
Knock Knock Eye: Myopia Is Officially a Disease: What the AMA Reclassification Means
Knock Knock, Hi! with the GlaucomfleckensShow Notes
The Blue Cross Blue Shield Association put out a truly hilarious study complaining that AI tools drove nearly $1 billion in extra costs for their insurers over two years, blaming hospitals and doctors for using AI to code more accurately. This from the industry that pioneered using AI to deny claims. It's an arms race now, and the only people who actually lose are patients, premiums keep going up regardless of who wins.
Then two big eyeball wins. The AMA House of Delegates finally reclassified myopia as a disease, which should push pediatric progression treatments like Stellest lenses, ortho-K, and atropine drops onto medical insurance instead of cash pay. And Dr. Morgan Micheletti's team sent 135 intraocular lenses to the International Space Station for six months to see if cataract surgery could survive deep space travel, most held up remarkably well.
Takeaways:
Blue Cross Blue Shield Association is complaining that AI tools have driven ~$1 billion in extra insurer costs, ignoring that insurance companies pioneered using AI to deny and downcode claims.
The healthcare AI arms race is a battle for a fixed pot of money, and patients always end up paying via higher premiums.
The AMA House of Delegates has adopted a resolution formally classifying myopia as a disease, opening the door for medical insurance coverage of progression treatments.
Stellest lenses, orthokeratology, and atropine eye drops are the current options for slowing pediatric myopia progression, with Stellest showing about 70% reduction over two years.
Dr. Morgan Micheletti's ISS study found that most acrylic intraocular lenses survived six months exposed to space, suggesting cataract surgery in space may eventually be feasible.
—
To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live
We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]
Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken
Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/
If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken
If you want more information on models I use:
Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact. For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15
As a proud FIGS Ambassador, visit https://WearFIGS.com and use code DrGFIRSTFIGS to shop, stay updated on new launches, and learn more about FIGS advocacy projects.
Check out FIGS on social platforms: @wearfigs
To learn more about Microsoft Dragon Copilot, visit:
http://aka.ms/knockknockhi
Cozy Earth almost never does 30% off, and they're doing it right now through the 11th. Go to cozyearth.com, use code KnockKnock, and get 30% off home and sleepwear. Cozyearth.com, code KnockKnock
--
A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information.
Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices
More from Knock Knock, Hi! with the Glaucomfleckens
This week I get into the No Surprises Act, starting with my own $20,000 out-of-network bill after my cardiac arrest and the nine-month fight to resolve it. The law was supposed to prevent exactly that, and from the patient side it works. But the arbitration system behind it is now processing millions of claims per year (not the 22,000 the feds expected), doctors are winning about 85% of the time, and insurance companies are lobbying hard to rewrite the rules.
Dr. Lindsey Fitzharris is back and she brought her best book yet. Sleuth Hound: The Case of the Real Sherlock Holmes, out October 20th, which tells the story of Joseph Bell, the Edinburgh surgeon who was the actual inspiration for Sherlock Holmes.
The weight of the healthcare system has been sitting heavy. Our practice officially dropped UnitedHealthcare after they offered a 0.8% rate increase, and I’m feeling genuine empathy fatigue for the first time since I came back to clinic after my cardiac arrest. I talk about what that feeling actually is, how to spot it, and what finally helped me through it last time. Also, Dr. Oz is pushing to eliminate modifier 25, which would effectively end same-day procedures in private practice.Then some actual good news: the 2026 Nobel Prize in Physiology or Medicine went to Peter Hegemann, George Nagel, and Karl Deisseroth for optogenetics. I walk through the 2021 Nature Medicine case of a man with 40 years of retinitis pigmentosa who regained the ability to locate and touch objects after an AAV-delivered opsin was injected into his retinal ganglion cells. It’s mutation-agnostic, it’s low-resolution, and it’s one of the most exciting developments in vision science in a long time.
We did back-to-school night for our ninth grader and I came away wanting to re-enroll myself. The CS teacher (28 years in the classroom) convinced me that what computer programming really teaches is attention to detail, one misplaced space breaks the whole thing, and the Spanish teacher, who grew up under Franco with his left hand literally tied to his chair for writing right-handed, had a philosophy so good I almost asked if I could come on Monday. After the break, I get into the AI mathematics controversy. OpenAI announced their agents solved the Navier-Stokes equations using 10,000 agents over 88 hours on a problem humans have worked on for 60 years, but an NYU mathematician and an Anthropic researcher claim OpenAI trained on their ongoing unpublished work without attribution, which is a more acute version of the IP argument that's followed AI from the start, and it bugs me in a way I don't have a clean answer for.
This week Kristin and I sat down with Dr. Sasha Hamdani, a board-certified psychiatrist, ADHD expert, and author of the new book Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply. Sasha breaks down the actual neuroscience behind why some of us feel emotions so intensely, and gave us some genuinely useful tools for dealing with it. We also got a proper medical explanation for hangxiety, which, as someone who has experienced it, I found extremely validating.