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Increasing the rate of dry eye treatment can improve outcomes, generate more revenue
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Improving the low rate of treatment for dry eye may not only enhance quality of life and surgical outcomes, but it can also increase business for the ophthalmology practice, one presenter said.
Marguerite McDonald, MD, FACS, told colleagues at Hawaiian Eye 2011 that a 38% increase in dry eye is expected to occur between 2004 and 2020.
"Dry eye currently affects almost 21 million Americans, and yet, only 2.5 million of our patients are actually being treated for it, so there is a huge opportunity to do good here," she said.
Dr. McDonald highlighted a prospective multicenter study that assessed the prevalence of dry eye in 272 eyes that underwent cataract surgery. The study found that more than 60% of eyes had abnormal tear breakup time, 50% of eyes had central corneal staining and 21.3% of eyes had low Schirmer's test results.
Another prospective study of 100 cataract patients found a 59% rate of blepharitis, she said.
Dry eye can affect the wavefront capture for laser vision correction, manifest refraction, laser programming and IOL calculations, Dr. McDonald said. In the case of limbal relaxing incisions or toric IOLs, the axis or magnitude may also be off.
Such potential complications encourage increased oversight, and Dr. McDonald said that the DEWS report recommends osmolarity, which has a positive predictive value exceeding that of other testing options, as the gold standard for dry eye testing.
In addition to revenue generated through office visits, dry eye testing and treatment may result in more patients being treated for additional ocular conditions, as well as more patient referrals, Dr. McDonald said.
"It's good medicine to treat dry eye. We have happier patients and better surgical outcomes. It's good business to treat dry eye, [due to] direct profits and the halo effect of referrals," she said.
- Disclosure: Dr. McDonald receives grant support from or is a paid consultant for Alcon, Abbott Medical Optics, Allergan, Bausch + Lomb, Ocularis Pharma, Santen, Inspire, Fera, IOP Inc., NexisVision, FOCUS Labs, TearLab, Pfizer and Ista.
Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.
This presentation highlights the impending public health problem of an increased demand for continued youthful vision among the aging population. This dilemma will force ophthalmologists to be attentive to dry eye symptoms that would be “subclinical” in a less discerning patient population. Moreover, as an increasing portion of our cataract procedures are performed with a specific refractive result in mind, the importance of normalizing the ocular surface will also increase, even for those patients who have no complaints attributable to dry eye.
– John A. Hovanesian, MD
OSN
Cornea/External Disease Board Member
Disclosure: Dr. Hovanesian is a paid
consultant for IOP Ophthalmics, Tear Science, Inspire, Allergan and Ista.