Eyepic Eye Care

Age-related Macular Degeneration (AMD), What is it?

Age-related macular degeneration (AMD) is the leading cause of blindness, affecting more than 10 million Americans, more than glaucoma and cataracts combined. This ocular condition is caused by the deterioration of the central portion of the retina, known as the macula. The Macula is responsible for focusing central vision, the ability to read, drive a car, recognize faces or colors, and seeing fine details. This is a common ocular condition for patients over the age of 50. New eye care technology helps to diagnose AMD in minutes.

Eye Care Technology

Thanks to technological evolutions in the eye care industry, eye care practitioners can now use high-tech devices to diagnose early signs of age-related macular degeneration. At Eyepic, we believe that investing in the latest technology directly benefits our patients’ health. Normally during our comprehensive medical eye exams, which include an OCT (Optical Coherence Tomography), we can diagnose sight-threatening eye conditions such as AMD in their early stages long before visible symptoms appear. Now in the addition of the Maculogix AdaptDx Pro, we can diagnose AMD three years before a doctor can see it in the normal eye. This is because the Maculogix AdaptDx Pro accurately measures dark adaptation speed.

Dark Adaptation

Dark adaptation is the automatic adjustment of the eye from bright light to low light, involving reflex dilation of the pupil. Dark adaptation speed is a key metric to diagnosing early stages of AMD because the healthy eye adapts relatively quickly from bright light to darkness while the process can be impeded in the eyes with AMD.

At the early stages of AMD, rods (photoreceptor cells in the retina that enable good vision in low light) function starts to deteriorate before cones (photoreceptor cells in the retina that enable good vision in bright light) function. As AMD evolves, cones start to deteriorate, which leads to a decrease in visual acuity. Rods are affected earlier and more critically throughout the disease.

The eye should be able to adapt from bright light to darkness within 6.5 minutes. Anything above this represents a breakdown in the rods. Simply put, the quicker the dark adaptation speed is, the better it is.

Maculogix

We invested in Maculogix’ AdaptDX Pro to test patients for AMD. With 20 years of clinical research behind it, this non-invasive device is one of the most accurate tools to detect early signs of AMD three years prior to any visible signs on the retina. It automatically aligns with the eye to capture an accurate measurement of dark adaptation speed. Routine tests with Maculogix’ AdaptDX take about 5 min (compared to around an hour or more with other devices).

Our Patients First

Our patients’ health is our priority. Therefore, investing in advanced eye care technology is an obvious choice for us. It allows us to diagnose almost any eye condition in its early stages, react faster, and formulate the appropriate treatment plans in order to preserve our patients’ vision quality.

Schedule your AMD test today!

In the United States, approximately 120,000 people are blind from glaucoma. Glaucoma accounts for around 12% of the causes of blindness. Our leading NYC Optometrist Dr. Vu is telling us more about glaucoma, how to diagnose it, its risks, treatment, and why it is important to diagnose glaucoma early.

What is Glaucoma?

Glaucoma is a group of eye conditions that damage the optic nerve. The optic nerve is a collection of neurotransmitters that acts like an electric cable sending information to the brain for visual interpretation. The optic nerve can become damaged either because of a higher or lower-than-normal pressure within the eyes and/or poor blood circulation to the optic nerve from vascular conditions like diabetes and hypertension. The optic nerve is vital for good vision.

Some common types of Glaucoma:

1 – Open Angle Glaucoma

With open-angle glaucoma, the intraocular pressure (IOP) of the eye rises because the normal amount of eye fluid cannot drain properly.  The drainage is called the angle and it lies between the cornea and iris which in the case of open-angle glaucoma is open but the trabecular meshwork within the angle is partially blocked. If it is not diagnosed and treated in the early stages patients will gradually lose peripheral vision because of the increased pressure that damages the optic nerve.

2 – Closed Angle Glaucoma

Closed-angle glaucoma is the result of the iris bulging forward which diminishes or blocks the drainage angle of the eye; formed between the cornea and iris. If this occurs, fluid cannot circulate correctly, and pressure increases. If the drainage angle gets completely blocked, eye pressure increases very quickly, this is known as an acute attack. A patient with an acute attack needs to seek his/her ophthalmologist helps as fast as possible or he/she can go blind.

