Lesson Learned: Ask Twice, Consult Once

HOT TOPIC

VSP Vision to Acquire Eyemart Express

California-based VSP Vision has agreed to acquire Texas-based Eyemart Express from its current owners, FFL Partners and Leonard Green and Partners. Eyemart Express operates nearly 250 stores across 42 states. This acquisition is part of VSP Vision’s strategy to expand its network and serve more than 85 million members.

According to a press release from VSP, both companies share a commitment to providing affordable, high-quality eye care and eyewear, and this partnership aims at increasing access to eye care, especially in what they deem rural and underserved communities. The acquisition is pending regulatory approvals and is expected to enhance VSP’s ability to meet the eye care needs of its diverse member base.

My Two Cents

By my calculation, this marks VSP’s second purchase of a corporate optical chain, the previous being Visionworks. I was always taught as a student that VSP was created to help grow private practice; however, current market dynamics have altered that mission. Kudos to VSP for what appears to be a superb acquisition, though. I know numerous individuals at Eyemart Express, and they are incredible doctors and members of the optical community. They will surely be an asset to any company they join.

Interestingly, at one of our offices, the two nearest opticals are VSP-owned Visionworks and Eyemart Express.

OUTSIDE THE LANE

What’s the Code for an Eye Injury Caused by Cattle?

Oklahoma State football coach Mike Gundy recently found himself in a bizarre situation when he was head-butted by one of his cows, resulting in an eye injury.The incident occurred during his team’s bye week, and Gundy, known for his unique personality and trademark mullet haircut, opted to hold his weekly press conference via Zoom with his camera turned off to keep everyone from seeing the injury. "I've got a bad eye that I didn't think would be particularly enjoyable for people when they were looking at my pretty face in a live interview," he explained to reporters. Gundy also quipped that the cow seemed to have been watching the Oklahoma State football games and decided to take out its frustration on him. Despite the injury, he maintained a light-hearted attitude, although he admitted to feeling dizzy and having difficulty functioning normally, suggesting a concussion.

My Two Cents

It sounds as though Coach Gundy had himself some excellent minor subconjunctival bleeding along with orbital area trauma/bruising. As we all know, there isn’t much to do about that except give it time to heal. Rest up, coach. It’s a long football season, and just like your players, you’ve taken some lumps and bumps this season.

CAN YOU RELATE

This week’s Can You Relate is just that—one of those moments I’m sure we’ve all gone through. Total embarrassment in clinic when you ask another provider a stupid question.

It happens to us all, and it occurred to me this past week. So even when you think you have a bad day, know you’re not alone. Now, not to toot my own horn, but I think I’m a pretty darn good clinician—especially when it comes to fitting scleral lenses and treating dry eye. Well, I recently had one of my long-time scleral lens patients present to the clinic with extremely blurred vision for 3 days and an eye that had gone “foggy.” She also reported that the eye was so light-sensitive and irritated that she couldn’t open it.

The patient had a self-reported history of radial keratotomy (RK) OU with six—SIX!!!—touchups on the right eye and three—THREE!!!—touchups on the left eye. Upon entering the exam room, all the lights were off, and she was moaning and groaning about her left eye. We chatted about the problem, and I asked the usual questions: Did you take your lens off? Was there pain upon removal or any excessive discharge? Any flashes/floaters, etc? Then, after navigating her to the slit lamp through touching/feeling and our best game of Marco Polo, she got her head in the moderately correct position for a view. The problem, however, was that she refused to open her eyes, and after prying her eyelids open, I could get only a sliver of a view. What I was able to see was even more unique than usual when examining the RK-scarred cornea. It looked like mucus was floating underneath her cornea—and with RK patients, who knows what it could be.

I instilled a few drops of proparacaine in her cornea, stepped out to grab my teammate, Blake Williamson, MD, and asked him to take a peek. I gave him a brief rundown on her unique history and informed him of what my sliver of a view showed. We made our way back to the exam room, and upon entering, the patient’s eyes were wide open. She was also in much better spirits, thanks to the numbing drops. Dr. Williamson got her in position behind the slit lamp, took a quick glance, and asked how long her scleral lens had been on her eye.

My heart dropped. The patient had just told me her lens had been off for days, and my glance behind the slit lamp was so focused on the mucus that I hadn’t even thought of the lens still being on the eye. Sure enough, I could see the scleral lens on her eye from where I was standing. It was a total and utter embarrassment—I couldn’t remember the last time I had done something like this!

The point of this story is for anyone who has recently had a bad day. Rest assured that it indeed does happen to all of us!

IMAGE OF THE WEEK

Eye with Sjögren syndrome and heavy cosmetics.

Paul Hammond, OD, FAAO, @kmkoptometrypro

QUOTE OF THE WEEK

“My best attribute is knowing when not to answer stupid questions.”

— Gina Gershon