Special to Ophthalmology Times®
Optometric practice is going through a lot of change, with online sales of contact lenses and prescription glasses eroding some of optometry’s traditional revenue streams.
At the same time, an aging population is leading to an increased demand for treatment of age-related eye diseases, such as cataract, glaucoma, macular degeneration, and dry eye. Given these trends, more optometrists are seeing the financial and clinical need to go beyond vision care to manage or co-manage medical conditions.
Dry eye disease presents a perfect opportunity for ophthalmologists and optometrists to work together for the benefit of our patients. There are two common situations in my practice where this occurs.
Scenario 1: The proactive OD
I work with many optometrists in the surrounding community who will diagnose patients with dry eye and offer a range of treatments to address their symptoms. They may prescribe immunomodulators like Restasis (Allegan), Xiidra (Novartis), or Cequa (Sun), microwavable moisture masks, oral omega-3 supplements, lid hygiene wipes, and artificial tears.
If these measures aren’t enough or if they suspect the patient actually has impacted meibomian glands that require a procedure for evacuation, many will refer the patient to me for thermal pulsation therapy (LipiFlow, TearScience/Johnson & Johnson Vision).
I will treat the patient and send them back to their optometrist for ongoing management of their ocular surface disease, with the understanding that the patient may need a repeat LipiFlow treatment in a year or two.
To capture patient referrals like this, it is important that optometrists in your area learn about the advanced technologies you offer, both for diagnosis and for treatment. This is essential for dry eye, but also for procedures like cross-linking for keratoconus and refractive cataract surgery.
We send an e-newsletter to primary-care providers and optometrists; send a practice liaison to visit practices in person; and offer educational seminars for COPE credit, as well as non-credit dinner programs that are a mix of social networking and educational reinforcement. I have found it powerful to demonstrate our technologies whenever possible at these seminars.
At a recent gathering, for example, several optometrists discovered that they had significant gland dropout on LipiView meibography, despite being asymptomatic. That experience helped to underscore the value of the diagnostic tool better than anything I could have said.