Meibography (Lipiscan by TearScience) may also be performed as well. Tech does the work-up: in a full-blown dry eye clinic, this will likely include interferometry (Lipiview by TearScience), osmolarity (TearLab), and MMP-9 measurements (InflammaDry).It is fast and helps the doctor, patient, and staff get an idea of the situation. Check in: patients will fill out the Speed questionnaire first.What does the typical exam experience look like for a DES patient in a DES clinic? The unit can run between $20-30,000 but it also provides you with topography and some external imaging capabilities. Epshtein recommends the Non-invasive TBUT because it gives you natural information. Have you seen a shift in demographics of DES patients?ĭr. You should always strive to treat the dry eye on the front end. It is integral that we, as primary care providers, catch this condition and treat on both the front and back end of surgery. Their untreated dry eye can lead to poor measurements on the front end of surgery, decreased vision afterwards, and increased dryness symptoms post surgery. Instead, these patients are having surgery and coming out with poor outcomes. Recent studies have shown that roughly 63% of cataract surgery patients had level 2 dry eye (meaning they needed a cyclosporine or other prescription therapy), and 50% had central staining (which should be prompting punctal occlusion, amniotic membrane treatments, etc).
We have the time and compassion to treat these, and we are well equipped to do so. They are developing worsening dry eye symptoms daily, and beyond that, many of them need surgery- outcomes of which depend highly upon their ocular surface integrity. There is no better profession in the world to treat dry eye than optometry and no better time to do so than now.
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