New Year’s resolutions for 2025
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Happy New Year! How was your holiday season?
As usual, I am sitting down to write this column long before any of the stuff I am asking about has actually happened for me. It is 19 degrees in Cleveland today, and Lake Erie is a roiling cauldron of seasonal agitation. Kinda like me, to be honest. At my latitude, the fourth quarter of each year is by far the busiest for eye doctors of all stripes. Last-minute “you just have to see me” visits compete with long-planned clinical events, both of which must share space with the needs and desires of my growing family.
Kudos and mad respect always to the eye doctors here who are also moms in the active stage of “momming,” particularly at this crazy time of year. How do you do all of it with so much grace?!
Let me begin the year as always by reminding you who I am, what I am doing here and why. This column and the accompanying blog represent my thoughts on the world of dry eye disease (DED). The people, places, products and patients that make up our little slice of the eye care universe. Every thought, every word is my own. I am not paid to write any of this, and for sure I do not receive any compensation from any industry player (I’m totally good with that). My goal is to represent the eye doctors who just go to work. Who spend the entirety of their professional hours sitting at the slit lamp and taking care of patients. I hope my drivel is at least a little bit helpful to those who do.
OK. On to this year’s resolutions!
- I know what you are thinking: Did he actually do more Schirmer tests in 2024? Sigh. Sadly, no. But I did do a whole bunch of objective measurements of the tear meniscus level using the M&S Bruder Ocular Surface Analyzer and found that to be helpful. I will keep trying on the Schirmer thing in 2025.
- Speaking of Schirmer tests and meniscus heights, both measurements are a helpful cue for punctal occlusion intervention. A low meniscus or anesthetized Schirmer under 8 mm should prompt you to consider this.
- Prediction: 2025 is the year of punctal occlusion. I resolve to do more of this when testing indicates that it will likely be helpful. For SkyVision, this means Lacrifill (Nordic Pharma).
- Sadly, because of this resolution, I also resolve to figure out the barbed wire-festooned landscape of billing regulations associated with punctal occlusion and come up with a protocol to use this therapy despite all the barriers we face to do so properly.
- This month has brought more than its share of unusually demanding new patients coming for DED consultations. At least it seems that way. I am going to work very hard on my resolution to always start with the understanding that it is their symptoms making the demands and to continue to respond with patience and compassion.
- Along those lines, I have noticed that the divide between what we might call “basic” DED care and “advanced” has become much starker and more obvious. Most patients can be handled quite well by following my “Basics” series published last year (part 1, part 2, part 3, part 4). I resolve to try to formulate a similar series for complex cases.
- I resolve to publicly share how grateful I am for the help I receive with my own patients when I run out of ideas. I will start here and now with a shout-out, mad respect and deep appreciation for Rony Sayegh, MD, at the Cleveland Clinic who backstops me on some of my most challenging cases. Thank you, Rony. You are a gift.
- With all our new medications and in-office procedures, it is tempting to simply layer on more and more care for our patients with DED. I resolve to think about the burdens that all medical care can bring to my patients as I formulate their treatment plans. One of my topics for 2025 will be revisiting the concept of minimal effective dose.
- Last year I resolved to increase my professional travel. To accept more invitations to speak or to attend meetings. How did I do? Meh, not well at all. I really am sincere in this desire, though, so help me out. Invite me to something! If I can convince Beth to come along, I might even say “yes”! Looking at you Tom Oetting, Dave Granet and everyone at NYU who forgot I trained there.
And now, something a little different. I once read about a practice in which one suggested a resolution for another. A spouse, family member or friend. I think that is absolute madness! Still, perhaps with a tiny tweak, we might find a way to make that a better idea. Let me finish with a couple of resolutions that we might share.
- Let us all resolve to be kind. To make kindness our first initiative. To consider the other person sitting across from us, on the other end of the text or call, or reading what we have written and how that might affect them. To make being kind our default option.
- Let us all resolve to be healthy. To do the work we can do to make ourselves so. To remember that we are surrounded by people who need us, care about us and who would miss us terribly if we were gone. Resolve to see your doctor, address risk factors, tidy up your diet and get off the couch.
- Let us all resolve to make time for our friendships. Being a friend requires commitment, time and effort. Doing so is as much a gift to ourselves as it is a gift to our friends. We would all do well to read the book The Good Life by Robert Waldinger, MD, and Marc Schulz, PhD, on the importance of close personal relationships for a long and healthy life.
And lastly, I resolve to be right here, each month, for as long as I can, for as long as you’ll have me. Happy New Year to you and yours. May we all resolve to make it the best year yet!
RIP Scott Hunter, Oct. 27, 1975-Dec. 3, 2024. We all miss you terribly.
- For more information:
- Darrell E. White, MD, of SkyVision Centers in Westlake, Ohio, can be reached at dwhite@healio.com.
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