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Once you get employees to realize that their success or failure ultimately is up to them, the pressure is off you as a manager. The pressure is squarely in the place it needs to be: on the employees. Your only job then becomes augmenting their growth with the tools they need to be the hardest-working technicians you ever will have.

Children who have convergence insufficiency (CI) will respond better to weekly treatment sessions with a trained vision therapist than to a strictly home-based eye exercise program, according to a study released by the National Institutes of Health (NIH).

Determining the optimal size for an optical dispensary will allow the practice to obtain the highest return on investment and return on assets. The optimal size can be calculated in one of two ways. The first is to determine the number of dollars each square foot of space can generate. The second method is to calculate the percentage of total practice revenues the dispensary represents. Whichever method is used, remember the general rule for dispensary size: "bigger is better."

Visual merchandising is the art of displaying merchandise to encourage sales. Dispensing ophthalmology practices can create eye-catching displays by following some simple rules. Grouping frames by price point and brand helps to organize options for the customer. Displays can highlight individual brands through repetition, a pyramid design, using odd, rather than even numbers of items, considering the texture of background materials, and more.

Carl Zeiss Meditec and Optovue announced that they have resolved their legal disputes pending in the Northern District of California and in Massachusetts Superior Court.

The novel technology found at the heart of an adaptive optics flood illumination fundus camera (AOFIFC, INOVEO)-an electromagnetic deformable mirror (Mirao 52-e, Imagine Eyes)-is designed to facilitate the acquisition of even higher resolution images than those captured by optical coherence tomography systems.

Both subjective and objective evaluation of diabetic macular edema (DME) can produce good results. In a recent study, the initial results of objective evaluation with retinal imaging technology (Heidelberg Retina Tomograph Retina Module, Heidelberg Engineering) showed good sensitivity and moderate specificity, whereas subjective evaluation by two expert assessors produced high sensitivity and specificity. Nevertheless, with optimization, the results of the two forms of evaluation became more evenly matched, suggesting that the retinal imaging technology can aid clinicians in detecting DME.

1-year results from the HORIZON open-label extension study of ranibizumab (Lucentis, Genentech) for the treatment of exudative age-related macular degeneration show that treatment beyond 2 years relatively is safe and well tolerated, but previously treated patients who received ranibizumab monthly for 2 years may be susceptible to loss of vision with less-frequent dosing during the third year of treatment.

Adjuvant use of bromfenac ophthalmic solution 0.09% (Xibrom, ISTA Pharmaceuticals) with ranibizumab (Lucentis, Genentech) reduced the reduced the number of ranibizumab injections needed to control choroidal neovascularization secondary to age-related macular degeneration. Use of the two drugs together resulted in better visual acuity outcomes than those achieved with ranibizumab alone.

Visual acuity gains occurring in a 12-week, fixed-dose period were maintained throughout the 52-week trial of a novel agent (VEGF Trap-Eye, Regeneron Pharmaceuticals) for neovascular age-related macular degeneration. During the 9-month, as-needed dosing phase, the mean number of injections for all patients was two, and gains in visual acuity of up to nine letters were reported.

When data were analyzed from 25 patients who reached the 18-month visit in a phase II trial evaluating epiretinal brachytherapy (EpiRad90 Ophthalmic System, NeoVista) with bevacizumab (Avastin, Genentech), they demonstrated that the novel combination was associated with a significant gain in vision, an acceptable safety profile, and with minimal need for additional anti-VEGF treatment beyond an initial two injections.

Sirion Therapeutics Inc. announced that a difluprednate ophthalmic emulsion 0.05% (Durezol) indicated for the treatment of inflammation and pain associated with ocular surgery is now commercially available.

Drug development for retinal disease is particularly challenging because traditional routes of drug delivery often are unable to achieve desired therapeutic levels, and the disease process often involves multiple complex pathways. An unmet medical need still exists-particularly for the two most prevalent diseases, age-related macular degeneration and diabetic retinopathy-but several phase III trials show promise.

One concern of the theory of evolution is how a highly complex organ such as the eye might develop if there are not intermediate forms of rudimentary eyes that confer a survival advantage to the organism. An intermediate life form recently has been discovered, and Ophthalmology Times Chief Medical Editor Dr. McDonnell hypothesizes that it may have implications for patient care.

Advanced Medical Optics (AMO) announced that the FDA has granted premarket approval of a clear dispersive ophthalmic viscosurgical device (OVD) (Healon D) for use as a surgical aid in cataract extraction, IOL implantation, corneal transplant, and glaucoma filtration surgery.

A new intravitreal insert (Iluvien, Alimera Sciences) currently in clinical trials manages a slow, long-term release of corticosteroid into the vitreous chamber. Preliminary results show the device to be very promising and possibly more favorable than other similar devices used for the treatment of diabetic macular edema.

A collaborative effort to design an intracortical visual prosthesis has progressed to the point that tests of a prototype in a human volunteer are being planned. The results of psychophysical testing in normal volunteers indicate that the prosthesis could provide sufficient visual functionality to enable users to perform useful visual tasks.

Parents of children with amblyopia may have several reasons (or excuses) for not following a prescribed patching regimen. Ophthalmologists who are following the Pediatric Eye Disease Investigator Group guidelines but are not achieving the desired results, should first examine whether patients are adhering to the prescribed therapy.

The adequate management of posterior uveitis in children is difficult but imperative. Many treatment options exist, but to determine the best one for patients, it may be best to divide them into two groups at least initially: those with unilateral disease and those with bilateral disease. Treatment decisions then will follow, based on the severity of the disease.

In the past year, the world of ophthalmology has seen some significant headlines. They captured numerous issues that included patient satisfaction and quality of life, infectious outbreaks, and controversy over treating patients with unapproved drugs. In a press briefing at the American Academy of Ophthalmology (AAO) meeting, "2008 year in review: An update on key issues in the news," ophthalmologists provided an update.

An undiagnosed problem plagues ophthalmology practices, according to Shani Lenard, who believes that the relationship between physicians and administrators can affect the success of a practice. Lenard, practice management consultant, MediScend, Pembroke Pines, FL, and panel members Ann M. Hulett, COE, CAE, Rocky Mountain Eye Center, Murray, UT; Gregory S. Brinton, MD, MBA, founding partner of Retina Associates Utah, Layton; and Traci Fritz, COE, administrator, Fite Eye Center, Clinton Township, MI, discussed the characteristics that build good relationships and key behaviors and explained why they foster success.

Visual hallucinations caused by Charles Bonnet Syndrome (CBS) are not infrequent in older individuals with decreased visual function. While individuals who experience these hallucinations, which are usually generic people, animals, patterns, or scenes, understand that what they are seeing is not real and often are not disturbed by the images, they are worried about the reaction of their families, friends, and physicians.

When faced with a postcataract surgery refractive surprise, implanting a secondary piggyback IOL can be a successful option with careful attention to selecting appropriate candidates, IOL model, and power calculation technique, said Warren E. Hill, MD, a private practitioner, Mesa, AZ.