Management of Mild Glaucoma With SLT

John P. Berdahl, MD; Tanner J. Ferguson, MD; and Mitch Ibach, OD, FAAO

Eyetube

John Berdahl, MD; Tanner Ferguson, MD; and Mitch Ibach, OD, FAAO, discuss a case of a female patient in her late 70s with a history of cataract surgery and mild glaucoma. She was taking topical medication to manage her glaucoma but experienced conjunctival hyperemia and ocular surface disease from the drops. The three hosts review the potential treatment options for this patient and outline the decision to perform selective laser trabeculoplasty (SLT) to eliminate medication burden.

Ocular Syphilis: the Great Imitator

Learn some of the different ways this increasingly common disease can present and proven ways to manage it.

Connor Kortright, OD

Modern Optometry

Ocular syphilis, often dubbed the great imitator because it can present as several other conditions, continues to challenge clinicians with its diverse and often misleading presentations. With incidence rates rising annually,1 optometrists are increasingly likely to encounter this elusive disease in practice. In my home state of New York, new cases of syphilis have steadily increased to reach more than 10,000 in 2022, after essentially no new cases were reported in 2000.2 This article presents five cases that show the diverse presentations of ocular syphilis and just how difficult it can be to detect this tricky, and increasingly common, disease. CASE NO. 1: A MISDIAGNOSED KERATITIS A 33-year-old Black man presented with bilateral eye pain persisting for 1 month.3 It was initially treated as conjunctivitis by a previous provider. He had a pustular facial rash, and his vision was reduced to 20/70 OD and 20/60 OS. Examination revealed bilateral peripheral ulcerative keratitis. Workup later confirmed syphilis infection with HIV coinfection. The patient was initially treated with steroids but was transitioned to 4 million units of intravenous (IV) penicillin every 4 hours for 14 days after confirmation of syphilis infection, leading to remarkable visual recovery (20/20 OU). CASE NO.

Retina Coding Crash Course

This outline will help you begin to master this necessary skill.

Justin C. Muste, MD, and Omesh P. Gupta, MD, MBA

Retina Today

KEY TAKEAWAYS Understanding the fundamentals of coding early in fellowship helps you document correctly, communicate clearly, and avoid costly errors later in practice. Every claim links a Current Procedural Terminology code, which tells the insurer what you did, and an International Classification of Diseases, 10th Revision code, which tells them why you did it. Modifiers are short, two-character codes that give extra details about the service(s) performed, while J-codes identify a specific medication and dosage, so that the insurer can reimburse appropriately. Starting retina fellowship brings you a step closer to the complex world of coding. While attendings and billing teams often handle final claims, understanding the fundamentals early helps you document correctly, communicate clearly, and avoid costly errors later in practice. In addition, coding also plays a role in legal documentation by keeping care traceable. The Current Procedural Terminology (CPT) is a standardized coding system created and maintained by the American Medical Association that describes medical, surgical, and diagnostic procedures and services performed by health care providers. Each CPT code is a five-digit number (plus modifiers, depending on the circumstances) that tells insurers exactly what service or procedure was done (Table 1). This guide breaks down coding essentials from a retina fellow’s perspective with common examples relevant to retina clinics and surgery. THE BASICS Coding is, essentially, a form of standard communication between a specialist and insurer.