Despite the many, valid attempts his doctor made to correct his condition, it was simply too aggressive. This taught me that no matter how much effort I apply, some patients have severe disease. It may not be possible to get an ocular surface picture perfect, but it is up to ODs to continue treatment and keep the patient as comfortable and healthy as possible. Although many patients are able to achieve and maintain normal tear osmolarity without inflammation, some will require ongoing treatment and may never achieve perfect control. This is just a fact of the disease and it does not indicate a failure on the ODs part. Realizing this gave me a new confidence in dealing with my difficult cases.
At the end of the visit, I was surprised to find that I had learned infinitely more than I had expected. Not only did I learn tips and techniques for better diagnosis and management of dry eye disease, I gained insight that helped me improve my patient flow and gain confidence. I learned ways to improve not only my dry eye practice, but my primary care practice, as well.
I urge ODs to step outside of their own four walls and visit another practice. I am certain it will lead to a new viewpoint that will take practices to the next level.
Dr. Showalter was sole owner of EyeDoctors and Dry Eye Center WV in Vienna, WV, until becoming a partner doctor with Total ECP in 2018. She is a Diplomate of the American Board of Optometry. She is a consultant with Eyevance Pharameuticals.