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Ocular 911

by Christopher J. Kuc, OD

Christopher J. Kuc, OD, reviews his talk about the optometrist’s role in encountering ocular emergencies. Dr. Kuc explains how optometrists following the medical model of practice can manage emergency cases—ranging from endophthalmitis events to acute angle closure crises—in a way that provides meaningful care to patients.

Comments (2)

Response from Christopher J. Kuc, OD: There is no way to bill for these supplies or in-office treatment, even in the event of AACC (other than billing an office visit or gonioscopy in event this was necessary). My point was simply if you are managing glaucoma, acute angle closure is one situation we should be offering palliative treatment in office. As you can see, extensive ONH damage happens due to the rate at which the pressure elevates/ischemia that develops at ONH. When managing glaucoma, the drug companies will typically offer samples for providers who prescribe, but I do understand this does not occur in all situations. A bottle of Diamox 250mg tabs will last for about 3 years. We order ours through the local pharmacy, and as you stated, this can be expensive. However, it may be possible to establish a relationship with your pharmacist where you are able to acquire a smaller supply at a discounted rate, I'm not sure. In summary, if you are managing glaucoma, oral acetazolamide and whatever topical anti-glaucoma meds you have at your disposal would be worth administering even if you are sending out for management/LPI. The logistics of how to economically have the plan in place I agree can be challenging and I sympathize with you as I at one time had a small private practice where I ran into these same obstacles. Thanks for commenting, I hope this response was somewhat helpful!

Daniel Y. (8 months ago)

How do we bill for the drugs and in office supplies? In my 20 yrs, I've never had an acute angle closure show up in my office and I'd have thrown out probably $2000 of drugs to have the supplies ready to care for these cases and I don't get them as samples.

javguy (8 months ago)