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WHAT’S HAPPENING
Dr. Trese, Academy Laureate, Dies at 76
Michael T. Trese, MD, preeminent pediatric vitreoretinal surgeon and 2021 Academy Laureate, died Oct. 21. He was 76.
Dr. Trese revolutionized his field in the late 1980s with the concept of lens-sparing vitrectomy. He was also a dedicated educator who shared his surgical skills with a generation of fellows and colleagues. And the techniques he developed are now performed around the globe and have restored sight to untold thousands of children.
Dr. Trese also changed the face of telemedicine. Recognizing the difficulties in providing timely screening of babies for retinopathy of prematurity, he spearheaded the development of photographic screening protocols used worldwide. He also investigated numerous pathways in the pathogenesis of retinal disease. Most recently, he and his colleagues explored the application of regenerative medicine to cellular signaling pathways in the retina—a possible game-changer for preventing visual loss and restoring sight.
Dr. Trese served as Director of Vitreoretinal Surgery at the University of Kansas prior to joining Associated Retinal Consultants in 1982. He was a Clinical Professor of Biomedical Sciences at The Eye Research Institute of Oakland University, Clinical Associate Professor at Wayne State University School of Medicine, and Chief of Pediatric and Adult Vitreoretinal Surgery at William Beaumont Hospital.
He is survived by his wife, brother, four sons, and nine grandchildren. He was preceded in death by his son, Patrick.
All Issues of Ophthalmology Science Are Now Indexed in PubMed
As of October, all Ophthalmology Science issues are indexed in PubMed Central. Full indexing means that the journal’s articles and authors will gain more visibility due to the database’s high traffic.
After a rigorous review process—in which only 7%-8% of applications are approved—the National Library of Medicine accepted Ophthalmology Science for inclusion in PubMed, the preeminent global database for biomedical literature.
In March of 2021, the Academy launched Ophthalmology Science. It is an online open access journal focused on publishing preclinical developments, phase 1 and 2 clinical trials, laboratory-based work, ophthalmology informatics, and clinical science. Ophthalmology Science is the fourth of the Academy’s Ophthalmology journals and its first open access journal.
Read Ophthalmology Science at www.ophthalmologyscience.org.
Highlights of the Fall Council Meeting
At the Sept. 29 Fall Council Meeting, Council leaders Thomas A. Graul, MD, and Prem S. Subramanian, MD, PhD, were pleased to see 77 state, subspecialty, and specialized interest societies represented.
Topics covered. Councilors joined discussions on several important topics, including the Department of Veterans Affairs’ Federal Supremacy Project, the proposed revision to Rule 13 of the Academy Code of Ethics addressing misinformation, and the legislative victory on the scope battle in California, which was realized the day prior to the meeting.
Allied health shortage. The Academy’s Senior Secretary for Ophthalmic Practice, Ravi D. Goel, MD, addressed the allied health shortage and the path-way forward, including the development of educational resources by the American Academy of Ophthalmic Executives (AAOE) to help practices with recruiting and retaining allied health staff and the increase in courses focused on technician training at the Academy’s annual meeting. In addition, Dr. Goel talked about AAOE’s lean management webpage (aao.org/lean), which provides resources on how to implement lean principles. During nine regional break-out meetings, councilors weighed in on the allied health shortage and its impact on private and academic practices across the country.
Hall of Fame Award. The meeting closed on a high note with a presentation of the Academy’s Secretariat for State Affairs Hall of Fame Award to Cynthia A. Bradford, MD, for being on the front lines of patient advocacy for her entire career.
Watch Winners of the Global ONE Network Video Contest
The Academy’s Global ONE Network Advisory Board members have chosen the winners of the 8th Global ONE Network Video Contest:
Grand Prize: Gerd U. Auffarth, MD, (Germany) for “CSI Heidelberg: A View From Inside”
Second Place: Fernando Gonzalez Del Valle, MD, (Spain) for “Implantation of Fiber-Free Aniridia Prosthesis in a Posttraumatic In-The-Bag Intraocular Lens Dislocation”
Third Place: Jayesh Vazirani, MD, (India) for “Out of the Box—Allogeneic Simple Limbal Epithelial Transplantation With Combined Cataract Surgery”
View these videos and more at aao.org/browse-go-guide-multimedia.
