Your providers at Korb & Associates hope that you and your loved ones are safe and healthy. Because we cannot be in the office now, we thought that we would pass on a few eye related concerns that are specific to this uncertain time. Many patients are calling to ask questions about potential loss of insurance benefits and contact lens orders. We also what to review the basics of conjunctivitis, as there are sporadic cases related to COVID-19. We will review some pearls on best practices when handling contact lenses. Finally, the CARES act has extended benefits for tele-health and OTC medications, and we explain this for you.
PLEASE TAKE A FEW MOMENTS TO REVIEW OUR COVID-SAFE PROCEDURES FOR YOUR UPCOMING VISIT
While we are all still learning to cope with the reality of an ongoing pandemic, we strive to make every element of your experience as effective, efficient, compassionate and as safe as possible. You have probably already been briefed to some extent by our staff regarding our new procedures when your appointment was scheduled. However to keep you, our staff, and other patients safe, please take a minute to read about our protocols.
- Because we wish to keep the waiting room clear whenever possible, we have enabled virtual check in. Please text or call the main office number (617) 426-0370 when you have arrived at our building If you are in a car, you are welcome to remain there. If you travel by public transportation, you will be buzzed into the building and can wait in the large hallway upstairs. Once our check in staff have confirmed that your exam room is completely disinfected, you will be called and asked to come down the elevator.
- You will be greeted by a staff member at our entry door, where your temperature will be taken and COVID screening questions asked. You will then be brought directly to your exam room. One issue that some offices are having is when patients have been outside in the hot weather, it causes their temperature to increase temporarily. This is why it is a good idea to wait in your car (with air conditioning on) or in the air conditioned hallway upstairs. With our current schedule we do not anticipate that you will be waiting for more than a few minutes. Please try to arrive 10-15 minutes early so that you have time to cool down if it is a hot day, and to also give yourself time to get downstairs.
- No visitor policy: We know how important it is to have family with you, but for the safety of all, we cannot allow visitors at this time. If you require assistance, exceptions are made for minors or required caregivers. Please request this at the time of your visit so our staff can make accommodations. Your guest will also be screened for signs of illness.
- A senior member of our clinical staff will contact you to review your health history and current medications.
- Please be advised that our optician will be seeing patients by appointment only to ensure physical distancing.
- We are taking all necessary precautions to stop the spread of the virus and other germs. All doctors and staff wear masks at all times. We use N-95 masks, face shields, protective eyewear and gloves when appropriate. We ask that patients come to their appointments with masks or appropriate facial coverings. If needed, we will supply you with a disposable mask.
- Extensive disinfection procedures following CDC guidelines are used in all areas of our practice throughout the day with special attention to clinical areas.
- Some aspects of your exam experience will be different. We have broken up the clinical staff into teams that work with one doctor only, and the teams do not interact. You will be seen by the doctor and their team member only, and you will spend your entire visit in one exam room whenever possible.
- A virtual check out system and optional touch free payment systems have been implemented.
We welcome you to refer your family members, friends and co-workers who are in need to eye and vision care. Your referrals support our small businesses and ensure its future success! While your experience may feel different, our commitment to you remains the same. We will make every element of the patient experience as effective, efficient, compassionate and as safe as possible.
Korb & Associates
Learn more about our dry eye clinic
Learn more about our myopia control clinic
We hope that these suggestions are helpful!
Using Vision Benefits That You Might Lose and Contact Lens Prescriptions.
For those of you who have contact lens replacement benefits that you may lose due to the unfortunate disruption of the labor market during the COVID-19 challenge, we are here to help you use those benefits before they go away. With our existing “Shelter in Place” guidelines we are unable to perform contact lens evaluations and authorize prescriptions that may be expiring. As such, and within the admittedly extended limits of the standard of care and our doctor’s authority under the Federal Fairness to Contact Lens Consumers Act and the Federal Trade Commission’s (FTC) Contact Lens Rule, we will do the following, starting immediately:
•For those with unexpired contact lens prescriptions who have had an examination within the last twelve months, we will dispense up to a 6-month supply of your current lens prescription.
•For those who have not been in during the past 2 years and have an expired prescription, we will dispense up to a 3-month supply for daily disposable CLs or 6-month supply for monthly CLs, of your current contact lens prescription.
•For those wearing custom CLs or medically necessary custom CLs and are in need of lens replacement, we will order and dispense them to you if you have been seen within the last twelve months. Many labs are extending their warranty periods during this crisis if there is a problem with the lenses. If you want to try to use insurance to pay for the lenses, please notify us at the time of the request, as it will take several weeks to process the request an obtain insurance determination on the claim.
