Dry eyes are on the rise—and optometrists and other eyecare professionals must be prepared to treat this common condition. According to the latest estimates, one in four patients visit eyecare facilities complaining of dry eye symptoms. Along with lid disease, two of the main factors leading to the increase of Dry Eye Disease are aging and extended screen time, both of which will only continue to surge.
The increasing prevalence of this unfortunate condition prompted the Eyes On Eyecare team to survey 1,022 eyecare professionals (including 757 practicing optometrists) in February of 2021. We wanted to assess their approaches to the diagnosis, treatment, and management of dry eye in order to help clinicians better manage this condition and ultimately provide relief to their patients. The result is the 2021 Dry Eye Report, which is the largest report on Dry Eye Disease ever publicly released. As with all Eyes On Eyecare reports, this data is absolutely free for anyone to download, based on our belief that empowering ECPs with data will ultimately help them diagnose and treat more patients.
The 2021 Dry Eye Report covers:
- Average confidence in treating dry eye: How comfortable are eyecare physicians in treating this increasingly prevalent condition?
- Dry eye education: What kind of education have optometrists received regarding Dry Eye Disease? What kind of education do they feel would be most beneficial to grow their confidence in diagnosis, treatment, and management?
- Screening and diagnosis: How many ODs utilize validated dry eye questionnaires in their patient intake? How do ODs identify Dry Eye Disease patients?
- Treatment and management of eye dryness and Dry Eye Disease: How do ODs classify their approach to Dry Eye Disease management in practice? What are their go-to treatments for each type of dry eye? Are ODs looking to expand their lines of service?
- Practice services: How many optometrists are expanding or thinking of expanding their dry eye services? What is the financial impact of adding dry eye services to your practice?
- Analysis and actionable advice from three dry eye specialists: Damon Dierker, OD, FAAO; Hardeep Kataria, OD, FAAO; and Ahmad Fahmy, OD, FAAO, Dipl. ABO contributed commentary and insights to this report.
- And more!
ODs want more education on dry eye diagnostics
Though many ODs felt reasonably confident in the diagnosis and treatment of dry eye, many survey participants felt their education in the diagnostic arena was lacking. On a scale from 1 to 10, respondents averaged only 6.26 on their assessment of receiving education in optometry school on utilizing specific diagnostic equipment to treat Dry Eye Disease.
“Surprisingly, however, most respondents rated their confidence level in treating Dry Eye Disease 6/10 (on a scale of 1-10, 10 being the most confident level). Furthermore, 71% of the respondents are either interested in expanding their scope of services in the realm of DED or are open to receiving more education.”
- Hardeep Kataria, OD, FAAO
Respondents varied on the type of education they felt would be most helpful, with some preferring case-based lectures while others would opt for open discussion of best practices. A third group felt virtual lectures and workshops were ideal.
Successful Dry Eye Disease treatment starts with screening
Doctors reported that although they believe well over half of their patients had some level of Dry Eye Disease, only 64% of patients in their practices were screened.
“While doctors felt that about 60% of their patients had some degree of DED, only two-thirds of patients were estimated to be screened. The take-away for me is if we acknowledge that DED is so common, why don’t we screen everyone? What is the most efficient way to do this?”
- Damon Dierker, OD, FAAO
Respondents reported the use of patient-reported symptoms and slit lamp examination as their primary screening tools. Many feel the evaluation of meibomian gland function is also integral, with 85% in agreement with the statement that screening for meibomian gland dysfunction (MGD) should be part of a comprehensive eye examination. However, only 27.8% incorporate validated dry eye questionnaires, like SPEED or OSDI, into case history or patient intake forms, despite their effectiveness in achieving a more accurate assessment.2
Dry eye treatment trends and traditions
Survey respondents named artificial tears for patients with aqueous deficient dry eye and compresses, lid scrubs, and other at-home OTC therapies for those with MGD as their top treatments for Dry Eye Disease. Survey results indicate that many doctors are not comfortable recommending prescription medications or performing in-office procedures, such as thermal pulsation and intense pulsed light (IPL) therapy.
According to Dr. Dierker, “It’s fantastic to see that 84.7% of our respondents understand the importance of identifying MGD as a part of every comprehensive exam. But only 5.8% of our colleagues offer in-office OSD treatments as a go-to treatment. I don’t think home warm compresses and eyelid massage alone are an effective obstructive MGD treatment for the majority of the folks we see daily with this disease.”
Dry eye outcomes and opportunities
As with any disease, the ultimate goal is improving patient outcomes and quality of life. This is especially significant when it comes to Dry Eye Disease, as the constant discomfort it brings can take a toll and have a considerable psychological effect on sufferers. With optometrists being on the forefront of managing Dry Eye Disease, which affects approximately 9 million people a year, developing a dry eye practice offers an incredible opportunity.
- de Paiva, Cintia S. Effects of Aging in Dry Eye. Journals.lww.com. https://journals.lww.com/internat-ophthalmology/Fulltext /2017 /05720/Effects_of_Aging_in_Dry_Eye.5.aspx. Published April 1 2018.
- Yuichi Okumura, Takenori Inomata, Nanami Iwata, Jaemyoung Sung, Keiichi Fujimoto, Kenta Fujio, Akie Midorikawa-Inomata, Maria Miura, Yasutsugu Akasaki, Akira Murakami. A Review of Dry Eye Questionnaires: Measuring Patient-Reported Outcomes and Health-Related Quality of Life. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459853/. Published May 26, 2020. Assessed August 3, 2020.