FOR THE RECORD
Election Results
On Nov. 1, 2022, voting closed for seven positions on the 2023 Board of Trustees. The results are as follows:
President-Elect: Jane C. Edmond, MD
Senior Secretary for Ophthalmic Practice: Ravi D. Goel, MD
Senior Secretary for Annual Meeting: Bennie H. Jeng, MD
Trustee-at-Large: Lisa Diane Kelly, MD
Code of Ethics Rule 13 - Communications to the Public: Approved. This new rule states that communications must not promote health-related misinformation or claims that are false, deceptive, or misleading; statements based on opinion must be identified as such and must not contain material claims of safety and/or efficacy that cannot be substantiated.
For more information about the elections, visit aao.org/about/governance/elections.
TAKE NOTICE
Submit an Article to Ophthalmology Science’s Neuroprotection Issue
Ophthalmology Science, the Academy’s Gold Open Access journal, will publish a special issue on neuroprotection. Submissions are being accepted through June 30, 2023. All open-access fees will be waived. The special issue will feature guest editors Adriana Di Polo, PhD, Thomas V. Johnson III, MD, José-Alain Sahel, MD, and Joel S. Schuman, MD.
Submit at www.editorialmanager.com/xops/default1.aspx.
Nominate a Colleague for the Laureate Award
Every year, ophthalmologists distinguish themselves and the profession by making exceptional scientific contributions toward preventing blindness and restoring sight worldwide. The Academy Board of Trustees recognizes these extraordinary contributions with its Laureate Award, the Academy’s single highest honor. The award recipient is announced each fall, and the Laureate is recognized during the Opening Session of the annual meeting.
Nominate a colleague by Jan. 31, 2023, using the application at aao.org/about/awards/laureate.
Seeking Outstanding Ophthalmologists
Would you like to nominate a colleague for next year’s Outstanding Humanitarian Service Award or Outstanding Advocate Award? Submit your nomination by April 3, 2023.
The Outstanding Humanitarian Service Award—which has been combined with the International Blindness Prevention Award since 2021—honors an Academy member who best illustrates commitment to community and charitable care in the United States or abroad. The Academy selects up to two recipients per year.
Visit aao.org/about/awards/humanitarian to learn more about the award or nomination process.
The Outstanding Advocate Award honors an Academy member who has demonstrated a pattern of advocating for the profession at the state and/or federal level over a period of at least several years.
Visit aao.org/about/awards/advocate to learn more about the award or nomination process.
Nominations must be submitted via the online portal by April 3, 2023. You can see the award description at aao.org/awards for any additional requirements and nomination submission information.
Give to Your Favorite Programs Before the Tax Year Ends
Time is running out to make your 2022 tax-deductible gifts. Consider giving back to an Academy program you’ve benefited from, such as the ONE Network or IRIS Registry; or show your support for the Minority Ophthalmology Mentoring program, the Parke Center, EyeCare America, or Global Outreach. Your gift will help sustain the Academy’s education and quality-of-care programs, creating a better tomorrow for ophthalmologists and patients.
Visit aao.org/donate.
MIPS 2022: Apply for a Hardship Exception by Jan. 3, 2023
Are you planning to apply for a hardship exception for the 2022 performance year of the Merit-Based Incentive Payment System (MIPS)? The deadline to apply is 8:00 p.m. EST on Jan. 3, 2023. There are two exception applications available: 1) the extreme and uncontrollable circumstances (EUC) hardship exception and 2) the promoting interoperability (PI) hardship exception.
The EUC exception. You may submit an application that allows you to request reweighting for any or all performance categories if “extreme and uncontrollable” circumstances—such as a public health emergency, a natural disaster, or a fire that destroys your practice—prevents you from fulfilling MIPS’ requirements.
