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Objective: To determine the rate of Medicare opt-out among optometrists and ophthalmologists and to contrast the differences in the characteristics and geographic distribution of these populations. Design: A retrospective cross-sectional study. Setting: Using a publicly available Centers for Medicare & Medicaid Services (CMS) data set, we collated data for ophthalmologists and optometrists who opted out in each year between 2005 and 2023. We calculated the rate of opt-out annually in each year window and cumulatively from 2005 to 2023. Comparative analysis was used to identify clinician characteristics associated with opt-out. Main outcomes and measures: Both annual and cumulative rate of ophthalmologist and optometrist opt-out from Medicare. Results: The estimated prevalence of Medicare opt-outs was 0.52% (77/14,807) for ophthalmologists and 0.38% (154/40,526) for optometrists. Ophthalmologists opting out were predominantly male (67.5%), had a longer practice duration (average 31.8 years), and were more often located in urban areas (83.1%), compared to optometrists (53.2% male, average 19.6 years in practice, 59.1% in urban areas, p = 0.04, p<0.001, p<0.001 respectively). Approximately 83% of ophthalmologists were either anterior segment or oculoplastics specialties, while the majority (52.1%) of optometrists were in optometry-only practices; >75% of identified clinicians were in private practice. Geographical distribution across the US showed variable opt-out rates, with the top 3 states including Oklahoma (3.4%), Arizona (2.1%), and Kansas (1.6%) for ophthalmology and Idaho (4.3%), Montana (3.1%), and Wyoming (1.4%) for optometry. Conclusions and relevance: Few ophthalmologists and optometrists opt-out of Medicare but this trend has significantly increased since 2012. Of those who disenrolled from Medicare, 83% of ophthalmologists were in urbanized areas while 41% of optometrists were in non-urbanized areas. Because reasons for Medicare opt-out cannot be solely determined by administrative data, further investigation is warranted given the potential impact on healthcare accessibility. [ABSTRACT FROM AUTHOR]

To examine trends in ophthalmic trauma secondary to five major sports (baseball, soccer, tennis, football, basketball) and identify differences between patient characteristics and time period (pre-COVID vs COVID) of injury. The National Electronic Injury Surveillance System was queried to extract cases related to the sports of interest from 2011–2020. Entries were analyzed by age, sex, diagnosis, location, and disposition, with narrative descriptions assessed to characterize the mechanism of injury and visual sequelae. National incidence was extrapolated and Pearson's ?2 and Fisher's exact tests were performed. Among 98,995 presentations, most involved male (83.5%) and pediatric patients (59.2%). Contusion/abrasion (57.3%) was the predominant diagnosis, with injuries primarily precipitated by contact with a ball (44.9%) and occurring in the recreational setting (49.0%). Visual sequelae were documented in 6.4% of injuries. Patients were commonly treated/examined and released (95.6%). Between sports, significant differences in diagnosis (p <.001), mechanism of injury (p <.001), location (p <.001), visual sequelae (p <.001), and disposition (p =.005) were observed. Stratification by age indicated significant differences in diagnosis, mechanism of injury, and location (all p <.001). Stratification by sex indicated significant differences in the mechanism of injury (p <.001) and visual sequelae (p =.04). Stratification by time period indicated significant differences in diagnosis (p =.002) and mechanism of injury (p =.001). There are notable differences in sports-related ocular injuries by patient characteristic, revealing important considerations for their clinical evaluation and the development of safety guidelines. [ABSTRACT FROM AUTHOR]

To describe the relationship between history of atopic disease on systemic and ocular manifestations of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN). Retrospective chart review of patients with SJS/TEN patients. Those with and without prior atopic diagnosis were compared. In total, 200 patients with SJS/TEN were identified. A total of 23 patients also had an atopic diagnosis. Four, 10, and 18 had atopic dermatitis, allergic rhinitis, and asthma respectively. Acute ocular severity was significantly worse in the atopic cohort. No significant differences in overall systemic severity of SJS or mortality were found between the atopic and non-atopic cohorts. Compared to our hospital system's general population, prevalence of an atopic diagnosis was significantly higher in those with SJS/TEN. Patients with a history of an atopic diagnosis appear to have more significant acute ocular involvement during their SJS/TEN hospitalization. Atopic conditions appear to occur more frequently in the SJS/TEN population compared to the general population. [ABSTRACT FROM AUTHOR]

