“Today’s surgical patients are more informed and often have higher visual expectations, particularly with premium intraocular lenses (IOLs) and refractive procedures, making strong OD/MD communication more important than ever,” said Jade Coats, OD, FAAO, in a session that she copresented with Jessilin Maelia Quint, OD, FAAO, and Vin Dang, OD, FAAO, at Optometry's Meeting 2026 in Phoenix.
“Surgical comanagement allows optometrists to provide continuity of care and ensure that patients receive support and guidance before, during, and after surgery from a provider they already know and trust,” added Dr. Quint. The best patient outcomes happen when surgeons and optometrists work together as a team to combine surgical expertise with long-term ocular health management, she said.
Specifically for cataract surgery comanagement, Dr. Coats said a key strategy is the comprehensive preoperative evaluation and counseling by the optometrist. “ODs are often the first providers to identify visually significant cataracts and can help determine when symptoms begin to affect quality of life,” she explained. “Beyond identifying lens opacity, it is important to assess ocular surface disease, macular status, corneal irregularities, dry eye, and refractive stability prior to referral because these factors significantly influence surgical outcomes and patient satisfaction.”
Dr. Coats further pointed out that setting realistic expectations early is key, especially for patients considering premium IOL technology or spectacle independence. “Helping patients understand the tradeoffs between multifocal, extended depth of focus, toric, and monofocal lens options before the surgical consultation often improves patient confidence and postoperative satisfaction,” she said.
As postoperative cataract comanagement also continues to evolve, Dr. Coats stressed that optometrists play an essential role in monitoring healing, managing ocular surface disease and inflammation, identifying complications early, and guiding patients through visual adaptation. “Effective communication protocols between the surgeon and optometrist are critical to ensuring seamless postoperative care and timely intervention when needed,” she explained.
With refractive surgery comanagement, Dr. Coats relayed that the OD’s role begins with identifying appropriate candidates and recognizing contraindications. “Careful screening for dry eye disease, irregular corneas, ectatic risk factors, unstable refractions, and patient lifestyle needs remains essential,” she said, adding that matching procedures such as LASIK, photorefractive keratectomy, small incision lenticule extraction, refractive lens exchange, or phakic IOLs to patient goals is important.
“One of the most valuable clinical pearls for practicing optometrists is that patient education and expectation management are often just as important as the procedure itself,” she said. “Patients who understand healing timelines, visual fluctuations, and realistic outcomes tend to have a significantly better overall experience.”
Dr. Quint added that optometrists play a critical role in identifying surgical candidates, optimizing the ocular surface preoperatively, and managing long-term postoperative care to improve outcomes. “This is a tremendous opportunity for optometrists to take the lead in the surgical comanagement journey and guide patients through every stage of care while strengthening continuity, trust, and outcomes.”
Dr. Coats further relayed that collaborative care models are increasingly incorporating advanced diagnostics and shared technology platforms that improve communication and continuity between practices—adding that artificial intelligence could be beneficial, particularly in the setting of scribing and comanagement communication.
“We recently implemented an AI scribe at our office and it’s helped me cut down on my daily charting after clinic time,” said Dr. Dang. “It’s also able to generate letters to our comanagement doctors and referral base to keep them apprised on the patient’s outcome.”
Dr. Dang added that advanced diagnostics that optometrists use for pre-op consist of at least meibography to examine the meibomian glands or use of the latest all-in-one diagnostic dry eye analyzers such as the Tera Dry Eye Imager (Topcon Healthcare), the Keratograph 5M (Oculus), the Dry Eye Analyzer (MiBo Medical Group), or the Ocular Surface Analyzer (Synergy Eye Care). “These advanced diagnostic instruments evaluate the ocular surface by looking at the blinking pattern or lack thereof, the lipid layer thickness, and noninvasive tear breakup time,” he said. Optometrists can use a biometer to determine axial length and IOL power for myopia control management, and optical coherence tomography can be used to diagnose macular edema post cataract surgery, he continued.
Dr. Coats concluded, “as surgical technologies continue to advance, comanagement relationships are becoming more integrated, with optometrists taking a larger role in perioperative care, long-term follow-up, and management of chronic ocular conditions that can influence surgical success.” OM
Dr. Coats, Dr. Quint, and Dr. Dang report no relevant disclosures.