Topcon News

Elevating a Dry Eye Practice: How Advanced Technology Can Lead to Exceptional Practice Success

For Celesta Ferreira, OD, of Cypress Optique in Cypress, Texas, the biggest inspiration to building an exceptional dry eye practice is based on experience. “I’m a severe dry eye sufferer and have been all my life. Even when I was in optometry school, we were not taught fully the extent of how this chronic condition presents with pain and suffering. It’s our responsibility as optometrists to address this,” she says.

She certainly wishes someone had addressed it with her. “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 and find appropriate treatments,” she says.

When it came to selecting a topographer, she chose the Topcon CA-800 device for several reasons. Her exam lanes were already equipped with Topcon technology, an extra bonus in having all her technology integrate flawlessly. Her practice is a cold start, so the price point was very attractive. And it has a small footprint.

She also saw it had advanced diagnostic capabilities, and she could use it as a vital patient education tool. But the more she got to know the Topcon CA-800, the more she realized it could do. “I didn’t know that I could do tear breakup time (TBT) and meibography on it. It’s marketed as a topographer, but for those who want to treat dry eye, there is much more available here,” she says.

Easing into the protocol

When she first added the topographer to her practice about nine months after she opened, “I didn’t implement the extensive testing protocol for dry eye – until I realized what I could do with the technology. I initially used it for pupils and topography, and if someone talked about dry eye symptoms, I’d do the imaging and TBT,” she recalls. But as she started to attend more dry eye conferences, she heard a common refrain about dry eye: You won’t know unless you look.

So she began to look. “I heard doctors say that patients have zero symptoms and not a gland left. I understand that – 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 completely changed her protocol. Now all patients are getting pupils, topography, blink rate, TBT and meibography. “It does take a little extra time, so a busy established practice may not be able to incorporate all of that, but they can at least do one extra test.”

When she started to look for dry eye, she found it – in big numbers. Her dry eye practice has nearly doubled, and she is finding dry eye in patients she would have not screened based simply on their profile. “I was so astonished to find that even a 6-year-old patient of mine barely had two glands left. He essentially itched his eyes dry, and his glands suffered because of this. I am constantly amazed at how drastic the loss of meibomian gland function can be for those who say they have no symptoms. That’s true, too, for those who have symptoms that are constantly overlooked.”

Marketing the specialty

While Dr. Ferreira had hoped to build a specialty practice, initially she was using only word-of-mouth referrals. “Now I’m really promoting the specialty because I have the technology to test and treat patients. The Topcon CA-800 helped give me the confidence that I can detect the condition and educate patients about it,” she says.

During her comprehensive exam, she may tell patients that based on their test results, she is concerned about their dry eyes. She shows them the data she pulled and explains that she’d like to evaluate them further. Patients return for a medical exam and in-depth testing. “The data I get from the Topcon is my gateway into showing them what’s going on,” she says.

It’s also essential to show patients that the individualized treatment plan she develops is working. “They can see the numbers. A patient who had a TBT of 1.2 and is now at 12 or 13 after a few months of treatment gets that reinforcement that it’s working. Similarly, a patient who chooses not to have treatment can see if the condition is progressing.”

Not your passion?

Dr. Ferreira knows that dry eye care is not everyone’s cup of tea. She’s passionate about it, and she’s made the investments in her practice to diagnose and treat patients. She’s willing to educate the community, talking to moms’ and women’s groups. And she’s happy to take on her colleagues’ patients for dry eye care. Those colleagues who add a few tests for dry eye, which is so easy to do with the Topcon CA-800, can show patients that their discomfort or pain has a cause — and that there are optometrists who can help.

“It is our job and our promise to help these patients. If you don’t love doing it, you can still identify these patients and send them to someone who can help them. Building my dry eye practice has drastically impacted my bottom line and the quality of life for my patients.”