Some signs of acute attack:

•         Sudden severe eye pain
•         Sudden blurry vision
•         Headaches
•         Nausea
•         Vomiting
•         Seeing rainbow-colored rings or halos around lights

3- Narrow-Angle Glaucoma

Narrow-angle glaucoma occurs when the drainage angle, located between the iris and cornea becomes restricted much like closed-angle glaucoma as mentioned above, however, some patients are predisposed to narrow-angle glaucoma, they are but not limited to:

• Older patients (older than 60) with dense cataracts
• Asian and Indian descent
• Family History of Narrow Angle Glaucoma
• Hyperopia (far-sightedness)

Risk factors

“Glaucoma can be diagnosed at any age, though it may be more common in adults over the age of 40. Risk factors include; family history, far-sightedness, high levels of near-sightedness, steroid responders, and vascular conditions like diabetes and hypertension.  During the early stages, patients are unaware that they are losing their peripheral vision because they simply turn their heads to see. That is why it is important to have annual comprehensive eye exams and screenings.  Remember there is no cure for glaucoma so it is best when diagnosed early for better control and management.” Says Dr. Vu, our leading NYC optometrist.

Diagnosis

“Because we have an integrated eye care practice (Ophthalmologists and Optometrists under one roof) it is easier for us to diagnose and manage glaucoma treatment. To diagnose glaucoma, our doctors measure the eye pressure, inspect the eye’s drainage angle, examine your optic nerve, test your peripheral vision, and measure the thickness of the cornea” says Dr. Vu.

Treatment

 There are a few different types of treatments for glaucoma including eye drops, laser treatment, and surgery.

Medication– It is very common for optometrists and ophthalmologists to prescribe eye drops. The eye drops will lower the pressure in the eye and prevent damage to the optic nerve.

Laser Treatment – It is a simple procedure that doctors can do in their offices. Lasers can either create an opening in a narrow or closed-angle or aid in the fluid drainage in the angle

Surgery – In case the medication and laser treatments do not work the ophthalmologist can perform surgery, placing implants to aid in reducing the pressure within the eye.

The importance of eye exams

“According to the World Health Organization, glaucoma is the second leading cause of blindness in the world. Glaucoma can have no symptoms for a long period of time and when vision loss starts, it begins with peripheral vision. This means, if you have glaucoma you might not notice anything until significant vision loss or an acute attack. Therefore, getting a regular eye exam is important. It can help your eye doctor detect glaucoma in the early stages and start adequate treatment and management.  Early detection is key in preserving vision and avoiding irreversible vision loss.” Says Dr. Vu, our leading NYC Optometrist.

Improving end-to-end customer experience

Patients’ experiences do not only happen when patients see their eye care provider. The end-to-end customer experience has many touchpoints and interactions between patients and eye care practices. These touchpoints and interactions are opportunities to enhance customers’ experiences and ultimately create a positive image for the practice. Here are some steps to improve patients’ experiences:

Giving the best eye care services and products

Selecting designer and economical eyeglasses, quality lenses, advanced medical equipment, having an optical lab on-premises, and all eye care services under one roof all contribute to a high-quality customer experience. When patients are greeted by a clean practice in which they can have all services they need without having to be referred somewhere else; it makes it easier for them to enjoy the eye care process.

For example, if a patient comes for an eye exam and the doctor is able to detect a minor retinal hole-thanks to the advanced technology and needs to be referred to an ophthalmologist for laser surgery it will save the patient precious time if an ophthalmologist is already on-premise.  Patients often feel more comfortable knowing they do not have to re-explain their health history, preferences, and concerns at another practice. Another example would be a patient coming for an updated eyeglass exam because he/she broke her glasses besides the huge selection he/she can have a fast turnaround on a new pair of glasses all thanks to an integrated optical lab on-premise.

The choice of products and services offered by an eye care practice directly impact customer experience. Having as many options available with high-quality equipment will help reduce possible stress, anxiety, and any possible negative outcomes a patient can have. Investing in great products and services will help create a sustainable eye care practice.

Scheduling

Scheduling is the first point of engagement patients have with an eye care practice. During this touchpoint, it is important to minimize the wait time, to schedule the appointment, collect all necessary data to determine the urgency of the appointment, and adapt as much as possible to the patient’s date and time request. Having a representative to send appointment confirmations, instructions, and reminders are also very important to personalize patients’ experiences. If the scheduling process is well optimized, patients will feel their time is respected and the practice knows what they are doing. Which is the first step to create high-quality customer service.

