How to Be Successful with TearCare for MGD

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6 min read

In this video from Interventional Mindset, Dr. Brandon Baartman offers five tips for successfully using TearCare to treat meibomian gland dysfunction (MGD).

By providing localized heat therapy, in conjunction with manual expression, the TearCare System has proven to significantly reduce the symptoms of dry eye disease caused by meibomian gland dysfunction (MGD). Implementing TearCare into your practice provides another powerful tool in the fight against evaporative dry eye disease. Follow these steps to ensure success.

Interventional Mindset is an educational series that gives eye physicians the needed knowledge, edge, and confidence in mastering new technology to grow their practices and provide the highest level of patient care. Our focus is to reduce frustrations associated with adopting new technology by building confidence in your skills to drive transformation.

Browse through our videos on a variety of topics within cataract and refractive surgery, glaucoma, and ocular surface disease to learn practical insights into adopting a variety of new surgical techniques and technology.

1. Assess your practice’s needs.

It is important to have a clear idea of how your practice will generate patients and which patients you plan to treat with TearCare before bringing in the technology. However, it is not only beneficial to assess your current patient volume and demand but to evaluate your current dry eye practice overall, including criteria and modes of testing.
Start with these questions:
  • At present, does every patient fill out a dry questionnaire?
  • Does your practice use the ASCRS algorithm to identify those patients that might benefit?
  • Is testing on all preoperative refractive and cataract patients standard?
  • What tests does your practice currently administer (staining, tear osmolarity, meibography, InflammaDry)?
  • Do you have a dedicated dry eye schedule?
  • If not, would the practice benefit from a set dry eye clinic?
Answering these questions will enable you to be intentional and strategic when implementing the TearCare System.

2. Deputize your team and allow them to create ownership.

Your team members are often the first point of contact for patients and will play a pivotal role in the success of a new treatment. In many instances, they will implement the dry eye questionnaires/tests and help you perform the procedure. Therefore, it is critical before the rollout to educate your staff on the technology’s role within the treatment regimen and how it will improve patient outcomes.
Educate them on dry eye disease, meibomian gland dysfunction, the impact of both on overall ocular surface health, plus the significance of this health as it relates to refractive and refractive cataract surgeries. Galvanize your team around this treatment by giving them a deeper understanding of the value of an optimized ocular surface.
Also, allow your staff to take ownership of the procedure and create the best possible patient experience. Encourage them to design a comfortable space that is creatively equipped with things like aromatherapy or relaxing music. If you do not have a designated physical space, this can be done with a mobile cart that houses the TearCare unit.

3. Take time to educate your patients.

In addition to educating your team, set aside time to educate your patient on evaporative eye disease and how enhancing meibomian gland function will alleviate symptoms and boost their ocular health. Explain how an unstable tear film can lead to their fluctuating vision. The deeper the understanding of how advantageous the service can be, the more likely they are to be eager to participate in the treatment.
And, as a picture speaks a thousand words, use images/video whenever possible to show them the difference between normal and abnormal meibomian glands and where they fall in the spectrum. Utilize TearCare's unique ability to be performed at the slit lamp by taking slit lamp photos of the patient’s eyelids before and after treatment, then presenting them for comparison. Filming a video of the actual expression process is also an incredible method for offering positive reinforcement. Visual proof coupled with the abatement of aggravating symptoms will instill a sense of trust in the patient, which leads to practice loyalty.

4. Follow up on the results.

In order to gain objective findings on the success of the procedure, schedule a follow-up visit with the patient within a few weeks of the initial treatment. In addition to taking a history to reassess symptoms and appraise subjective improvement from their perspective, perform another round of dry eye testing to document improvement. Again, utilize images (meibography, topography, slit lamp photography) to demonstrate progress.
As a practice, track and keep your own data on results to share with staff, colleagues, and patients. Collect and keep detailed patient cases for educational purposes.

5. Take a multitactical approach.

Dry eye disease is multifactorial and must be treated as such. It is essential to focus on each of the components of dry eye disease, including tear quality, tear volume, and ocular surface inflammation.
To gain the best overall results, use a three-pronged approach. TearCare does an excellent job of addressing MGD by relieving obstruction to bolster tear quality and restore the normal lipid layer. However, it is also imperative to increase tear volume and decrease inflammation. So, along with TearCare, consider utilizing temporary collagen punctal plugs. To combat inflammation, prescribe an anti-inflammatory like LOTEMAX SM.
In general, use all of the treatments at your disposal and adjust accordingly until you achieve the desired results. TearCare, used in tandem with other treatment strategies, will yield the best outcomes.

Conclusion

In closing, by implementing the TearCare System, you can empower your practice to better treat meibomian gland dysfunction leading to more positive patient outcomes. Following the guidelines above will make the addition of TearCare a seamless and successful one.
Brandon Baartman, MD
About Brandon Baartman, MD

Brandon Baartman, MD, attended Gustavus Adolphus College in St. Peter, Minnesota, for his undergraduate degree and graduated with honors from Wake Forest School of Medicine in Winston-Salem, NC. It was during medical school that Dr. Baartman realized his passion for ophthalmology and the true impact of sight-saving surgery around the world through his travels to Honduras, Ghana, and the northernmost region of the Indian Himalayas.

Dr. Baartman completed his Ophthalmology training at the Cole Eye Institute, Cleveland Clinic in Cleveland, Ohio, where he served as the Chief Resident during his last year and was recognized by the Cleveland Clinic with an Excellence in Teaching award. He joined Vance Thompson Vision in July 2017 to continue his career with a one-year advanced anterior segment fellowship with Dr. Thompson, Dr. Tendler, and Dr. Berdahl. In his career, Dr. Baartman has participated in numerous clinical trials, published a number of peer-reviewed articles and book chapters, and has been awarded for his research presentations on a variety of topics in the field of ophthalmology. After his fellowship, Dr. Baartman elected to stay on as an associate with Vance Thompson Vision.

Brandon Baartman, MD
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