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Cranial Nerve Testing Refresher

Posted By MOA Admin, Wednesday, May 27, 2020

Cranial Nerve Testing Refresher

Heather Atcherson, O.D.
Young OD Committee Chair
Well 2020 has not been what most of us expected it to be! I hope for everyone's health and safety during this time.

Earlier this year, I had a unique case that required testing multiple cranial nerves. Having a quick reference guide available would have been very helpful, so I wanted to create one to share. If you work in a more medically-focused practice, you may know this forwards and backwards, but if not, I hope you will appreciate this little refresher.

Cranial Nerves I-XII and How to Assess Function:

Cranial Nerve 1 (Olfactory): Assess smell/odor recognition (coffee, soap, alcohol, cloves, etc).

Cranial Nerve 2 (Optic):Measure monocular visual acuity, confrontation or formal visual fields, pupil reactivity (direct and consensual), color perception with HRR/Ishihara (also can be important to utilize the red cap desaturation test), and fundoscopic evaluation of the nerve.
Cranial Nerve 3 (Oculomotor):Extraocular muscle testing in "H-pattern" - CN III controls the medial rectus (adduction in to nose), superior rectus, inferior rectus, and inferior oblique. It also controls the elevation of the eyelid, so check for evidence of ptosis.

Cranial Nerve 4 (Trochlear):Extraocular muscle testing in "H-pattern" - CN IV controls the superior oblique.


Cranial Nerve 5 (Trigeminal):Three sensory divisions - VI (Ophthalmic), VII (Maxillary), VIII (Mandibular). Sensory function tested with faint pressure pinprick or cotton wisp test. Have patient close both eyes and lightly press at a site along the forehead, cheek bone, and lower jaw. Ensure sensation is present on both sides and assess symmetry. Also assess corneal sensitivity with cotton wisp test. When touched, each eye should have a reflexive blink response. The motor fibers only travel to the mandibular division. Motor function tested by having the patient bite down hard. You should be able to feel the muscle contraction of the masseter muscles (around jaw) and can assess symmetry between the sides.
Cranial Nerve 6 (Abducens):Extraocular muscle testing in "H-pattern" - CN VI controls the lateral rectus (abduction away from nose).

Cranial Nerve 7 (Facial):Check for hemifacial weakness. Patient should be able to smile and grimace and have fairly equal symmetry between the sides. Can also check for taste (salty, sweet, etc) on anterior 2/3 of the tongue (test on both sides).

Cranial Nerve 8 (Acoustic/Vestibular):Hearing is tested with formal audiologic measures (Weber and Rinne tests). The vestibular portion can be assessed by checking for presence of nystagmus and differentiating the direction, duration and any particular triggers.
Cranial Nerve 9 (Glossopharyngeal) & Cranial Nerve 10 (Vagus):CN IX and X are often assessed together. Have the patient open their mouth and say "ahhh." The uvula should hang straight. If paresis present, the uvula will pull over toward the "good" side.

Cranial Nerve 11 (Spinal Accessory):Assess the sternocleidomastoid (neck) muscle by applying pressure to the left side of the patient's jaw and having them attempt to turn their head toward the pressure. Repeat on right side. Should have symmetrical resistance on both sides. Then assess the upper trapezius muscle by applying pressure to patient's shoulders and having them lift upward against the resistance.

Cranial Nerve 12 (Hypoglossal):Have patient stick out their tongue and look for any asymmetries. If any weakness present, the tongue will deviate toward the side of the lesion.

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Patient-Centric Care

Posted By MOA Admin, Wednesday, May 27, 2020

Patient-Centric Care

John Burns, O.D.
MOA Past President

It is hard to believe that I have been practicing Optometry for over 30 years, in private practice for over 25. From a young age, I was enamoured by optometry. My optometrist was the only doctor I liked to visit. The doctor was nice, the visits were always cordial and most importantly, there were no shots!

After I was accepted to PCO, my mother sent me a copy of my 6th-grade graduation yearbook. Graduates were asked the all important question, “ What do you want to be when you grow up?” Unlike my friends who wanted to be a millionaire, my response was an eye doctor (or baseball player).

As I reflect on my career, it strikes me how much the profession has changed. For the most part this change has been positive. Expanded scope of practice and medical and technology advances have allowed me to care for my patients in ways I never dreamt of as an optometry student - LASIK co-management, multifocal IOL’s, Lipiflow, scleral lenses, myopia management just to name a few. However, certain advancements if not managed well can create a disconnect with patients. Our response to COVID-19 social distancing and PPE requirements poses a similar problem.

