Communicate effectively with DED patients to maximize treatment success

Dry eye disease (DED) is becoming more prevalent than ever before due to a number of factors, the latest of which is increased digital device use and mask wear as a result of the COVID-19 pandemic. (See P.16)

As a newer graduate practicing in Denver, where humidity was lacking in everyday life, DED was a very common condition seen in my patients. I found the most difficult cases to treat were asymptomatic DED patients. I’d see inflammation, injection, meibomian gland dysfunction, low TBUT, etc. Trying to explain to an asymptomatic patient why they needed to spend time and money on something that wasn’t “bothering” them was a challenge. The good news: I found a specific analogy to be most helpful.

Here’s how a typical conversation would go:

THE CONVERSATION

Doctor: “I’m seeing a lot of signs of a condition called dry eye disease. The most common symptoms of this condition are eye watering, itching, redness and eyes feeling tired or irritated. Do you experience any of these symptoms?

Patient: “Nope. Not at all.”

Doctor: “Great! Dry eye symptoms can be annoying at best and debilitating at worst. I’m happy you’re not experiencing any symptoms. That said, dry eye disease is a progressive condition, meaning that if we don’t do something to control it now, it’s very likely to get worse.”

Patient: “But my eyes don’t feel dry. Can’t we wait until I start to have symptoms before we start treatment?”

Doctor: “This situation is similar to having a cavity: There may be no symptoms in the early stages, but dentists recommend having a filling done to prevent it from getting worse. If untreated, your tooth is likely to become painful and more invasive procedures, like root canals or extractions, may be necessary. Similarly, I recommend we start treatment early to prevent your dryness from getting worse, which would require more intense, costly procedures.”

THE OUTCOME

I’ve found that patients tend to understand “prevention” and are more eager to get on board with the recommended treatment plan. Taking the time to explain to asymptomatic patients the reason it’s important to start managing the condition early tends to increase compliance and provide a more positive outcome. OM

 

 

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DR. O’BRIEN is the owner and optometrist at Denver Eye Care & Eyewear Gallery in Denver, N.C. She is heavily involved with student programming through the private practice clubs and Vision Source NEXT program and works with iCare Advisors as a consultant to help others pursue their cold-start private practice dreams.