Article

CLINICAL: Dry Eye

Ocular Surface Wellness

Let’s actively explain DED as it relates to overall ocular health

Although there is some truth to the fact that asymptomatic dry eye disease (DED) patients don’t buy in to their diagnosis, much less their treatment plan, I would argue that we, as a profession, have also contributed to this lack of buy in.

How? We didn’t do anything sooner to start the dialog about the importance of ocular surface wellness, as it relates to overall ocular health. Dentists, however, nailed the importance of oral hygiene as it relates to teeth and the mouth overall. They accomplished this via several public service campaigns decades ago (bit.ly/37RxV4L and bit.ly/3a3B4QO ), as well as by making appearances on “Sesame Street” (bit.ly/2TeDIfL ) and “Mr. Rogers” (bit.ly/32p9hax .) The result: Six-month dental check-ups have become the norm, along with annual physicals.

To increase the likelihood of patients understanding the importance of ocular surface wellness, as it relates to overall ocular health, and thus, presenting to us regularly, so we can intervene, if needed, I suggest we do the following:

BE VIGILANT

Many patients subscribe to a “don’t ask, don’t tell” policy regarding their personal health and wellness. However, when it comes to eye care, optometrists have a unique opportunity to provide ocular wellness education when the patient is triggered to get an updated spectacle or contact lens prescription, as examples. After all, when the patient reaches for that last contact lens in the blister pack, she needs a comprehensive ocular wellness exam, so we can ensure she has optimum ocular health to continue with her vision correction successfully.

The bottom line: Regardless of the reason for the appointment, let’s be vigilant in educating all patients about, and looking for, signs of DED in patients who don’t voice related concerns. We may identify the condition before they do because, again, patients can be asymptomatic. Further, some patients do not verbalize all their concerns because they deem them as a natural part of aging, contact lens wear, etc. Also, these patients may think we cannot help. It’s our job to let them off the hook and let them know we can help.

REFER TO ORAL HYGIENE

When explaining the importance of ocular surface health, I recommend briefly discussing with patients the anatomy and physiology of the eye and the mouth, in terms of their striking similarities, especially in relation to lubrication:

“Just as saliva works to clear debris from teeth to fight against cavities, the tear film works to keep your eye moist to preserve its health and your vision. As a result, it’s important for you see me at scheduled appointments, so I can assess the health of your ocular surface and prescribe specific hygiene, if needed, to get it healthy. (This is required for your comfort and quality of vision).”

Doing so gives ocular surface wellness the same importance as dental care, in the patient’s eyes, and rightfully so!

TAKE-HOME MESSAGE

Optometry is late to the game in educating the general public about the importance of ocular surface wellness, as it relates to overall ocular health. But we can increase its awareness among the public and, thus, annual comprehensive eye health examinations by doing what is outlined above. OM