Modifying DED Diagnosis

Tips for seeing patients during the pandemic

In past introduction sections of the dry eye disease (DED) PMO, the U.S. prevalence of the condition — 6.8% of the adult population, reports the American Journal of Ophthalmology, by the way, — has been discussed. Additionally, DED’s etiology (inflammation, meibomian gland dysfunction, patient demographics); the motivation to treat it and the incorrect preconceived notions about diagnosing and treating it have been mentioned. Given that some optometrists have not yet reopened their practices and others are seeing a limited number of patients, due to the unprecedented COVID-19 pandemic, I’d like to focus this DED PMO introduction on how to modify DED diagnosis to fit these “new normal” practice situations.

Dry eye disease may be on the rise due to increased screen use.
Image courtesy of Dr. Hauser


Long belabored as too time intensive and irrelevant to patients, DED surveys provide an opportunity to demonstrate value. In a time when savvy eye care providers would like to capture more medical patients, a DED questionnaire casts the widest net and can aid in identifying patients who may have the condition. (Find questionnaires at .)

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With your patients’ permission, why not send a mass email that contains your preferred DED questionnaire, with the note that in these times of increased digital screen use, you wanted to check in to make sure they aren’t experiencing blurred vision, burning, excessive tearing, foreign body sensation or light sensitivity?

Upon receiving answers that raise your suspicion for DED, you can then schedule a telehealth appointment or an in-person appointment, in following all the recommended guidelines ( and ) to prevent the contraction of COVID-19. Often, optometrists claim case history covers all the bases when it comes to identifying DED. However, during these times, uncovering symptoms via a DED questionnaire is an asset for O.D.s.


Given that the COVID-19 pandemic is, to say the least, nerve-wracking, the prevailing instinct of some optometrists may be “get in, get out” when it comes to seeing the DED suspect. Let’s not let this instinct rush us through the ocular health assessment.

Just as the patient took the time to fill out the DED questionnaire, we have a responsibility to be thorough and complete, while maintaining efficiency. To limit time spent in the lane and, therefore, potential exposure to the coronavirus, let’s consider beefing up our websites to include more content about DED. Patients can then be directed to the site before or after the examination. If follow-up questions arise from patients post in-office appointment, answers can be provided through telehealth appointments. (For how to explain to patients DED diagnostic devices and therapies, see “Discuss DED Diagnostics,” p.21, and “Educate on DED Therapeutics,” p.24.)


As health care providers, we have to be mindful that distance does not negatively impact our patients’ well-being. Optometrists have always had a uniquely personal relationship with patients and, during this unique time, that will continue.

Let’s be vigilant to maintain that connection by reaching out to inquire about possible DED. Additionally, let’s be mindful of the business opportunities that can come from providing stellar care. Such care can be the impetus for the creation of a DED clinic (see “How to Create a DED Clinic,” p.34). OM