What are the best products for treating dry eye disease?
Anna Ross, OD, is a corneal specialist. Her passion for treating dry eye disease (DED) stems from a desire to alleviate patients’ uncomfortable and painful symptoms—and offering the DED services they are seeking.
Michael Moorehead, OD, also specializes in anterior eye diseases. Although DED is prevalent in Dr. Moorehead’s patient population, he didn’t feel equipped to optimize treatment outcomes. After educating himself through professional opportunities, his practice takes pride in offering patients the latest and most effective treatments
“At the time, we were diagnosing with fluorescein strips and the Schirmer’s test,” Dr. Ross said. “We also relied on Tier 1 treatments, since that’s all we had at the time.”
What was your prior approach to diagnosing and treating DED?
Prior to adding E-SWIN technology to his armamentarium, Dr. Moorehead relied on eye drops, lid scrubs, and warm compresses without much success.
“I was frustrated with that and looking for options,” she said. “That's what impressed me about E>Eye. No one regretted buying it, everyone was impressed with the results, the service is great, you can get quick support on the phone, and it’s portable. Doctors I respect recommended it, and I love how comfortable it is for patients.”
What is TearCheck and how are you using it to evaluate DED?
TearCheck provides multiple exams for dry eye analysis, including:
- OSIE® - Ocular Surface Inflammatory Evaluation
- TFSE® / NIBUT - Tear Film Stability Evaluation / Non-Invasive Tear Breakup Time
- Abortive blinking
- Eye redness
- Demodex
- Meibography IR
- Eye fitness test
- Corneal topography
Dr. Moorehead:
- Uses TearCheck to screen nearly every patient
- Includes TFSE/NIBUT, meibography, and the eye fitness test (at a later time)
- Integrates a questionnaire
- Uses a meibomian gland evaluator once screening is complete
- Presents findings to the patient
“The meibography is the most compelling test for the patients,” he said. “Being able to see those glands and educate them about how that fits into their symptomatology and the other findings is really helpful — as is the non-invasive tear breakup time (TBUT). I find that to be quite useful both in diagnosing and assessing treatment progress.”
Dr. Ross:
- Uses TearCheck for patient screening
- Finds meibography and the high-magnification camera that demonstrates Demodex very valuable
- Individualizes tests based on the patient’s needs
- Went from not having a dedicated dry eye exam to offering a comprehensive DED protocol
What is E>Eye, and why did you decide to purchase it to treat DED?
E>Eye is E-SWIN’s IRPL® (Intense Regulated Pulsed Light) device. Dr. Moorehead said his purchase decision was based on the:
- Recommendation of one of the conference speakers
- Increased patient comfort compared to other technologies
- Comprehensive training
“The fact that we had somebody coming in to train us on the instrument was a big part of my decision, because I needed somebody with experience,” he said. “E-SWIN provided that person, and she did an excellent job training us. That has been a huge contributor to our success.”
Factors that sold Dr. Ross on E>Eye:
- Recommendations from colleagues
- Inclusion of consumables in the E>Eye package
- Solid warranty
- Excellent customer service
- Portability
- Comprehensive training
“Training the staff on the whole process kind of evolved the practice,” she explained. “It was more than just buying the products. It was reevaluating how we think as a practice about dry eye, and we even got the patients to buy in. It was a big change in our practice and a really positive one.”
How has the use of E>Eye benefited your practice?
In patient discussions, Dr. Moorehead focuses on assessment results and underscores the fact that DED is a chronic and progressive condition that will get worse if not treated: “I tell them I'm a good example of that, because I wasn't treating myself properly ten to twenty years ago when I could have used this technology. I share my own personal experience with it, which has been very positive.”
How do E-SWIN products benefit your patients? Patient results he’s witnessed over the past six months of use include:
- Enhanced treatment effectiveness for most patients
- Increased patient comfort
- Improved tear film stability
“Patients tell me their eyes are feeling better,” Dr. Moorehead explained. “I would say easily 80% get positive results.”
A big benefit Dr. Ross appreciates is being able to offer patients another way to treat DED that addresses the root cause: “I think they really appreciate the option for a more innovative procedure.”
Educational points she includes, especially for those with chronic and sometimes-severe DED:
- Part of the treatment goal is to halt disease progression
- IRPL is an adjunctive treatment and not a cure
- Other DED treatments should be continued
“Although treatment goals and results will vary, most of the patients have been really happy,” she said. “Recently, one of the first patients we started in September came back for another treatment, and he was just ecstatic. His vision was good, and it was wonderful to witness. This has been really positive for the practice.”
