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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

Does this next statement sound all too familiar to you? There is no doubt in our practice that we have become reliant on computers for everyday chores. Chores like EMR which we have adopted into our practice for many years. During the summer months of 2011, we dove headfirst into EHR software. We were told that if we were not compliant by the beginning of 2014 that we would get dinged by some agencies for not getting on board. In hindsight, was that just a scare? I still have colleagues who refuse to push the button and go on board with any type of EHR software. Are they smarter than us? Today, we are running once again with the thought of having to incorporate ICD-10 into our practice by Oct 1, 2015. What if we did not comply with this directive? What will be the consequence? So what exactly is ICD-10? Please allow me to retract just a bit. What is ICD-9? ICD-9 is the ‘International Classification of Diseases’ – 9th edition. That would make ICD-10, the 10th edition. The International health care system around the world has adopted the ICD-9 and now ICD-10 so a common coding method could be utilized that would be recognized around the world. Where does Optometry fit into this?...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

I for one do not enjoy our summer months. It can become quite uncomfortably warm during the day but it does cool off during the evenings. Our practice is located in Southern California considered to be in the low desert. When it becomes hot and muggy, we generally see brown haze captured and nestled near and around the mountains. If I had the know-how, I would generate a huge hole in the mountains and install a huge fan to blow all the smog to the desert towns. Unfortunate for us, there are many engineers living on the other side of the mountains and they are geniuses. They would install larger fans and blow the dirty air right back into our city. Again a no-win situation for all. So what do we do about it? In California, the air resource folks have required special low emitting gasoline to be sold during the summer months. That is why when you visit our state in the summer months that our gasoline prices are so expensive. Just be patient and the price will come back down in the winter months. Sounds simple enough. I decided to give my readers a break from my ranting about contact lenses. Having said that, I would write every article until the sun ceases to shine, about all the wonderful...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

HAPPY MOTHER’S DAY to each and every mother. Mothers never seem to receive enough recognition for having given birth to each of us. Let us all give special thanks to each of our mothers. THANK YOU MOM for putting up with me all these years. Where would I be without your tender love? INTERESTING PATIENT 3 years ago, a young man in the music industry walked into my office. He greeted me cordially when I entered into the exam room. He was 28 years of age. He began to tell me about his eye condition. I listened to every detail taking notes along the way. With every contact lens patients, our staff performs a corneal topography map and they make sure to place the topo map on my desk. It has been my custom to first listen to the patient as I have always found out that that is where it all begins…Listening, listening and more listening. The stories that patients relate to me in the exam room could fill volumes. One day when I elect to retire, I will sit down and recall the most interesting cases to share with my colleagues. Until that day comes, I can always share those cases with my readers for now. The patient related that he had seen many eyecare practitioners to date and that he had...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

We are approaching the Holiday Seasons, perhaps, the happiest time of the year for most of my readers. HAPPY THANKSGIVING! This is the season to gather with friends & family to munch of goodies and share whatever we are grateful for. Don’t forget to reach out and lend a helping hand to someone less fortunate than us. CXL for KERATOCONUS: We are beginning to see more and more OMD’s offering this service to help curtail keratoconus. This procedure involves a simple procedure that can dramatically improve the quality of life for many keratoconus and ectasia patients. This procedure can halt the corneal shape change. This has in turn enabled the patients to achieve improved vision and avoid corneal transplantation. Most likely this procedure will be receiving FDA approval in the not too distant future. So what will be our role as O.D.’s to becoming involved with patient care? We refer the more advanced cones to local OMD’s that offer this service. We then provide contact lenses about 3 months after the procedure. It can be done on both eyes at the same time or one eye at a time. CXL utilizes Riboflavin (Vitamin B2) and UV-A radiation to improve the corneal rigidity by increasing...
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Optometrist Prespective by Harvey Yamamoto, OD

Optometrist Prespective by Harvey Yamamoto, OD

I’m a huge fan of remodeling one’s office very 3-5 years. Anyone can swing a paint brush or roller for beginners. A new coat of paint can spruce up the old walls. Two years ago my staff talked me into remodeling the office. I listened to their plans and upon hearing their complete makeover – I honestly balked at the idea. They wanted to retile the waiting room for starters. Then take out the flooring in 3 exam rooms and the kitchen. What? Are they nuts? The expense of installing wood flooring was more than what I had budgeted for. What they did not know was that I knew we had been laying one tile floor on top of one another for the past 3 upgrades. Our floors were high enough which made this project a major one to tackle. The staff then volunteered their husbands to do the work at night after their work was done. They would work for $10/hr. Hey, I couldn’t resist. My wife and I went shopping and purchased a large truckload of tiles, grouting, wood flooring materials, tools, etc. The boys came after work on day #1 and began to chisel out the flooring in the waiting room. Hours later, very little progress was being made. I went home and brought back a small air operated flooring...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

