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Scientific evidence can guide choice of dry eye diagnostics
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WASHINGTON — Ophthalmologists must decide which of many dry eye diagnostic tests to use to decrease the overall cost of diagnosing and treating dry eye disease, according a speaker here.
There are a multitude of dry eye tests, but assigning value, knowing which ones are backed by scientific evidence, and which can best guide diagnosis is important in the decision making.
“I encourage you to get meibomography in your practice, I encourage you to get osmolarity in your practice -- and MMP-9. They will make a big difference for you and you can utilize each one of these in an intelligent way, address them with your patient, and select the appropriate therapy,” John D. Sheppard, MD, said during Cornea Day at the American Society of Cataract and Refractive Surgery annual meeting.
MMP-9 testing is a useful marker for whether a patient should be treated with an anti-inflammatory, and osmolarity testing can screen out patients who will have unpredictable biometry before cataract surgery, Sheppard said.
“Meibomography is a device that measures the tear meniscus and the tear film breakup time that takes me about five seconds in the clinic. Otherwise, you buy a $40,000 machine,” he said.
When tests are validated by evidence-based medicine, then “the practice wins, the patient wins, the providers win, and the payers win. You can have the right diagnosis the first time, the right treatment, no unnecessary prescriptions, fewer visits to the office and more productive work days for our patients. That pays.” – by Robert Linnehan
Reference: Sheppard JD. Diagnostic imaging for dry eye disease: Is it worth the cost? Presented at: American Society of Cataract and Refractive Surgery annual meeting; April 13-17, 2018; Washington.
Disclosure: Sheppard reports he has financial relationships with AbbVie, Aerie, Alcon, Aldeyra, Allergan, Bausch + Lomb, Bio-Tissue, Clearside, EyeGate, Kala Pharmaceuticals, NovaBay, Omeros, Parion, Portage, Santen, Science Based Health, Shire, Sun Pharmaceuticals, TearLab, TearScience and Topivert.