As an energetic young OD, I purchased my practice from an established doctor who was retiring. Quickly, patient volume began to decrease and I realized that my Optometry school education did not prepare me to run a business. Knowing that I needed help, I hired a management consulting firm. The most valuable lesson I learned, which has since informed how I practice and how I run my practice, was the difference between a doctor-centric and patient-centric experience. Armed with this knowledge, I understood that my new patients were simply being loyal to “their” doctor (the former practice owner) and to keep them I would have to work to earn their trust and loyalty. And so I did, and continue to do.

I have spent the last 26 years as a patient-centric office, aiming to provide a Ritz Carlton experience vs. the practice-centric experience often received at large retail chain stores. In the wake of the current pandemic, this fundamental seems more important than ever. And so, as I again reevaluate the need for change to address current COVID-19 restrictions and guidelines, I do so with my patients in mind. My door may be locked and my face may be covered, but my patients know that I am here if they need me ready to greet them with a smile.

Wishing you all good health.


Myopia Management: Quick Facts

Vicky Wong, O.D.
MOA 1st Vice President

We will all get to hear these questions soon enough, so here’s a refresher on facts and clinical studies for when these patients (and parents) are back in your chair!

 

Q: When will my child’s vision be stable?
A:
In the general population, 50% stabilize by 18 years old, 75% by 21 years old, and 90% by 25 years old. That ALSO means that one in four 21-year-olds have NOT reached a stable Rx.

 

Q: It doesn’t matter if my child’s glasses get thicker and stronger, they can just wear contacts later, so what’s the big deal?
A:
We are aiming for a reduced risk of visual impairment later on in life. Each additional diopter increases risk by 67% for Myopic Macular Degeneration. The incidence of retinal detachments is 0.015% in patients with less than -4.75D and it increases to 3.2% if myopia is greater than -6D. That's a 20x greater risk factor with a mere 1.25D jump! Each additional diopter increases risk by 25% for visual impairment, in general, later in life.

 

Q: Well, I only got glasses in high school and then it stayed the same since then! Why does my 7-year-old need glasses now?
A:
Age of onset is one of the greatest factors of predicting high myopia- in addition to how many myopic parents and initial Rx at the age of onset. It is proven that there are both environmental AND genetic factors for myopic progression.

 

Q: Do we have to put the full Rx strength in my child’s glasses? Can’t we just knock it down a little so they don’t get too dependent on it?
A:
Clinical studies since ~2002 actually prove that under-correction CAUSES the progression of myopia.

 

Q: My child is way too young for contacts (MF or ortho-k designs) right?!
A:Due to a lack of learned risky behavior, children (8-11 years olds were studied) actually have a 60% less risk of CL related microbial keratitis and/or infiltrates than adults and teenagers as found in a study with over 1,800 patients.

 

New technology on the horizon for the US

  • MiSight- now offering online certification for their FDA approved for myopia control daily soft CL for select US optometrists
  • Defocus Incorporated Multiple Segments (DIMS) spectacle lenses will soon come to the US market; studies show a promising 52% reduction in myopic progression. Hoya MyoSmart, Essilor Myopilux, Shamir MyLens, and Zeiss MyoVision are out in clinical trials or overseas markets currently.

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Learning to Adapt

Posted By MOA Admin, Wednesday, May 27, 2020

Learning to Adapt

Whitney Fahrman, OD
MOA President Elect

I am a very fortunate employed optometrist who was not furloughed. Throughout the suspension of routine care, I continued to work seeing emergency cases. Some days, I went into the office to see just one patient, but I was still able to practice and make a difference. However, the past month was not without frustration – many issues that we could not foresee made caregiving far more difficult than usual. Urgent same-day referrals were especially hard, like the suspected optic neuritis I saw. After getting the run around for what seemed like forever, I ended up having to send the patient to an ER 1.5 hours away. 

When doing 90, I’ve been having the patient reach around and put their finger at the top of their mask. I then advise them of course to wash their hands. Some colleagues have their patients tape the top of their mask, but I haven’t tried this yet. I also have yet to do any refractions with the mask, which I’m sure will be interesting. I wash my hands before and after each patient and I wear gloves when examining the patient. It took some practice getting used to flipping lids with gloves on!

