One of the questions I’m most commonly ask is “Why dry eye?”—why is dry eye the condition to which you chose to dedicate your career?
My counter to that question is, “Why not dry eye?”
Actually, that’s my counter to the question now. In the beginning, however, I was asking myself the same thing.
I worked in cataract and refractive surgery for 10 years before jumping into dry eye with both feet. To be honest (and I hate this phrase), surgical eye care was “sexier” than dry eye. Patients went from 20/terrible to 20/elated almost immediately after both cataract and refractive surgery. Almost instant gratification. The doctors were all heroes. What’s not to love about that?
Dry eye, on the other hand, was like treading water in the ocean far from shore: fatiguing and no rescue boats in sight for either doctor or patient. All was lost.
When I was tasked to create a dry eye center alongside my friend and colleague, Alan Kabat, OD, FAAO, I nearly said no to the invitation. I loved a challenge, and I admired Al, but this sounded like more than I cared to take on. Dry eye doctors were not heroes to their patients— they were zeroes. The patients were never satisfied and always finding a new complaint that I may, or may not, be able to identify clinically. I envisioned frustration for all involved.
Eventually, my competitive nature got the best of me, as it often does, and I agreed to collaborate in the creation of a “dry eye center of excellence.” From the moment we started, I loved it.
I’m a problem solver. It’s what I like to do, and dry eye disease (DED) presents all sorts of problems that need to be solved.
The most obvious—and first to tackle—is how to best treat the patient.
1. How do we engage the patient?
We made patient education a primary objective in our dry eye center. Many practitioners think that leads to inefficiency and wasted time. Nothing could be further from the truth. A well-educated patient will often ask fewer and more pointed questions.
The patient who doesn’t “get it” will pull out the dreaded list of questions and keep you for 20 minutes. At the end of the examination, the patients in our dry eye center often say my favorite words: “You just told me things no one else has ever said. I finally understand my dry eye.” They also understand I do not have a magic wand and can not necessarily fix it, but they are now willing to partner with me.
Education needn’t be just in the hands of the eyecare provider. The greatest successes in dry eye are shared by the entire team who cares for the patient. Dry eye patients can require a bit more attention than other patients. Utilizing staff to work with the patient can provide balance and not encumber a single staff member.