Cecelia Koetting, OD, FAAO, DipABO

In this segment, the expert panel focuses on patient counseling, adherence, and expectation-setting when initiating Acoltremon.

In this segment, the expert panel reviews the COMET-1 and COMET-2 clinical trials, highlighting how these studies evaluated both signs and symptoms of dry eye disease to determine the therapeutic impact of Acoltremon.

In this segment, the expert panel discusses how Acoltremon fits within the broader treatment landscape for dry eye disease, particularly in relation to anti-inflammatory therapies.

In this segment, the expert faculty explore the mechanism and clinical role of Acoltremon, a newly available dry eye therapy that targets sensory innervation to stimulate basal tear production.

The experts further discuss managing neuropathic pain, differentiating peripheral from central mechanisms, validating patients’ symptoms, and using imaging technologies to enhance education and track progress.They describe strategies that rebuild trust, including clearly explaining findings during the exam, demonstrating abnormalities the patient can feel or visualize, and confidently outlining a tailored plan. The experts also find it helpful to show patients a comprehensive list of available treatments, reinforcing that many options remain. The panel highlights the importance of frequent follow-ups—often at 4 weeks, then every 3–6 months—to maintain partnership, monitor progress, and ensure patients never feel abandoned in their care. They also stress collaboration with local physicians for those traveling long distances, reinforcing continuity and shared control in management.

In this segment, the expert panel reflects on the rapid evolution of dry eye therapeutics and the impact of newer pharmacologic options on clinical practice.

In this segment, the expert panel addresses one of the most challenging aspects of dry eye management: engaging frustrated patients who have seen multiple clinicians without meaningful relief. The faculty note that by the time these individuals reach a dry eye specialist, many have lost hope, feel dismissed, or are emotionally exhausted from living with constant ocular discomfort. The panel emphasizes that validation and empathy are essential first steps—acknowledging the chronic, psychologically taxing nature of the disease immediately helps patients feel heard. They describe strategies that rebuild trust, including clearly explaining findings during the exam, demonstrating abnormalities the patient can feel or visualize, and confidently outlining a tailored plan. The experts also find it helpful to show patients a comprehensive list of available treatments, reinforcing that many options remain. The panel highlights the importance of frequent follow-ups—often at 4 weeks, then every 3–6 months—to maintain partnership, monitor progress, and ensure patients never feel abandoned in their care. They also stress collaboration with local physicians for those traveling long distances, reinforcing continuity and shared control in management.

In this segment, the expert panel focuses on how they individualize dry eye disease treatment by interpreting symptom patterns, clinical findings, and patient-specific factors. They acknowledge that the expanding range of therapeutic options can feel overwhelming, but emphasize that effective care comes from methodically analyzing what each patient’s presentation reveals. The faculty explain that targeted questioning—such as whether symptoms are worse upon waking or later in the day—can differentiate between issues like poor lid seal, nocturnal exposure, or evaporative stress. They highlight the importance of performing a structured slit lamp examination, waiting the full two minutes after fluorescein instillation, assessing corneal and conjunctival staining, evaluating tear meniscus height, and observing eyelid mechanics. These findings guide decisions about anti-inflammatory therapy, anti-evaporative strategies, obstruction relief, or eyelid-focused interventions. The panel also stresses environmental and behavioral contributors, using real-world examples to educate patients and encourage active participation. Visual tools—including photos, videos, and simple imaging—help patients understand their condition and the chronic, multifactorial nature of dry eye disease.

In this segment, the expert panel discusses the clinical importance of distinguishing basal tear production from reflex tearing when evaluating patients with dry eye disease. They explain that although both types of tears share many biochemical components, basal tears contain these elements in much higher concentrations, making them essential for epithelial health, nerve function, and overall ocular surface stability. Reflex tears, by contrast, simply wet the surface temporarily and often run down the cheek—giving patients the misleading impression that their eyes “can’t be dry.” The faculty note that this distinction frequently arises in patient conversations, especially when individuals believe that tearing rules out dryness. They use relatable examples, such as tearing from cutting onions or removing debris from the eye, to illustrate that reflexive tearing does not replace true basal tear function. The panel reflects on how treatment options for dry eye have expanded significantly over time, allowing clinicians to better address deficiencies in the tear film’s protective baseline components.

In this discussion, the expert panel emphasizes practical, accessible strategies for identifying underlying contributors to ocular surface disease and dry eye. They note that clinicians do not need advanced or expensive technology to diagnose dry eye effectively; instead, consistency and recognition of key signs and symptoms are essential. The panel highlights the value of brief, structured assessments—such as a “90-second workup”—that incorporate symptom questionnaires like the OSDI, fluorescein and lissamine green staining, and simple tear break-up time measurements. Several faculty members underscore the importance of evaluating meibomian gland structure, whether through meibography or basic transillumination. They discuss the usefulness of rigidly separating aqueous deficient from evaporative dry eye, describing the condition instead as a continuum where each subtype often leads to the other. Tear meniscus height is identified as a powerful but underutilized diagnostic cue. The panel also stresses the importance of considering patient-specific factors—environment, hobbies, and prior eyelid surgery—that influence tear film stability and symptom severity.

A variety of eye drops for dry eye took the stage at this year's conference.

Cecelia Koetting, OD, FAAO, DIpABO, details her poster presentation at AAOpt's Academy 2025 meeting.

Cecelia Koetting, OD, FAAO, DipABO, emphasized that the field of regenerative medicine is continuously expanding, with new devices and approaches constantly emerging.

A conversation with survivor and advocate Jasmine Grace Marino.

The surgery isn't over until the healing is don

CRU 2025 provided the latest insights regarding glaucoma, dry eye disease, retina, myopia, neurotrophic keratitis, and keratoconus.

Cecelia Koetting, OD, FAAO, DipABO, and Madeline Yung, MD, discussed emerging treatment and patient care options for those with presbyopia during CRU 2025.

Cecelia Koetting, OD, FAAO, DipABO, weighs in on patient assessments, staining pattern insights, and diagnostic tips for patients who may have dry eye disease.

Cecelia Koetting, OD, FAAO, DipABO, details a talk she gave among optometrists and ophthalmologists at CRU 2025.

An overview of prescription medications available for DED.

EnVision Summit Cochair Cecelia Koetting, OD, FAAO, Dipl ABO, says that attendees should get ready for more discussion-based panels at this year's conference.

EnVision Summit optometry faculty Sherrol Reynolds, OD, FAAO; Katie Rachon, OD, FAAO, Dipl ABO; Ashley Wallace-Tucker, OD, FAAO, FSLS, Dipl ABO; Jessica Steen, OD, FAAO, Dipl ABO; and Cecelia Koetting, OD, FAAO, Dipl ABO; express excitement for the upcoming conference and why optometrists should attend.

Key takeaways from the past year that can help optometrists look ahead to 2025.

Cecilia Koetting, OD, FAAO, DipABO, cited data from a recent study that found that presbyopia treatment with 0.4% pilocarpine led to up to 86% of patients achieving 20/40 or better.

Resolving eye care disparities can yield positive results for patients of all backgrounds.

Technological advancements may improve treatment options.

A travel in time and across the world shows the development of refractive surgery and how eye care providers can play a part in the future of pre- and postoperative refractive surgery care.

Cecelia Koetting, OD, FAAO, DIPABO chats with Optometry Times about her role with EnVision Summit's new optometry program and the excitement surrounding the event.

Even if DLS is completely normal and expected, it can be mentally and emotionally difficult for patients.