The Buzz on Eyetube

Glaucoma Today

iDose Implantation: Pearls and Technique Arkadiy Yadgarov, MD Goniotomy BANG Technique Abdelwahhab Azzawi, MD, FEBO, MRCPS (Glasg) Suprachoroidal MIGS Antonio Fea, MD, PhD Overhanging Bleb Excision Leo Seibold, MD

Behold, the Power to Reverse Mydriasis Is Here!

The wait is finally over.

Modern Optometry

HOT TOPIC Mydriasis Reversal Drop Now Available in US Viatris has announced the US commercial launch of phentolamine ophthalmic solution 0.75% (Ryzumvi) to treat pharmacologically induced mydriasis produced by adrenergic agonists (eg, phenylephrine) or parasympatholytic (eg, tropicamide) agents. Initially FDA-approved in September, Ryzumvi was evaluated across two random, vehicle-controlled, double-masked MIRA-2 and MIRA-3 clinical trials. The drug’s onset of action was found to occur in roughly 30 minutes. Ninety minutes after administration, 49% and 58% of patients who were administered two drops of Ryzumvi returned to < 0.2 mm of baseline pupil diameter compared with 7% and 6% who were administered a placebo, respectively. My Two Cents It will be wonderful to tell patients that we do in fact have “that drop that reverses dilation.” After being routinely asked for this drop for the past 11 years of clinical practice, I’ll finally have an answer that patients will appreciate. I do, however, have a few questions about the product. First off—and it’s probably a dumb question, as I usually seem to have, but—I noticed the indication for the drop is “for the treatment of pharmacologically induced mydriasis produced by adrenergic agonists or parasympatholytic agents.” What about hydroxyamphetamine hydrobromide and tropicamide (Paremyd, Akorn) drops or compounded combination drops (such as the ones we get from Imprimis) that have phenylephrine and tropicamide? Would this drop be considered “off label” to reverse patients dilated with combination drops? Also, what’s the price point? Do practices bear this cost, or do we charge patients for the dilation reversal?

Shielding Your Wealth From Potential Liability

The basics of a solid asset protection plan.

David B. Mandell, JD, MBA

Modern Optometry

Many optometrists are right to be concerned about potential liability. Life and work as a physician, practice owner, and parent bring with it many types of liability risks, including malpractice, employee claims, HIPAA violations, contract disputes, slip-and-falls, and car accidents. To shield wealth from these potential claims, eye care practitioners have the option to implement asset protection planning. A Sliding Scale As an initial step, an asset protection professional will approach a client with unprotected assets much in the way that a physician approaches a patient. Like physicians, asset protection professionals will first try to get a client to avoid bad habits. For a medical patient, bad habits might mean smoking, drinking too much, or a poor diet. From an asset protection standpoint, bad habits might include owning property in a physician’s own name, owning it jointly with a spouse, or operating any medical practice with business assets exposed. Beyond bad habits, asset protection specialists will try to structure assets so they have the best protection that is reasonably possible under the circumstances, which can include how much the client wants to spend, the value of the asset, and the client’s marital status, state of residence, and interest in estate planning. Each asset protection tool has certain efficacy and costs/benefits. The most common misconception that physicians have regarding asset protection is thinking that an asset is either “protected” or “not protected.” In reality, each asset is shielded from liability to a certain degree.