Our primary goal at Derby City Eye Care has always been to ensure that we are providing the highest standard of care to our patients. In light of the current pandemic, and in compliance with the latest recommendations from the Centers for Disease Control, Kentucky Department of Health, Kentucky Optometric Association, and our local government officials, we are now taking extra precautions to do this as safely and efficiently as possible. To this end, we have updated our office policies and procedures as follows:

• External office doors will be locked

• • To limit the number of individuals and visitors coming in and out of the office, all external doors will be locked at all times except to allow the entering/exiting of doctors, staff, and patients
  • Only those patients with pre-scheduled appointments will be allowed to enter the office
  • Patients under 18 years old, and patients with disabilities, may have 1 guardian/caregiver accompany them into the office and testing rooms, if necessary

• Coronavirus screenings before entry

• • All doctors, staff, patients, and guardians will be screened for COVID-19 symptoms and elevated temperature before entering the office
  • If anyone has been sick with a fever, dry cough, or shortness of breath, or if they have come in contact with anyone they suspect or know to be sick, within the past two weeks, they will not be allowed into the office and will be rescheduled
  • If anyone has a temperature above 99.9 degrees (Fahrenheit), they will not be allowed into the office and will be rescheduled

• Masks and face coverings

• • All doctors and staff are required to wear masks while they are in the office – especially since we work with a vulnerable patient population
  • Patients and guardians are highly encouraged to wear a mask or cloth face covering for the same reason

• Modified waiting area for social distancing

• • All but two chairs have been removed from the waiting room (and are spaced more than 6 feet apart) – magazines and advertising materials have also been removed

• Enhanced hygiene compliance

• • ALL DOCTORS, STAFF, PATIENTS, AND GUARDIANS SHOULD AVOID TOUCHING THEIR FACE, NOSE, MOUTH, AND EYES AT ALL TIMES
  • Every patient and guardian must wash their hands upon entering the office
  • All doctors and staff will wash their hands as much as possible including (but not limited to): upon entering the office, before touching patients, after contact with patients, in between patients, and before exiting the office

• Enhanced sanitizing compliance

• • All surfaces that have come in contact with a patient or guardian during their visit must be sanitized before another patient can enter the office, including (but not limited to): door handles, chairs, clipboards, writing utensils, counter tops, sink handles, and equipment – this will be done using soap and water, alcohol pads, disinfecting wipes, and/or disinfecting sprays

• Prioritizing patient populations/services

• • To ensure that Derby City Eye Care is alleviating eyecare demands placed on other healthcare providers and facilities during this crisis and taking care of the essential eye care needs of our patients in an organized manner, we are currently prioritizing the following groups when scheduling appointments:

1) New and existing patients with eye emergencies (sudden vision loss, flashes and floaters, red eyes, etc.)

2) Existing patients with systemic and eye health conditions (diabetes, glaucoma, cataracts, macular degeneration, etc.) who have had a recent change in vision

3) Existing contact lens patients whose prescription is expired or who have had a recent change in vision

4) Existing patients who have recently broken their glasses or who have had a recent change in vision

If you have not had a change in vision within the last month or two, we ask that you please delay your visit to our office for at least 3-4 weeks

Even though things will look and feel a little different the next time you visit our office, please know that we are happy to be caring for you again, and we genuinely appreciate all your patience and support during this challenging time.

Dr. Fowler

Power of One™ Concept Proves Itself Over and Over

Doctor builds his contact lens practice by promoting one-day and one-month replacement, with one-year exams

When Jeremy Fowler, OD, graduated from optometry school 10 years ago, he went to work in an optometric practice where two-week replacement contact lenses were the norm. One day, he sat with a representative from Alcon who told him about the Power of One™ concept. “It seemed novel and simple to me, and being just out of school, I didn’t have any particular allegiance to one specific lens replacement strategy. So I followed their advice to promote one-month and one-day contact lenses, with an emphasis on one-year return visits for a comprehensive eye exam.” It soon became his most successful strategy and one he has used in practice ever since.

Dr. Fowler recently opened a practice in a new Walmart Supercenter in the Louisville, Kentucky area. “When I started this practice, I said I wanted to be on the cutting edge of technology, focused on giving my patients the best options for their eye health and comfort.”

His personal experience is a factor. He wears DAILIES® AquaComfort PLUS® contact lenses. “I have tried several different contact brands and lenses, comparing the comfort and vision in my own prescription. Some brands were uncomfortable and others I had to adjust the correction to get crisp vision; but with DAILIES® AquaComfort PLUS® lenses, the comfort and correction were just right,” he says.

His testimonial must make an impact, as about 70 percent of Dr. Fowler’s contact lens patients are in daily disposables. “They are comfortable, clean and convenient. For anyone who wears contact lenses part time, as I do, it should be the obvious choice. There is a huge untapped potential market for part-time wearers or those who have never considered contact lens wear,” he says. He explains that his status as a part-time wearer adds credence to the idea. “I have this option for you, and it’s one I personally use. If you want to wear something other than your eyeglasses – when you’re going out for dinner or somewhere for the weekend or working in the yard and you want to wear your sunglasses – these daily disposable contact lenses are a great option.” He’ll also plant the seed that many patients enjoy these lenses so much that they end up wearing them all the time. “So often, patients react by saying, ‘Why hasn’t anyone else offered me this?’”

