One Step Closer to Dilation Reversal

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One Step Closer to Dilation Reversal

Last week, Ocuphire Pharma announced that the FDA had accepted its New Drug Application (NDA) for Nyxol (phentolamine ophthalmic solution 0.75%) for the treatment of pharmacologically induced mydriasis. The FDA assigned a Prescription Drug User Fee Act (PDUFA) date of September 28th, 2023.

Nyxol is a proprietary, preservative-free, stable, investigational eye drop formulation designed to uniquely modulate the pupil size by blocking the alpha-1 receptors, which can be found only on the iris dilator muscle. The drop accomplishes this without affecting the ciliary muscle.

My Two Cents

Nyxol could be a game-changer in our everyday practice. I can’t tell you how many times patients have asked for the “dilation reversal drops,” and when I explain that they no longer exist, there's both shock and horror in their (well-dilated) eyes. Patients may be remembering Rev-Eyes (dapiprazole HCl 0.5%, Bausch + Lomb), which became available in 1990 for the same purpose. However, that product is no longer available in the United States and never quite caught on with eye care practitioners. Here's to hoping that Nyxol will enjoy a different fate.>

Nyxol is also being developed for other purposes, including presbyopia and dim light disturbances (ie, difficulty driving at night). Nyxol is involved in 12 clinical studies (three phase 1, five phase 2, and four phase 3).

PROFILES FROM THE PROFESSION

A Charitable OD With Eye Care in His DNA

Raised by two optometrist parents, you could say that Scott Moscow, OD, was destined to be an eye care professional. “The family joke is that my parents brainwashed me and my sister into becoming their retirement plan,” he jests. A full-time optometrist, contributing writer to optometric publications, lecturer, billing and coding consultant, community volunteer, and more, this Roswell, Georgia, OD grew up working as a technician and optician in his family’s practice, and now serves as Clinical Director, working alongside his parents, younger sister, and three other optometrists.

Dr. Moscow is certified to perform both subcutaneous and subconjunctival injections, which he says are essential to practicing full scope optometry. He performs subcutaneous injections more frequently than subconjunctival injections, but believes that “subconjunctival injections will be used much more in the future, especially for patients who are noncompliant with their eye drops.”

Dr. Moscow also has his own frame line, Lenox Eyeware. For each frame sold (to a patient or another retailer of the line), Roswell Eye Clinic makes a donation to the 501(c)(3) nonprofit charity Angels Among Us Pet Rescue, which is dedicated to saving dogs and cats from high-kill shelters in north Georgia. From optometry to charity, Dr. Moscow says he has a hard time saying no to a good cause; he is a member of his local Rotary Club and has volunteered with the Georgia Optometric Association’s Eye to Eye Program. However, “Family, charity, work, and fun are not mutually exclusive,” he notes. “I always involve and/or invite my wife and son to as many events as possible.”

In 2021, Dr. Moscow’s son was born prematurely and spent the first 10 weeks of his life in the hospital’s neonatal intensive care unit. The experience prompted Dr. Moscow and his wife to get involved with the March of Dimes organization, which works to end preventable maternal health risks and deaths, end preventable preterm birth and infant death, and close the health equity gap. Dr. Moscow, his wife, and their son are the 2023 March of Dimes Ambassador Family.

If you want to suggest an optometrist to be featured in an upcoming edition of Significant Findings, email kroman@bmctoday.com or jdavidson@weceye.com

CAN YOU RELATE

Do you know your value? How important is it to you to have a good boss?

My fiancé Hallie works at an allergy and sinus referral center and is the only registered nurse (RN) in the clinic’s five local offices, with the rest of the staff being medical assistants (MAs) or licensed practical nurses. Hallie’s boss is an incredible leader who is full of compassion and clearly values Hallie’s skills as an RN. She recently took maternity leave, and the clinic temporarily brought in someone from the corporate office to take her place. This individual does not appreciate Hallie’s value to the clinic as an RN and has made it abundantly clear that an MA could do her job for significantly less money.

This situation inspired me to share with you all that wherever you’re working, you should feel valued! Patients appreciate the care that a highly trained and skilled worker brings. I’ve heard more of my optometric colleagues say that they are beginning to feel that their employers don’t value them as much anymore and that their jobs could theoretically be performed by lower-paid staff. We need to remember that we are the eye experts who our patients want to be cared for by and get their glasses and contact lenses from—not from an online exam, an app, or a technician.

I previously worked at a private practice where I was not valued as a doctor nor was I treated professionally, so I left. Don’t be afraid to stand up for your value!

OUTSIDE THE LANE

The Importance of Mental Health for All

The major issue of mental health among physicians has been addressed in most medical trade journals, notably in the latest issue of Modern Optometry. One thing I didn’t realize, however, is that the mental health crisis isn’t just affecting adults in growing numbers—it’s also affecting children. Many adolescents have been in emergency rooms with severe mental health issues since the beginning of the COVID-19 pandemic. These children, as young as 8 years old, present with suicidal thoughts or severe behavioral problems, where they may be at risk of harming themselves or others. (Read more.)

According to one study of 28,000 children 6 to 17 years of age who were enrolled in Medicaid and had at least one trip to the ER over 1 year, less than one third had been seen by an outpatient mental health visit within 7 days of being discharged from the ER, and little more than 55% had a follow-up appointment within 30 days. These follow-ups have been proven to: lower a person’s suicide risk, increase the chance that individuals will take their prescription medications, and decrease the chance that they will make repeated trips to the ER.

It's clear that we, as a society, have a lot of work to do to put more of a priority on the importance of not only our own mental health, but also on that of our friends, family, and colleagues.

QUOTE OF THE WEEK

“Values are like fingerprints. Nobody’s are the same, but you leave them all over everything you do.”

—Elvis Presley