Courtney Goetsch, OD, knows what it means to be a dry eye sufferer. She began experiencing dry eye symptoms when she was a teenager. So she knows what a frustration dry eyes can be for patients – and she is acutely aware that dry eye symptoms are not just a sign of aging. “One in four people experience dry eye symptoms,” she says, and many are not getting the relief they need.
Not only is dry eye uncomfortable, dry eye sufferers complain that their red and watery eyes aren’t attractive. Dr. Goetsch, who is a partner with Unity Eye Centers (which has three main locations and two satellite offices), said that the leadership team committed to bringing comprehensive, advanced dry eye services to northeast Nebraska shortly after forming their group.
In early 2020, a team of six doctors brought together several local practices and merged them under one, care-oriented umbrella forming Unity. The doctors felt that they could gain greater buying power for products and technology in all of the practices. Adding the dry eye service line is just one example of the group’s synergy in its first couple of years under one umbrella.
“We did our homework, and Ann Hoscheit, OD, of EyeBridge Consulting Associates, helped us navigate building a dry eye service line from the ground up. She led our team by establishing a uniform clinical standard of care, establish a screening process that ‘filled the funnel’ for ocular surface consults, identified a focused line of retail treatment products and put us in touch with helpful vendors and suppliers when needed,” Dr. Goetsch says. In addition, Dr. Hoscheit also oversaw the design of important tools in the dry eye clinic, such as screening process, treatment handouts and informed consent forms. “A dry eye committee met every one to two weeks to develop protocols and procedures, with a goal of establishing a dry eye center of excellence that would ensure that our own patients were optimally treated as well as attract patients whose dry eye care was not adequately managed.”
There is now a dry eye service line in three of the Unity Eye Centers practice locations: Norfolk, Columbus and Grand Island. “If any of our patients needs an ocular surface consult or advanced treatment option, it would not take them more than 35 minutes to get to one of those locations,” she says. Between the locations, the practices utilize TempSure™ Envi radio frequency technology, the Equinox low level light therapy (LLLT), BlephEx® and Zocular products for managing eyelid biofilm and Lipiflow for patients with more serious obstructive disease. New technology is also on the horizon as the demand for dry eye services has sky rocketed.
Not all patients need extensive treatment for dry eyes, but the protocol in place helps the doctors determine who does. “There’s still this perception in some places that dry eye only affects certain populations. Just recently, I saw a 24-year-old dry eye sufferer. We have men and women of all ages. Digital device usage has changed the way we need to look at dry eye,” she says.
The doctor uses the evaluation to determine if the condition is inflammatory, obstructive or both. The treatments range from biologics to nutraceuticals and from punctal plugs to the various advanced technologies.
DON’T OVERLOOK SKINCARE AND COSMETICS
Contributing factors to dry eye disease can also be the products that people use on their skin. “So we have added a skin care line that we’ve branded for the practice. Ninety percent of the staff is using these products, and everyone can speak to how some of the products on the market can contribute to eye dryness and how ‘eye doctor approved’ skin care makes a difference,” Dr. Goetsch says. In addition to promoting “eye-safe products,” the Unity line of products includes: a gentle cleanser, hydrating serum, restorative moisture and mineral sunscreen. These products are applied after their advanced treatments and available for sale, optimizing the patient outcomes.
To help raise staff members’ awareness about dry eye procedures, the practice allowed everyone on staff to have one procedure. Those who have dry eye symptoms could tell patients about how much their own symptoms resolved. Staff can continue to have treatments at discounted rates. “I often hear a staff member tell a patient, ‘It’s nothing to worry about. I have had it done; it feels good and made a difference in my symptoms.’ A doctor can say that, too, but it really resonates when the patient is hearing a staff member describe their experience.”
PROMOTING THE SERVICES
New services require education. The practice occasionally sets up VIP events with wine, charcuterie and prizes for a limited list of invited guests. These are patients who may have complained of dry eye symptoms, been diagnosed with dry eye or simply responded to a social media event announcement directed at dry eye sufferers. Equipment and product representatives are on hand for the presentations, and the guests rotate between stations that provide a complimentary meibomian gland scan, radiofrequency demonstration or a lesson in skin care. The focused education goes a long way: “We sold more than $3,000 in skin care products, and 30% of the guests signed up for a full dry eye evaluation.”
Dr. Goetsch says that the new center works for a variety of reasons. First, the doctors were intentional and strategic in their planning, and they have created an environment that fosters inter-practice referrals. “I anticipated that I would see dry eye patients for one to one-and-a-half days per week. It’s turning into nearly three days a week now,” she says. The next step will be to delegate some of the tasks to skilled technicians, who have been hands-on and provided important leadership as the program geared up.
There are some sobering statistics when it comes to dry eye care. Dr. Goetsch notes that the doctors wanted to get those patient experiences in the rear-view mirror as quickly as possible for dry eye sufferers. “No longer do patients need to keep returning to their eye doctor because the previous treatment didn’t work. Nor should they have to change doctors multiple times to find someone who is committed to helping them get their dry eyes treated. We want to treat them well at Unity Eye Centers.”
Read advice from other doctors who are helping dry eye sufferers in their clinics.