Scenario 2: The surgical referral who isn’t ready
We often see patients who have been referred for cataract surgery but who turn out to have an unstable tear film that I want to address before surgery.
The patient may have a positive MMP-9 test, abnormal osmolarity, and moderate to severe meibomian gland dropout—but it may be the first time they have been told they have dry eye. This can be a tricky situation that calls for diplomacy.
I tell the patient that we have specialized equipment that specifically checks for dry eye disease.
“Not all practices have this technology, so that’s why Dr. Smith referred you to me,” I will tell them. “We’ll get that tear film stabilized and then we’ll be able to get more reliable measurements for surgery. When you go back to Dr. Smith after surgery, she will continue taking care of your dry eye, as well.”
Also by Dr. Matossian: Everything you thought you knew about astigmatism and dry eye is wrong
This can let the patient know that their care is important. It creates a level of trust, and can help lead to a better outcome.
I also take the time to communicate directly with the optometrist and educate him or her about my findings and the treatment protocol that is needed to ensure the patient gets the best outcome from cataract surgery.
As partners in the patient’s care, we both want to avoid time-consuming refractive surprises and instead have a satisfied patient with excellent visual outcomes.
Both of these scenarios are working well for our practice. What strategies have you used to promote good co-management relationships with optometrists in your region?
Cynthia Matossian, MD, FACS
E: [email protected]
Dr. Matossian has no relevant financial interests to disclose.