The Future Ain’t What It Used To Be.

It is with great humility that I begin my tenure as the Chair of the Board of a truly extraordinary company - OMIC. Following such legends as Rich Abbott, Tamara Fountain, and immediate past Chair George Williams is a tall task, but one I embrace. Dr. Williams served on Board committees for 14 years and before becoming our Chair he led the Finance Committee. He oversaw the growth of our company to a record high of 5000 insured ophthalmologists and his leadership left OMIC in the best financial condition in our history.

Looking forward, I am reminded of Yogi Berra’s prediction that “the future ain’t what it used to be.” Ophthalmology and all of medicine are facing tremendous disruptive changes, which are coming at a fast and furious pace. Every ophthalmologist encounters unsettling challenges on a daily basis, whether from new federal or state mandates, scope of practice issues, private equity agendas, or drug supply and pricing issues. Fortunately our partner, the American Academy of Ophthalmology (AAO), has unequalled federal and state advocacy staff and physician leadership to advocate for our patients. Dr. Williams transitioned from leading OMIC to current AAO president earlier this year.

OMIC’s mission is twofold. First, we want to provide high quality insurance. In other words, we want you to sleep well at night. OMIC’s board and committee members are practicing ophthalmologists who face the same disruptive changes all of you do. To make life easier, the Board asked staff to streamline our application process and change our bylaws so we may continue to insure practices that are owned by private equity firms.

The second part of our mission is to promote quality ophthalmic care and patient safety. This Digest focuses on ocular toxicity of commonly prescribed drugs often listed in our senior patients’ medical records. These include hydroxychloroquine, ethambutol, glucocorticoids, osteoporosis medications (bisphosphonates), erectile dysfunction agents (tamsulosin), topiramate, anticholinergics, and anti-hypertensive agents.

This issue is personal for me. I followed a patient in her mid-seventies who presented with complaints of decreased vision from 20/25 to 20/50 while on ethambutol for three months for treatment of atypical mycobacterium infection. Her exam was unremarkable with subtle VF changes and few color vision abnormalities. Stopping ethambutol therapy and observing the patient’s vision drop to 20/200 over two agonizing months is an ophthalmologist’s worst nightmare. Fortunately, her vision gradually returned to normal within 3 to 4 months. It was alarming to learn that the patient had been prescribed the correct dosage based on her weight yet still developed optic neuropathy.

This patient was lucky: ethambutol toxicity is preventable with careful monitoring of dosage and examination, and immediately discontinuing it prevented irreversible damage. Other drugs present greater challenges. In this issue we provide insights on how to best protect our patients.

Finally, Yogi said it best about our future and as I step up to the plate as your Chair I will be ready for whatever is thrown my way. You can be assured that OMIC's team has its eye on the ball, our head in the game, and we will always have your back.