Archive for November, 2005

David Langford

FDA Asks Similasan to Drop Two Brands

I commented in August about the preposterous claim that a Similasan eye drop could improve cataracts (or its symptoms). The FDA apparently sent Similasan a letter basically asking them to drop Cataract and Pink Eye drops since an average consumer can’t be trusted to make a correct diagnosis; therefore, the treatment shouldn’t be available over the counter. Kind of like it you experience rectal bleeding, there shouldn’t be an over-the-counter treatment available since it could be cancer, or it could just be the fact that you ate 2 pounds of almonds the night before.

I got the news from Contact Lenses Today e-mail newsletter. I suggest that everyone subscribe. (My only complaint is that it doesn’t offer an RSS feed.) Here is the transcript of the news regarding Similasan:

FDA Sends Warning Letter to Similasan
Last week’s CLToday included news on Similasan’s Cataract Care eye drops (See, Natural Relief for Cataracts, Nov. 23). It has been brought to our attention that the FDA sent a warning letter to the company in August of this year, after review of the company’s pharmaceutical manufacturing facility in Switzerland. The letter details problems with the plant’s equipment, control procedures and labeling for some products, including Cataract Care. The letter states, “Similasan Pink Eye Relief eye drops and Similasan Cataract Care eye drops are misbranded … The conditions for which they are offered are not amenable to self-diagnosis and treatment by individuals who are not medical practitioners.” The FDA also says because patients can’t distinguish symptoms of cataracts from symptoms of other serious disorders, OTC treatment is inappropriate.

By the way, I believe you pronounce Similisan the Japanese way, not the red neck way. “Sim-IL-i-sahn” not “Simil-ASS-an.” Imagine how Miyagi would have pronounced the Karate Kid’s name if he was Simil instead of Daniel.

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David Langford

Canadian Optometrists are Terrorists?

Ontario’s Health Minister called optometrists in his province terrorists because of a funding dispute between the government and optometrists. Imagine that. Optometrists just want to get paid and a socialist healthcare regime calls them terrorists. That’s a case of the pot calling the kettle black if I ever heard one. May freedom ring and capitalism prevail the world over!

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David Langford

Newer Optician Site

I’ve recently become aware of a site for opticians, www.opticiansfriend.com, because the site administrator left some comments in this blog. I really like this site. He’s got a lot of information pertinent to optometry. The site has a blog and a forum. It’s also got a good iseikonic lens calculator. In the two years I’ve practiced, I actually did that once for a guy who had cataract surgery in one eye, but wasn’t eligable to get it in the other eye yet. In IHS I couldn’t do contact lenses. I saw there was a proprietary software solution out there, so I just demo’d it and made some pretty funky looking lenses! But hey, they worked and the patient was happy that he didn’t see double any more.
Anyway, Mr. Cordova has a very nice site, and I encourage everyone to check it out. I’m subscribed!

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David Langford

Dry Eye “Blog”

[edit 11-12-2005: Don't read my original entry below. I just sound mean when I rant. I should have just politely e-mailed the person in private, stating my concern about RSS feeds (or lack thereof). All is better now because dryeyeblog.com has an RSS feed (see the comments for the link). Woohoo! Sorry that I'm mean. I'll try to be less mean in the future.]

In my opinion a blog that does not include an RSS or Atom site feed is really only a “blog.” It might as well be just another website. If you subscribe to the e-mail newsletter Optometric Physician, then you saw in the 11-7-2005 news section that

“Vision Research, makers of TheraTears dry eye products, has launched www.dryeyeblog.com, aimed at providing doctors and patients with a means of keeping updated on the latest news, research and information on dry eye.”

Excuse me, but how can you keep me updated unless you provide a site feed? (Do you actually expect me to remember to always go check your site every day?) Since they are just using a blogger.com template, they could at least turn on the Atom site feed so that their news imports automatically into my bloglines feed aggregator. (If they ever get it, someone please leave a comment so I can subscribe.)

UPDATE: They responded and added a feed. That’s what I call service.

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David Langford

AOA’s InfantSee is a Big Fat Liberal Plot

I wrote a brief entry a while back critiicsing the concept of InfantSee. I would encourage everyone to read the reply I recieved from Dr. Scott Jens because I am going to discuss my opposition to InfantSee more in depth with this new entry.

Somehow the concept of InfantSee (ODs offering free exams for infants) was founded, the AOA champions it, and they get former President Jimmy Carter to be its spokesperson. They also paid a visit to Surgeon General of the USPHS, Admiral Richard Carmona (my former boss), and he praised the AOA’s efforts.

Now, let’s put aside this rosy newspaper fluff and talk about the sinister concept of InfantSee. To summarize the remainder of this entry, InfantSee is nothing more than a left wing, liberal agenda concept, but instead of government footing the bill, they want you, the private entrepreneur optometrist, to foot the bill.

Catering to the liberal agenda is not a new concept with the leaders of our optometric associations. You will recall that the keynote speaker at the 106th Annual American Optometric Association (AOA) Congress (June 2003) was Al Franken (a.k.a. that guy who played Stuart Smalley and also the author of the libelous “Rush Limbaugh is a Big Fat Liar.”) This also coincided with Franken’s doomed-to-failure launch of liberal radio, “Air America.” (I’ll save my comments on how hypocritical, ironic, and down right deceitful it is for liberals to feign patriotism in the title of their radio network because Ann Coulter and Rush Limbaugh have already made a panoptic study on how unpatriotic liberalism is.)

