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  “ODs ON FACEBOOK”

DRYSPELLS

TWO TRICKS EVERY O.D. SHOULD KNOW FOR TREATING DRY EYE DISEASE

ALAN GLAZIER, O.D., F.A.A.O.

FOR THOSE whose eyes are dry, we salute you! Dry eye disease (DED) is rampant, so it’s not surprising that “ODs on Facebook” contains a slew of posts about treatment, related contact lens complications and medical billing.

Here are two such posts:

DENIED!

Let’s start with the “dry” stuff — pre-authorizations. One “ODs on Facebook” member posted that she called to obtain a pre-authorization for cyclosporine emulsion 0.05% (Restasis, Allergan), but the patient’s insurance denied the pre-authorization because her diagnosis wasn’t Sjögren’s syndrome or keratoconjunctivitis sicca. The O.D. wrote that she didn’t diagnose the patient as having keratoconjunctivitis sicca because the patient’s condition lacked corneal involvement: “Now I have to appeal it [the denial].” Her question: Can one legitimately call dry eye disease keratoconjunctivitis sicca if there is no corneal involvement?

This post received two likes and 17 replies.

Examples of replies:

• “If you do sequential stain 5-10 minutes after your initial installation of dye, it is very likely that you will find corneal involvement. It is crazy that ‘dry eye’ isn’t good enough but if you write cornea dry in Latin it qualifies!”

• “Stain 5 minutes post tetracaine” (This enhances corneal absorption of the dye.)

• “Are you just staining with NaFl or also lissamine green? A lot of times, [corneas] will stain with LG even if they don’t with NaFl.”

SOLVED WITH GLASSES

One “ODs on Facebook” member posted that a long-term DED patient who has been “treated with every known drop unsuccessfully” recently presented for a one-month follow-up, thrilled with the changes in her eyes. The last prescribed treatment was a pair of computer glasses, instead of progressives, to wear while at work. The treatment resulted in no burning, tearing or redness and a TBUT of more than 12 seconds OU.

“It was a shot in the dark . . . But it worked! Desperate times call for desperate measures. #thinklikeanoptometrist” she wrote.

This post received 126 likes and 16 comments. Examples of comments:

• “It’s amazing what as little +0.50 over distance Rx can do!”

• “Even with expansion of scope of practice and the new knowledge that research is bringing to us, isn’t it amazing what can be done with the right application of ophthalmic lenses?”

• “Mid range on top/near add on bottom in progressive with AR makes the hours we spend at computer much more tolerable, [I’ve] had many patients deny the problem until my persistence of benefits convinced them to try — 90% are amazed at improvement in visual comfort, less headaches and yes less dryness concerns — simple ophthalmic lenses to the rescue.” OM

DR. GLAZIER is founder of Shady Grove Eye and Vision Care, in the Rockville, Md. suburbs of Washington DC. He is an author, inventor, industry consultant and frequent lecturer on ocular disease and Internet marketing. He has relationships with Surefire Social, CooperVision, J&J Vision Care, Vision Source, Vantiv, Vision Expo and Vision Systems Inc. Email aglazier@youreyesite.com. Be sure to follow him on Twitter @EyeInfo or PM him on Facebook.