This article was originally published in a sponsored newsletter.

You can expand your clinic by investing in diagnostic equipment to enhance the capture rate of your ocular surface disease patients and therapeutic equipment to enhance the treatments that you currently offer.

Take, for example, the utilization of osmolarity within eye care. Hyperosmolarity is one of the most widely-accepted biomarkers included in the definition of dry eye disease. I often use osmolarity as a point-of-care test, and I have found that it is valuable to my practice for several reasons.

First, patients appreciate metrics in their eye care, and they like to have their therapeutic treatment validated by a lab test. When we do this testing, I explain that a high osmolarity simply means that the solute concentration of their tears exceeds 308 milliosmoles, which can cause desiccative damage to the corneal epithelium. When patients see by the numbers that treatment is lowering their osmolarity and bringing both eyes within 8 milliosmoles, it adds to their confidence in me and in the regimen that I’ve prescribed.

Another important attribute of osmolarity is helping to unravel dry eye masqueraders. For instance, a patient with epithelial basement membrane dystrophy (EBMD) will have all the symptoms of dry eye disease, yet in most cases, their osmolarity will be in the normal range. Inflammation, secondary to the EBMD, is typically high in these patients due to the release of MMP-9 by the stressed epithelial cells.

The other condition I often find masquerading as dry eye disease is conjunctivochalasis (CCH), or “mechanical dry eye.” In CCH, the conjunctival tissue separates from an unhealthy and deteriorated Tenon’s Capsule, then fills the inferior fornix and rises above the inferior lid margin, preventing a healthy rewetting of the corneal surface. This, in turn, will mimic the symptoms of dry eye disease, but osmolarity will often fall within the normal range.

I find osmolarity testing to be a useful tool in my dry eye clinic. It not only helps monitor progress of treatment and differentiate dry eye from other conditions, but it is also widely appreciated and accepted by patients.

Douglas K. Devries, OD has a degree in financial management from the University of Nevada and graduated from Pacific University College of Optometry. He is co-founder and managing partner of Eye Care Associates of Nevada. He is an adjunct clinical professor of optometry at Pacific University and residency program director. He dedicates the majority of his clinical practice to ocular surface disease.