Hello to summer. Once again, I watch my electric bill climb through the roof. If only my bottom line would climb as quickly as our electric bill then I would be content for another year. As promised, I feel that glaucoma is a very important aspect of any optometrist’s daily practice. If we miss it then we can be held for negligence and can be in court trying to defend ourselves before a jury. So, why not prepare ourselves with proper equipment and knowledge about the disease? I found perhaps one of the most interesting articles on the subject matter pertaining to glaucoma in the Optometry Times that I will share with my readers. The article was written by Dr. Benjamin P. Casella and I could not have said it any better. He starts by calling his article: “7 Pearls to guide glaucoma treatment.” At this point, I will excuse myself and sit back and listen to his choice words. “It’s a tough diagnosis to make…and take away once made. We hear about structure vs. function in glaucoma. We hear that structural damage should correspond with functional damage (as evidenced by visual field studies). We go to weekend lectures and see tidy cases of inferior neuroretinal rim notches with...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

A giant “Hello” to all of you. March is now here and we are dealing with windy days in my neck of the woods. Trees are tumbling down with many branches falling on the road to work. Some folks have had an entire tree limb fall on their car. Very scary stuff. Hope all is well with my readers. Stay well my friends and most of all, eat healthy and live a long life. New stuff is here. During November of 2013, GP Specialists began their study on their new small iSight Scleral lenses. Many of our doctors have been inquiring about smaller scleral lenses. Our R&D department began to conduct in-house R&D over several months until they came up with the new and exciting 13.4mm scleral lens to go along with their 16.4mm sclerals which have been performing exceptionally well. Never one to be caught sleeping, GP Specialists decided to formulate a smaller version based upon the polynomials of the original design. They incorporated several large scleral experts across the country to evaluate the smaller version. After 4 months of extensive testing, the new sclerals performed flawlessly. New patients have found that the new smaller sclerals were easier to insert/remove and not as intimidating...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

HAPPY HOLIDAYS AND HAPPY NEW YEAR TO ALL MY READERS FROM ALL OF US AT C&E VISION – YOUR BUYING GROUP OF CHOICE! I like to begin each New Year’s editorial by taking a quick review of what we have done in our practice during the year. It’s now been over 4 years since we rededicated our practice to focus more on contact lenses and ocular disease. We feel so fortunate to have the privilege within the scope of our license to treat so many eye problems from fitting the casual contact lens patients to the more difficult cases plus all the various medical eye problems candidates that we see in our daily practice. Yes, optometry has become a fun profession along the way. Unfortunately, we are not being compensated enough for all the education, equipment, time which we all have put into our practices. To those who are putting themselves each day on the firing line like we do – congratulations! Thank you for supporting the C&E Buying Group for so many years. It is through your loyal support that we exist to this day. This year will mark the 31rd year of The C&E Buying Group. I personally would like to extend my hand to each of you for your support. May 2015 bless each of you...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

HAPPY THANKSGIVING to all my readers. This year has been fleeting very quickly for me and my family. The C&E Family would like to reach out to each of you with Holiday Cheers as we are now approaching into the Holiday season which signals the end of 2013. I pray that each of our members have had a good year in spite of the ongoing economic slump that we have been mired in for so many years. It is now the end of my 2 year effort to move our practice into more highly specialized fitting of the difficult to fit contact lens patients. Yes, I must admit that these patients do consume a lot of chair time but the rewards have been there both emotionally and financially. YamaKone IC: Many of my readers have inquired about this lens. Several colleagues have asked that I write more details about this lens. The YamaKone IC is a byproduct of my lifelong dream of having a soft lens for our cone patients who have become gas perm intolerant. The most important ingredient for me was that this lens must be simple to fit. During the initial R&D phase of developing this lens into which it is today was time consuming. I would spend upwards of 4 hours per patient putting my practice in a huge backlog....
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

In our neck of the woods, summer is bearing down hard on us and we do whatever it takes to avoid the heat. Hopefully all of our members throughout the country are doing alright. Something unusual happened to me in our office. First one computer lost its hard drive. I had taken that one to Best Buy to have the Geek Squad replace the hard drive. That computer was fairly new with 8 MB of memory and 750 gigs of HD. They asked if I had the restore media discs but I had forgotten, (actually too lazy to make any restore discs.) They asked that I call HP to purchase the hard drives. After spending what seemed like an eternity talking with various techs from India, I finally got one who told me what I had to do. I went online and with my limited computer skills, I plodded for what seemed like several hours before I hit the jackpot. I crawled into bed close to 1 a.m. so I wouldn’t wake the wife and dozed off to sleep. When we woke in the a.m., I could hardly contain my happiness by announcing to the wife that I finally figured out how to order the recovery discs. I answered all the questions: S/N/ Product, code, name of computer, how many bytes, etc, etc, etc. The place that had the recovery...
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Optometrist Perspective By Harvey Yamamoto, OD