Some EUC exceptions are automatic. In some locations, the EUC exception may be applied automatically to clinicians who don’t submit any MIPS data and aren’t reporting as part of a group. For example, CMS has said that it will apply the automatic EUC exception to some Kentucky counties that faced severe flooding last summer. To check if such an exception applies to your zip code, visit https://qpp.cms.gov/participation-lookup, but note that CMS can be slow to update its list of areas that are eligible for the automatic EUC exception.
The PI exception. You may submit an application that allows you to request reweighting specifically for the PI performance category if certain circumstances apply (e.g., your EHR system was recently decertified or insurmountable barriers prevent you from obtaining sufficient internet access).
New for 2022: CMS will automatically apply a PI exception to small practices that don’t report any PI data.
For more on hardship exceptions, visit aao.org/medicare/resources/MIPS-extreme-hardship-exceptions.
MIPS 2022: Reporting Manually Via the IRIS Registry? You Need to Get Busy!
If you report MIPS manually via the IRIS Registry, make sure you complete the following steps by Jan. 31, 2023.
Step 1: Download the IRIS Registry Preparation Kit. The kit includes step-by-step instructions for inputting and viewing your MIPS data. Academy members can download it for free (aao.org/iris-registry) or purchase it as a spiral-bound book (aao.org/store).
Step 2: Make sure membership dues are current. All your practice’s ophthalmologists must be up to date with their Academy membership dues. To confirm membership status, call 866-561-8558.
Step 3: Finish entering quality data. Finish entering your data for quality measures into the IRIS Registry’s quality dashboard. Follow the instructions in the IRIS Registry Preparation Kit, which explain how you can tag which patients are eligible for a measure and which, if any, of those are excepted from it.
If you report a quality measure on fewer than 100% of patients, do not cherry-pick. CMS has stated that if you report on a measure for fewer than 100% of applicable patients, you should not select patients with the goal of boosting your performance rate.
Step 4: Complete the information in the MIPS dashboard. Finish entering clinician information and practice settings, report quality measures (including data completeness totals), report improvement activities, and—if applicable—attest to promoting interoperability measures.
Include the data-completeness totals. If you are manually reporting patients for a quality measure, you must provide the total number of patients eligible for that measure (from all payers), plus, if the measure includes an exception, the total number of patients who are excepted from the measure.
Step 5: Sign the data-release consent form (DRCF) and submit your data to CMS. Once you have finished attesting to your MIPS performance, sign the 2022 DRCF via the IRIS Registry dashboard (aao.org/consent-form), and then submit your MIPS data and attestations to CMS. For more information on this process, see the IRIS Registry Preparation Kit.
New MIPS Rules for 2023
CMS published the 2023 MIPS rules in November and, at time of press, was expected to publish the 2023 quality measure benchmarks in late December. Meanwhile, the Academy is in the process of reviewing the new regulations and updating its MIPS resources.
Bookmark these URLs. For guidance on the 2023 regulations, visit the following pages, which will continue to be updated:
Check your email each week. To learn about the latest MIPS developments, watch for Washington Report Express (Thursdays), Medicare Physician Payment Update (first Saturday of the month), and, if you are an AAOE member, Practice Management Express (Sundays).
Volunteer: Be a Congressional Advocate
The Academy’s Congressional Advocacy Program plays a critical role in driving a pro-ophthalmology legislative and regulatory agenda. Through the program, Congressional Advocates form a national network of ophthalmologists who provide important constituent input to their members of Congress and congressional staff on key Academy priorities.
Learn more at aao.org/volunteering, then choose “Advocate.” (This is just one of many Academy volunteer opportunities.)
OMIC Tip: Delayed Diagnosis and Treatment of Giant Cell Arteritis
Allegations of “failure to diagnose” are common in medical malpractice lawsuits against ophthalmologists, and diagnostic error is an issue of ongoing concern in the health care community. Giant cell arteritis (GCA), in particular, has a short window for diagnosis and treatment. If an ophthalmologist misses symptoms or lacks access to a complete and accurate patient history, they may not follow through to confirm the diagnosis and coordinate treatment. The patient then risks severe bilateral vision loss, and the treating ophthalmologist incurs liability exposure. Here are some steps to mitigate those risks:
Aim for specificity. For example, with a patient reporting a headache spanning two days and a “curtain” over his or her vision, the ophthalmologist can gain valuable information by asking more about the precise nature of that “curtain” (e.g., whether it is transparent or dark).
