AAOpt 2024: A Rapid Fire on retina

Julie Rodman, OD, MS, FAAO, presented at the 2024 American Academy of Optometry meeting on systemic diagnosis and retinal referrals. In a Rapid Fire session with Carolyn Majcher, OD, FAAO, Jessica Haynes, OD, and Daniel Epshtein, OD, FAAO, Rodman discussed how systemic conditions like malignant hypertension can affect the eye, using a case of a patient with retinal vein occlusion and glaucoma as an example. Rodman emphasizes the importance of comanaging patients with primary care physicians to prevent severe ocular complications. She recalls a pivotal moment from her residency where a retina specialist highlighted the necessity of involving primary care in patient treatment. The session aims to underscore the significance of systemic health management in maintaining ocular health.

This summary was written by utilizing AI resources.

Video transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Emily Kaiser Maharjan:

Hi everyone. I'm here with Dr Julie Rodman, who is here to discuss her retina presentations at the 2024 American Academy of Optometry meeting. She's presenting 2 talks, one is a Rapid Fire session on systemic diagnosis, and the other is on retinal referrals. So welcome, Dr Rodman, I'm so pleased that you could make it. It's going to be a great conversation.

Julie Rodman, OD, MS, FAAO:

Thanks so much for having me.

Kaiser Maharjan:

Of course. So first, can we start with the Rapid Fire session? Can you tell me a little bit more about how it's structured? What's on the plate, what's on the menu for that discussion?

Rodman:

Yeah, so the Rapid Fire session, I'm doing with some of my esteemed colleagues, Dr Carolyn Majcher, Dr Daniel Epshtein, Dr Jessica Haynes. Each of us has a really big passion for retina and particularly how our systemic condition can affect our ocular state. So I will talk directly to my portion of the Rapid Fire, but each of us will do essentially 15 minutes discussing a cool case that we've had that really highlights how important it is to manage our systemic health. So the case that I had was a gentleman that had malignant hypertension and presented with a retinal vein occlusion. And essentially what the talk will be, first of all, is introducing what retinal vein occlusions are, how they are remotely related or not – I should say, intimately related – with both high blood pressure and diabetes, and then really focusing on the ocular manifestations that occur when patients have different types of vein occlusion. So the patient that I had actually went on to develop quite a few bad ocular complications. He went on to develop glaucoma, lots of other things that normally we don't see with vein occlusion. So this really talks to the importance of managing our systemic health, working with our primary care physicians, making sure that we're not walking into an optometric or any eye care setting with a blood pressure that's really, really crazy. So that's essentially what each of us is going to do, kind of talk about a patient that we've had that presents with something systemic that affected the eye in a significant way, in a bad way.

Kaiser Maharjan:

Fantastic. And with that, that kind of brings in a little bit of comanagement into the conversation. Do you have any you know, tips, tricks, nuggets of wisdom for comanaging patients with primary care physicians or other specialists?

Rodman:

Yeah, and I'm glad you asked that. You know, I remember when I was a resident, it was really the first time I was managing one of my own vein inclusion cases, and I remember going to present it to the retina specialist because the patient had macular edema and needed to be treated. And she said to me, "Julie, what's the most important thing that you need to do in this case?" And I said, "Well, I'm doing it right now. I'm talking to you." And she said, "No, what's the most important thing?" And I said, "Oh, I need to get in touch with the primary care physician, don't I?" And I'll never forget that kind of pearl, that these are patients that need to be comanaged, not only with eye professionals like retina specialists or, you know, glaucoma specialists or whatever it is, but also with their primary care physicians. Because at the end of the day, if their primary care physicians, or I should say, if the patient had good control their systemic health, then we wouldn't be in the situation that we were in. So fostering really good relationships with internal medicine, with retina, with general ophthalmology, and making sure that we feel comfortable kind of referring and sharing care of these patients.

Kaiser Maharjan:

Yeah I think that's really lovely.

Rodman:

It's humbling.

Kaiser Maharjan:

Yeah, and it's important too, you know, because you're caring for the whole patient, and they're not just a floating pair of eyeballs.

Rodman:

And I'll never forget it. You know, when someone calls you out on something, you never forget it.

Kaiser Maharjan:

Oh, no, absolutely. So how did you go about choosing your case for this specific talk?

Rodman:

Well, the 4 of us kind of brainstormed on what we thought would be interesting and getting engaging topic for our colleagues, things that we see all the time that potentially could be very visually debilitating for patients. And really, like you said, emphasizing the importance of not just taking care of the eye, but taking care of the person. So we kind of went through a bunch of ideas, and we all had a case where a patient systemic state was was bad and resulted in pretty significant ocular sequelae.