So, how does Al Franken, probably desperate to spread the word of his left wing radio show, get to be the keynote speaker at an American Optometric Association meeting? Obviously there are liberal forces in the leadership of the AOA. At least Essilor footed the bill to bring him there. In all fairness, I did not attend the 2003 AOA convention, so I did not listen to Franken. I still ask the question, “ What relevance does liberal Al Franken have to organized optometry?” Obviously at lot if the leaders of our AOA are involved in a socialist movement like InfantSee.

How does InfantSee relate to liberal agendas (i.e. socialism)? I just read the last pages of Ann Coulter’s book, “How to Talk to a Liberal (if you must).” She makes it painfully clear that our nation’s government has become a Nanny. Rush Limbaugh’s book, “See, I Told You So,” while written in the early 1990s, is still pertinent today. Liberals haven’t changed. Limbaugh asserts that liberals think they know what’s better for your family than you do. Liberals want you to abdicate all your resources the government, and they will benevolently redistribute it. The government must make children have free exams because their stupid parents won’t do it on their own.

I think the AOA is trying to make this a bigger public health issue than it really is. Here me out. Ideally, we pay taxes only for those things we couldn’t do ourselves or in small populations, like build roads or provide public health response in the case of something like the plague breaking out. With all of the challenges facing the public health of the nation, how far up their do eye exams for all children rank? I think exams for children applies to the free market principle of supply and demand. If parents really wanted their child to have an eye exam, that child would get an eye exam with parents footing the bill (either by pay-out-of-pocket or insurance premiums and co-pays). Our dues money that AOA spent on forming and advocating InfantSee would be better spent with public/parent education on the importance of eye exams for their children. If the parents want their child to potentially experience poor performance, or in some cases disability, due to an unrecognized vision condition, then that a decision that their child will have to live with. I’m sure society can always use more minimum wage workers.

However, if a parent is responsible enough to do all they can to ensure opportunity for the success of their child, they will no doubt budget for an eye exam along with soccer cleats and preschool tuition.

That being said, another free market principle applies: business marketing. We all do things like give away freebies as a marketing tactic. The idea being, whatever I give away for free will be compensated by generating increased revenue. In healthcare, we typically offer free screenings as not only an exercise in public health, but also to increase business! If I do enough screenings, I’ll find individuals that fail, and, therefore, will be in the market for my products and services. Why didn’t the AOA advocate free screenings instead of free full exams in the first place?

At the GWCO conference in October 2005, the AOA president himself told us that the AOA is sponsoring a bill before congress requiring eye exams to children. He mentioned that organized ophthalmology is sponsoring a competing bill, which emphasizes screenings, not exams. Of course, I wouldn’t want to refute InfantSee in my blog because if I say screenings would be better, then I’m dangerously siding with the arch enemy of optometry: organized ophthalmology (which is sad because on a personal and professional level, I’ve only ever met 1 or 2 ophthalmologists who are unfriendly to optometry.)

I think the only ones to benefit from InfantSee would be ophthalmologists, not optometrists. In many cases, if there is a problem at age 6 months, I would refer to the pediatric ophthalmologist (who can now make more money because she/he can bill for a consultation while I made zero dollars for my expert diagnosis and management plan).

Also, in an exam, I have all the liability if I’m wrong. If I give away the exam, I just assumed some risk without any reward or compensation for malpractice insurance premiums. Now, lets change the idea of “free exam for 6 month olds” to “free screening for 6 month olds.” That makes me happy. Children either meet the criteria or they don’t. Now I’m comfortable with the risk because the criteria were set by some highly educated body.

But these last two arguments aren’t really the point. The point is that InfantSee is a veiled liberal/socialist program. We should all have recognized it as a liberal plot when we learned Jimmy Carter is the spokesman. I encourage every conservative eye care practitioner out there to embrace free market principles and reject InfantSee. Do not become an InfantSee provider and encourage your colleagues to boycott this program. Instead, we should educate our patients on the value of early eye exams for children just like we educate them on the value of progressive addition lenses. Parents should expect to pay for children exams just like they do no-line lenses.

P.S. The following paragraph is taken from the AOA website. The items in perenthesis are mine.

Join AOA in the “pomp and circumstance” as the AOA officially opens its 2006 Optometry’s Meetingâ„¢ in Las Vegas by bringing a well-known keynote speaker to attendees. Previous speakers include: former President Jimmy Carter (liberal), Al Franken (liberal), John Naisbitt (who?), Paul Harvey (a thorn in my side because he markets vitamins as helping floaters go away which I have to constantly explain to patients was debunked by AREDS), Frank Sesno (CNN journalist and most likely a liberal), John Stossel (most likely conservitive), Dave Barry (just a funny guy- politics not immediately clear), and James Carville (very liberal) & Mary Matalin (conservative).

It is obvious to me that our AOA leadership caters to liberalism with their keynote speakers 4-2.

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