Pursuing My "Why"

Taking the Leap from Clinic to Corporate

By Amanda K. Lee, OD

Every now and then, there are a few things that happen in your life that make you pause and take notice. The first time you fell in love, graduating from school as a doctor, the birth of a child, and someone asking if you’d step out of your private practice – that you’ve help build with pure grit and determination – to do something completely different.

That’s what it was like when I was approached by MacuLogix to become their Director of Professional Relations. I will admit that I had thought about doing something else within the eyecare industry, but hey, when your practice is successful, growing, and patients like and respect you; you already have a pretty good reason to get up in the morning. This can make it hard to focus on anything outside of your day to day.

Considering the statistics of AMD and what MacuLogix is capable of doing, that question, that opportunity, haunted me. In fact, the more I thought about it, the more exciting it became.

Acting locally, thinking globally

Suddenly, I couldn’t ignore the huge unmet need to detect and treat AMD patients in my hometown, in the USA, and even in the entire world. The statistics are staggering! Eyecare professionals of every kind are missing this devastating disease in at least one out of our four patients; and three out of four AMD patients are self-diagnosing only after one of their eyes has an acute decline in vision.^1,2 At that point, it’s most often too late and damage to the retina is not repairable. That means that there are a few hundred patients walking out of our practice each year without either of us (patient or the doctor) knowing if they have early stages of AMD that we could be treating today. Hey, I’m not a perfect doctor, yet I gave 100% to my patients every day, and we still missed those patients

My “A-Ha!” moment

The AdaptDx dark adaptometer helps us find patients with subclinical AMD up to three years before we can see it in the retina. What?? (needle on the record). Stop and think about that for a moment…UP TO 3 YEARS before we can see it in the retina? The AdaptDx technology that MacuLogix brings to our clinic could actually help us prevent blindness caused by AMD. Not only that, I believe it’s life-saving. Knowing blindness, the end result of untreated AMD, contributes to disability, depression, and death, you would think that as well!

In 2017, my business partner and I starting using the AdaptDx in our clinic and quickly detected new cases of AMD. We immediately took action to educate, treat and monitor those patients. With the first few patients, I was worried they wouldn’t like hearing the news of an early AMD diagnosis. But they proved me wrong. While surprised, they were thankful that we had the technology to diagnose the disease and the knowledge to help them understand it.  Some were even relieved as they could finally make sense of why they were having so much trouble seeing or driving at night.

Becoming an agent of change

So, I knew I had to do something to help get this message out – beyond the patients in my community. I knew that I had to change other eyecare provider’s minds just like my mind was changed by colleagues of mine who were even earlier adopters of this technology. I could continue to see a few thousand patients a year in my practice OR I could be an agent of change and make a real dent on the looming AMD statistics that we all read about daily. I had found my calling.

We all know that AMD is becoming more prevalent with our aging population. Keep in mind that the Baby Boomers are aging into Medicare at a rate of over 10,000 people per day.  According to Forbes, the cost to Medicare for those boomers – especially the last year of their life ($10,000 per individual per year) – makes the experts feel that the system will topple by the year 2033. And those are just the Boomers!

In the eyecare world we live in, we know that AMD (9.2M) is more prevalent than diabetic retinopathy (4.9M) and glaucoma (2.7M) combined.³ That AMD number will actually double in the next 20 years as the population over 65 and those with AMD double. If we look at the nearly 10 million patients affected here in the US alone, that number is dwarfed compared to those affected worldwide which is 170 million. A sobering statistic is that AMD is the leading cause of poor visual outcomes and disability in the industrialized world and the third leading cause globally. If you look at age being the greatest risk factor AMD will increase to over 20 million by 2050 here in the US, while the global impact by the year 2040 will be 288 million.^4,5

So that’s the eye care world that we currently live in, but let’s put it into perspective a little bit differently. What most doctors, including myself, don’t know is how AMD stacks up against other diseases that we are bombarded with every day. According to a study published in December 2016, “In the U.S., the prevalence of AMD is similar to that of all invasive cancers combined and more than double the prevalence of Alzheimer’s Disease. This high prevalence leads to an annual $4.6 billion direct healthcare cost due to AMD in the U.S. As the aging population increases, this expenditure is likewise expected to increase proportionately.”⁶

Pursuing my “why”

Which brings me back to the original question, “would you ever consider stepping out of your practice to do something else within the industry?” After reviewing just a few of those statistics we just discussed, I believe in the South we would say “heck yeah!” It became a very compelling reason to do something different. Really, it became my “why” and “how” I want to make a dent on this planet. I know in my heart that optometrists nationwide have the ability to change the outcome of this devastating disease we call AMD. I know that they already have the knowledge and the technology, they just need to be shown how to put it into practice. That’s what a couple of great doctors did for me, and now I am just going to pay it forward.

The more who know about this disease, the less people will needlessly lose their sight, and isn’t that really what we all went to school for, to prevent vision loss? Well, that’s why I went to school to become an optometrist, so that I could help people by preserving and protecting their vision. So, I took this new position with the hope of changing the standard of care for AMD and preserving the vision of patients beyond my backyard of Myrtle Beach, SC. It is such a haunting WHY that it has now become my new crusade. Talk about a fantastic reason to get up in the morning!

Yours in optometry,

1. Neely D, Bray K, Huisingh C, Clark M, et al. Prevalence of undiagnosed age-related macular degeneration in primary eye care. JAMA Ophthalmol. 2017;135(6):570-5.

2. Olsen TW, Feng X, Kasper TJ, Rath PP, Steuer, ER. Fluorescein angiographic lesion type frequency in neovascular Age-Related macular degeneration. Ophthalmology. 2004; 111(2), 250–255. doi.org/10.1016/j.ophtha.2003.05.030. Accessed May 23, 2018.

3. American Academy of Ophthalmology. Eye Health Statistics. https://www.aao.org/newsroom/eye-health-statistics. Accessed February 5, 2018.

4. Sources for Macular Degeneration: Facts & Figures [http://www.brightfocus.org/sources-macular-degeneration-facts-figures]. Accessed 28 Oct 2015.

5. Wong WL, Su X, Li X, Cheung CMG, Klein R, Cheng CY, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2:e106–16.

6. Pennington KL, DeAngelis MM. Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors. Eye and Vision. 2016;3:34.