Good luck to all of you as we start seeing patients for elective care again this week. Adaption takes time, so my recommendation is to start slow and see what new practices work best for you and your office. It will get easier and thereby less stressful as you get into your new groove. Fingers crossed, the new normal will soon become a faint memory. In the meantime, be safe and well. 

Dr. Fahrmans
Hopefully, this will slowly improve as current restrictions continue to get lifted.Adapting to PPE and disinfecting requirements for doctors and patients has been another challenge. Wearing an N95 mask all day over your glasses or goggles is not only awkward and uncomfortable, but it makes your glasses fog and drastically reduces daily water intake. I have found that a folded piece of tissue in the mask does help with the fog. I am still searching for a solution to the occasional overheating from the surgical gown I wear. And then there are the patient care obstacles…

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A Scrub by Any Other Name

Posted By MOA Admin, Wednesday, May 6, 2020

A Scrub by Any Other Name

Dr. Dean Gogerdchi
MOA President

As optometrists around the state prepare for patient care in the post COVID-19 era, many are planning to implement office policies that serve to protect staff, patients, and the community at large. Along with masks, gloves, and hand sanitizer, many practitioners are considering switching from business attire to medical scrubs.  

The uniform got its name because it was initially worn by medical personnel in the scrubbed environment. Traditionally used only by those in surgery, almost all healthcare personnel now wear some type of scrubs whether working in a hospital, clinic, surgical center or private office. Medical scrubs are easily disinfected and emphasize cleanliness in the office setting. They come in more options than just the traditional v-neck and drawstring combination. Scrubs are now available in many colors and styles that include collars, buttons, and pockets.  

Some consider medical scrubs used in a non-surgical setting taboo. “I don’t work in a hospital and I’m not a nurse or dentist, so why would I wear scrubs?” Many adhere to the traditional white lab coat with their name embroidered on the front pocket. Others have worn a shirt and tie for their entire career.

Office attire along with other COVID-19 related updates are topics that will be discussed by our panel of five local optometrists this week during the MOA’s Back to Work Forum.  Join the conversation this Wednesday at 7:00pm as we prepare for the “new normal” that lies in the weeks ahead. 

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Preparing to Reopen

Posted By MOA Admin, Thursday, April 30, 2020

Preparing to Reopen



 

 

 

 

 


Guides For Reopening

Doctor Examining Patient

As we work toward reopening Maryland, the MOA wants to assist you in making the necessary preparations. Below you will find guides from the President’s Administration, Governor Hogan, and the AOA with suggestions and recommendations to ensure your safety and the safety of your patients. The Centers for Medicare & Medicaid Services (CMS) has also issued recommendations for reopening healthcare facilities.

The Guidelines for Opening Up America Again

Optometry Practice Reactivation Preparedness Guide

Maryland Strong: Roadmap to Recovery

 

In addition to these guides the AOA and MOA will be hosting webinars to answer questions doctors have about reopening their practices.

 

Practice Reactivation #AskAOA Webinar

Wednesday, April 29, at 9 p.m. ET

Please register early and submit questions in advance.

 

MOA Back to Work Forum

Wednesday, May 6 at 7:00 p.m. ET

Register here (space is limited)

 

 

 

 

 

 

PPE Resources

PPE on Smiley Face

PPE remains in great demand as many healthcare providers, including optometric practices, take steps to reopen. Listed below are a few local and and national companies that have PPE available for purchase.

 

AOA Excel COVID-19 PPE Resources (AOA/MOA Member Benefit)

 

Laird Plastics Baltimore

Contact: Karen Buckleman

8991 Yellow Brick Road

Baltimore, MD 21237

410-780-7100

Office: 800-873-8405

Fax: 410-780-7115

 

Face MasksMod-Clips, and otherInfectious Control Barriers

 

LaVanture Products Company

Contact:Richard E. Lavanture

Phone: 574-264-0658

Direct: 574-206-2225

Fax: 574-264-6601

Email: richard@lavanture.com


See chart below
(Limited supply - prices/quantities are subject to change)

Item

Price per item

Minimal order (negotiable)

Isolation gown -

AAMI level 2 gowns

$9

10,000

Hospital grade gloves

(1 carton/1,000 gloves)

$106

1,000

Surgery grade gloves

(1 carton/1,000 gloves)

$173

1,000

pulse ox monitors

(several types)

$19.32-$21.40

1,000

isolation suit -

Disposable coverall SMMS, 60 gsm

$14

10,000

face shield

$4

10,000

KN95 masks(Under 50,000)

$2.50

No minimum

 


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Physician Practice Financial Relief Guide within the CARES Act

Posted By MOA Admin, Wednesday, April 22, 2020

Physician Practice Financial Relief Guide within the CARES Act

 

Barbra Johnson, O.D.
CMOS President

The federal government has established various options to help physician practices offset the financial impact of COVID-19. Many of these programs were enacted into law after significant AMA and AOA COVID-19 advocacy with the U.S. Congress and Administration as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Families First Coronavirus Response Act and are now being implemented by the federal agencies.

