Serving the Changing Visual Needs of Women Patients

Providing eyecare that serves the needs of women who are pregnant or experiencing other hormonal changes meets a vital need and projects a family-friendly message.

Women sometimes have eyecare challenges that differ from men due to the hormonal changes that they experience during pregnancy and at other times in their life such as through the use of contraceptive pills and during menopause. High-quality artificial tears and switching to a new silicone hydrogel daily replacement lens will become important to prevent excessive inflammation or irritation.

Many of your patients will experience similar symptoms due to hormonal changes. Here are some key points to consider about keeping women’s eyes comfortable through hormonal changes including pregnancy.

In Exam Room: Educate and Reassure Patient

In order not to assume anything, do not address pregnancy eyecare concerns until a woman has told me she is pregnant or asks about it on her own before then. Reassure the patient that pregnancy usually doesn’t cause major issues with eye health, but for those issues you do see, it usually has to do with contact lens intolerance due to hormonal changes in the tears and ocular tissues (most likely) or minor prescription changes that may or may not be permanent. The biggest concern is the development of gestational diabetes and potential diabetic retinopathy.

It’s good to let them know, however, that breastfeeding may extend the issues, but regardless, the benefits for the baby’s eye development through breast milk are fantastic! There are significant brain development advantages to breast milk. It is common for baby formulas to advertise that their brand offers all the necessary nutrients for eye and brain development. Breast milk is even better than those formulas as it naturally contains all of those nutrients. Since 30 percent of our overall brain function is dedicated to vision, the same nutrients in breast milk that enhance brain function also, therefore, are beneficial to the infant’s vision.

Added Precautions Recommended for Pregnant Patients

Don’t dilate pregnant or nursing women unless there is a prominent need to do so to adequately check the health of the eye (for instance, diabetes, risk of retinal detachment, or any other sight-threatening condition). In those cases, have them use punctal occlusion to limit systemic absorption. Rarely, you would come across situations of red eye/infections.

Conceptive Pills Also Cause Hormonal Changes

Even before women become pregnant, they may be experiencing eye discomfort related to the kind of birth control pills they are taking. If a woman has a sudden change in experiencing dry eye, or notices a pattern of dryness throughout the month, that is a flag to ask questions about what type of birth control she is on (it seems to be better with monocyclic brands than tricyclic because the monocyclic pills provide a steady dose of hormones whereas the tricyclic pills change hormone levels weekly and can be more problematic for SOME women).

Opportunity to Begin Education About Pediatric Eyecare

Become active in the InfantSEE program. Tell your pregnant patients about the program as a “gift to them and their baby” as the comprehensive exam is complimentary. As long as the baby is developing normally, they should have an eye exam in the first six to 12 months, again between ages 3-4, and every year thereafter. If there is a problem, there will be more exams scheduled. You should have a bulletin board in your office dedicated to taking pictures with the infants and then posting them up (with parents’ permission). It’s a great conversation piece and helps to educate others about the program.

Make sure you have the HIPAA Marketing Release Form signed before using marketing materials featuring patients.

How Many of Your Patients Know What Digital Eye Fatigue Is?

You have some digital eye fatigue syndrome education to deliver to patients. 72% of patients are not even familiar with the term “digital eye fatigue,” according to The Vision Council’s VisionWatch Digital Eye Fatigue Syndrome report. Those patients with children will also need an education on the impact of the condition on their children’s eyes, as 37% of patients with children say they are not concerned about it. Interest in digital eye fatigue syndrome in children, however, may be growing. 47% say they are somewhat concerned about the condition affecting their children and 16% say they are very concerned.

1)  Review your verbal communication to patients. Record and listen to your case presentation. Make sure you are not talking over the heads of your patients. The more complex your sentences and the more syllables in your words, the less likely patients are to understand what you are trying to communicate. 2) Review all written communications from your practice to patients. Check your web site, your treatment protocol handouts, your recall communications; make sure everything is built to communicate in a clear an effective manner. Simplify.

Now, does it really surprise you that 72% of patients are not familiar with the term “digital eye fatigue syndrome?”  Wouldn’t this be better communicated to patients as: “Do your eyes get tired when you spend time reading on your tablet or phone?”

Do Your Patients Know About their Sports Eye Injury Risk?

