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Specialized eyecare for dry eye disease
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By Ryan Beck, OD
March 5, 2025
For many reasons, optometrists should be both optimistic and opportunistic with the position they find themselves in today, especially the eyecare professionals who are involved with the management and decision-making of the practice.
One reason, of course, is the expected increase in demand for eyecare services as the population ages and awareness of the importance of eye health grows.
Additionally, increased screen time by a wide swath of the U.S. population has led to eyestrain and other issues. (Studies show that people of all ages blink far less often when concentrating on a screen, which in turn causes the eyes to dry out.)
At the same time, the ophthalmology supply is projected to decrease by 2,650 full-time equivalent ophthalmologists (12 percent decline) between 2020 and 2035.1 The consensus view is that one of the effects of this ophthalmologists’ shortage is that ODs will become busier and have an increasing opportunity to expand their presence in areas of specialized care.
I became interested in specialized care opportunities shortly after receiving my optometry degree from Nova Southeastern University and then following up with clinical training at the University of Miami’s Bascom Palmer Eye Institute.
At first, it was the specialty fitting of contact lenses for patients with advanced cornea diseases, which then led me into the area of diagnosing and treating dry eye disease (DED).
DEWS II Report Provides Update on Dry Eye Treatment
At about this time, the Tear Film & Ocular Surface Society (TFOS) issued a follow-up to its landmark Dry Eye Workshop (DEWS) report. The goal of the TFOS DEWS II2 was to achieve a global consensus concerning multiple aspects of dry eye, including updating the definition and classification of dry eye and developing recommendations for the diagnosis, management and treatment of this disease.
In a short time, it was clear that dry eye was about to become a potential opportunity for any optometrist who wanted to add something unique to his/her practice and be in position to provide a more comprehensive selection of eyecare services for their patients. This is one of the things that led me to consider adding dry eye services within our eyecare group.
One reason dry eye has become an important specialty area is the incidence and rising number of diagnoses. The most recent studies estimate that as many as 50 million people in the U.S. have some sort of evaporative dry eye disease,3 which means there are between 10 percent and 15 percent of the population suffering with dry eye symptoms.
It’s truly a multifactorial problem, which is why it is so broad.
What to Consider Before Launching Specialty Care
But before making such a big career step, I recommend that ODs think about a few elements that will contribute to their success and future satisfaction.
For me, specializing in an area such as dry eye was a way to fuel my passion for patient care and to challenge myself in a different way. And it also may provide a financial benefit to the practice when implemented successfully.
The first, and most important consideration, before embarking on this effort is to consider all the specialty opportunities available and to make a decision based on the area of care you are passionate about. Without the drive to achieve this addition it will be an uphill battle to find success. You must be able to commit to the additional time and investment involved.
The second important factor before beginning a specialty focus in your practice is to consider the demographics of the area. What patients are actually going to need treatment where your practice is based?
Other factors to consider:
- What are the treatment possibilities for that patient?
- Are they going to be able to afford the prescribed treatments?
- And are these services/treatments going to be reimbursable by insurance?
Once you have the sense of the challenges and opportunities, then it’s time to consider the different types of equipment that’s needed, the training required and any adjustments to workflow within the practice. This all happens before you begin to roll out the plan and execution process.
Going Beyond Eyewear and Contact Lenses
One hurdle to overcome once you begin is the rethinking of the “selling” aspect of your practice. Often in optometric practices, we’re used to providing routine eye examinations, contact lens and eyewear sales and various over-the-counter products and services.
There’s a certain price point that optometrists are used to with these services, whether it’s a high-end practice or more mainstream. But many of the specialty services, including dry eye, are not yet covered by medical plans and they can be expensive, and rightfully so since they often are medical procedures and require a lot of doctor and staff time.
Some practitioners are challenged when moving from eyewear and contact lens sales – which may require a minimal out-of-pocket or co-pay expense – to the more expensive elements of specialty eyecare. This becomes a “big ask.”
What works well is to offer a financing solution, such as the CareCredit credit card, which can fill the financial gap and offers patients a way to finance treatment over time. It’s no longer such a hit on their wallets and they are still able to access the needed care.
The CareCredit option can make treatment more affordable, especially for those patients who are challenged today by absorbing any out-of-the-ordinary monthly expense. The CareCredit option permits a patient to spread out their payments over time, and at the same time they can get the product or specialized care they need quickly.
Not every patient is interested in a financing arrangement, of course, but knowing a financing solution is available may lead to a greater rate of acceptance. Simply ask patients if they would like to learn about flexible financing. For our practice, this is an approach that helps to start an important conversation and to inform the patient that a financing solution may be available.
References
- https://pubmed.ncbi.nlm.nih.gov/37739231/#:~:text=Results%3A%20From%202020%20to%202035,mismatch%20of%2030%25%20workforce%20inadequacy.
- https://www.tearfilm.org/public/TFOSDEWSII-Executive.pdf
- https://dryeyedirectory.com/dry-eye-statistics/
Ryan Beck, OD, is the medical director at Dry Eye Rescue Clinic in Boca Raton, Fla.
