Optometrist Perspective by Harvey Yamamoto, OD

Harvey Yamamoto, ODJust a few days ago, my wife and I was listening to the radio on the way to work when we heard a very interesting story.  Some professor began to collect data on 1,500 of the smartest kids who graduated from a college in California in 1921.  He followed their careers until he passed away in 1956 then some one else took over.  Then in 1999, that person died and then the person being interviewed on the radio took over for the last 11 years.  The interviewer asked one question that caught my attention:  “Did you discover the secret to long life?”  The gentleman said, “Yes”.   We turned up the volume at this point and continued to listen.  He said, “Those who worked very hard non-stop lived the longest.”  Those who retired early died shortly after retirement.  Men died shortly after losing their spouse while women went on living without their spouse for many years.  Mental dementia occurred in people who stopped working.  My wife looked at me and said, “No worries. You are never going to retire.”  End of story.

Just the other day, I received a fax from one of our healthcare vendors with this note on the Diabetes diet, exercise & medication cycle “Importance of Diabetes Tests”.  The message stated that we now have nearly 25+ million Americans with diabetes and another 57 million with pre-diabetes.  The study has found that there are a large number of children being diagnosed with diabetes due to pediatric obesity.  In our practice, diabetes affects nearly 1 out of every 5 adults, far greater numbers than glaucoma patients.

Over the years that I have been in practice, I have studied this disease by talking with my doctor and reading whatever I could by going online.  We also have many dietitians as patients and they have become a wonderful resource of knowledge.  For the past 5 years, we have begun to give medical counsel to our diabetic patients in the form of diet, exercise & losing weight.  The diet portion of our conversation centers on what they can and should not be eating.  It is always shocking to us when we find patients that have lost control of their condition primarily based upon their eating habits.  Our patients are surprised to discover that we have a tremendous knowledge about this subject matter and they seem to listen intently to our advice.

Today, we have a number of M.D.’s that have begun to send us their diabetic patients for counsel.  We cover the results of the blood work and give advice on the things that they can do to increase their compliance and decrease their blood glucose levels.  One of the main tools that we utilize in our counsel is showing our patients their digital retinal photos.  During this portion of the exam, we go over every aspect of their retina.  These sessions have been extremely successful as they become more compliant with their health.  Diabetes Food PyramidAs eyecare practitioners if we expect to become a small part of our patients “team” then we must educate ourselves as much as possible about this lifelong disease.

Blood tests: We inform our patients that their LDL levels should be less than 100 mg/dL, their HDL levels should be greater than 40 mg/dL & their triglycerides should be less than 150 mg/dL.  We cover blood pressure readings and the need for having A1C blood work performed at least annually if not sooner if they are not under control.  Many of our patients have come to rely on our counsel to keep their health status in check.  We feel that it is our duty to improve our patient’s quality of life as much as we can.

Cholesterol: We have found that most of our patients when questioned about their cholesterol will confess that their physicians have told them about this issue.  At that portion of the exam, I always like to take a few minutes to talk about the food groups that they are eating on a daily basis.  We always discover during this portion of the exam the food groups that they should not be eating.  It’s fun to see these patients the following year and they report that they have lost weight and feel so much better because they now have gotten their blood glucose under control.

So don’t be shy about spending a few minutes with your diabetic patients and share with them your good counsel on diet & exercise.  This has been the greatest practice builder that I have ever found.

Ortho-K: It pleases me to see that many of my readers have begun to follow my advice and are now fitting many patients with Ortho-K lenses.  It is not only a great practice builder but it adds greatly to the bottom line.  GP Specialists reports that since my articles about fitting high myopic patients with the GOV 4 lenses that they have noted a large increase of orders from my readers.  The GOV 4 lenses will correct up to -10.00 of correction.  It’s a thrilling experience when you can change a person’s life by helping them see without glasses during their day time activities.

GP Specialists: I have been conducting some serious R&D by fitting our many cone patients with custom designed toric soft lenses.  GP Specialists has become our lab of choice in many regards.  Their turn around time is pretty awesome and our cone patients all seem to prefer soft lenses over the gas perm lenses when given the choice.  We caution these patients about compromising their visual acuity when they exchange their gas perm lenses for soft lenses but they are more than willing to do the exchange.  The motto is, “Comfort is very important to our patients”.

Thank you for the many referrals that many of my readers have been sending us for their difficult to fit cones and high cylinder GP Specialists/ BioCureve Logocorrection.  GP Specialists/Biocurve has made us custom toric lenses up to -10.00 cylinder with great success.  We also get our fair share of post-Lasik patients that we have fitted successfully with Biocurve lenses.  It’s always so exciting for us to see the smile flash across our patient’s faces when they pick up their custom soft lenses.

We are now in the infant stages of Phase II of our cone study with custom soft lenses.  Hopefully, I will have more information by sometime next year on what our studies have been able to uncover.  We have never had so much excitement with any R&D projects before we began our quest to find the solution to fitting our advanced cones with soft lenses.  Phase II began in early September of 2011 and we have dedicated 12 months to this project.  We have learned much but we still have more to learn.  Only by trial and error do we learn.  The failures have been many but with each such failure comes new knowledge.

Many thanks to Biocurve for their assistance in helping us through the maze of discovery.  The progress has been much slower than we have anticipated but we are beginning to see the light at the end of the tunnel.   Many thanks also to our cone patients who have allowed us to use their eyes in our long process of discovery.

Medibeads System: During my last editorial, I touched upon the new sensation in our practice.  Since the last editorial I spoke about my daughters wish to have the Medibead system to be made in a single design so she could heat & treat just the one affected eye and her daughter could watch T.V. while being treated.  Well, the kind folks at Bruder Healthcare complied and sent us one sample for just one eye.  What a difference that has made!  Bruder is now making that available and GP Specialists (800-889-0379) Bruder Healthcare Medibeads Heat Wrapwill be more than happy to order these for you as they are non-stock items.  The cost to you will be $10.00 and should retail to your patients for $25.00.

These systems are patent pending and are washable, reusable, odor-free, and will not support bacterial growth which is a huge plus for us eyecare practitioners.  As I wrote during the last editorial, these systems comprised of medibeads draw moisture from the air and release it as they clean with deep-penetrating moist heat when microwaved (20 seconds). No need to add water.

The time released moist heat from the MediBeads delivers therapeutic levels of treatment for up to 30 minutes.  One can even throw them in the freezer for effective cold therapy.

When a patient complains in our practice about sinus problems, dry eyes or styes we recommend these MediBeads.  GP Specialists reports that they quickly ran out of stock during the first 3 days after my editorial hit the stands but they are fully stocked to fill all back orders and new orders.  I recommend stocking 6 of these in your practice.  When placing your orders via GP Specialists ask for the Eye Hydrating Compress.


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