Driving Practice Growth with Dry Eye Business

By Kate Gettinger, OD October 13, 2020

In this day and age, it’s becoming rarer to see the eyecare practice of old, where the emphasis was simply on fitting and dispensing standard glasses and contacts. As times change and markets shift, we as optometrists must learn to adapt. Not only does this adaptation help us financially, but it also allows us to address new areas of concern in our patient base. One of perhaps the easiest changes to incorporate into your practice is the treatment of dry eye disease.

If you have any familiarity with the statistics of dry eye, shifting your practice to address it is a no brainer. Epidemiologic studies have estimated the prevalence of dry eye disease to be anywhere from 7.4% to 33.7% of the population, meaning that you won’t have to look far for a patient base. Studies have also shown that dry eye incidence increases with age, so as we confront the growing geriatric population of the baby boomer generation, dry eye is only going to become more prevalent in our offices. In addition, face mask use during the COVID-19 pandemic has been linked to an increase in ocular irritation and dryness. Let’s face it: Dry eye isn’t going away anytime soon.

Now is a great time to shift your practice to address this growing area of concern so that you can be well prepared for the influx. According to Market Scope, the global revenues associated with dry eye treatments are projected to climb to over $6.2 billion in 2023


Now is a great time to shift your practice to address this growing area of concern so that you can be well prepared for the influx. According to Market Scope, the global revenues associated with dry eye treatments are projected to climb to over $6.2 billion in 2023. Understanding dry eye disease, as well as currently available treatments, will help you improve your patients’ quality of life as well as secure yourself a financial stronghold in a field that is constantly under threat from online retailers.

Dry eye diagnosis and treatment is something that a patient can’t seek out online as they could a pair of glasses or a year supply of contact lenses, and so you can be assured of patient loyalty and a steady revenue stream if you choose to cater to the dry eye population.

As a medical profession, optometrists should be constantly considering what can be done to improve patients’ health and quality of life, and dry eye falls perfectly into this category. Dry eye treatment is also one of the easiest ways to implement a medical model into your practice, so it’s a great way to get your feet wet if you’ve primarily practiced in a refraction-centered setting. The initial start-up cost is also minimal, making it even easier to hit the ground running.

Dry Eye Practice: Where Do I Start?

 Establishing a basic dry eye practice is relatively easy as long as you are motivated and realistic. If you’re feeling a little rusty in your dry eye knowledge, it can be helpful to peruse online continuing education material or sign yourself up for a more intensive education session like those offered by Dry Eye Boot Camp. If you don’t understand the complexity of the disease you are working with, you are more likely to get frustrated with discouraging results, not to mention your patients may also lose patience with you.

Once you’re feeling confident in your dry eye prowess, setting up your dry eye clinic can be as easy as acquiring some NaFl staining strips and a questionnaire to let patients evaluate symptoms. The SPEED Questionnaire or the Ocular Surface Disease Index (OSDI) evaluation forms are quick, non-invasive, and often can be included with your regular check-in paperwork and filled out by a patient while in the waiting room. These questionnaires can help you identify dry eye patients before they are even in your chair, as well as evaluate the severity of patient symptoms in order to help guide a treatment plan. Often, patients won’t directly state their eyes feel dry, so by using these quick surveys you can identify those who might otherwise slip through the cracks.

A detailed patient history and an evaluation of the tear film and cornea with some NaFl staining is all you need to get started to treat dry eye. However, you can build on this basic model to suit your dry eye clinic needs. For example, you can strengthen your diagnosis and treatment plan success by the implementation of additional exam components such as:

●     Testing tear osmolarity with TearLab, which can give you an objective diagnostic test

●     Performing Meibography using Lipiscan or LipiView II Interferometers, which can help you identify factors contributing to dry eye

Once you’ve confirmed the diagnosis, you’ll need a treatment plan. This can be as simple as starting artificial tears twice a day but often doesn’t stop there. The key to a successful treatment plan is to not overpromise and know what consists of a realistic goal.

It can be helpful to create tiered goals that are tailored to individual patients. Dry eye disease can be a frustrating and time-consuming condition, so by setting smaller, attainable goals along the way you can keep patients satisfied and motivated, while also achieve realistic results as you work towards a larger overall goal.

LipiFlow Dry Eye Treatment | Find The Right Treatment For Your Dry EyesIf you’ve used the LipiView as part of your diagnostic testing, it pairs well with LipiFlow for establishing a treatment plan. The LipiFlow is remarkably easy to incorporate into your practice flow for treating MGD-related dry eye and you can even train technicians to perform the procedure. Devices like the LipiFlow express meibomian glands and improve gland function, often providing remarkable relief to long time dry eye sufferers. Another option is Alcon’s iLUX, which comes with a 1-click smart tip patient interface. The iLUX was introduced in 2019 and many doctors like its ability for treatments to be personalized to each patient.

While some patients benefit from a single LipiFlow or iLUX treatment, many opt for routine procedures performed two to three times a year.

Good For You, Good for the Patient

As mentioned before, incorporating dry eye treatments into your practice comes with its own financial incentives. Most dry eye diagnostic testing can be billed to a patient’s medical insurance. For tests and treatments that aren’t covered by insurance, you can charge a low, flat-rate fee for each procedure. Should a patient decide to pursue a more costly therapeutic strategy such as LipiFlow, you can offer the incentive of deducting this initial diagnostic fee from the overall treatment cost. The cost of most diagnostic tests and therapies will provide a quick return on the cost of the equipment as well as a boost to revenue.

 Keep in mind that you can use a 92012 code whenever you change therapy at a follow-up visit, and these codes typically have a slightly better reimbursement rate. Once you have established a steady treatment regime, you can use 99213 codes for all routine follow-ups.

Another easy way to expand your dry eye practice and increase your profit margin is to carry dry eye-related products in the office. Allergan allows ODs to sell Refresh directly out of office, which can help increase patient compliance and essentially create a one-stop-shop for their dry eye needs. Some practices will also choose to carry Avenova solution, Bruder masks, and Omega-3 and fish oil supplements.

Overall, establishing a dry eye clinic can be relatively risk-free, especially since you can start out with diagnostic tests that you likely already have laying around your office and the majority of your patient base is likely already suffering from dry eye, whether you know it or not. It’s an ideal way to build a loyal, happy patient base and feel good about providing necessary medical treatment to a growing population. 

Kate Gettinger, OD

Dr. Kate Gettinger grew up in upstate Illinois and obtained her Bachelor’s in Biology from Truman State University. She worked throughout her undergraduate career at an optometrist’s office and fell in love with the profession. She received her Doctorate in Optometry from University of Missouri-St. Louis Optometry School and received honors for specialization in low vision, including the William Feinbloom Low Vision Award. Dr. Gettinger enjoys treating and managing dry eye, macular degeneration, glaucoma, and diabetes. Her professional interests include ways to improve healthcare access to at-risk communities and improving public health. Dr. Gettinger routinely contributes to optometry publications and writes both educational and advocacy articles. Currently residing in St. Louis, Dr. Gettinger enjoys spending time outdoors with her dog, trying new foods and dining out at local restaurants, playing trivia, brushing up on her French language skills, and exploring new challenges.

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