Check-in

When a patient comes to check in for a scheduled appointment or a walk-in visit, it is the first in-person touchpoint with the eye care provider. Patients will start developing their opinion based on how they are greeted, how the practice seems to be organized, and the atmosphere of the practice. If the staff is very friendly, the facility clean, and the process enjoyable, patients will start to create a positive opinion of the practice.

The doctor’s role

Once a patient has checked in he or she will ultimately have to see a doctor. The role of the doctor is to make the patients feel comfortable, listen, and address their concerns. For example, a patient can come for an annual eye exam and actively not say anything. If the doctor does not ask the right questions, we might not know that the patient actually has blurry vision or any other symptoms that can be related to underlying eye conditions. When doctors show they care about patients, empathize with their problems, it shows that the practice genuinely cares about the community.

Post-appointment follow-up

If patients need a follow-up appointment, or another eye care service, it is always a good idea to make it personal. A practice can have dedicated staff to contact patients over the phone, ask them how they are feeling, give them care recommendations until the follow-up, ask them if they have any questions, and show them that the practice deeply cares about them and want them to feel happy, relaxed and cared for.

High-quality customer service

Providing high-quality customer service in eye care is an end-to-end process. Every employee of an eye care practice has to acknowledge and embrace his or her responsibility to provide great customer service. The goal of an eye care provider is to see patients as people and not only as numbers. When this happens, the staff becomes more empathetic, processes are improved to respect patients’ time, and the overall customer experience is optimized.

Improving end-to-end customer experience

Eyepic has recently been listed by 71three as one of the best Optometrist websites; we are so happy that our hard work has been recognized. We are a brick and mortar serving the New York Metropolitan area without an eCommerce as of yet. So why did we invest in building a great website if our eye care practice conducts business in person?

The world is online

Referrals work well in the eye care industry, but the world is online. A website is often the first impression of the practice. If potential clients find themselves on an outdated, lackluster website that is not user-friendly they will most likely exit and view another without ever contacting the practice. When an internet user leaves a website without going to a second page, it is called bounce rate. By redesigning our website to make it more professional and user friendly, we dropped our bounce rate by 15%. The seamless design attracted most users to our “homepage” and because the website was easily navigated potential clients then continued on to our “contact us” page or our “request appointment” page. Having a good website for your business will no doubt increase your chances of attracting new clients.

Most people are now browsing on their mobile devices. This means that a professional website should be optimized for mobile viewing to ensure that a user can navigate the website; if it is quick to load and formatted for a smaller screen the greater the chances that it can attract new clients. Internet searches and website visits are used by consumers more than any other method of research to contact businesses.

Brand credibility

A website will validate and establish brand credibility – or it can not. The first impression is a lasting one and your website is most often the face of your practice. Our first website had a design that did not reflect our mission and vision and potential clients picked up on that.  When we evaluated our credibility to potential users with surveys we found that many users labeled our website as a “scam” which could not be farther from the truth. We provide high end, detailed-oriented eye care with the most up to date technology. We had invested in the technology, staff, doctors, products, and services but it did not translate to a thriving practice because our first impression on the internet was untrustworthy. We had to take a step back and create a website that mirrored the in-person experience.

All digital roads lead to your website

We know that most people search online to find the products or services they need. There are many marketing strategies to reach internet users. A company can do online advertising, create SEO strategies (to rank in the first search engine pages), use social media as a means of communication, create email marketing campaigns, and so on. The only issue is that all these strategies will eventually lead users back to your website and/or associated landing pages. Which makes all your investments in digital marketing fruitless unless your website is polished and professional.

Customer service

We live in a digital world in which customer service is key to sustainable growth. Clients can leave reviews online, refer your business to friends, and help your business grow. By providing them with a user-friendly website, you ensure that they get the best experience even before reaching out to your practice or coming to the physical locations. Your website will show them you care about your business and that you can be trusted.

Get ahead of your competition

When you invest in a great website alongside marketing to develop your online presence, you can get ahead of your competition. With long-term marketing efforts, your website will grow and rank better on Google and other search engines. This means greater exposure to users looking for your service and/or product categories before your competitors. Internet users rarely go on the second search engine page to find what they are looking for. If your website becomes authoritarian online, you have higher chances to convert new clients and have a successful business.

