This article was originally published in a sponsored newsletter.
My patient interactions are most impactful when I talk with them instead of staying focused on the conversations I have with myself while I examine them. I know that sounds silly, but I bet you've done this too. Perhaps you've examined a patient and noticed that their meibomian glands are coated with black gunk and their lash extensions are riddled with Demodex collarettes. Did you think to yourself, "Seriously, gross. Why do people do this to themselves?" and just recommend that they stop wearing make-up entirely? If you did, I'd be curious whether you ever saw that patient again. I say this to encourage you to get out of your head and start having thorough conversations about proper eye and visual hygiene with every patient. Our patients don't know what they don't know, and it's not fair of us to judge their habits and decisions if we haven't educated them. Think about it. Have you ever been to the dentist without having a discussion about proper brushing, flossing and gum care? You leave your dentist visit every six months with a goodie bag reminding you to care for your teeth correctly. What do your patients take home from your office?
Teach your patients about proper cleansing, harmful habits and ingredients that can be detrimental to their eye health. Show them images of meibomian glands and why it's important to blink properly, how nutrition can impact them and ways we can intervene if their glands aren't functioning fully. Ensure that you investigate the base of the lashes by asking patients to look down. Explain why you're doing this and walk patients through proper care for their lashes. My go-to suggestions are using a water-based cleanser (e.g., micellar water) and hypochlorous spray to kill bacteria, removing make-up every night and avoiding mascaras with harmful ingredients. Also be sure to ask about eyelash serums with prostaglandins that can cause meibomian gland dysfunction and dry eye disease, and talk about the power of patients' real tears. Keep products in your office so you can give them real solutions when they ask for recommendations for products to use. Advise them to look for ingredients such as peptides in serums, vitamin C/E and other antioxidants, niacinamide, caffeine and eyebright in brightening creams for the periocular area when they're shopping on their own.
Invest in building your protocol for eyelid health as well. For example, in every exam, I tell patients I'm looking for lumps or bumps on their lids because that is the most common place to get skin cancer. They're surprised at first, but once I ask when they last used sunscreen there, it clicks. We then discuss the proper use of sun protection in the form of ophthalmic sun lenses.
If you aren't comfortable having these types of discussions, find a champion in your office who is passionate about this topic and can further educate patients on what you prescribe for them. Patients are hungry for this information, and you'll be surprised how grateful they are to know you're a resource for them in this area too.
