BLOG: Grow your practice by treating dry eye

Treating dry eye is an opportunity to grow your practice, both in numbers and in revenue. As optometrists, we are the primary gatekeepers for our patients’ eye health and in a prime position to manage and treat chronic dry eye disease.

The population affected by dry eye disease (DED) is significant, with an estimated 6.8% (16.4 million) of Americans diagnosed with DED and an additional 2.5% with undiagnosed DED (Farrand et al.). I see this as the perfect opening to expand our services beyond providing prescription lenses and help our patients receive care for the overall health of their eyes.

It starts with awareness. We must learn the symptoms and inform our patients that DED is a disease that we can treat. The Eye Love campaign fronted by Jennifer Aniston did a fabulous job of bringing DED awareness to the public, and I had patients coming in and requesting the Eye Love product. We just need to keep the momentum going.

Revenue potential

Dry eye patients add to your bottom line. Let’s say that you see 20 patients per day. Approximately half will present with some level of dry eye. Depending on whether they have mild or chronic symptoms, you will then schedule them for a $75 medical follow-up visit. If only one patient per day returns for a follow-up appointment, you have added an additional $375 per week and $19,500 annually. This is without purchasing any equipment.

Building loyalty and referrals

DED treatment is a field where we can really shine as optometrists. Yes, ophthalmologists can treat DED, but their focus is on surgical procedures. There’s a lot of dry eye out there, and we need to be more diligent in making sure that we are screening these patients properly for cataract surgery. In fact, the 2017 PHACO study found that three out of four patients referred for cataract surgery had corneal staining (Trattler et al.).

We have the opportunity to diagnose and treat DED patients prior to referring them out for cataract or other surgeries, which is not only an additional source of revenue, but makes patients (and the ophthalmologists we refer them to) very happy. Happy patients are loyal patients who refer their friends and family.

Thanks to our screen-intensive lifestyle and environmental factors, the number of patients affected by DED is not going to decline. Additionally, the Baby Boomer generation is at an age where they need cataract surgery, and many of these patients have dry eye due to age-related hormonal changes and other comorbid conditions such as diabetes and high blood pressure. These patients often want premium intraocular implants, which require a healthy cornea to achieve the desired outcomes.

If we neglect to stabilize dry eye before referring our patients out for cataract surgery, their surgeon may require them to postpone surgery until the cornea is healthy. This could cause our patients to wonder why we did not recommend a treatment plan to fix the problem before sending them to the surgeon or, worse, they will come to us with exacerbated DED after cataract surgery, faulting us for failing to diagnose and treat their dry eye. Not only will they experience disappointing surgical outcomes, but treating dry eye post-surgically is a lot more challenging.

When we diagnose DED and recommend treatment options that will reduce the risk of a failed premium lens implant, we shield ourselves from the blame of an unsatisfactory surgical outcome; patients may proceed informed, knowing they already have DED and knowing its associated risks.

Dry eye and the contact lens wearer

Despite the increase in prescribing daily disposable contacts, and new materials promising more moisture and comfort, the 23% dropout rate for contact lens wearers has remained unchanged for over 20 years (Dumbleton et al.). The primary cause of dropout is irritation caused by dryness.

My approach is to educate my patients about DED and explain that our eyes must produce enough high-quality tears to handle a piece of breathable plastic in the eyes. I will recommend postponing or stopping contact lens wear and outline a plan to medically treat their eyes. As long as patients understand that the goal is to get them back into contacts, they will feel much better about the process.

If you treat them, they will come

We have several approaches we can take to treat our DED patients including over-the-counter and prescription artificial tears, warm compresses, nutraceuticals and good hygiene practices. Recognizing and treating dry eye, rather than dismissing it, is an opportunity to grow your practice.

I’m a dry eye patient, and I understand what my patients are feeling. I want to treat dry eye, and my peers and referring physicians who prefer not to treat DED refer patients to me. A happy dry eye patient is loyal for life and your best marketing tool. When patients feel that that you hear them and that there is a treatment, they will come.

References:

Dumbleton K, et al. Eye Contact Lens. 2013;doi:10.1097/ICL.0b013e318271caf4.

Farrand KF, et al. Am J Ophthalmol. 2017;doi:org/10.1016/j.ajo.2017.06.033.

Trattler WB, et al. Clin Ophthalmol. 2017;doi:10.2147/OPTH.S120159.