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Nancy Groves
Nancy Groves is a freelance medical writer.
Despite a heightened atmosphere on the Relative Value Scale Update Committee due to Congressional mandates to reallocate funds from specialty codes, ophthalmologists have been spared from the significant financial impact affecting certain other specialties. However, a number of important ophthalmic codes have been placed under review, leading to decreases in payment for some procedures.
The Medicare Access and CHIP Reauthorization Act of 2015 and its Merit Based Incentive Payments System are here to stay for the foreseeable future and are likely to significantly impact reimbursement for ophthalmologists as part of a shift away from traditional fee for service medicine. In this changing landscape, eye care practitioners need to understand the basics of the system, such as reporting requirements, and begin to consider new models of care.
Doctors place focus on delivery of care
An intraocular device is a new concept in the treatment of AMD that taps into telescopic mirror technology to redesign patients' vision
Neil Choplin considers the importance of retinal nerve fibre loss in early glaucoma.
A 20-item questionnaire is expected to be useful for evaluating the health-related quality of life of adults with strabismus and practical application in a clinical setting. The patient-derived questionnaire assesses both psychosocial and functional aspects of strabismus.
Fundus autofluorescence imaging, one of the modes available in a new instrument (Spectralis HRA+OCT, Heidelberg Engineering), enhances its utility as a diagnostic device and a tool for monitoring therapy of patients with retinal and macular diseases.
The Collaborative Initial Glaucoma Treatment Study (CIGTS) showed that substantially lowering IOP, whether through medication or surgery, can prevent vision loss. One of the major trials of recent years, CIGTS also showed that surgery was an effective first-line treatment and had important findings on quality of life.
Although tonometry remains a vital tool in glaucoma management, the significance of individual measurements should be regarded with a healthy degree of skepticism. Central corneal thickness (CCT) measurements should be incorporated into global assessment of glaucoma risk, but trying to correct tonometry readings by CCT is not appropriate.
Clinicians have an array of techniques and devices available to them for assessing progression of glaucoma, and more are under development. Such tools rely on either subjective or objective measurements, with the latter generally providing more reliable results. Frequent, long-term follow-up with one or more of those approaches will increase the likelihood of detecting progression early.