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Allergy can be good entry point for new prescribers
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Ocular allergy is in season, making this a perfect time for those of you who so far have refrained from using your TPA privileges to make the move to prescribing.
As Dr. Jimmy Bartlett said in an article in our January launch issue for Operation Optometry Prescribe, treatment of allergic disease is probably the best place to start if you've been reluctant to dive into prescribing therapeutic agents. And when you provide relief for someone who has suffered from red, itchy, burning eyes every spring, you'll have a happy, devoted patient who speaks highly of your practice.
Opportunities in allergy
The opportunities laid out in these pages by our authors and expert sources are too good to pass by. I would call out three major factors that make allergy your best entry point for therapeutic drug prescribing.
Many of your current patients experience severe allergy symptoms. Statistics indicate that perhaps one in ten of your patients is suffering significantly — and often needlessly — from ocular allergies at this time of year. Look especially for clues to identify the atopic patient: very fair coloring, perhaps some low-grade dermatitis and conjunctivitis. Ask if they have experienced flare-ups of ocular allergic symptoms every spring. Prophylactic mast cell stabilizers might help them avoid the extreme discomfort they have come to feel is inevitable. Just be careful to use them appropriately.
In our TPA Notebook, Drs. Ron Melton and Randall Thomas give their clinical pearls about when, how and in whom to use mast cell stabilizers. More important, they note when it is not efficacious to use these agents.
Relief of allergy symptoms is key to treatment. Many clinicians have observed that simply eliminating the stimulus for patients to rub their eyes is sufficient to prevent some seasonal allergies from progressing to major problems. Symptomatic treatment can help break the cycle of itching, eye rubbing, inflammation mediator release and allergy exacerbation. Judicious use of topical nonsteroidal anti-inflammatory drugs, as outlined in the article on page 21 of this issue ("Steroids vs. nonsteroidals for ocular allergy"), can provide relief of symptoms with an extremely low risk of complications.
Allergy relief can enhance contact lens wearability. Here's where therapeutics and traditional optometry should form a seamless whole. Allergy relief can provide motivated patients with an added measure of confidence to try contact lenses, and patients who tried to shed their glasses for summertime sports but found lenses intolerable might have underlying allergy problems. In either case, some judicious allergy therapy could help these patients succeed in wearing contact lenses. Often it is simply a matter of pairing artificial tears with the contact lens prescription.
Patient need is primary
This is the basis of Operation Optometry Prescribe: providing better patient care by using all the tools at optometry's disposal. A very few readers have complained to me that we're urging ODs to prescribe regardless of what the individual patient needs. That's ridiculous. We are urging ODs to upgrade the care they give by starting to practice the full scope of optometry, or to establish that scope of practice more objectively by writing prescriptions for medications they are now dispensing from samples. Patient need is the necessary condition for any change in practice. Anything else that we talk about — whether it's personal satisfaction, practice enhancement or professional status — is a windfall.
For Your Information:
- Joseph Hoffman is Editor-in-Chief of Primary Care Optometry News and can be reached at (800) 257-8290; fax: (609) 853-5991; e-mail: jhoffman@slackinc.com; or mail at 6900 Grove Road, Thorofare, NJ 08086.