Optimizing the Business of Dry Eye

Practical guidance for success.

Patti Barkey, COE

Cataract and Refractive Surgery Today

Dry Eye University (dryeyeuniversity.com) was established with the aim of elevating the business of dry eye disease (DED) in modern eye care practices. With the support of industry partners, program 26 sold out in February 2024 and was attended by ophthalmologists, optometrists, private equity teams, and practice CEOs with their staff. DED is big business. An estimated 36 million individuals have DED in the United States, although the reported prevalence ranges greatly. As the CEO of a practice that specializes in DED care, I have found that at least eight out of 10 patients who walk through our doors have some signs and/or symptoms of DED. In contrast, my work with practices all over the country through Dry Eye University and industry partner relationships suggests that only 3% to 5% of US practices embrace DED patients. The goals of care are to halt the progression of this lifelong disease and increase patient comfort. In a business sense, however, patients with chronic conditions such as DED and glaucoma are akin to annuities on a practice’s productivity sheet year after year. This article shares tips on how to optimize a DED business. FINANCIAL CONSIDERATIONS Advertising.

Treating Astigmatism With Femtosecond Laser

Omar F. Almallah, MD

Eyetube

This video demonstrates treating up to 2 diopters of against-the-rule regular astigmatism with femtosecond laser using a triplanar, self-sealing, clear corneal incision and maintaining excellent wound closure with IOL implantation.

The Utility of En Face OCT for Detecting Neovascularization in DR

We conducted a study of our own to better understand this association.

Mizuki Hamada, MD, and Kotaro Tsuboi, MD

Retina Today

AT A GLANCE In a recent longitudinal study, the authors detailed the early stages of retinal neovascularization using both en face OCT and en face OCT angiography (OCTA) in eyes with diabetic retinopathy. OCTA’s capacity to detect flow signals above the internal limiting membrane has provided a more reliable method to categorize lesions. By pinpointing neovascularization precursors instead of relying on indirect retinal features to forecast progression risk, we may be able to achieve greater precision in identifying eyes on the verge of developing proliferative diabetic retinopathy. While OCT has enhanced the objective diagnosis of diabetic macular edema (DME), early detection of proliferative diabetic retinopathy (PDR) remains challenging for ophthalmologists and often requires a thorough dilated fundus examination or fluorescein angiography (FA).1 Recent advances in OCT angiography (OCTA) not only enable the identification of retinal neovascularization (RNV) above the internal limiting membrane (ILM), but also offer a wider field of view, making OCTA a promising tool.2-4 Additionally, structural OCT can be instrumental in detecting RNV, particularly in distinguishing it from intraretinal microvascular abnormalities (IRMA).5,6 In a recent longitudinal study, we detailed the early stages of RNV using both en face OCT and en face OCTA in eyes with DR.7,8 PUTTING THE THEORY TO THE TEST We conducted a cross-sectional study to analyze the sensitivity and specificity of en face OCT and en face OCTA for the detection of clinically occult RNV in nonproliferative DR (NPDR).9 We obtained four high-resolution scans (600 x 600 sampling densities over 9 x 9 mm) and generated a 17 x 17 mm widefield OCTA scan. We created two different custom slabs for en face OCT and en face OCTA to optimize RNV detection (Figure 1). RNV lesions were identified using a combination of en face OCT, en face OCTA with custom vitreoretinal interface slab, and cross-sectional OCTA. Figure 1. RNV lesions (yellow arrows) on en face OCTA (A) and en face OCT (B). Cross-sectional images (C and D) from the location of the dashed lines show a small RNV tuft. Of the 63 enrolled eyes, 27 (43%) had severe NPDR, 16 (25%) had moderate NPDR, and 20 (32%) had mild NPDR.