is compromised, increased dry eye symptoms can be heavily triggered by the environmental conditions a patient faces. Increased screen use and environmental factors, along with dry winters, the impact of air conditioning during the summer, and even exposure to UV rays, are examples of how the physical environment canexacerbate dry eye.

In a worst-case scenario, dry eye can cause chronic long-term anatomical changes. The mildest of these are visual disturbances/visual tasking and corneal staining, but over time we can see corneal scarring and a reduction in best corrected visual acuity. We can also see long-term eyelid margin changes, and corneal changes can occur that can become permanent.

Judge Rules in Favor of AHA Vacating HHS Online Tracking 'Bulletin' as Unlawful and Beyond Agency Authority

American Hospital Association | News

June 20, 2024

A United States District Court Judge in Texas today ruled in favor of the AHA, Texas Hospital Association, and hospital plaintiffs, agreeing that Department of Health and Human Services “bulletins” that restrict health care providers from using standard third-party web technologies that capture IP addresses on portions of their public-facing webpages were unlawful final rules and vacating the March 2024 Revised Bulletin.

“It’s easy for eyes to glaze over at a thirty-page opinion discussing the administrative esoterica accordant with HIPAA compliance,” United States District Court Judge Mark Pittman wrote today. “But this case isn’t really about HIPAA, the Proscribed Combination, or the proper nomenclature for PHI in the Digital Age. Rather, this is a case about power.… While the Proscribed Combination may be trivial to HHS, it isn’t for covered entities diligently attempting to comply with HIPAA’s requirements.… The Court GRANTS the Hospitals’ request for declaratory judgment and DECLARES that the Proscribed Combination, as set forth in the HHS Bulletin of March 18, 2024, is UNLAWFUL, as it was promulgated in clear excess of HHS’s authority under HIPAA.”

The AHA, joined by the Texas Hospital Association, Texas Health Resources, and United Regional Health Care System, last November sued the federal government to bar enforcement of an unlawful rule, masquerading as guidance, that has upended hospitals’ and health systems’ ability to share health care information with the communities they serve and analyze their own website traffic to enhance access to care and public health. In response to the lawsuit, HHS OCR in March issued updated guidance for HIPAA-covered entities and business associates on using online tracking technologies. The AHA contended the revised bulletin was still unlawful, and Judge Pittman agreed in today’s ruling.

AHA General Counsel Chad Golder stated, “For more than a year, the AHA has been telling the Office for Civil Rights that its ‘Online Tracking Bulletin’ was both unlawful and harmful to patients and communities. We regret that we were forced to sue OCR, but we are pleased that the Court today agreed with the AHA and held that OCR does not have ‘interpretive carte blanche to justify whatever it wants irrespective of violence to HIPAA’s text.’ As a result of today’s decision, hospitals and health systems will again be able to rely on these important technologies to provide their communities with reliable, accurate health care information.”

Seventeen state hospital associations and 30 hospitals and health systems filed friend-of-the-court briefs supporting AHA and its co-plaintiffs in this lawsuit.

Healthcare Cyberattacks Are Costing an Average of $11 Million Per Breach

— Ransomware attacks have dominated, accounting for over 70% of healthcare cyberattacks in the past two years.

Healthcare Finance | By Nathan Eddy

June 24, 2024

The global healthcare sector experienced a staggering 1,613 cyberattacks per week in the first three quarters of 2023, nearly four times the global average, and a significant increase from the same period the previous year, according to a KnowBe4 report.

This surge has contributed to a steep rise in cyberattack costs for healthcare organizations, with the average breach cost nearing $11 million – more than three times the global average – making healthcare the costliest sector for cyberattacks.

Ransomware attacks have dominated, accounting for over 70% of successful cyberattacks on healthcare organizations in the past two years.

Phishing and social engineering tactics are the primary methods used to initiate the majority of cyberattacks, with estimates suggesting that 79% to 91% of attacks begin this way.

The report noted employees in large healthcare organizations have a 51.4% likelihood of falling victim to phishing emails, giving cybercriminals a better than even chance of successfully breaching these institutions.

"Healthcare is already expensive, partly due to the cost of equipment and consumables needed to diagnose and treat illnesses and injuries," said Erich Kron, security awareness advocate at KnowBe4. "Paying a multi-million-dollar ransom, plus the cost of a security team brought in for incident response, is a significant outlay of funds."

He added this is especially true given the huge size of modern healthcare systems that may be connected across the country.

WHY THIS MATTERS

Healthcare organizations collect and process a huge amount of sensitive data – and cybercriminals know it.

The risk of regulatory fines and lawsuits related to the leakage of this information is monumental, which allows attackers to leverage the risk to demand large ransoms.

The healthcare industry is also very computer-driven, with a huge number of network-connected devices and computer systems online at any time.

"After an attack, it is critical to make sure these devices do not contain backdoors or other malware that will allow attackers to reinfect the network again in the future," Kron said. "This all takes time, skills and money to accomplish."

He added the sheer volume of attacks on something as critical as healthcare, combined with the extremely high click rates in the industry, paints an unfavorable picture for the future of healthcare data.

"Not only is data at risk, but healthcare workers are also often overwhelmed with patient loads and the loss of technology further burdens them, possibly to the point of breaking," he cautioned. "This could result in dangerous mistakes being made, not out of malice or carelessness, but out of exhaustion."

THE LARGER TREND



Change Healthcare, Ascension and Kaiser Foundation Health Plan are among the most recent targets of far-reaching cyberattacks, the fallout from which is likely to continue even as new breaches arise.

Kron said with attacks becoming more common – and apparently more damaging – healthcare organizations need to take a focus on cybersecurity in the same way they focus on safety.

"At the end of the day, a successful ransomware attack is a safety concern for the patients and employees and must be treated as such," he said.

KnowBe4, based in Clearwater, Florida, offers security awareness training and simulated phishing platforms. It is used by more than 65,000 organizations worldwide, according to the company.

From Kron's perspective, it is critically important that healthcare organizations look closely at their specific risks and develop a plan to address them.

"Not every organization is the same, so the critical risks may vary from place to place and it is important to not spend financial and human resources addressing low-risk items," Kron said.

He explained a focus on human risk is important – most ransomware attacks start with a phishing email directed at an employee. "It is also relatively low-cost and can be tied in many ways to existing safety programs," he said.

The goal is to improve the security culture of the organization in the same way to make sure employees think about keeping patients safe.

In addition, healthcare organizations should have robust incident response plans in place and should test them often.

Kron explained many organizations have found themselves unable to make decisions, figure out processes, or contact key decision-makers while dealing with an incident.

"A lot of time that could be used to stop the spread of malware or start recovering is wasted while figuring out what to do next," he said. "A solid plan that is tested is invaluable in these situations."