Dry Eye For Rainy Days

Providing management can make a practice recession proof

Recently, there have been rumblings of a possible recession. Again, these are just rumblings and, in fact, some media outlets, such as The New York Times, are printing pieces that reveal “sluggish growth” vs. an “outright recession.” (See .) That said, these rumblings got me thinking about how dry eye disease (DED) management, in helping provide a higher level of care to patients, can help make a practice recession proof. As Sir Isaac Newton determined while sitting under an apple tree, what goes up, must come down, so I think general preparation is wise.

What goes up will eventually come down, so Sir Isaac Newton found.


Researchers estimate that over 16 million U.S. adults have diagnosed DED, and an estimated 6 million have reported symptoms of the condition, but have not received a diagnosis, reports a recent American Journal of Ophthalmology study. Additionally, while DED is linked with advancing age, this study shows it is, “notable among those ages 18-34 years.” Further, other studies reveal pediatric cases of DED, with one BMC Ophthalmology study implicating smartphone use as a risk factor.

Given these large numbers and the fact that DED also affects children, it makes sense that managing the condition can make a practice recession proof. However, a truly successful DED clinic is one in which its optometrists are consistently identifying the condition in all patient populations. To accomplish this, symptom-related questions should be included on all patient history forms, and both the ocular surface and lids scrutinized on each and every patient. Further when treatment is prescribed, DED patients should be educated on its benefits, the importance of follow-up appointments and how aggressive treatment, such as thermal pulsation, can actually offer a cost-savings over time.


Patients do not like how DED looks or feels: It can make eyes appear red and “drippy” and cause relentless discomfort and unstable vision. The fact is, DED is harder for patients to ignore than other ocular diseases, such as glaucoma, which, for most patients, is painless and has little impact on vision until significant damage occurs. As a result of this fact, I have found that DED patients are less likely to miss initial and follow-up appointments.

In 2008, “The Great Recession” was in full swing. The practice where I worked offered many high-end services for patients, for example, LASIK and premium IOLs, but patients weren’t scheduling LASIK surgery or choosing multifocal IOLs. Additionally, they weren’t even coming for follow-ups for glaucoma. However, the one facet of the practice that continued to steadily roll along was the practice’s DED clinic.


Offering ocular nutritional supplements, warming masks and lid hygiene products in office can provide patient convenience and compliance, as well as a modest margin for the practice. Additionally, for those averse to stocking such products, some companies offer practices virtual inventory options that ship directly to patients. OM