Smoking Is Associated with Higher Intraocular Pressure Regardless of Glaucoma.

Cigarette smoking is known to play a role in several ophthalmologic diseases, but reports about the effect of smoking on intraocular pressure and glaucoma have had conflicting results. In this study published in the journal Ophthalmology Glaucoma, Drs. Cecilia and Aaron Lee and their co-authors takes advantage of the American Academy of Ophthalmology IRIS (Intelligent Research in Sight) Registry, a database of 60+ million unique patients and 15,000 eye care providers to examine the connection between smoking history and intraocular pressure in more than 12 million smokers, past smokers, and nonsmokers. The authors controlled for other factors known to raise IOP (age, sex, cataract surgery, glaucoma surgery) and compared mean interocular pressure between patients with and without glaucoma according to their smoking history. They found that intraocular pressure was highest in the smoking group, a trend that was present in almost every year of life.

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Prognostic utility of whole genome sequencing and polymerase chain reaction tests of ocular fluids in post-procedural endophthalmitis

Endophthalmitis is a rare but significant potential complication of eye surgery that can result in a substantial loss of vision. Microbial culture remains the gold standard for detecting organisms associated with endophthalmitis, but in 30% of cases no organism is identified. Molecular testing such as PCR or deep DNA sequencing have been increasingly used in ophthalmology, and can identify and characterize pathogens with unprecedented detail. We sought to apply these techniques to a prospective cohort of patients with endophthalmitis and correlate the findings with clinical outcomes, to determine whether they provide additional prognostic information for the management of post-procedure endophthalmitis.

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Medicare incentive payments to U.S. ophthalmologists for use of electronic health records: 2011-2016

The use of electronic health records offers a lot of advantages in terms of providing accurate, coordinated, up-to-date care for patients and may also help to reduce medical errors. The benefits depend on widespread implementation, however, and there have been challenges with getting physicians to use electronic records because they can require extra time, effort, and cost.

To encourage physicians to implement electronic health records into their practices, an incentive program was created by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which provided direct payments yearly to physicians who adopted the use of electronic health records. To earn these incentive payments, providers were expected to demonstrate meaningful use of certified EHR technology according to metrics which were linked to certain goals for the program, such as improving efficiency and coordination of care, reducing disparities, etc. The program was designed to reward early adopters, as the payments decreased after the first two years.

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Associations between recent and established ophthalmic conditions and risk of Alzheimer's disease

Alzheimer's disease affects millions of adults and is the most common type of dementia. Identifying risk factors for Alzheimer's may lead to early detection and preventive measures that are based on a better understanding of the disease processes involved. The eye provides substantial information on brain health, and may give some clues to the pathogenesis of Alzheimer's disease. Eye conditions such as glaucoma, age-related macular degeneration, and diabetic retinopathy have some shared characteristics with Alzheimer's disease, such as progressive neurodegeneration, characteristic amyloid beta deposits, and microvascular disease. This study aimed to investigate potential associations between four eye conditions (glaucoma, age-related macular degeneration, diabetic retinopathy, and cataract) with Alzheimer's disease in a large cohort of patients.

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Evaluating Access to Eye Care in the Contiguous United States by Calculated Driving Time in the United States Medicare Population

In this important study, Dr. Cecilia Lee, Dr. Aaron Lee, and their co-authors used census and mapping data to quantify how far Medicare patients travel to access eye care in the contiguous United States. This type of information about medically underserved geographic areas is essential for improving access to care. The authors note that the issue of rural access to care has been cited as a reason for increasing the number of eye care providers in the United States. Some providers also use access to care as an argument for increasing optometrists' responsibilities and scope of practice.

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