 

Below is a list of some of the relief mechanisms* (as of April 21, 2020)

 

1.HHS Emergency Funding via UHC

2.CMS Accelerated/Advance Payment Program for Medicare

3.EIDL-Small Business Administration (SBA) Loans

4.PPP-Payroll Tax-Related Benefits

5.Main Street Business Lending Program

 

1)Health and Human Services Public Health & Social Services Emergency Fund

 

This funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19. The payments should arrive via direct deposit.These are payments, not loans, to healthcare providers, and will not need to be repaid.

 

All facilities and health professionals that billed Medicare FFS in 2019 are eligible for the funds. These are GRANTS, not loans, and do not have to be repaid. The funds will go to each organization's TIN which normally receives Medicare payments, not to each individual physician. The automatic payments will come to the organizations via Optum Bank with “HHSPAYMENT” as the payment description.

 

A lot of OD’s did receive this GRANT last week.

 

2)Medicare Accelerated/Advance Payment Program

 

As part of the CARES Act, providers and suppliers (including physician practices) are able to request up to 100% of the Medicare payment amount they have historically received over a prior 90-day period. These advance payments received are LOANS and are subject to automatic recoupment by CMS or repayment by the provider or supplier. They will be deposited to you the same as your Medicare payments with NOVITAS HCCLAIMPMTas the payment description.

 

The Loans are available to Part A providers, including hospitals, and Part B suppliers, including doctors, non-physician practitioners and durable medical equipment (DME) suppliers. While most of these providers and suppliers can receive three months of their Medicare reimbursements, certain providers can receive up to six months.

 

I applied and was funded within 6 days and hope that this LOAN will be converted into a GRANT

 

3)Economic Injury Disaster Loan Emergency -EDIL

 

The SBA’s Economic Injury Disaster Loans offer up to $2 million in assistance and can provide vital economic support to small businesses to help overcome the temporary loss of revenue they are experiencing.

 

These loans may be used to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact. The interest rate is 3.75% for small businesses. The interest rate for non-profits is 2.75%.

 

Additionally, although confusing, businesses are eligible to apply for an Economic Injury Disaster LoanADVANCEof up to $10,000.This advance will provide economic relief to businesses that are currently experiencing a temporary loss of revenue. Funds will be made available following a successful application. This loan advance willNOThave to beREPAID.

 

Applied, have not heard anything

 

4)Paycheck protection program-PPP

 

This payment is based on your payroll and will convert over to a GRANT if at least 75% of the loan proceeds are used for payroll expenses. It originates and is funded by your local bank with SBA supervision.

 

This is the program that most OD’s are interested in as it will help you keep and pay your staff I t must be used within 8 weeks of receiving payment.

 

A lot of us have applied, been approved and funded with this program. Waiting to see if this will reopen.

 

5)Main Street Business Lending Program

 

On March 23, 2020, the Federal Reserve announced the creation of a Main Street Business Lending Program (the “MSBLP”) to support small and medium-sized businesses.

 

This program will be a Federal Reserve-run credit facility that provides financing for banks and other lenders to make low interest loans to eligible businesses with between500 and 10,000 employees.The Federal Reserve has indicated that additional details should be forthcoming in mid-to-late April, though they have not provided an expectation as to when lending under this program may actually commence. Timeframe No timeframe is currently specified—additional details about the program are expected by mid-to-late April.

 

This program is probably not for smaller Optometric Practices

 

A few other State or Federal funding assistance that you may want to look into

And if you are in Montgomery County, Maryland


I have applied, but have not heard anything

 

*https://www.ama-assn.org/system/files/2020-04/physician-practice-financial-relief-guide.pdf


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Don't Quit Your Day Job!

Posted By MOA Admin, Wednesday, April 15, 2020

Don’t Quit your Day Job!

