Ocular Allergy: Nothing to Sneeze At

eye allergies

Ocular Allergy: Nothing to Sneeze At

Why you should seek allergy patients, and how to attract them.


Due to the aging of America, the fact that ophthalmologists can no longer keep up with the increasing patient load, several new patients resulting from the Affordable Care Act and more patients looking for one-stop, all-inclusive eye care, O.D.s must transition their practices to the medical model. This is essential if they want their practices to survive and thrive. Identifying and treating ocular allergy is the key to successfully creating a medical model practice. The reasons:

It shows patients that optometry isn’t exclusively refractions, contact lenses and eyewear.

It shows patients that O.D.s have prescribing rights and, therefore, the ability to treat other medical eye conditions, such as glaucoma. (You become the go-to eyecare physician for everything eye related.)

It brings in a huge stream of medical eyecare patients, as ocular allergy affects up to 40% of the U.S. population.1

Here, I explain how to attract allergy patients and build a medical model practice.

1 Provide staff education.

Educate your staff, particularly your front-desk staff. (I was once frustrated to hear that the reception desk staff in a previous practice was turning away patients because they weren’t aware I treat all medical eye conditions.) If staff doesn’t know you can treat these problems, prospective patients won’t know.

To provide staff education, schedule a short in-service day at which you explain the signs and symptoms of ocular allergy (show clinical photos) and its comorbidity with other ocular surface conditions, such as dry eye disease (DED) and conjunctivitis.

Finally, explain that you’re counting on them to help you identify possible ocular allergy patients and to educate these patients that you possess the expertise and prescribing rights to treat it and other medical eye conditions.

2 Screen for allergy.

Properly screen all patients for the condition on the patient history form and through an allergy work-up. Specifically, include a basic allergy questionnaire regarding signs, symptoms, frequency and onset, as well as severity and timing. These simple specific questions are often all that is needed to guide you at the slit lamp and, therefore, make a definitive diagnosis. For those wanting a more comprehensive questionnaire, check out “The Eye Allergy Patient Impact Questionnaire” ( By screening every patient, you’re educating them that you can diagnose and treat ocular allergy. This leads to friend and family referrals.

Take-Home Points

Ocular allergy is a gateway for seeing other medical eye conditions.

Several ways exist for you to attract and retain ocular allergy patients.

3 Provide the latest treatments.

Antihistamines/mast-cell stabilizers, steroids, gel drops and ointments, etc. are all excellent means of providing relief, and therefore, patient satisfaction. This binds them to your practice for other medical eye conditions. (See “Prescription Ocular Allergy Medications,” below.)

4 Market the service.

Make both current patients and prospective patients aware of your ocular allergy skills through marketing.

Internally, hang posters that detail ocular allergy signs and symptoms and the various treatments available. Also, have a printed page or a pamphlet in your reception area that describes ocular allergy and the services you provide to enable patients to achieve relief. In addition, consider showing animated videos of ocular allergy, and include the latest treatment information in practice newsletters — patients love to see their doctor is current on the latest care, as it reinforces to them that they’re receiving the best care.

Externally, include ocular allergy under “services provided” on your practice website. Consider highlighting this on your home page: “Itchy, red, watery eyes? You may have ocular allergy. We provide the latest care to provide you with relief.”

Use your practice’s Facebook page to highlight the service as well. To make patients aware of your Facebook page, send a letter about it and how the page will provide the latest news in eye care. Next, post weekly or monthly updates on your Facebook page regarding ocular allergy. Also, consider asking patients to post their positive experiences with you: “I’m glad we were able to help you. We want to help others like you. Would you mind sharing your experience through a brief Facebook post, or leaving us a review online?” Then, watch your practice grow.

In addition, send all current and prospective patients in your area a direct mail piece in the spring and fall seasons — the seasonal allergy peaks — that details ocular allergy and lists the benefits of treating the signs and symptoms with the latest and greatest allergy medications, to which you have access.

Finally, send letters to other healthcare practitioners in your area that describe allergic conjunctivitis is often mistaken for DED and vice versa, and that you have the ability to successfully treat both conditions. I often receive referred patients who have failed DED treatment, as the two conditions can exacerbate and coexist.

Prescription Ocular Allergy Medications

Alcaftadine 0.25% (Lastacaft, Allergan) – q.d. dosing for patients age two and older

Azelastine hydrochloride 0.05% (Optivar, Meda Pharmaceuticals) – b.i.d. dosing for patients age three and older

Bepotastine besilate 1.5% (Bepreve, Bausch + Lomb) – b.i.d. dosing for patients age two and older

Emedastine difumarate 0.05% (Emadine, Alcon) – q.i.d. dosing for patients age three and older

Epinastine hydrochloride 0.05% (Elestat, Allergan) – b.i.d. dosing for patients age three and older

Ketorolac tromethamine 0.4% (Acular LS, Allergan) – q.i.d. dosing for patients age three and older

Ketotifen fumarate 0.025% (Alaway, Bausch + Lomb) – b.i.d. dosing for patients age three and older

Olopatadine hydrochloride 0.2% (Pataday, Alcon) – q.d. dosing for patients age three and older

Olopatadine hydrochloride 0.1% (Patanol, Alcon) – b.i.d. dosing for patients age three and older

A gateway

Identifying and treating ocular allergy is a proven gateway to achieving a successful medical model practice. Again, with America’s aging population, ophthalmology’s shrinking numbers, new or different patients through the Affordable Care Act and patients’ desire for one-stop, all-inclusive eye care, the survival of our practices hinges on transitioning to the medical model. OM

1. Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988-1994. J. Allergy Clin. Immunol. 2012 Oct;126(4):778-83.

images Dr. Beatty has spent the last seven years in a cornea a refractive surgery practice at Cavanaugh Eye Center and is now in private practice at WestGlen Eyecare. E-mail him at Or send comments to optometricman