•All contact lenses will be shipped directly to you unless there is urgent medical necessity to examine you. Please share your situation with us as you place the order.
·For daily disposable CL wearers, we recommend that you purchase a six-month supply if you want to take advantage of the lens manufacturers’ rebate programs. These are all available online. You will need your receipt from the purchase to file the rebate claim.
·Please let us know if you have vision insurance benefits for CL replacement (VSP or EyeMed) when you contact us and we will verify and apply them to your purchase. We will process your order as soon as your benefits have been verified. Our billing team will contact you with information about your remaining responsibility prior to ordering. · We will waive shipment charges for the above categories of lens orders
To place an order, please email email@example.com
If you have specific questions for your doctor, please visit our website at www.korbassociates.com to schedule a time to speak with your provider.
Some patients with COVID-19 have developed conjunctivitis. Normally at this time of year we get many emergency patients with conjunctivitis due to allergies. Below is a short description of the different types of conjunctivitis.
We are making the following common sense recommendations:
· Try not touch your eyes. If you do, then please wash your hands for 20 seconds with soap and water.
· If you are using artificial tears or other ocular medications, try not to contaminate the tip by touching the lids or eye.
· Do not share artificial tears.
· Do not touch the bottles of drops or saline solution with unwashed hands.
Conjunctivitis (or pink eye) is the inflammation of the conjunctiva — the transparent mucous membrane which covers the white part of the eye. Infectious causes of an inflamed eye and conjunctivitis include bacteria, viruses and fungi. Non-infectious causes include allergies, foreign bodies and chemicals. The often present with characteristic symptoms. These are described below.
Bacterial conjunctivitis is a common and caused by bacteria that infect the eye through various sources of contamination. The bacteria can be spread through contact with an infected individual, exposure to contaminated surfaces or through other means such as sinus or ear infections. Dirty contact lens cases, use of contact lenses that are not properly sterilized, blepharitis (unclean lids) or use of contact lenses on a full-time basis is a risk factor. It is somewhat contagious.
Bacterial conjunctivitis usually produces a thicker eye discharge or pus and can affect one or both eyes. Patients will often note that the eyes are “stuck together” in the morning with a tenacious material. Bacterial infections can also invade the cornea, which can be very serious. If you experience light sensitivity and severe pain, you may have a corneal infection. You should call our emergency line immediately. Like any bacterial infection, antibiotics may be used, however there are many resistant organisms now in the community. Fortunately, most cases of bacterial conjunctivitis will clear up without treatment after 1-2 weeks. This is not always the case for corneal involvement.
Antibiotic eye drops may be required if:
- The infection is severe
- The patient is immune compromised
- The infection does not clear up on its own within a week
Treatment of bacterial conjunctivitis is typically accomplished with topical antibiotic eye drops and/or eye ointments. The treatment usually takes from one to two weeks, depending on the severity of the infection, but the patient will not be infectious 12-24 hours after starting the eye drops. Patients should not wear contacts, should irrigate their eyes several times per day with saline solution and should discard cosmetics, their contact lenses and their contact lens case.
Viral conjunctivitis (this would be in the COVID-19 category)
Viral conjunctivitis is another common type of pink eye that is highly contagious as airborne viruses can be spread through sneezing and coughing, as well as by contact with contaminated objects. Viral conjunctivitis can also accompany common viral upper respiratory infections such as measles, the flu, the common cold (usually adenovirus), and of course, COVID-19.
Viral conjunctivitis usually produces a watery discharge although sometimes the eyes can get quite crusty upon waking. Often there is a scratchy feeling. Usually viral infection starts in one eye and quickly spreads to the other eye. Viral conjunctivitis is more common than bacterial conjunctivitis. There are no medications that are effective. While it can be severe, especially in the first week, it is self- limited and usually resolves within 7 to 21 days. Symptoms should start to improve after the first week.
Treatment of viral conjunctivitis usually involves supportive therapies, such as saline rinses several times a day, lubricating eye drops, and sometimes remedies hat help reduce the symptoms: for example, vasoconstrictors, decongestants to reduce the surface swelling and antihistamines to reduce occasional itching. Treatments usually are continued for one to two weeks, depending on the severity of the infection.
Frequent handwashing, not sharing towels or pillows and disinfection of surfaces are recommended. Patients should not wear contacts, should irrigate their eyes several times per day with saline solution and should discard cosmetics, their contact lenses and their contact lens case.