Ask the right questions. In addition to eliciting accurate information about the patient’s eye complaint, query older patients about constitutional symptoms. A careful review of signs, symptoms, and systems can help distinguish the few patients who could have GCA from the large number of older patients with more common eye problems seen daily in ophthalmic practices. Don’t wait for the patient to offer the information; ask for it.
Use a checklist. OMIC’s sample “GCA Checklist” is available at: www.omic.com/giant-cell-arteritis-toolkit. The checklist will prompt you to obtain information to build a more thorough history and offers cues to take action.
OMIC offers professional liability insurance exclusively to Academy members, their employees, and their practices.
ACADEMY RESOURCES
Learn About Diagnosis and Management of Periocular Malignant Melanoma
You can earn 2.5 CME credits with the Academy’s new Learning Plan titled “Diagnosis and Management of Periocular Malignant Melanoma.” This activity reviews the differential diagnosis of malignant melanoma and provides outcomes data, guidelines for surgical excision, and biopsy techniques for the management of the disease.
Get started at aao.org/learning-plan-detail/diagnosis-and-management-of-periocular-malignant-melanoma.
Attend the 2023 Ophthalmology Coding Update Webinar
On Jan. 10, 2023, 2:00 p.m. ET, Academy Secretary for Federal Affairs David B. Glasser, MD, and Academy Director of Coding and Reimbursement Joy Woodke, COE, OCS, OCSR, will present the 2023 Ophthalmology Coding Update webinar (1 CME). Topics covered during this live Zoom webinar will include:
- the 2023 Medicare fee schedule,
- CPT codes for orthoptic training and quantitative pupillometry,
- category III code for laser trabeculotomy with OCT, and
- revalued codes for dark adaptation eye exam and anterior segment imaging with FA.
Learn more at store.aao.org/2023-ophthalmology-coding-update-webinar.html.
Order Your Updated 2023 Coding Books Today
Protect your practice’s reimbursements with the trusted tools that coding professionals use every day. The 2023 ICD-10-CM for Ophthalmology is shipping now. In addition to the popular Ophthalmic Coding Coach and Coding Assistant series, you can also preorder essential Academy-developed references for retina coding and CPT.
Order now at aao.org/codingtools to receive them as soon as they are available.
Empower Your Entire Practice Team Through AAOE Membership
Join the American Academy of Ophthalmic Executives (AAOE) in January for a full year of valuable member benefits, including AAOE-Talk, the online community that connects members with practice management support in real time; an expanding video education library; strategic coding and business intelligence from Academy experts; and more.
Learn more about AAOE membership at aao.org/joinaaoe.
Save 10% on Patient Education Brochures Until Jan. 9
Don’t leave your patients to self-diagnose with “Dr. Google.” Patients prefer to leave your office with easy-to-understand, ophthalmologist-reviewed brochures from the Academy. These high-quality patient education brochures save you chair time and can also mitigate your informed consent risk.
From now through Jan. 9, 2023, save 10% on every pack of 100 patient education brochures using code PEB2022 at checkout. No minimum purchase is required to take advantage of this limited-time offer.
Order today by visiting aao.org/patientbrochures.
MEETING MATTERS
You Can Still Register for AAO 2022 Virtual and Subspecialty Day
Even if you missed the live broadcast of the virtual meeting Sept. 30-Oct. 3, you can register for AAO 2022 Virtual through Jan. 17.
AAO 2022. Experience the recorded content from AAO 2022 when you register for the virtual meeting. More than 300 sessions and courses are available to view on demand through the AAO 2022 Virtual meeting platform.
Subspecialty Day. Register separately for Subspecialty Day Virtual–Friday (which includes glaucoma, pediatric ophthalmology, refractive surgery, retina, and uveitis content) and Subspecialty Day Virtual–Saturday (which includes cornea, oculofacial plastic surgery, and retina content). You will gain access to all sessions recorded in Chicago for the Subspecialty Day meetings taking place on the same date.
