
The Technology Powering My New Dry Eye Center
For Celesta Ferreira, OD, of Cypress Optique in Cypress, Texas, the inspiration to create an outstanding dry eye practice was driven by the belief that optometrists have a responsibility to comprehensively manage ocular surface disease and prevent the chronic discomfort that can be associated with this condition. Dr. Ferreria described her own experience suffering from severe dry eye throughout her life and shared that this was a motivating factor in igniting her passion for treating dry eye and helping others understand the full extent of how this disease can negatively impact patients on a daily basis. “I felt like I never had a proper eye exam that checked for dry eye, so when I opened my practice, I knew I needed to bring in the technology that would allow me to diagnose [this condition] and determine the appropriate
treatments,” she reflects. Ultimately, her frustration with the lack of an accurate dry eye assessment led her to equip her practice with the necessary equipment to achieve her goal of identifying and addressing the root cause of dry eye disease.
When selecting a corneal topographer to aid in this mission, Dr. Ferreira noted that she chose the Topcon CA-800 Corneal Analyzer for several reasons. The affordability and compact design of this instrument complemented the needs of her cold-start practice and provided seamless integration with the existing Topcon equipment that was used to outfit her exam lanes. In addition to these practical aspects, she valued the advanced diagnostic capabilities of the CA- 800 which made it possible for her to expand her scope of patient education. “It’s marketed as a topographer, but for those who want to treat dry eye, there is much more available here,” she noted. Utilizing the full features of the CA-800 allowed her to accurately describe and demonstrate to patients the physical manifestations of dry eye, such as reduced tear break up time (TBUT) and tear meniscus height. She was able to easily and efficiently capture high- resolution images of the corneal surface in order to analyze the quality of the tear film and the meibomian glands.
Building a Dry Eye Protocol
Dr. Ferreria recalled her initial experience incorporating the CA-800 device, roughly nine months after she opened her practice. “I didn’t implement the extensive testing protocol for dry eye until I realized what I could do with this technology. I initially used it for pupillometry and topography, and if someone talked about dry eye symptoms, I would obtain [meibography] imaging and TBUT,” she recalls. However, as she started to attend more professional conferences focused on dry eye, she heard a common refrain: “you won’t know unless you look.” From this point on, Dr. Ferreria built her dry eye protocol with this philosophy in mind. “I heard doctors say that patients can have zero symptoms and not a gland left. I understand this because often patients assume that the way their eyes feel is normal. I began to look and prove it rather than base my testing on the patient’s symptoms.”
As a result, she uses her CA-800 device to assess pupillometry, corneal topography, blink rate, TBUT, and meibography in all patients. Although this does take some extra time, Dr.
Ferreira notes that even one extra test to better understand a patient’s risk for dry eye is helpful and worthwhile. When she started to look for dry eye, she found it – in big numbers. Her dry eye practice has nearly doubled in size as a result, and she has diagnosed this condition in many patients she would have not screened based simply on their profile. She was astonished by many of these cases, such as that of a 6-year-old patient who only had a few meibomian glands remaining because of persistent eye rubbing. “I am constantly amazed at how drastic the loss of meibomian gland function can be for those who say they have no symptoms. This is true, too, for those who have symptoms that are constantly overlooked.”
Marketing the Specialty
While Dr. Ferreira had the goal to build a specialty dry eye practice from the beginning, she was initially relying on patient referrals by word-of-mouth. “Now, I am really promoting the [dry eye] specialty because I have the technology to test and treat patients. The Topcon CA-800 helped give me the confidence to detect the condition and educate patients,” she says.
During her comprehensive exams, she makes sure to explain to patients the information she obtained during their preliminary dry eye screening and share her reasoning for ordering a more detailed evaluation. Patients often return for a medical exam and in-depth testing for this reason. “The data I get from the CA-800 is my gateway into showing patients what is going on,” she says. With the help of tracking features on this device, she is able to directly show patients the efficacy of the individualized treatment plan she prescribes. Demonstrating an increased TBUT time after treatment, for example, is great reinforcement to show patients that treatment is working.
Conclusion
Dr. Ferreira’s passion for comprehensive dry eye management and her investment in the right tools for success has allowed her to actively promote her specialty practice with confidence. With the help of the Topcon CA-800 device, she can diagnose and educate patients effectively and fully address their dry eye concerns, leading to tangible improvements in signs and symptoms. “Building my dry eye practice has drastically impacted my bottom line and the quality of life for my patients,” she reflects. Although Dr. Ferreira acknowledges that dry eye
might not be every optometrist’s passion, for those who are dedicated to addressing this condition, the investments in diagnosis and treatment can be transformative for both patients and for the practice.
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