Autoimmune Rheumatic Disease
Learn these clues to see whether you may be dealing with more than dry eye disease.
Although excellent treatment options are available to alleviate dry eye disease (DED) symptoms, such as ocular burning, and signs, such as redness, patient adherence can be a challenge. The reasons for this include using the treatment as-needed rather than following the prescription, forgetfulness, cost, lack of education regarding the seriousness of DED, and patient intolerability.1-5 So, how, specifically, can you overcome these challenges? Benjamin E. Azman, OD; Jackie Garlich, OD, FAAO; Cecelia Koetting, OD, FAAO, Dipl ABO; Cory J. Lappin, OD, MS, FAAO; Jessilin Quint, OD, MBA, FAAO; and Pamela E. Theriot, OD, FAAO, weigh in here:
EXUDE CONFIDENCE
“For ODs to be successful in encouraging patients to adhere to their prescribed treatment plan, they need to be confident, clear communicators, and committed to what they are prescribing. When this is your foundation, patients will perceive you as a doctor who is truly passionate about solving their ocular issues and as someone who views them as a human being and not just a number or a set of eyeballs. If the patient senses any hesitation or lack of confidence in the plan, it doesn’t matter how nice your office is, how many tests you did, or what clinical pictures you show them—they are less likely to go along with your plan of action. After step one, taking the time to educate them on your findings, including photos or scans, is the cherry on top and will reinforce your understanding of the diagnosis and commitment to helping them.”
– Benjamin E. Azman, OD
FORWARD-THINKING OUTLOOK
The Tear Film & Ocular Surface Society’s Dry Eye Workshop III Management and Therapy section provided a prescribing algorithm to “offer guidance to clinicians in selecting relevant interventions.” The report also included this statement: “Patient education and adherence to treatment regimens remain essential for sustained symptom relief.” One won’t work without the other.
MAKE IT TANGIBLE/FOLLOW UP
“One of the most powerful things we can do is make the disease tangible. Showing patients meibography, staining, or matrix metalloproteinase-9 results turns an abstract diagnosis into something real and personal. I also simplify and stage treatment plans (rather than overwhelming patients with five changes at once), clearly explaining the “why” behind each step and what success should feel like. Finally, building in intentional follow-up—whether that’s a scheduled recheck, a technician touchpoint, or accountability through a structured dry eye program—dramatically improves adherence because patients know we’re actively partnering with them, not just handing them a bottle and hoping for the best.”
– Jackie Garlich, OD, FAAO
TAKE A MULTIPRONGED APPROACH
“Getting patients to adhere to our prescribed treatments can be difficult. I have found the following to be helpful:
Explain what the situation and diagnosis is and what this can mean long-term for their vision and quality of life.
Use photos and show the results of tests.
Explain what the prescription is for and how it will help.
Set expectations: How long will it take to work, how long will they need to take it, and what happens if they don’t take it? Include possible side effects they shouldn’t be concerned about.”
– Cecelia Koetting, OD, FAAO, Dipl ABO
USE PHOTOS/OBJECTIVE TESTING
“I am a huge advocate of using photos and objective testing in dry eye patient education. This allows me to visually show the patient each area of concern, which helps them better grasp exactly what is going on. For instance, it is one thing to tell a patient they have meibomian gland dysfunction, but it is a different experience entirely to show them their own meibomian gland loss using meibography or decreased tear film lipid layer thickness using interferometry. Also, I give patients a list of every recommended treatment, and I explain how each addresses the specific factors contributing to their dry eye. It is easier for a patient to comply when they understand the purpose behind [treatments].”
– Cory J. Lappin, OD, MS, FAAO
EXPLAIN THE PURPOSE OF TREATMENT
“ODs can improve treatment adherence by helping patients understand both what to do and why it matters. Clearly explaining the purpose of treatment, the risks of not treating the condition, and the expected outcomes increases patient motivation and buy-in. Showing clinical images or test results can make ocular surface disease more tangible and reinforce the importance of treatment. My patients also benefit from take-home materials that reinforce my recommendations, giving them time to review and better understand the details after leaving our office.”
– Jessilin Quint, OD, MBA, FAAO
MAKE IT A HABIT
“Since DED is a chronic condition, I always approach my treatment plan as a new set of habits for the patient to develop. I give some simple steps that they can easily integrate into their daily routine, and I emphasize the results they’ll get in return, including clear vision and comfortable eyes. As an example: ‘While showering, take 20 seconds to use your foaming eyelid cleanser to scrub your lids and lashes.’”
– Pamela E. Theriot, OD, FAAO
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