As an ophthalmologist, you probably have a picture in your mind of the typical chronic dry eye patient: a woman, over 50, probably wearing a frown.
There’s no denying that age is a major cause of chronic dry eye, that women are more likely to develop dry eye, and that hormonal changes brought on by menopause increase the chances of a mid-life onset of the condition that affects 20 to 30 million Americans.
So, yes, if you’re going to include a dry-eye center of excellence in your practice, you will be treating legions of middle-aged women, many of them unhappy. That demographic likely will always make up the lion’s share of your dry-eye practice. But the face of dry eye is changing, and it’s no mystery what is driving the evolution: electronic devices.
We’re spending more and more time poring over smartphone, tablet, computer, or television screens – one 2016 study estimated we’re up to an average of 10 hours a day.1 And all that time screen-time is drying younger and younger eyes. Studies show that the normal blink rate of 20 times a minute drops to 3 to 5 times a minute when we are on digital devices. This causes drying of the ocular surface, which is often accompanied by fluctuating or blurred vision, redness, burning, mild itching, headache, and/or eye strain.
In our practice, we’re seeing significant numbers of college kids with dry eye. And at one of our offices located near the U.S. Merchant Marine Academy, we’re treating crowds of midshipmen and women who are coming in with chronic dry eye.
So, if you needed another reason to dedicate a part of your practice to treating chronic dry eye, or to create a Dry Eye Center of Excellence, here it is: dry eye is already the number-one medical condition that motivates patients to see an eye-care professional.2 Between the surge of aging Baby Boomers and the increasing numbers of patients with Type 2 diabetes, dry eye numbers are certain to grow. Now, we can add to that mix younger screen-staring patients as well.
You can earn the trust and loyalty of all of them by offering, in addition to medication when necessary, some simple strategies to relieve chronic dry eye:
• Control the airflow. Don’t blast the car heater or air conditioning directly into your face, or sleep with a ceiling fan directly over your bed
• Dodge the draft. If cold or hot air is blowing on you at work, close the vent, or, if possible, change your desk orientation.
• Use a humidifier. They’re especially essential if you live in a dry climate.
• Lower your screen. Looking down at your computer means less exposed eye area, which means less area for tear evaporation to occur.
• Live by the 20/20/20 rule. Every 20 minutes, take a 20-second break from staring at your computer, and look 20 feet away. The suggestion relaxes the muscles that help with up-close reading.
But as those younger dry eye patients start filling your waiting room, don’t neglect those middle-aged women, no matter how cranky they may be.
Remember, if that middle-aged woman looks unhappy, it may be because she’s dealing with some less-than-enjoyable physical changes, and at the same time, she’s also likely to be juggling a job and family -- and caring for elderly parents or in-laws.
All that may be stressful for her, but potentially good news for you. Those elderly family members may well have cataracts, glaucoma, or some other eye condition, while her teenaged daughter or son may want to trade glasses for LASIK surgery.
The bottom line: That middle-aged lady is the decider for many people’s medical care. Make her happy, and the halo effect for your practice will be tremendous.
Marguerite McDonald, MD, FACS, with OCLI on Long Island, NY, is clinical professor of Ophthalmology at NYU Langone Medical Center, NY, and clinical professor of Ophthalmology at Tulane University Health Sciences Center, New Orleans, Louisiana.