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Manage the patient's environment, manage the patient systemically, manage inflammation first, and communicate effectively with patients may be considered the new "rule"book for ocular surface disease management.
"Remember those four simple rules and you'll be well on your way to successful management of OSD," he said. "If you do those things, in most patients, you'll be pretty close to taking care of the problem. If you don't do those things, you probably won't be as successful no matter what other topical therapeutic options you use," said Dr. Morris, a private practitioner here and managing partner of Morris Education & Consulting Associates and Ocular Technology Associates.
Evaluating patients' systemic well being as well as topical disease is the second important element in OSD management, Dr. Morris said.
"In my experience, OSD is often a manifestation of larger systemic diseases or issues," he continued. "Think like a physician and look for underlying disease that may be manifesting itself on the ocular surface."
Examples of such diseases include systemic allergies, acne rosacea, and various autoimmune disorders.
Treating inflammation first is always crucial to controlling and managing OSD, Dr. Morris said. And finally, effective communication with the patient is crucial.
"As optometrists, we're service providers. If you don't communicate to patients what their condition is, what you're doing about it, what common side effects they should anticipate, and so on, then you're probably not going to do very well managing the disease and the patient. Remember, it's not only about medicine, it's also about customer service," he noted.
Dr. Morris said managing the environment, managing the patient systemically, managing the inflammation first, and communicating effectively with patients may be considered the new "rulebook" for ocular surface disease management. "Remember those four simple rules and you'll be well on your way to successful management."
Get started early
Dr. Morris also is an advocate of early diagnosis and early treatment. He noted that it's usually not the case that dry eye or other OSDs start out as severe. They usually start out mild, but are ignored or mistreated.
"The best way to manage OSD is to manage it early in the course of the disease instead of waiting until a certain severity level is reached," he said.
"Our single biggest problem in managing OSD is that everyone ignores it and waits until it gets so bad that conventional treatments just won't work effectively. Or, optometrists wait to treat and then find they have to load their patients up with five or six different treatment strategies. When diagnosed and treated early, management of OSD is fairly simple and the available treatment regimens are very successful," Dr. Morris said in conclusion.
Scot Morris, OD, FAAO
Dr. Morris has received honorariums as a consultant or advisory board member from Allergan, Aton Pharmaceuticals, Bausch + Lomb Vision Care, CIBA Vision, ECR Vault, Essilor Labs of America, Inspire Pharmaceuticals, Luxottica, and Office Mate Software Solutions. He also receives educational grants for the National Student Practice Management Symposium.