Article

Reader and Industry Forum

Using Online Sources to Supplement Dry Eye Education

Reader and Industry Forum

Using Online Sources to Supplement Dry Eye Education

BY CAROLYN PERUGINO, BSC, & ETTY BITTON, OD, MSC, FAAO, FBCLA

Dry eye is a complex, multifactorial disease that severely affects approximately 3.2 million women and 1.68 million men over the age of 50 in the United States (The Definition and Classification Subcommittee of the International Dry Eye WorkShop, 2007; Schaumberg et al, 2009; Schaumberg et al, 2003). Millions more are affected by milder forms of dry eye (Schaumberg et al, 2009; Schaumberg et al, 2003). Globally, meibomian gland dysfunction (MGD) is thought to be the primary cause of dry eye, with reported prevalence nearing 70% in certain Asian populations (Nichols et al, 2011; Schaumberg et al, 2011).

A diagnosis of dry eye can overwhelm some patients because of its chronic nature and the various treatment modalities often required to manage symptoms. Management options may include ocular lubricants, warm compresses, lid hygiene, nutraceuticals, and prescription medication. Despite an eyecare practitioner’s (ECP’s) best efforts to verbally inform patients on diagnosis and treatment, some recommendations may be underemphasized, neglected, or simply forgotten once patients leave the office.

Education Is Key

Previous studies revealed a negative correlation between anxiety and education, suggesting that patients who had an enhanced understanding about their dry eye could potentially better cope with their condition (Li et al, 2011; Meijer et al, 2009). Furthermore, the 2008 World Health Organization (WHO) Health Systems and Policy Analysis suggests that engaging patients in their care, with supplemental documentation, can promote patient compliance by reinforcing explanations of diagnoses and treatments (Coulter et al, 2008).

ECPs can use educational pamphlets and tear-off sheets supplied by the industry on topics such as blepharitis, MGD, and general dry eye. These provide valuable information and are time-saving tools that can help patients conceptualize their condition. Some practices also offer tailored instruction sheets to help further enhance compliance.

Modern-day patients are increasingly accessing information about their health conditions via the Internet, whether to validate recommendations by their health professionals or for personal interest. The Internet can provide a wealth of information, but not all of it is good information. Practitioners can assist patients by guiding them toward evidence-based sites.

Using the Internet Effectively

We have compiled a list of free access, North American websites that can help patients better understand their dry eye diagnosis (Table 1). Tools that are provided include patient-friendly videos, printable brochures, and resource sheets for patients. There are also numerous websites from companies in the industry with good patient information and videos that ECPs can use in educating their patients; however, they are not compiled here.

TABLE 1 Patient-Friendly Organization Websites for Dry Eye
Topic Website Organization Video
Dry eye www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye?sso=y AOA No
  www.mayoclinic.org/diseases-conditions/dry-eyes/basics/definition/con-20024129 Mayo Clinic No
  www.nomoredryeye.ca Also accessible through: http://dryeyedisease.ca CPM Yes
  www.allaboutvision.com/conditions/dryeye.htm Access Media Group No
  www.emedicinehealth.com/dry_eye_syndrome/article_em.htm WebMD No
  www.geteyesmart.org/eyesmart/diseases/dry-eye/index.cfm AAO Yes
  www.nei.nih.gov/health/dryeye/index.asp NIH Yes
  www.patienteducationcenter.org/articles/dry-eye-syndrome Harvard Medical School No
  www.webmd.com/eye-health/eye-vision-tv/video-how-to-soothe-dry-eyes WebMD Yes
Sjögren’s Syndrome www.sjogrens.org SSF Yes
  sjogrenscanada.org SSA Yes
  www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Sjogrens-Syndrome ACR No
Dry Eye Related to CL Wear www.allaboutvision.com/contacts/lenses-dry-eyes.htm Access Media Group No
  www.medicinenet.com/script/main/art.asp?articlekey=157658 WebMD No
MGD vision.about.com/od/sportsvision/a/Evaporative-Dry-Eye.htm IAC Company No
  www.aapos.org/terms/conditions/141 AAPOS No
  Information on the MGD Report
www.youtube.com/watch?v=ueKsA98a0r4
TFOS Yes

Abbreviations:

AAO – American Academy of Ophthalmology

AAPOS – American Association for Pediatric Ophthalmology and Strabismus

ACR – American College of Rheumatology

AOA – American Optometric Association

CPM – Canadian Pharmaceutical Manufacturer

NIH – National Institutes of Health

SSA – Sjögren’s Society of Canada

SSF – Sjögren’s Syndrome Foundation

TFOS - Tear Film & Ocular Surface Society

Ultimately, this online information should enhance patient compliance by supplementing the information provided by their ECP. These websites should encourage patients to take a more proactive approach in the management of their dry eye while enriching patient education.

Saving Chair Time

ECPs are increasingly adopting health information technology in their practices, either through the use of personal health records (PHRs), electronic health records (EHRs), or electronic medical records (EMRs) (Office of the National Coordinator for Health Information Technology, 2014). This technology makes it more convenient for both healthcare professionals and patients to keep track of their diagnoses and treatments, among other things.

Additional resources are available for practitioners to communicate with their patients through practice websites, email, and social media. Consequently, patients can be directed to additional information concerning their condition, including dry eye, directly from their ECP.

An informed patient can save chair time, as follow-up visits can focus on new concerns rather than repeating previous instructions. Furthermore, it may promote discussions with the ECP regarding alternate or trending treatment modalities or protocols.

Guide Your Patients’ Search for Additional Information

Many patients may independently research information about their condition online. However, they may not necessarily be visiting the most credible websites.

Guiding patients toward reputable online resources can supplement and reinforce information provided during the course of the eye exam. Moreover, these websites may help to validate ECPs’ treatment plans and consequently aid in improving patient compliance as well as patient retention to the practice. CLS

For references, please visit www.clspectrum.com/references and click on document #234.


Carolyn Perugino is an optometry student at the École d’optométrie, Université de Montréal and a student fellow of the American Academy of Optometry (AAO). She presently holds the position of vice chair of the AAO student chapter for the school. You can reach her at carolyn.perugino@umontreal.ca. Dr. Bitton is an associate professor and the director of the Dry Eye Clinic at the École d’optométrie, Université de Montréal. Her research interests include tear film evaluation, dry eye and its effect on contact lens wear. She is a consultant or advisor to Alcon Canada, Allergan Canada, Labtician, CooperVision, and Advanced Vision Research.