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By Paul Karpecki, OD, FAAO
May 19, 2021
Dry eye is incredibly common. Some 16 million people in the U.S. are currently experiencing it, according to the National Eye Institute. Effectively diagnosing and treating this condition creates patients whose lives have been vastly improved, and who are much less likely to drop out of wearing contact lenses. That translates into lifetime patients who are eager to refer friends and family, and who come back every year for an exam, contact lens prescription renewal and purchase. Here are key actions to take to ensure you make the most of this opportunity to help patients and build your practice.
Train Employees So Everyone is On Board in Effort to Identify & Serve Dry Eye Patients
The doctor isn’t the only one who needs to be alert to the symptoms of dry eye and knowledgeable about the treatment services your practice provides. Everyone in the office has a role in the process of identifying and caring for these patients.
For example, the receptionist answering the phone needs to be aware of the most common symptoms of dry eye. That way when a new patient calls for an appointment, and describes her issue as fluctuating vision and eyes that feel dry and gritty, the receptionist will know to alert the doctor to a likely case of dry eye coming in. If the receptionist has been trained well enough, they could even take the initiative of booking the patient into a day and time slot you have set aside for dry eye patients.
The technician, who is taking a patient’s history, has to be familiar with the symptoms to know what to keep their ears open for, and they have to know the right follow-up questions to ask to make it easier for the doctor to zero in on how best to help the patient.
Fortunately, there are resources that can help train your staff to work with you to serve dry eye patients. ABB Optical Group has staff training and educational opportunities for practices to empower staff to feel comfortable and confident when talking to patients about dry eye.
Make Time in the Exam Room to Ask In-Depth Questions & Do 3 Essential Things
ODs themselves often forget to ask patients about how their eyes feel at the end of the day, and about the key discomforts that might signal dry eye. Patients usually don’t realize that it isn’t normal not to be comfortable in their contact lenses, or for their eyes to feel dry and irritated. They may assume these discomforts are just part of the aging process. It’s up to the doctor to review the patient history and dig further when the patient says their eyes no longer feel as comfortable in contact lenses, or that they are having difficulty with their vision when working long hours on the computer.
In addition to the information you glean from conversation with the patient, there are three essential things to do to diagnose dry eye:
· Use the slit lamp to closely examine the lid margins and the base of the lashes.
· Express the meibomian glands and examine the oil that is expressed.
· Use a sodium fluorescein stain to detect staining on the conjunctiva as well as cornea.
These simple diagnostic protocols go a long way toward effectively diagnosing dry eye.
Boost Patient Quality of Life & Practice Profitability
Diagnosing and effectively treating dry eye is foremost of great importance because it transforms lives. Patients whose dry eye has been relieved are often able to be more productive and happy. Some patients even report being more up for socializing because their eyes feel so much more comfortable. And many are overjoyed to be able to wear their contact lenses regularly again.
After the first concern of helping patients, dry eye diagnosis and treatment is a tremendous opportunity to build a highly profitable practice. The number one reason for dropping out of contact lenses is dryness and discomfort, of which dry eye or meibomian gland dysfunction plays a role. If you could address these issues early, think of the many patients you could keep in their contacts. Consider that 16-18 percent of contact lens wearers drop out of their lenses annually. We know there are about 45 million contact lens wearers in the U.S. If even 16 percent drop out each year and assuming each contact lens patient generates $300 per year for the practice, that comes to over $3 billion that is dropping out of optometry every year.
For the individual practitioner, the loss of those contact lens wearers means losing not just the purchase and services related to the contact lenses, but the patient themselves, as a patient who was forced to drop out of their lenses is unhappy, and unhappy patients tend not to stay in practices. Moreover, even if the patient stays in the practice, without the need to come in annually for a contact lens prescription renewal, they may wait longer between comprehensive exams.
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Another place where a practice could unknowingly be losing money due to dry eye is in spectacle remakes. Patients may attribute their poor visual quality to their new glasses, rather than to a condition within their eyes. That prompts them to come back dissatisfied with their glasses and request a costly remake in terms of time and reputation.
Beyond the loss of profitability from issues like contact lens dropouts, glasses remakes and missed annual exams, there is an opportunity to add beneficial and profitable advanced dry eye treatments to a practice, such as thermal pulsation, punctal occlusion, blepharoexfoliation, Intense Pulse Light (IPL) or Low Level Light Therapy (LLLT) treatments, which can easily add $50,000+ to a practice annually. Or to offer key at home treatments including lid hygiene products such as hydrating compresses (Eyeleve/Bruder).
Offer Options You & Your Patients Can Have Confidence In
Diagnosis and treatment in the office can sometimes be successfully coupled with at-home treatments. There are exciting new products in the biologics category that allow the patient to provide moisturizing relief at home. One such product is Regener-Eyes® LITE, an ophthalmic solution that is applied as an eye drop. This product, offered exclusively through the patient’s eyecare professional, was designed to provide advanced moisturization for patients. This non-surgical, long-lasting solution is administered daily by the patient.
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Many of the patients to whom I have prescribed Regener-Eyes LITE have noted significant improvement by the time they have finished the first bottle, within just three weeks. As the product must be purchased from, or ordered through, an ECP, your patients have incentive to return to you for care. The impressive results they experience leads to conversation among friends and family about where they got the great new eye drop that’s been making them feel so much better. That means more patients coming to you for help with their dry eye and contact lens discomfort.
Another great thing about Regener-Eyes LITE is the simplicity of getting it to your patients. Regener-Eyes LITE is available for ECPs to order through ABB Optical Group, and it can be shipped directly to your patients.
Experience the Rewards of Providing Life-Changing Treatment
Providing effective dry eye diagnosis and treatment is incredibly rewarding and fun. The patient response is amazing. Dry eye is negatively impacting the ability of many people to fully live their lives. To be able to provide relief that gets them back to doing the things they most enjoy is a great privilege.
Paul Karpecki, OD, FAAO, is a partner with Gaddie Eye Centers in Kentucky and clinical director, Corneal Services and Advanced Ocular Surface Disease at Kentucky Eye Institute. To contact him: karpecki@karpecki.com