A customer service industry

The eye care field is also a customer service industry. Eyecare patient and provider relationships are based on the quality and uniqueness of interactions between staff members, doctors, and patients. Creating a great patient experience starts by treating patients as if they are a part of the family and not as a customer.

The entire eye care staff: doctors, opticians, technicians, and front desk are customer service representatives. The experience and knowledge they give to patients will directly impact the sustainability of the practice for years to come.

First touchpoint

Great customer experience starts when patients first reach out to eye care providers. At this time, everything the staff does will set the quality of eye care services. If patients experience poor customer service before seeing the doctors this will set the patient up in a negative frame of mind regardless of the quality of care that was provided by the doctor. The goal of an eye care practice is to provide high—quality patient experience to patients at every step of the eye care process. Eye care practitioners should go above and beyond patients’ expectations to set their practices up for long-term success.

Happy patients, happy doctors

Happy patients who experience a seamless eye care process and high-quality services are more likely to return to the same eye doctor. They are also likely to recommend the practice to friends and family. Great patient experience also leads to good online reviews. According to surveys, 70% of potential patients will choose a healthcare practitioner over another depending on their online reviews. The reputation of an eye care practice will be critical in determining whether potential patients reach out or not.

Data collection

How a practice collects and uses data also directly impacts patient experiences. If data is not accurately collected and used, mistakes are made and it can become a hurdle to achieving a high-quality patient experience. For example, if patients leave with the wrong eyeglass prescriptions because of errors in the process, they will not see well with the glasses, they can experience headaches, and they will return unhappy to change their glasses. The thoroughness of staff and doctors is key to achieving excellence in patient experiences.

Customer service and patients

Customer service is highly important to patients. Patients seek eye care services because it is a necessity. Yes, the process can be taxing. Imagine a patient who does not have glasses and comes to get an eye exam. After the eye exam, the doctor tells him that he needs to wear glasses or contact lenses every day because he has high myopia. He informs him that it is important to follow his recommendations because high myopia can lead to severe eye conditions such as retinal tears and holes. This patient’s life just changed. If he has a great customer experience he will digest the pill better than if a poor customer experience adds up to the bad news. Patients want their eye care providers to show they care about them. They want them to empathize with their problems.

By providing high-quality customer service to patients, eye care practitioners ensure the stability and longevity of their practice. It creates a solid foundation to build up long-term relationships with patients, which leads to practice profitability and sustainability.

MiSight for Myopia Control

Myopia is increasingly becoming a public health concern, affecting around 35% of adults in the United States. It is a refractive condition where the light is focused in front of the retina because the eye is “too long” hence “long vision” is blurry, in short, the patient is nearsighted.

A study conducted by the journal of ophthalmology predicts that by 2050 4.8 billion people worldwide will have myopia of which 938 million will have high myopia (defined as a prescription starting at -5.00 D). The majority of cases are in the United States and Asia.

The higher the prescription the thinner the retina becomes which greatly increases the chances of developing macular degeneration, macular hole, retinal detachment, damage to the optic nerve aka glaucoma, and cataracts (PSC) because of a compromised retina. This is precisely why we need to control it and commence treatment options at an early age.

Multifocal contact lenses have shown great promise in slowing the progression of myopia in children because it addresses the axial length of the eye. Addressing axial elongation helps reduce the risk of myopia-related ocular issues as previously mentioned.

One type of multifocal contact lens – MiSight – was studied over three years on children with myopia aged 8 to 12. Two groups of children were randomly selected to participate in this study. One group wore normal contact lenses, and the other group wore MiSight soft multifocal contact lenses. After 36 months, the soft multifocal contact lenses proved that they significantly reduce the progression of myopia.

This figure demonstrates that MiSight contact lenses slow the progression of myopia over a three-year period. The progression in the cycloplegic spherical is less by 69% after one year and 59% after two and three years with the MiSight contact lenses.

MiSight Comfort

90% of children in the study reported that the lenses were easy to put on the eyes. 97% of them also say they liked wearing their contact lenses compared to only 57% saying they like wearing their eyeglasses.

Recommendation on MiSight

The findings of the 3-year clinical study prove that myopia is significantly slowed by MiSight contact lenses. This is because MiSight lenses target axial elongation. During this 3-year study, no serious eye issues happened to the children. This proves the safety of soft contact lenses for children.

MiSight contact lenses help children with this condition see better and live a better life. By slowing the progression of myopia early in life, soft contact lenses can help reduce the risk of life-threatening eye conditions. It

What is Transcranial Doppler (TCD)?