Every 13 minutes, an emergency room in the United States treats someone for a sports-related eye injury. According to the National Eye Institute, eye injuries are the leading cause of blindness in children in America, and most injuries occurring in school-aged children are sports-related. The results of an eye injury can range from temporary to permanent vision loss.

The NEI notes that baseball is the sport responsible for the greatest number of eye injuries in children aged 14 and younger. While basketball is the sport that records the highest number of eye injuries for those ages 15-24.

Polycarbonate lenses must be used with protectors that meet or exceed the requirements of the American Society for Testing and Materials (ASTM). Each sport has a specific ASTM code. Polycarbonate eyewear is 10 times more impact resistant than other plastics.

Eye injuries can include painful corneal abrasions, blunt trauma and penetrating injuries, inflamed iris, fracture of the eye socket, swollen or detached retinas, traumatic cataract and blood spilling into the eye’s anterior chamber. All athletes who have poor vision or blindness in one eye should take particular care to protect their remaining vision.

Why Haven’t You Taken Your Child to Receive an Eye Exam Recently?

Among the 1,532 parents responding to the Vision Council’s VisionWatch Parent for Child Report who have not taken their children to receive an eye exam within the past two years, 63% claim they have not taken their children for an exam because their children do not need an exam. Parents with children over the age of 10 living at home and parents with more than one child living at home were more likely than other parents to avoid eye exams for their children because of the belief that their children don’t need one.

A significantly large portion of parents who have not taken their children for an eye exam recently (35.6%) believe that their children are too young to experience vision problems and therefore do not need an exam. Parents with only one child living at home, and parents with a child under the age of 10 were more likely than other parents to avoid taking their child for an eye exam due to the belief that their child is too young for a vision problem. 14% of parents said they have not taken their child for an eye exam recently because their vision problems are only minor. This was especially true for parents of older children (age 10 and older) and parents with more than one child living at home. For almost 8% of parents whose children have not received an eye exam recently the perceived high cost of an exam has prevented them from taking their child for an exam. The notion that the exam will cost too much was a particular strong deterrent for parents with no vision insurance and for parents with an average household income of under $40,000 annually.

7% of parents with children who have not received an exam in the past two years said they were too busy to take their children for an eye exam. This was especially true for parents with more than two children living at home and for parents with children between the ages of 10 and 13. Another 7% of parents said their children had not received an exam recently because they did not have an eye doctor. This was especially the case for parents with an annual household income under $40,000, those with no vision insurance coverage and for parents with children over the age of 13 living at home.

What are the numbers?  1 in 4 school-aged children have vision problems.
 
What is the risk?  Undiagnosed visual conditions cause unresolved life problems. What is the solution?  Education.
 
How good of a job are we doing?  Based on the Vision Council’s report, not good. We have to start somewhere, so let’s start in our practices. We can do this by signage in the office.

Here are three signs that should be in every doctor’s office:

“Did you know that 1 in 4 school-aged children have vision problems? A child who has never seen the world clearly has no reference point to tell you that something is wrong. Don’t let your child live with a problem that can be easily addressed. Get your child’s eyes examined yearly by an optometrist.”

“Did you know that the eyesight test done by the school nurse or by the pediatrician does a poor job of identifying visual problems? It identifies correctly about half of the children screened. In other words, when children are given the test, about half are told they do not have a problem when they do or told they do have a problem when they do not. Don’t let your child live with a problem that can be easily addressed. Get your child’s eyes examined yearly by an optometrist.”

“A child’s body changes every year. The eyes are part of the body and they change just like the rest of the body. Just because your child had an eye exam one or two years ago does not mean they are still the same today. Don’t let your child live with a problem that can be easily addressed. Get your child’s eyes examined yearly by an optometrist.”

Where Do You Take Your Children for Eye Exams?

Independent eyecare practitioners (ECPs) seem to be the provider of choice for parents who have taken their child to receive an eye exam sometime within the past two years, according to The Vision Council‘s VisionWatch Parent-Child Vision Care Report.

In fact, 51.2% of all parents with children who have received an eye exam within the past 24 months took their child to an independent ECP for that exam. Parents with health insurance coverage, especially vision care coverage, were more likely than other parents to have taken their child to an independent ECP to receive an exam. Moreover, parents with children who wear prescription eyewear, particularly eyeglasses, and parents from households with high annual incomes were more likely to have taken their children to an independent ECP for their most recent eye exam.

