OVERCOME THREE HURDLES AND BUILD A MODEL OF CARE BASED ON PREVENTION

HAVING BUILT my practice on the preventive care model, it’s always interesting to see the reaction/acceptance from new patients. Generally, when one goes to the doctor here, there’s not a lot of “proactive” advice, just loads of reaction. Fixing the problem after it comes about, as most of us know, isn’t always the most efficient and effective resolution to an issue.

Prevention provides little glory, but for many patients who have embraced my preventive care model, it offers a tremendous amount of value. As of late, I think this has incredible application in the world of dry eye disease (DED).

Here, I discuss how to overcome three common hurdles optometrists must face in providing preventive care for DED.

HURDLE NO. 1 WE HOLD OUR OWN MISCONCEPTIONS ABOUT DED

The first hurdle one faces in regard to our patients and DED is how to dispel myths regarding the condition — yes, it is a disease. Get over your own misconceptions. It’s chronic, often progressive, and it is not managed well without intervention. Until you embrace that concept, patients won’t give it the seriousness it deserves when it comes to your treatment plan.

HURDLE No. 2 DED IS CONSIDERED A DISEASE OF “OLD” PATIENTS

Patients think DED is a disease of “old” patients who have a list of complaints about dryness. Our lifestyles have essentially made us stare for the majority of the day. Our extended use of digital devices has ruined our blink rates, and our meibomian glands are paying the price.

I actively image the meibomian glands of a large number of my patients, and it’s alarming to see the rate of gland drop-out in my 20-somethings. Very often, they have the start of symptoms to go with it, but sometimes not. Remember when your professor in school told you the confounding nature of DED in that symptoms don’t always match clinical signs? If you are going to embrace the prevention and education of your patients, you have to be ready to talk DED in the absence of symptoms.

HURDLE NO. 3 DED CARE TAKES TIME AND EFFORT — IT TAKES GRIT

DED is not an easy fix. Every patient has different symptoms, variables and openness to treatment plans that need dynamic management. You may need to discuss DED with a patient for several visits, through several years before he’s ready to proceed with treatment.

In the world of prevention, you must invest your expertise and time with each and every patient. I came across this quote some time back, by epidemiologist Christopher Howson, and it resonates with me in regard to patient care: “Care is an absolute. Prevention is the ideal.” Perhaps, this should be your new approach to DED. OM

DR. WESLEY practices at Complete Eye Care of Medina, a Vision Source practice, which she opened in 2008. She was honored as Minnesota’s Optometrist of the Year in 2011. Email drwesley@cecofmedina.com.