Natalie Sukontasup, O.D.
2nd Vice President/Membership Committee Chair

Over the last few weeks, all of us have had to adjust to a new way of living that many of us could not have foreseen. Unless of course you are a survivalist, then these are your glory days. As an optometrist and mom, balancing work and home life has introduced new challenges. But challenges are made to be overcome. As optometrists, we are great at triaging, diagnosing and putting a treatment plan into place. For this reason we are uniquely qualified to adapt to the challenges of stay at home orders and social distancing guidelines. And as a parent, our ability to be a master multi-tasker will be put to the test more than ever. I am confident we will rise to this challenge.

Making Masks
At-home Office

As many of you, I have spent the last few weeks coming up with new staff protocols, adding protective barriers, implementing shut-down processes, and setting up a telehealth service. Even as a self-proclaimed taskmaster, this was no easy feat! Now at home, my dining room has become my new office where I conduct telehealth calls, my sunroom has become a mask-making factory and my living room is the MOA membership office. My new normal is conducting telehealth calls in between homeschooling and meal preparations. Didn’t we say as a profession, we would never be able to work from home? After two weeks of this, I am all too ready to return to the comforts of my slit-lamps and phoropters. On the other hand, this government-imposed stay-cation has allowed me some of the greatest gifts that my workaholic self would never allow. I have enjoyed mid-day walks with the family, having dinner together at a normal time and simply slowing down. OH! And how many of you have become the new master chef in your household? Or are you the family barber? I hope you are faring better than me, because I’ve been told to not quit my day job!

MOA Member Comm
“But Natalie, that’s nice and all but I am too stressed about my loans, earning an income, paying my staff! How can I possibly enjoy this time?” My answer to that is, control the things you can. Initiate your plan of action and defer your payments and adjust your spending habits. It’s a bit cliché, but make the most of your time off and before you know it we will all be talking about returning to work but this time with a few extra PPE’s! But that’s for another blog. Stay tuned and Stay Safe!
Don

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The New Normal

Posted By MOA Admin, Wednesday, April 1, 2020

We hope today's Tuesday Talk finds everyone well, hunkered down safely with family in the wake of the Governor’s Executive Order yesterday. For those of you who are still working in a practice or health care facility setting, we urge you to take every possible precaution to remain safe and well. These uncertain times are very stressful for everyone with our day-to-day life being so drastically altered. Unlike other states, Hogan’s Executive Order has no end date – the Maryland stay in place directive will remain law until the “State of Emergency” is no longer in effect, or another Executive Order is issued. This begs the question…what will become the new normal?

 

While keeping physically healthy is certainly everyone’s main priority, financial health is a serious concern for many. With so many Marylanders out of work, the new normal for the State Unemployment Insurance Program as of tomorrow (April 1) will be extended hours to process UI claims for citizens who cannot apply online.For large manufacturing companies like the Maryland-basedUnder Armour and Johnson & Johnson, the new normal is a major paradigm shift from what they typically produce to PPE and life-saving vaccines to combat COVID-19 respectively. For non-emergent healthcare, the new normal today is a move toward telehealth. Like CMS, Governor Hogan and the Maryland Department of Health (MDH) have recognized the importance of telehealth during this crisis and have taken action to allow providers to continue to care for their Medicare & Medicaid patients and many private insurers likeUHCVSP and Cigna are doing the same. For more information on private insurer telehealth policies, visitthis website. For more information about the new normal and how optometry is responding, visit theAOA website, which is updated daily. Below are also some webinars you may find of interest as well. Please note that the AOA webinar is tonight and you must register in advance. Stay safe and be well…and stay tuned for more about the new normal.



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Maryland Optometry in the Face of COVID-19

Posted By MOA Admin, Friday, March 27, 2020

Governor Hogan

Yesterday, Governor Hogan announced the expansion of non-essential business closures expected based on "Interpretation Guidance from the State Office of Legal Counsel." With healthcareincluded among the "essential" business categories exempt from closure mandates, Maryland Secretary of Health Robert R. Neall issued the following "Directive and Order Regarding Various Healthcare Matters." The Secretary's Directive mandates thatall healthcare providers "shallperform only medical procedures that are critically necessary for the maintenance of health for a patient. The Directive further states that, "[a]ll elective and non- urgent medical procedures and appointments shall cease effective at 5 p.m.,Tuesday, March 24, 2020 and shall not be performed for the duration of the catastrophic health emergency."