13% of parents who have taken their children for an eye exam in the past two years went to an optical chain (such as Lens Crafters or Hour Eyes) for the child’s last exam. Optical chains were a particularly popular option for parents with children between the ages of 14 to 17 and parents with annual household incomes between $40,000 to $60,000. An additional 9.4% of parents took their child to a mass merchandiser location for the child’s most recent eye exam. Mass merchandisers were especially popular for parents who were not willing to spend more than $100 on their children’s eyewear.

Finally, a little over 16% of parents whose children have had an eye exam during the past two years took their children to a general MD. This was especially common for parents with more than two children living at home and for parents with younger children. Just over 8% of parents said they took their child to a department store or “other” location for their most recent exam.

What %?

Where did they go?

Why and What were the trends?

51.2%

Independent ECP

1.       Health insurance coverage, especially vision care

2.       Children who wear prescription eyewear

3.       Households with high annual incomes

 

16%

General MD

1.       Parents with > 2 children living at home

2.       Parents with younger children

13%

Optical chain

1.       Children between the ages of 14 to 17

2.       Annual household income between $40K-$60K

9.4%

Mass merchandiser

1.       Parents not willing to spend more than $100 on children’s eyewear

8%

Department store or “other”

 

1.       Does your practice actively promote seeing infants (e.g.: InfantSee)?

2.       Are you marketing effectively to children between the ages of 14-17?

3.       Does your optical have options for parents not willing to spend more than $100?

How Often Do Parents Take Their Children to the Eye Doctor?

Over one-third of all parents with children living at home report that their child(ren) have never received an eye exam, according to the The Vision Council‘s VisionWatch Parent Child Vision Care Report. Parents with only one child living at home, and parents with a child under the age of 10 living at home, were more likely than other parents to never have taken any of their children to get their eyes examined. Insurance coverage (of any kind) has little-to-no influence regarding the frequency or history of eye exams among American children.

It appears that the only noticeable and significant influence that insurance coverage has with regard to children’s eyewear pertains to prices and what parents are willing to pay for the eyeglasses their children wear. In particular, parents with some type of insurance coverage (health insurance, MVC and/or FSA/MSA) are more likely than parents without coverage to be willing to pay more than $99 for a pair of children’s eyewear.

These facts highlight the need to educate all patients about the need for children to have their eyes examined. Everyone is either a parent, grandparent, uncle, aunt or a friend of a child. The circle of everyone’s life touches a child at some point, therefore, educate everyone.  

Use a multimedia approach to educate people. Use simple signs placed in the reception area, computer screen savers, brochures, scripted elevator speeches by staff–use whatever you can to communicate the need for children to have their eyes examined. Make sure your primary message is that undiagnosed visual problems contribute to two unresolved life problems–school performance not at expected levels and poor athletic performance. Unresolved problems mean that children are making life choices based on what they can do rather then what they want to do. Make the point that unresolved means unnecessary.

Your action plan today is to re-examine how you are educating people about the need for children to have their eyes examined and then do it better.

Eye Exam 101

Getting a comprehensive eye exam is an important part of staying healthy. But do you know what the exam should cover?
http://aaoblasts.aao.org/t/523640/40864713/29703061/21/

A comprehensive eye exam is a painless procedure that should check on the following:
• Your medical history — assessed through questions about your vision and family history.
• Your visual acuity — tested by reading a standardized eye chart.
• Your pupils, evaluated to determine how well they respond to light.
• Your eye movement, which is tested to ensure proper eye alignment and ocular muscle function.
• Your prescription for corrective lenses — evaluated to ensure proper vision correction.
• Your side vision, tested for possible vision loss and glaucoma risk.
• Your eye pressure, tested as a possible glaucoma symptom.
• The front part of your eye, examined to reveal any cataracts, scars or scratches on your cornea.
• Your retina and optic nerve — assessed through a dilated eye exam using special eyedrops, which allows your Eye M.D. to thoroughly examine the back of the eye for signs of damage from disease.

Each part of the comprehensive eye exam provides important information about the health of your eyes. Make sure that you are getting a complete examination as part of your commitment to your overall health.