OMDI as an Alternative to Prostaglandin Analogues in Low or Nonresponders

Joseph F. Panarelli, MD; and Neda Shamie, MD

Eyetube

Joseph F. Panarelli, MD, sits down with Neda Shamie, MD, to discuss a phase 3, nonrandomized, two-phase, open-label, multicenter study that evaluated the IOP-lowering efficacy and safety of omidenepag isopropyl (OMDI) in patients with primary open-angle glaucoma or ocular hypertension who did not respond or responded poorly to latanoprost. What were the results? To access the full review, please visit the link here: https://pubmed.ncbi.nlm.nih.gov/37853676/

Interprofessional Collaboration Pays Off

Working alongside a patient’s primary care physician, the author was able to diagnose Sjögren syndrome and refer her for proper care.

Naureen M. Haroon, OD, MPH, FAAO

Modern Optometry

I was surprised to learn my new 62-year-old patient had been complaining about severe dry mouth to her primary care physician for the past 15 years with no relief. Year after year, she was advised to use mouth moisturizing tablets or a spray, and sent home. But when I heard her complaints of long-standing dry eyes and a dry mouth, I immediately thought of Sjögren syndrome (SS). These two symptoms don’t always indicate SS—especially considering the patient had no other underlying autoimmune conditions, such as systemic erythematous lupus or rheumatoid arthritis, as seen in secondary SS—but it should always be considered and ruled out. THE PATIENT ENCOUNTER While in my examination chair, I noticed the patient had a dry cough. She excused herself to grab a cough drop from her purse, which she explained was a daily occurrence. We discussed possible systemic and environmental factors that could exacerbate her dry eye signs and symptoms, and I started her on lifitegrast ophthalmic solution 5% (Xiidra, Bausch + Lomb) twice daily and fish oil. I also gave her a sample of artificial tears. We talked about punctal plugs, and I advised her to reach out to her primary care physician to request testing for SS. Following up, I sent a simple letter to the patient’s primary care physician, discussing my exam findings and my concern for SS.

Determining When to Use Modifiers -58 and -78

Both are used in association with the original surgery, but ultimately serve different purposes.

Joy Woodke, COE, OCS, OCSR

Retina Today

When retina procedures are performed during the global period of a surgery, an appropriate modifier must be appended to the CPT code for reimbursement. When an unrelated procedure is performed postoperatively in the fellow eye, for example, modifier -79 is used. However, when the surgery is related to the original procedure, either modifier -58 or -78 should be considered. DEFINITIONS When considering which modifier is appropriate for a related procedure, clinicians should carefully review the definitions of modifiers -58 and -78. Modifier -58 is defined as a staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period and has three definitions for use: 1. Planned or anticipated (staged) 2. More extensive than the original procedure 3. Therapy following a surgical procedure Modifier -78 is used for a related but unanticipated return to the OR or office procedure room by the same physician or other qualified health care professional during the postoperative period of the initial procedure. Reporting modifier -58 will initiate a new global period for the CPT code reported. Modifier -78, on the other hand, does not prompt a new postoperative period, and the original global period remains.