A Transcranial Doppler (TCD) is a quick (around 10 minutes), non-invasive, and painless test for patients of any age. It is a safe ultrasound that requires no dyes or radiation to look at all the major arteries and vessels; specifically from the carotid artery to the ophthalmic arteries, from an ocular health standpoint.

How does TCD work?

TCD is based on the principle of the doppler effect. The doppler probe creates ultrasound waves that move through blood cells within the vessels. The ultrasound waves create a recorded pattern and are analyzed by computer programs. Additionally, the information collected by the programs determines how the blood flows through the vessels; blood velocity. Blood velocity varies depending on age, gender, carbon dioxide levels, blood pressure, mental, and physical activity among other things. Differences in blood flow velocity should be interpreted considering these variables. TCD should be conducted with the patients at rest, not moving and not speaking.

Purpose of a TCD?

The purpose of this test is to assess patients’ risks of stroke, diagnosis of bleeding, and spasm of the blood vessels. A TCD measures the Ophthalmic Artery and Cerebral Vascular blood flow. As a result, an eye doctor can recommend a TCD when patients experience symptoms and conditions such as:

–     Sudden Vision Loss

–     Migraines

–     Visual Field Defect and Disturbance

–     History of Strokes

–     Blurry Vision

–     Double Vision

–     Glaucoma

–     Cardiovascular System Complications

–     Carotid Artery Disease

–     Hypertensive Retinopathy

–     Diabetic Retinopathy

–     Macular Degeneration

TCD is an essential and inexpensive tool used to diagnose and prevent a number of cerebrovascular disorders. Having this tool in our arsenal bridges the gap between a PCP/ Cardiologist and a Primary Eye Care Physician; allowing for transparency of information.  All physicians have a better understanding of a patients’ systemic health and how that may affect his/her ocular health or vice versa.

Integrated eye care

With so many eye conditions left untreated or undiagnosed and a decreasing number of board-certified ophthalmologists, eye care practitioners need to turn to integrated eye care now more than ever. Integrating Ophthalmology (MD), Optometry (OD), and Opticianry under one roof is the catalyst that is changing the future of eye care.

Doctor-Patient relationship

Relationships with patients are the key to an integrated eye care practice. Optometrists have an ongoing relationship with patients; oftentimes built over years of trust. Optometrists know the medical history, vision needs, and expectations. If optometrists are able to have a working relationship with ophthalmologists, then patient care and experience are undoubtedly enhanced. Take for example a long-time patient that has seen the optometrist minimally annually and has to have cataract surgery. Only his optometrist has an extensive history of spectacle prescriptions and understands what the patient desires. This valuable relationship and knowledge will guarantee that the patient’s expectations are set and met for cataract surgery. If both fields integrate under one roof, it makes it easy for patients to quickly get the care they need. Also to be able to have an open discussion with both practitioners.

System efficiency

With both ODs and MDs integrated into open practice, the electronic medical record system becomes more efficient. Immediately after a patient’s referral to an ophthalmologist, all doctors can see the diagnosis and ocular history of the patient; there is no waiting time between referral letters.

Environment fertile for excellence

Having an integrated eye care practice also creates a fertile environment for excellence. Optometrists become primary care providers for patients, which puts them in a leadership role to manage patients. For ophthalmologists, they can now rely on optometrists to continue management allowing them to focus on the next surgical case. The more surgery they do, the better they become at surgery, and the safer it is for patients.

Another pro of having an integrated practice is the well-being it provides to patients. They already know the practice and have no need of going somewhere new. They save time by not traveling further to get specialty care that may be reinventing the wheel in the sense of re-doing some of the auxiliary tests/examinations.

The bonus point for an integrated eye care practice is to add in-office opticians. Opticians are trained technicians who administer optometrists’ spectacle prescriptions. They cut optical lenses, and make sure patients receive the optical corrections they need. Having an optical lab on-premises allows record time services. Patients can come in to see their optometrist, get their prescriptions, and receive optical eyeglasses in record time.

Integrated eye care takeaway

With constant reforms in the healthcare industry, practices with multiple practitioners integrated can adapt quickly to changes. Anyone who knows how to operate integrated eye care will succeed. They will have the ability to react faster to healthcare trends, facilitate patients’ lives, give better eye care, and have the ideal environment to hone their skills or subspecialty skills.