CLINICAL

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Itching to See Medical Patients?

Then, actively identify and treat ocular allergy.

BRIANNA RHUE, O.D., F.A.A.O., TAMARAC, FLA.

To survive and thrive, optometrists must see medical eyecare patients. After all, the baby boomers, which make up a large percentage of the population, are aging into eye diseases; brick-and-mortar and online optical retailers have taken and continue to take a large piece of the frame and lens pie; and the amount of ophthalmologists is not growing.

I’ve found that keeping an eye out for ocular allergy — a medical eye condition — in your current patients is an excellent means of growing the medical eyecare portion of your practice. In fact it’s a no brainer, considering allergic conjunctivitis occurs in at least 20% of the population, according to a study by the AOA. That means at least one in five of our patients have some signs or symptoms related to allergies.

Are all these patients being addressed within your practice?

As primary eyecare physicians, changing whom patients think about and their habits of where they seek medical eye care begins with education in the chair. By diagnosing and effectively managing ocular allergy in our current patients, we plant the seed in these patients that we can identify and treat other medical eye conditions, such as glaucoma and AMD, making us the first doctor they’ll call when they encounter an ocular issue, regardless of what it is.

Here, I discuss how you can use ocular allergy to cement yourself as the go-to doctor for all medical eye care.

Elevate ocular allergy’s importance.

Unfortunately, ocular allergy may be missed or overlooked because it’s a mostly benign condition and, therefore, not assigned the same diagnostic urgency as other medical ocular conditions, like glaucoma and diabetic retinopathy. But, don’t forget that just as glaucoma and diabetic retinopathy negatively impact patients’ quality of life, ocular allergy does as well. So, if you fail to identify and effectively treat these patients, you risk losing them and their future medical eye care to another practitioner. Add the fact that at least one in five of your patients have some signs or symptoms related to allergies, and it’s time you make diagnosing and managing ocular allergy a focus in your practice.

To make ocular allergy a focal point, using the patient history form to ask whether the patient experiences itchy eyes, excessive tearing or redness can be a good place to start. My practice’s questionnaire form has boxes for patients to check any symptoms they are experiencing. For allergies, we specifically look at whether the patient checks itching, tearing and redness. Then we gear our case history toward those complaints. For established patients, we pay close attention to verbal complaints about ocular allergy symptoms.

My staff probes “yes” answers to itching, red and/or watery eyes by asking how frequently these symptoms and signs affect the patient, when they happen and how often they happen. Another easy way to probe allergies is to see whether the patient uses allergy medications.

Asking additional questions about allergies can open up a dialogue between you and your patient so you can truly understand how and when the allergies are affecting them, and prescribe accordingly. In addition, asking such questions enables you to establish ocular allergy is a condition that warrants attention, prompting patients to educate others that they shouldn’t ignore their own signs and symptoms. Further, such questions show patients you have the education and skills needed to diagnose and treat ocular allergy. (Remember: Some patients don’t realize optometrists have prescription rights, so they’ll seek their primary-care doctor or an ophthalmologist for medical ocular conditions. How often do you find out at patients’ annual exams that they had an eye problem during the year and did not come see you?) Once the patient knows you’re the ocular allergy doctor, they’ll refer those they educated about ocular allergy signs and symptoms.

Schedule follow-up visits.

Follow-up visits increase the amount of medical eye conditions you see because they remind patients of the condition you diagnosed and the treatment you prescribed. In addition, these visits enable you to further showcase your medical eyecare acumen.

Also, follow-up visits send the message to the patient that you genuinely care about their well-being, as these visits are comprised of questions about the progress of sign and symptom relief, an assessment of eye health post-treatment and the invitation of patient questions and concerns.

In short, follow-up visits reiterate to patients that you’re the doctor they should see for all their eyecare needs. (See “The Finances of Follow-up Visits,” page 28.)

Itch alleviated

When you start actively identifying and managing ocular allergy patients within your practice and schedule follow-up visits to assess their progress, you will see the medical side of your practice grow. This is because patients will see you as their one-stop for all their eyecare needs. OM

Dr. Rhue practices at West Broward Eyecare Associates, where she specializes in ocular disease and contact lens wear. She earned her undergraduate degree in Business at the University of Arizona in Tucson and received her Doctorate of Optometry at Nova Southeastern University in 2009. E-mail her at brhue@hotmail.com, or send comments to optometric management@gmail.com.