Is This the New Norm?

Is Retailing Therapeutics in Your Office the New Norm?

BY MILE BRUJIC, OD, FAAO, & DAVID L. KADING, OD, FAAO

Consider this tale of two patients. It is Monday morning, and a 24-year-old new patient comes into your practice. His chief complaint is that his distance vision has gotten worse. He reports never having his eyes examined before. Your exam finds that all ocular health findings are normal. The patient does have myopia of 1.00D in each eye. You explain how glasses can help his vision, and that anti-reflective treatment and photochromic technology may enhance his visual experience. Additionally, you discuss contact lenses as an option.

The patient expresses interest in trying contact lenses. You fit a daily disposable lens that day and dispense 10 diagnostic lenses following application and removal training. The patient also purchases new glasses that day and is scheduled for a contact lens follow-up visit in one week.

One week later, the patient says he loves the contact lenses and would like to order more. He thinks that he will wear them about three to four days a week. You finalize a prescription for a six-month supply, which he proceeds to purchase from you. In the end, the patient sees you for his examination, the contact lens fitting, and also to purchase his recommended treatments of glasses and contact lenses.

The next patient is a 54-year-old female who complains that her vision fluctuates. At times, her eyes are uncomfortable, in particular with long hours at the computer screen. You diagnose her with meibomian gland dysfunction. Your initial treatment plan involves warm compresses for 10 minutes at a time, twice a day. Additionally, you feel that this patient would benefit from omega-3 supplementation of 1,000mg q.d. p.o. as well as daily eyelid hygiene with commercially available lid scrubs.

You discuss the condition with the patient and explain that she can use a wash cloth that she has soaked in warm water for the compress, and she can acquire the omega-3s and lid scrubs from her local pharmacy. You tell the patient to return in about two months for a follow up to see how she is doing with her condition.

Why Is Medical Treatment So Different?

The second patient’s scenario is all too common, yet often leaves patients with many unanswered questions: How warm do I make the wash cloth? There are so many choices in omega-3s and lid hygiene, which should I choose? Although we think that we are doing our patients a good service, we may be confusing the situation more than helping them.

What if we provided patients with a heating mask that was specifically designed for use around the delicate tissues of the eye? What if we provided an appropriate ocular nutrient that we felt was in their best interest and prevented the confusion of trying to choose one? And what if we provided an eyelid hygiene system in the office? Wouldn’t this help ensure that our patients are using what we want them to and what will likely result in the best clinical outcomes?

The Verdict

With the potential to improve patient compliance and offer them the convenience of accessing their treatment in your office, we feel that it is a best practice to offer therapeutics to your patients when possible. CLS

Dr. Brujic is a partner of Premier Vision Group, a three-location optometric practice in northwest Ohio. He has received honoraria in the past two years for speaking, writing, participating in an advisory capacity, or research from Alcon Laboratories, Allergan, B+L, Optovue, Nicox, Paragon, SpecialEyes, TelScreen, Transitions, Valeant Pharmaceuticals, Valley Contax, VMax Vision, VSP, and ZeaVision. Dr. Kading owns the Specialty Dry Eye and Contact Lens Center in Seattle. He is the co-owner of Optometric Insights with Dr. Brujic. He has received honoraria for consulting, performing research, speaking, and/or writing from Alcon, Allergan, Bausch + Lomb, CooperVision, Oculus, Ocularis Pharma, RPS, Shire, TearScience, Valeant Pharmaceuticals, Valley Contax, Zeiss, and ZeaVision. Follow him on Twitter @davekading.