VIDEO: Developing dry eye protocol for patients may help increase awareness

Editor’s note: This is an automatically generated transcript, which has been slightly edited for clarity. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

I think dry eye awareness is important for everybody, including ourselves as eye care providers. I think regardless of what what subspecialty you’re in, what infrastructure you’re in, sometimes it can be frustrating because sometimes we’re seeing so many patients — we are backed up and now we have to have this whole spiel to educate our patients. So, I think the one thing we can do is in our own clinics develop a dry eye protocol for patients. It doesn’t have to be very extreme, very detailed. It can be just making sure, let’s say you have your technicians, train your techs. We train our techs to ask about ocular surface disease before I walk in the room. Does your vision come and go? Is it hard to drive at night? Do the lights bother you? Do your eyes water? So, I think using SPEED questionnaires, Ocular Surface Disease Index scores, these are all different tools that can help educate the patients for you. I don’t look at the numbers per se, but at least it helps educate the patients ahead of time, so now the patients are like, “Oh, these are symptoms of dry eye, I do have a couple of these,” and all of a sudden you have that discussion.

I think also when you involve the technicians, they can be much more available to help you after the patient to help tell them the diagnosis and you walk out of the room. I have scribes that are able to now explain what dry eye is a little bit more, go through the treatment options that we have. I have a list and check mark do this, this and this, so now the technician knows, OK, he wants you to use this, this and this, and they explain it to the patient as well. As a provider, you’re not spending that 20 minutes, half an hour, in that patient’s room because you have other rooms. So, I think we have to be more efficient, but we have to also diagnose and identify these patients as well. So, that’s No. 1.

I think No. 2, don’t be too overwhelmed with all the options. We just spent just now the last half an hour talking about all these options that we have from a pharmaceutical side as well as nonpharmaceutical side. But it’s sometimes as simple as just identifying, making the patients aware, even starting with an artificial tear or let’s say a cyclosporine of one kind or lifitegrast (Xiidra, Bausch + Lomb), or maybe doing some meibomian gland basic hot compresses. Even starting that way and then maybe sending to someone who is more into dry eye, that could be a big benefit for that patient, so you don’t feel like you have to be a dry eye specialist to really help these patients.

I think we get so focused on a lot of all those diagnostic tools I had mentioned earlier, but if you can identify them and if you don’t have those tools, you don’t feel comfortable, then sending them to someone who does have all those, who does have that kind of bandwidth, I think would help that patient long term as well. So, these are the things that we can do. And again, the more patients come through our door, the more we talk about ocular surface disease, the more we identify it, the more they will go home and talk to their friends and families, and that’s how things kind of help out. So, that’s my thoughts.

So, I think now we have a number of tools that allow us to help hone our treatment options for glaucoma patients. But even if you don’t have all those diagnostic tools, I tell doctors, pay attention to symptoms. If someone says, “My vision comes and goes when I blink my eye,” “I can’t read for more than 5 minutes without watering,” or “I watch TV and eyes start to water,” any of those kind of symptoms, that’s a symptom of unstable tear film. And so even that alone, you can identify, this patient needs to be treated. Now we could talk about honing our treatment options specifically for that condition, for that patient. But just paying attention to symptoms can really help you identify those patients who might need more treatment over time.