Allergic conjunctivitis (very common in the spring)
This pink eye caused by eye allergies is very common, especially in the spring. Eye allergies, like other types, can be triggered by allergens including pollen, animal dander and dust mites. Cosmetics, lotions and other household chemicals can also cause allergic conjunctivitis.
The most common symptoms of allergic conjunctivitis are itchy eyes, mild tearing and swelling of the lids and sometimes the white part of the eye. Symptoms can be reduced with 1) avoidance 2) cool saline rinses 3) OTC anti-allergy drops. We recommend Zatidor or Alaway, taken every 12 hours. Prescription medications are available if your symptoms do not improve. Itching or rubbing the eyes will only make it worse (although it will feel satisfying for a minute). Warm compresses may make your symptoms worse. If you sleep with your window open, it is likely that pollen will be on your bed.
If you have allergies, you will not have a fever or other symptoms such as muscle aches and extreme fatigue.
Gonococcal and chlamydial conjunctivitis
You can get pink eye from infections from sexually transmitted diseases including gonorrhea and chlamydia. Treatment requires oral antibiotics.
Giant papillary conjunctivitis
This pink eye usually impacts both eyes and usually contact lens wearers. This condition may cause contact lens intolerance, itching, a heavy discharge, tearing and red bumps on the underside of the eyelids. It is caused by contaminants on the surface of a contact lens, which causes an immune reaction. You may need to stop wearing lenses until it resolves. Occasionally prescription medications are used to hasten resolution.
This conjunctivitis from eye irritation that can result from many sources, including smoke, diesel exhaust, perfumes, hairspray, false eyelashes, cosmetics and other chemicals. Some forms of conjunctivitis also result from sensitivity to certain ingested substances, including herbs such as eyebright and turmeric or touching your eyes after cooking with spices. In some cases, reactions to topical ocular medications can cause toxic conjunctivitis.
If you get conjunctivitis, feel free to contact our office and one of the doctors will get in touch with you to discuss your symptoms.
INFORMATION FOR CONTACT LENS USERS
A very large percentage of our patients wear contact lenses. We wanted to reach out to you with some helpful suggestions.
It is not clear which disinfection solutions eradicate coronavirus, but hydrogen peroxide systems are probably more effective. If you choose to wear your contacts during this time, make sure to disinfect them properly. Never flush contacts down the toilet or put them in the sink drain. Be mindful that they may be contaminated with coronavirus if you are infected. Therefore, be careful when putting worn lenses on surfaces such as countertops.
The research literature is clear. To prevent contact lens infections of all kinds: bacterial, viral, and fungal, contact lens wearers must:
1. Wash hands thoroughly, at least 20 seconds, with soap and water, and dry hands completely.
2. Use daily disposable contact lenses if possible, and do not re-use them.
3. If solutions are required, use them appropriately. Follow manufacturers guidelines. Specifically, do not top-up or re-use solutions.
4. Replace cases monthly or more frequently. Rinse, wipe, and air-dry contact lens cases every day. Do not rinse lens cases with tap water.
5. Do not wear contact lenses when you are ill.
6. Never use tap water to clean any type of contact lens.
7. Contact lens users touch their face and eyes more than non-contact lens users. If you must wear lenses, please be careful.
This is actually a great time to give your eyes a rest from your contact lenses. Using contacts while on the computer is likely to increase symptoms of dryness. Using contacts if you have spring allergies is likely to make your symptoms worse.
CARES STIMULUS PACKAGE: Access to Health Care
We have enabled tele-visits. You can request a visit by emailing firstname.lastname@example.org
Temporary Relief for Telehealth and High Deductible Health Plans
The CARES Act provides a temporary safe harbor to high deductible health plans (HDHPs) compatible with health savings accounts (HSAs). Under the Act, a HDHP will not lose HDHP qualified status if it offers cost-free tele-health services to plan members before the annual deductible is satisfied. In other words, HDHPs can offer plan members access to tele-health services with no cost-sharing to the member, regardless of whether the deductible is met, and such members will remain eligible to make and receive contributions to an HSA. This offers significant relief to plan sponsors who want to offer first-dollar, pre-deductible tele-health coverage while still desiring to preserve HDHP qualified status. This is only temporary relief, and this safe harbor only applies for plan years beginning before January 1, 2022.
Over-the-Counter Drug Reimbursements from HSAs, FSAs, and HRAs
Eliminating an ACA prohibition, HSAs, health flexible spending accounts (“FSAs”), and health reimbursement arrangements (HRAs) can once again reimburse the costs of over-the-counter drugs with no prescription. This provision is effective for expenses incurred and amounts paid after December 31, 2019.