Eyeworld

165 EW MEETING REPORTER management of glaucoma. He spoke about IOP, first line treatments, additive therapy, preservatives, and the future. When treating glaucoma, physicians have to think about the IOP, he said. IOP is the strongest risk factor for the development of glau- coma. It is also the only modifiable risk or treatable disease factor. Potential limitations on IOP measurement include central corne- al thickness, corneal biomechanics, and sampling error. Despite the limitations, it's highly predictive of outcomes. Dr. Rhee also discussed prostaglandin analogues, the first line treatment, as well as other additive therapy and preservative options. To conclude, Dr. Rhee discussed the concept of progression. Over a 20-year period, 7–14% of patients will become legally blind. And 35 to 46% of primary open angle glauco- ma (POAG) patients will fail medical therapy and progress to surgery. Ad- ditionally, 50% of ocular hyperten- sives require 2 or more medications just to achieve a 20% reduction. There needs to be a paradigm shift away from palliative care to inter- rupting the primary pathophysiolo- gies, Dr. Rhee said. "We still need to focus on intraocular pressure." Current modalities are rho- kinase inhibitors, which may not interrupt pathophysiology, and ad- enosine agonists, but not enough is known about their mechanism of ac- tion at this time. "I think sustained release will be a game changer for us," Dr. Rhee said. Dr. Sarkisian discussed new techniques to fight glaucoma with a "war room briefing," referenc- ing glaucoma like the enemy, the doctors like troops, and the thera- pies to treat the disease as weapons. There is a new generation of "smart weapons" available. These weapons include medications, laser surgery, filtration surgery, and glaucoma drainage implants. You can often slow down the disease with extreme procedures, Dr. Sarkisian said. "You're not going to beat trabeculectomy when it comes to efficacy," he said, but you also have to consider what the tradeoff is. You want to leave as small a residual footprint as possible. Con- ventional glaucoma surgery should be reserved for the most aggressive forms of the enemy and should be used after other methods have been tried, he said. Editors' note: Dr. Rhee has financial interests with Aerie Pharmaceuticals, Allergan, Glaukos, Ivantis, Merck, and Santen Pharmaceutical. Dr. Sarkisian has financial interests with Aeon Astron, Alcon, Ellex, Endo Optiks, Glaukos, InnFocus, Ivantis, New World Medical, Sight Science, and Transcend. ASOA program focuses on employee engagement and finding success in failure Friday's opening ASOA session gave attendees a broad view of practice management techniques, highlight- ing ways that administrators can build a more successful, efficient practice. In the session's opening talk, "The Art of Employee Engage- ment," Bruce Maller, president of BSM Consulting, Incline Village, Nev., discussed the critical role that employee engagement plays in sustaining a successful business and providing the best patient care. "We're in a service business," Mr. Maller said. "At the core, that March 2015 No Cost DICOM Image Management System, diagnostic machine, & practice management integrations. Average Implementation Time: 90 days Server Sync increases remote office productivity & eliminates outages caused by unreliable internet connections. Mobile App securely access your patient records on your mobile device. ShareCloud streamline your implementation by sharing customizations and letters with other EyeMD EMR users. Subspecialty content included for Retina, Cornea, Pediatrics, & Glaucoma. Scalable to any practice size. AAO Patient Education Handouts integrated & updated automatically in EyeMD EMR. Iris Registry Support - registry based PQRS reporting & clinical practice benchmarking. For more information visit (877) 2 EYE EMR www.EyeMDEMR.com Corcoran Compliance Connection instantly performs a Corcoran Chart Review for compliance and provides E/M coding confidence at no additional cost. TM Ranked #620 Fastest Growing Private Company in the US TM Key Features ® continued on page 166

• Cover