Optometrist Perspective By Harvey Yamamoto, OD

Ahhhh, the fresh smell of spring is now upon us.  Spring is one of my favorite times of the year.  I extend a very happy spring season for my readers. SOFT CONTACT LENSES:  GP Specialists launched a new lens which is called YamaKone™ IC at the Global Specialty Meeting in Las Vegas during the last week of January.  The YamaKone™ lens is a family of specialty lenses with the keratoconic patients in mind.  My long time readers will know that fitting specialty contact lenses is one of my passions in life.  I find them stimulating and challenging.  Yes, they do take some chair time but the end results often bring about very happy patients who become very loyal and great for referrals. Every GP lab around the country has focused their attention to the development of their own brand of scleral lenses.  Some say that the growth of GP lenses can be directly linked to the rebirth of scleral lenses. By now, I’m sure that I’ve whetted the appetite of most of my readers about soft cone lenses.  What? Why? For what reason?   I have a very large Keratoconus practice which grew over a period of 49 years.  I have run into patients that eventually became so advanced that they no longer...
Filed in: Contact Lens, Editorial
Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

2013 is starting out of the gate on a solid note for our practice and we hope that all of our members are doing likewise. KERATOCONUS:  In my last editorial, I promised to report more on our clinical studies with soft contact lenses.   My passion for contact lenses began in 1959 and continues to this day.  Working with PMMA lenses taught me a great deal on edge designs.  I quickly learned that the comfort of the lenses depended on how nicely I made the edge’s. Keratoconus found me soon after I was discharged from the military service in 1964.  An OMD whom I had befriended while at Ft. Ord began to send me young cone patients to evaluate.  They were in their early teens and some as young as 9 years of age.  Thus my entrance into pediatric contact lenses began with fitting young cone patients.  I found that the young patients adapted quickly to the PMMA lenses and before I had gotten my feet wet, my calendar became filled with similar cases from around the country.  Word of mouth began to spread amongst practitioners that I was very good at fitting their cone patients. Those were the days when we were dependent on keratometry to weed out these cone patients.  The mires were...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

HAPPY NEW YEAR TO EVERYONE! As we begin a new year – ALL of us at C&E sends our best wishes to each and all of you. May 2014 be a wonderful and prosperous year to us all. It is my customary editorial to begin the New Year with some reflecting on the previous year. 2013 was filled with a lot of new happenings and perhaps more excitement than we could have ever fathomed happening to us. First of all, our goal for 2013 was to continue expanding upon our contact lens skills by fitting more and more difficult but interesting cases. Did we accomplish our goal? I’m pleased to announce that we actually met all of our goals. It’s good to set goals during January and then evaluate how well you did in accomplishing those goals. For whatever spirit drives me, I’ve always been goal oriented. In college, my goal was to find an avocation that excited me. I drove myself deep in my studies to accomplish those goals early in my collegiate life and I must admit that Optometry found me. Actually it was my college roommate who introduced me to Optometry and once I felt comfortable in pursuing Optometry my future was set for the rest of my life. So, here I am some 5 decades later and still deeply...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

Many of my readers have known my personal quest to uncover the hidden secrets of scleral lenses.  I can break it further down to 3 different classifications.  First, there is the corneal-scleral lens.  These lenses are anywhere from 13.0 to 15mm.  I began fitting these lenses about 3 years ago.  I soon ran into problems with these lenses clinging to the sclera creating a suction like effect. Fitting sclerals is very similar to fitting gas perm lenses.  Sclerals are like gas perm on steroids.  These lenses presented a steep learning curve for me.  Patients are able to adapt much quicker to these larger diameter gas perm lenses than they are to corneal lenses.  These lenses come to a rest over the sclera which makes them much less aware for the patient. I progressed from fitting the corneal-scleral diameter to the full scleral lenses that equal 18.0mm in size.  Although these lenses were quite comfortable to wear, we found that our patients had difficulty in learning how to insert these larger diameter sclerals. We then migrated to what we call:  mini-sclerals which equal 16.4mm.   Finally, we found the size that our patients could learn to handle. We found these to be very...
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Optometrist Perspective by Harvey Yamamoto, OD

Optometrist Perspective by Harvey Yamamoto, OD

At the beginning of 2012, I told my staff and friends that this was going to be a special year for us.  Last year, I had let it slip that my 50th year since I graduated had slip by unnoticed thus I promised myself that I would do something special during 2012 as some sort of private celebration. I had thought that it was time to do a “makeover” of my practice. I began by retiling the front entrance to our waiting room.  That is when an article by Dr. Gerber appeared:  “You cannot afford Not to do it.”  His first two points rang loudly in my ear.  Point #1: He stated that we should move our location.  Since we own our own building that made point #1 moot.  Point #2 stated that we should remodel.   Now that made a lot of sense.   My retired dentist noticed the change of the new tiling in our office and he remarked, “While attending CE lectures, they are told to do something to their practice every 5 years. “  He remarked on how nice the new tiles had made our practice look.   That was very inspiring and I wanted to do a bit more. I began to discuss my thoughts about remodeling.  One suggestion that I considered was wood flooring in the exam rooms.  My first...
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