Dr. Fowler also says that having a complete line of contact lenses in spherical, toric and multifocal designs in the same family is a big help. Recently, he had a patient whose job as a respiratory therapist presented challenges with contact lens wear. He works with patients on oxygen who must be in a very dry environment. “He told me that his eyes were constantly red and irritated, so I switched him from a monthly toric lens to the DAILIES® AquaComfort PLUS® toric. He called me two weeks later to say how much he appreciated the change in his comfort and appearance.’”

In most offices, when patients are happy with their vision and contact lens comfort, doctors don’t usually hear from them in between comprehensive exams. But unhappy patients may come in or call frequently with complaints – or they might just drop out of contact lenses altogether, and possibly the practice. “I’ve learned to think outside of the box with my patients,” Dr. Fowler says. “To bring them from unhappy to happy. That’s true for a patient like the respiratory therapist and it’s true for the presbyope who is frustrated with monovision.”

Whenever he moves a patient into a different lens design or material that he believes is a better match, the patient often expresses amazement – and some frustration – that no one else had suggested the option. “I’m not finding some unknown solution; I just listen to what they’re telling me.”

The monthly lens option

AIR OPTIX® Plus HydraGlyde monthly replacement lenses also play a role in Dr. Fowler’s practice. “Some patients prefer monthly replacement lens, and I want to provide them with an option that is designed for outstanding comfort from day 1 to day 30. The entire AIR OPTIX family of contact lenses is a great choice because they have lots of oxygen and the Smart Shield Technology resists deposits.”

Most importantly, Dr. Fowler doesn’t peg patients as either a daily or monthly lens wearer. “I often suggest to my AIR OPTIX® contact lens patients that they also try some DAILIES® contact lenses. It doesn’t have to be either-or. I tell them, ‘You might choose DAILIES® when you’re doing outdoor activities and wear your AIR OPTIX® lenses at work.’”

That’s the kind of customized, problem-solving recommendations that keep his patients coming back.

The final topic for tonight’s discussion is macular degeneration. A few of you mentioned to me earlier that you have a friend or family member that has been diagnosed with this condition. Macular degeneration is a progressive deterioration of the central retina that disrupts and distorts the vision. Currently, there is no cure for this condition, and it is often very devastating to those who get it.

The macula is a very small part of the retina, but it does about 80% of the work needed to navigate the world we live in. We use our macula to read, see color, perceive movement, and recognize faces. The rest of the retina just fills in the gaps. If the macula is not working properly it can cause a lot of problems.

Macular degeneration happens when the blood vessels under the central retina fail to remove dead cells and other trash from the back of the eye. As this trash accumulates, healthy cells and blood vessels get choked off from the nutrients they need to survive. Over time, the healthy cells die, the blood vessels leak, and vision is lost.

There are actually two types of macular degeneration: the dry (non-bleeding) form and the wet (bleeding) form. About 90% of people with macular degeneration have the dry form. Most of these individuals have vision distortion, but less than 10% of them have significant vision loss. On the other hand, 90% of people with wet macular degeneration have a significant loss of their central vision. You can’t see through blood, and the longer it stays there the more damage it does.

Several things can increase your risk of getting macular degeneration. Number one, of course, is age! The actual name of the condition is really age-related macular degeneration. There are currently 11 million Americans over the age of 50 with the condition, and 30% of Americans over 75 have it. Genetics also plays a factor – if it runs in your family, you are more likely to get it than not. Macular degeneration is almost exclusively found in Caucasians and affects twice as many women as men. Excessive exposure to the sun and smoking are also risk factors, as are other co-morbid conditions like high blood pressure, diabetes, and high cholesterol.

What are the symptoms of macular degeneration? Initially, you might have some difficulty recognizing familiar people or places until you get really close to them. You may also notice that certain objects seem distorted when you look at them – like a wall or a picture. They may appear to have a bump or a wavy area where they would normally be straight. Over time, macular degeneration also causes colors to fade – instead of being vibrant and bright they will appear dull and gray. Reading will also become problematic as words may seem to move, jumble, or otherwise not make sense.

Because there is no cure for macular degeneration, a lot of our treatments are aimed at trying to make an individual as functional as possible within their environment. This may include using brighter indoor lighting. Usually, the more light you have the better you are able to see, so that can be useful. Large print books and magnifiers are also helpful.

If the degeneration does progress to the wet form, treatment becomes much more invasive – and painful. The primary treatment is an ocular injection where medication is placed into the eye to dry up the blood. Lasers are also occasionally used, but once you laser the retina the tissue is scarred for life and is no longer useful.

So how do you avoid all of this? For starters, get regular eye exams – an ounce of prevention is worth a pound of cure. The earlier we catch it, the better the chance there is of slowing it down. Also, be sure to wear a hat and sunglasses anytime you are outdoors, and please don’t smoke. Finally, eat a balanced diet with lots of lutein and zeaxanthin. These super vitamins are found in things like tomatoes, red peppers, green peppers, yellow peppers, and carrots. They help remove the trash from the retina, so they are very useful in delaying or preventing this condition.

So I guess we went a little bit long, but you guys had some really great questions. Thank you again for letting me speak tonight. I am happy to answer any questions afterward, or like I said earlier, feel free to stop by the Crestwood Walmart and talk to me there.