 

Maryland will certainly benefit from the wisdom and immediate, decisive and unified action that has been taken by our executive and legislative leadership in the Hogan administration and General Assembly. The State continues to provide its citizens (employeesemployers, patients, caretakers, providers and first responders) with critical information related to health and financial well-being. Visit the Maryland Dept. Of Health CORONAVIRUS pagefor up-to-date information State initiatives and efforts. Optometrists are included among the volunteers being called to help on the front line. If you wish to volunteer your invaluable service during the pandemic as a medical volunteer, please visit the MDResponds website portal.

AOA Coronavirus Page
We want you to know that the AOA and MOA are here for you (members and non-members) as a resource during these uncertain times. We will all have to adapt to the new reality, so please visit the AOA and MOA COVID-19 dedicated website pages for optometry-specific updates and important information. The MOA and AOA are focused on addressing what we perceive as the most important issues facing the profession during the weeks/months to come - Your Physical and Financial Well-Being, Telehealth Care/Billing for Medicare/Medicaid & Privately Insured Patients, OD Licensure Renewal Requirements and Maintenance of Primary Care Role of Optometry as Essential Providers. The Maryland Board of Optometry (BOE) is also working hard to protect Maryland Optometry patients during the pandemic. The BOE will meet tomorrow, March 25 to discuss several pressing matters of critical importanceto the profession. The MOA will attend tomorrow's BOE meeting and will eblast everyone with updates from the AOA, MOA, BOE and MDH as they become available.
MOA Coronavirus Page

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Safety First! Healthcare during the COVID-19 pandemic

Posted By MOA Admin, Thursday, March 19, 2020
SAFETY FIRST!
Healthcare during the COVID-19 pandemic

  

As the COVID-19 pandemic escalates, the MOA continues to monitor healthcare industry news and outbreak recommendations. We are also in constant contact with the State Department of Health, Board of Examiners and the AOA. Below you will find important information and some useful State and federal links that provide daily status updates. We will continue to update you as more information becomes available. In the meantime, stay tuned, stay healthy, and most importantly, BE SAFE!

CDC UPDATE

CDC Resources for Clinics and Healthcare Facilities

 

 
ESSENTIAL CARE ONLY - HEALTHCARE INDUSTRY RECOMMENDATIONS
Based on new information about how the coronavirus is spread, the population it impacts and how symptoms present (or do not in asymptomatic patients), several healthcare organizations have recommended the voluntary suspension of health care procedures in a clinical setting. (e.g.College of Optometry Ontario,American Academy of Ophthalmology,American Dental Association). When considering the all important question of whether to keep your practice doors open, MOA asks that doctors and practices place the safety of patients, staff and the public first.Please consider whether your practice is able to adhere to the 10 person max gathering space social distancing recommendation and whether your practice ispreparedto protect patients, providers and staff.If you encounter a patient who appears symptomatic or has self reported being infected or concern about infection, refer the patient to his/her primary care physician to determine the best next steps -- DO NOT REFER THE PATIENT TO HOSPITAL!

USEFUL NATIONAL/STATE RESOURCES and INTERESTING DATA
AOA Statement: Doctor of Optometry and COVID-19(Health Policy Institute)
Maryland Board of Examiners in Optometry(updated Conoravirus information)
AOA Coronavirus Webpage(important updates and recommended collaborations)
References for Clinics and Healthcare Facilities
MDH COVID-19 Website Portal(check here for regular updates)
Workers Who Face the Greatest Coronavirus Risk(New York Times March 15, 2020)

EVALUATING & REPORTING PERSONS UNDER INVESTIGATION (PUI)

The CDC clinical criteria for a COVID-19 person under investigation (PUI) have been developed based on what is known about COVID-19 and are subject to change as additional information becomes available. Healthcare providers shouldimmediatelynotify theirlocalorstatehealth department in the event of a PUI for COVID-19.

AOA will be holding awebinar to review billing for telehealth servicesduring the COVID 19 public health emergency. Join our webinar onTuesday, March 17 at 9 p.m. ET. After registering, a confirmation email containing information about joining the webinar will be sent.

MEETING CANCELLATIONS & LIVE CE REQUIREMENTSFOR LICENSE RENEWAL
Doctors of optometry throughout the U.S. have expressed concern about being able to meet annual/bi-annual "in-person" CE requirements for license renewal. The MOA reached out to the BOE recently requesting consideration for doctors renewing during the 2020 cycle unable to attend pre-planned "Live" meetings. The BOE is looking for solution and will address the matter during its next meeting.
See "Upcoming Events" below for more information!

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