To describe the magnitude, party affiliation, temporal trend, and geographic distribution of political contributions made by ophthalmologists in the United States. This cross-sectional study used public finance data from the Federal Election Commission website to identify political donations from ophthalmologists between 2003–2019. Contributions were filtered for occupation lines matching either "ophthalmologist," or "eye surgeon," and each contribution was cross-referenced to catalogue donations as "Republican," "Democratic," or "Independent." From 2003–2019, a total of 31,855 political donations were made by self-identified ophthalmologists, totaling $11,603,672. Of all dollars, 10.7%, 19.5%, and 69.8% went to Democratic, Republican, and Independent committees, respectively. Political contributions directed towards the American Academy of Ophthalmology Political Action Committee (OPHTHPAC) constituted the majority (59.8%) of overall contributions. From 2003 to 2019, the total number of unique contributions increased significantly from 1135 to 3208 (? = 0.63; P <.01). In dollars, this translated to an increase from $482,300 donated in 2003 to $640,695 donated in 2019, although this trend was non-significant (? = 0.18; P =.48). Conversely, the average amount of each contribution significantly declined from $425 to $203 (? = -0.35; P <.001). As expected, larger states such as California, Texas, Florida, Illinois, Michigan, and New York had the highest contribution dollars, in that order. Political contributions from ophthalmologists have significantly risen since 2003, however there remain opportunities for growth in engagement with OPHTHPAC. Future analysis of how this involvement translates to representative health policy is warranted. [ABSTRACT FROM AUTHOR]

There is limited literature on the characteristics of pediatric ophthalmology leadership. The authors examined the demographics, academic backgrounds, and scholarly output of pediatric ophthalmology fellowship program directors. Despite a positive trend in gender equity in this position, efforts remain to resolve the "leaky pipeline" of women into ophthalmology leadership. [J Pediatr Ophthalmol Strabismus. 2022;59(6):e69–e72.] [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the potential link between methamphetamine use and infectious syphilitic uveitis through a retrospective chart review of four patients with both conditions., Methods: A retrospective chart review was conducted on four patients with a prior history of methamphetamine use and presented with vision loss at an emergency room or clinic that was ultimately diagnosed as syphilitic uveitis., Results: The average age of the four patients was 41.5 ± 9.8 years old, and each presented with symptoms of blurry vision after an average of 3 weeks. Clinical and serologic examinations revealed variable severity of syphilitic uveitis in each patient, and a confirmed history of methamphetamine use was found on a review of social history. Each patient had worsening visual outcomes after the initial presentation and diagnosis., Conclusion: Syphilitic uveitis is a challenging diagnosis due to its similarity with other ocular pathologies. This case series highlights the importance of maintaining a high level of suspicion for syphilis in patients with a history of methamphetamine use and uveitis to enable rapid treatment and prevent visual decline. The poor visual outcomes observed in these four patients underscore the significance of identifying and treating syphilitic uveitis promptly in this population and the barriers to treatment completion., Competing Interests: No author has conflicts or potential conflicts of interest.

Context: While existing data demonstrate that osteopathic physicians (ie, DOs) in primary care are more likely than allopathic physicians (ie, MDs) to practice in rural areas, no data exist on practice patterns of DO surgical subspecialists, such as ophthalmologists. Michigan has a relatively high number of DOs and, formerly, the most osteopathic ophthalmology residency programs in the United States. Analyzing the distribution of ophthalmologists in Michigan may reveal patterns and predict trends about the geographic distribution of DO surgical subspecialists across the country., Objective: To compare geographic distributions of DO and MD ophthalmologists in Michigan and identify differences in community size and type (eg, urbanized area, urban cluster, or rural area) of practice., Methods: A list of Michigan's ophthalmologists practicing in 2018 was developed using the Centers for Medicare and Medicaid Services, the American Osteopathic College of Ophthalmology, and the American Medical Association data sets. DOs and MDs were then analyzed by determining where each ophthalmologist practiced, identifying the size and type of community in which they practiced, and finally by comparing the percentage of DOs and MDs who practiced in various community sizes and each community type as defined by the US Census Bureau. A χ2 analysis was used to determine whether a difference existed in practice locations., Results: A total of 643 ophthalmologists practiced in Michigan in 2018, including 85 DOs and 558 MDs. A greater proportion of DOs worked in rural areas and urban clusters (57 [67%]), whereas a greater proportion of MDs worked in urbanized areas (368 [66%]). Of DOs, 28 (33%) practiced in cities with a population of at least 50,000 vs 371 MDs (66%). Fourteen DOs (16%) practiced in communities with a population of at least 100,000 vs 207 MDs (37%). χ2 analysis showed a significant difference in the geographic distribution of ophthalmologist DOs and MDs (P<.01)., Conclusion: Higher proportions of DOs practice ophthalmology in smaller, more rural Michigan communities compared with MDs, implying that a subgroup exists that tends to serve underserved areas.