As practices reopen, patients return seeking to replace lost contact lenses and glasses and to remove foreign objects from their eyes

Doctors of optometry share insights into their disaster planning and recovery

Water and contact lenses don't mix, but keeping the two separate after Harvey and Irma can prove challenging when there's water, water everywhere.

“In the practice, we have seen an increase in the number of foreign body and infections compared to the normal amount that we treat. It seems like about half or our patients had flood damage, and many lost contacts and glasses.”

Recent historic hurricane disasters in Texas and Florida have raised concerns about water quality in those states, after city sewage systems failed and floodwaters merged with water systems and industrial runoff. For doctors of optometry, who have been able to reopen, post-hurricane life-patients living in flood-damaged homes and engaged in the messy, post-disaster cleanup-looks a little different than it did before.

They've helped rescue their neighbors, supported their families and coworkers, and do their jobs under unusual and trying circumstances.

"In the practice, we have seen an increase in the number of foreign body and infections compared to the normal amount that we treat," says Peter Cass, O.D., president of the Texas Optometric Association, who reopened his Beaumont, Texas, practice Sept. 11. "It seems like about half or our patients had flood damage, and many lost contacts and glasses."

Contaminated water, contact lenses 'over-wear', and poor hygiene contributed to their infections, Dr. Cass believes. Doctors say they have also seen eye infections and irritations due to mold and drywall dust.

Below, they share insights into their disaster planning and recovery, beyond plywood and insurance.

Communicating with patients and staff is key


Ahead and after the storms, doctors of optometry and their staffs were reaching out to their patients. They called, they emailed and posted on Facebook.

"I sent an email Thursday (before the storm) telling patients to take all glasses and contacts with them and had many run in for extra contacts," says April Jasper, O.D., who practices in Florida. "I emailed and texted all my patients my cell number and told them to call me if they needed anything."

Like Jasper, as the dire weather reports came across, Dr. Ronald Hopping, O.D., AOA past president, and his staff in Houston contacted patients. They followed up with emails. And when one patient needed her glaucoma medicine, Dr. Hopping's son, Reed Hopping, O.D., ran it out to her. On Tuesday, Dr. Hopping read a note his practice had received from a patient after the storm. The patient thanked Dr. Hopping and the practice for their generosity and for thinking of her during Hurricane Harvey.

"I was in dire need," said the note writer who underlined "dire need." Dr. Hopping is planning to post the note in the breakroom as a staff morale builder.

Hopping also organized group texting for the optometrists and more than 20 staff members in his practice, to help office communications when it closed for Hurricane Harvey and, in case, they needed help or just moral support.

"That sense of community has carried over," says Dr. Hopping, adding that staff created food baskets and pitched in to pull up ruined carpeting in the flooded homes of their office colleagues.

Patients are returning to their practices at their own pace, subject to the availability of hotel rooms and gasoline, according to Tad Kosanovich, O.D., president of the Florida Optometric Association.

"Certainly, keeping the community safe in case of ocular emergencies, assessing hygiene and contact lens wear makes for challenging clinical assessment," says Dr. Kosanovich, noting optometrists' responsibilities to family and staff too.

"Because of optometrists' importance to their communities, we are concerned with each and every practice and their survivability," he says.

Keeping contact lens high and dry


Now is a good time to have conversations with patients on eye care and contact lens hygiene in trying conditions. Environmental and health officials were warning residents of hazards, including "bacteria and other disease agents" in the water they drink and wash their clothes.

Dr. Cass reopened his practice on Sept. 11, after being closed for nearly two weeks. They've been busy rescheduling appointments, even as they fix the damage from wind-driven rain, he says.

"There is a lot of repair work in my future," Dr. Cass says.

A lot of optometry work too.

"I treated one patient with a central corneal ulcer due to wet drywall getting in his eye," Dr. Cass says. "I used an amniotic membrane in conjunction with topical medications, and at his follow-up visit he was recovering well."

Edward Bennett, O.D., M.S. Ed., is chair of the AOA's Contact Lens and Cornea Section and a professor in the University of Missouri-St. Louis School of Optometry.

"The U.S. Food and Drug Administration (FDA) has recommended that contact lenses not be exposed to any form of water," Dr. Bennett says. "Although rare, a sight-threatening eye complication known as acanthamoeba keratitis is caused by an organism present in all forms of impure water (i.e., swimming pools, tap water, saunas, wells and showers).

"Certainly, contaminated water present during a flood would have that potential.," he adds. "If contact lens exposure to floodwater occurs, it is important to clean and disinfect the lenses with the solutions recommended by your optometrist. If symptoms of redness, blurred vision, or irritation or pain are present, I would see your optometrist immediately."

For more information, he referred doctors of optometry, optometric staff and patients to the AOA's contact lens safety website.

A little more than a year ago, Christopher Wroten, O.D., who practices in Denham Springs, Louisiana, was recovering from record flooding in that state.

"One of my patients nearly died after contracting Hepatitis C from floodwaters he waded through with a cut on his leg," Dr. Wroten says. "Of course, the other long-term risk, after drywall and insulation are exposed to flood waters for an extended period of time, is the formation of mold, so proper mitigation is critical after a building becomes flooded. This involves removing sheetrock and insulation, treating with an appropriate mold killing/mold resistant product, and allowing wood to dry to a moisture content of 14 percent or less before re-closing walls."

Be prepared, as much as you can


The Florida Optometric Association and Texas Optometric Association sent out helpful post-disaster tips to their members. Still, doctors of optometry say, it's impossible to think of every eventuality in a disaster. Recently, a question was posed on social media about paying staff when the practiced is closed following a natural disaster.

Having a clear policy ahead of time helps, they say. Dr. Hopping's office policy, for instance, covers compensation in the event of a disaster-three days' pay for everyone.

"I wanted to set the rules up front, so I wouldn't have to make decisions on the fly," Dr. Hopping says. "It pretty much has worked well in every situation we have been in. It builds staff loyalty. You want them to know you're there for them."

Support colleagues in need


Optometry's Fund for Disaster Relief
, a program of Optometry Cares®-The AOA Foundation, is optometry's exclusive financial support program that provides immediate assistance to those in need in the wake of natural disasters. Click here to make a tax-deductible donation to Optometry's Fund for Disaster Relief or click here to apply to Optometry's Fund for Disaster Relief.

September 20, 2017

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