the business of contact lenses

Beware the Dry Eye Treatment Rut

BY GARY GERBER, OD

I have been checking in for airline flights online for a few years. I usually go online one day before my flight to print my boarding pass. When I went to do that yesterday, I was given a new option (as well as the previous ones of printing, faxing, or getting my boarding pass at the airport): the ability to download my boarding pass to my smart phone.

While many choices were available, any one would get me on tomorrow's flight. The concept behind giving passengers these choices is similar to presenting dry eye treatment alternatives to your patients. There are two main points to consider.

Expand Your Treatment Options

First, laying out every treatment alternative to your patients and letting them choose one is not what this is about. As with the airline check in process, certain methodologies might be preferred or might work better for certain patients.

Historically, many of us have "treated" dry eyes by handing patients a few samples of artificial tears and saying, "Try some of these. Then go buy whichever one works and use it a few times each day." This does a significant disservice to patients who might genuinely benefit from much more effective alternatives such as changing their lens modality, polymer, and/or lens care solution; adding a nutritional supplement; or prescribing a prescription eye drop. So, while I'm in no way advocating that you let patients pick from a smorgasbord of treatment regimens, I am suggesting that you let patients know that you are up-to-date and that the old process of randomly choosing an over-the-counter artificial tear has disappeared along with scleral PMMA lenses.

Upgrade — and Show It Off

Second, and related to the above, is that you must tacitly imply to your patients that you are current in both technology and education. I've often said that the reason practitioners need to keep a fresh technology face on their practices isn't because of competitive pressures from other practitioners. Rather, it's because our patients live in a rapidly changing technological world. The dry eye patient you're about to examine in Room 2 is probably texting on his cell phone and listening to his iPod as you read this. Or, he may even be online reading about new treatments for dry eyes! He probably found your office online and may have booked his appointment via e-mail. Let's hope that while he is waiting for you that he is not sitting in a foot-pump examination chair!

Such a technology disconnect can do irreparable harm to the confidence patients must have in your clinical judgment. Again, this has nothing to do with your competitors having the latest Fourier domain OCT. It's about patients like me, downloading a boarding pass to a smart phone on Monday and being examined on Tuesday in what I could perceive as an antiquated office with technologies and advice that haven't changed in years.

As with the boarding pass alternatives, keep the big picture goal in mind. In my case, I want to get on the plane. In your patients' case, they want their dry eye problem fixed. Let them know that of all the alternatives available in your dry eye treatment toolbox, your recommended regime is the best for their particular case and has a high likelihood of alleviating their symptoms. Your recommendation may very well be an OTC artificial tear, but patients must leave knowing that you are up-to-date and that if those drops don't work, you'll dig deeper into your repository of technology and knowledge and do whatever you can to fix their problem. CLS

Dr. Gerber is the president of the Power Practice – a company offering consulting, seminars and software solutions for optometrists. You can reach him at (800) 867-9303 or DrGerber@PowerPractice.com.