CLINICAL

  diversify your portfolio

Make OSD A Practice Builder

Follow these four tips to establish an ocular surface disease clinic.

JEFFRY D. GERSON, O.D., F.A.A.O.

Although ocular surface disease (OSD) has a range of potential causes and complications, such as Sjögren’s syndrome and pterygia, dry eye disease and ocular allergy are the most common forms of the condition, making the creation of an OSD clinic a must for optometrists. Here are four ways to create the clinic:

1 Ask about symptoms.

OSD is often a very frustrating problem for patients who may have gone undiagnosed for years. In some cases, a patient may not mention the true extent they are bothered by OSD symptoms because they think, “My eyes are dry because of my age,” “My eyes are dry because I wear contact lenses” or some other reason. Therefore, ask all patients whether they experience itchy, watery, burning or gritty-feeling eyes and visual fluctuations.

If you focus solely on those who present with the aforementioned symptoms as a chief complaint, you miss the opportunity to help the large percentage of patients who have the condition.

2 Perform an OSD exam.

Schedule the OSD suspect for a separate OSD exam, at which you perform a refraction to identify vision fluctuation between blinks, a slit lamp exam to evaluate the lids and lashes for inflamed caruncles, lid telangiectasia, clogged or degenerating meibomian glands, a tiny or lacking punctum, incomplete blink, ectropion, entropion, lagophthalmos and/or anterior blepharitis. Also, apply pressure to the meibomian glands to assess meibum health, perform a snap-back test on the lower lid, and keep your eyes out for swollen pinguecula or conjunctival chalasis. Finally, note the presence, location and amount of punctate keratopathy when examining the cornea.

One way to make your OSD clinic stand out from others: Provide unique diagnostic modalities, whether they test tear osmolarity, inflammatory markers or tear film quality.

3 Run the gamut of treatments.

Have your tried-and-true options, such as artificial tears, on hand, but also keep in mind the lesser-known treatments that may provide symptom relief. For example, a supplement specific to OSD may be beneficial for the patient. (If you, the O.D., sell such supplements, you create an additional practice revenue stream.) In addition, you may want to invest in a device that provides relief to MGD-caused OSD patients. (You’ll be helping the patient while growing your bottom line.) Offering treatments not commonly found elsewhere cements your clinic as the go-to place for OSD.

4 Schedule follow-up appointments.

Have the OSD patient return, so you can determine the prescribed treatment’s efficacy. Patients greatly appreciate close monitoring. Whether revenue is generated from co-pays and insurance or out-of-pocket tests/procedures, the opportunity exists to substantially grow your practice.

Direct and indirect gains

As we make patients who have been uncomfortable for some time feel better, they are likely to not only be thrilled with their improvement, but also to tell others about it. Creating an OSD clinic is an excellent means of diversifying your practice portfolio because it provides avenues for direct and indirect profits. OM

DR. GERSON IS IN PRIVATE PRACTICE AT WESTGLEN EYECARE IN SHAWNEE, KAN. E-MAIL HIM AT JGERSON@HOTMAIL.COM. TO COMMENT ON THIS ARTICLE, E-MAIL OPTOMETRICMANAGEMENT@GMAIL.COM.