In-person registration benefit. If you registered for an in-person meeting in Chicago, you automatically have access to the corresponding virtual content for that meeting.
Access. The virtual meeting platform is open through Jan. 31, 2023. After Jan. 31, you may still view content online. Go to aao.org/myonlineproducts, log in, and choose the virtual product you registered for: AAO 2022 and/or Subspecialty Day. You will be able to access sessions on demand and claim CME credit (professional attendees only) through Aug. 1, 2023.
Learn more about AAO 2022 at aao.org/2022.
Claim CME Through Aug. 1, 2023
Claim CME credits through Aug. 1, 2023, for attending the live AAO 2022 or Subspecialty Day meetings or viewing virtual sessions. You can claim some credit in 2022 and some in 2023, or all in the same year. Limits are up to 50 credits for AAO 2022 and up to 12 credits per day for Subspecialty Day. You do not need to track which sessions you attend, just the total number of hours you spend in sessions for each claim.
For more information on AAO 2022, visit aao.org/annual-meeting/cme.
Plan to Attend AAO 2023 in San Francisco
Mark your calendar for AAO 2023 in San Francisco! The meeting takes place Nov. 3-6 (with Subspecialty Day meetings beginning on Friday, Nov. 3), in Moscone Center.
For more information on AAO 2023, visit aao.org/2023.
2023 Abstract Deadlines
Want to create content for AAO 2023? Submit your ideas for an instruction course or new Skills Transfer lab. Abstracts will be accepted from Dec. 8, 2022, through Jan. 10, 2023.
To submit, visit aao.org/presentercentral.
MEMBERS AT LARGE
Watch Dr. Osher’s Latest Video Journal: Vol. 38, Issue 3
The Video Journal of Cataract, Refractive, and Glaucoma Surgery (VJCRGS), created by ophthalmic surgeon and educator Robert H. Osher, MD, has been publishing educational cataract, refractive, and glaucoma videos since 1985. The surgical videos are submitted from ophthalmologists around the world and are hand-picked by the VJCRGS editorial board. The third issue of 2022, entitled “Intrascleral Haptic Fixation,” is an educational journey into the technique that is changing the management of complicated cataract surgery and was developed by Shin Yamane, MD, from Japan.
Watch for free at www.vjcrgs.com.
D.C. REPORT
Scope of Practice: Academy Defends Ophthalmology in 2022
This year, the Academy achieved major victories to preserve surgical standards and ensure patient safety.
Successes. Working alongside state ophthalmology societies and subspecialty organizations, the Academy succeeded in derailing optometric surgery proposals in multiple states, including California—which, because of its large population, has great national influence—where the governor vetoed a bill in September at the urging of ophthalmology and allies in medicine.
In Alabama, Minnesota, Utah, Vermont, Washington, and West Virginia, ophthalmology defeated the proposed scope of practice legislation in state assemblies. In Nebraska, the Academy is working to argue against a proposal that, at time of press, is still being considered in an administrative review process known in the state as “407.”
Key to success. The Academy worked collaboratively with state society leaders to create and implement effective state-specific advocacy plans. For example, prompt action by state society leaders in Alabama, Washington, and West Virginia allowed the Academy time to build support with legislators. In Vermont and Nebraska, ophthalmology’s presentations to legislators and staff were persuasive. And in Utah, targeted radio and digital advertising succeeded in engaging the public.
In addition to Academy members and state partners who are committed to advocacy engagement, the Surgical Scope Fund is one of ophthalmology’s most important tools in derailing optometry-backed legislation that erodes surgical safety standards and devalues the medical education and clinical residency training of physicians.
Join the fight. There were losses, however. Virginia and Colorado enacted optometric surgery legislation. With these setbacks, it’s more urgent than ever that Academy members get involved in advocacy at the federal and state levels. Now is the time to join your state ophthalmology society and become an active partner alongside society leadership in protecting patient safety standards for quality surgical eye care.