The need to treat before referring

Treating dry eye and ocular surface disease BEFORE cataract and corneal surgeries to maximize the potential for the best visual outcome— what an easy concept! Before referring a patient for any refractive surgery, it is vitally important to be cognizant of any dry eye disease and corneal surface issues that a patient may be dealing with. The earlier optometrists can identify and treat the condition, the better the surgical outcomes for the ophthalmologists.

Forgoing aggressive treatment of these ocular surface issues before sending a patient to an ophthalmologist can lead to surgery being delayed, or worse, the end results may not be as optimal as they could have been. If a patient were to have dry eyes before surgery, they would undoubtedly have dry eyes after surgery. 

Patient education is everything!

By simply taking the time to explain to each patient exactly why it is necessary that their corneas be ‘primed and prepped’ before surgery, the patients are willing and accepting to try some form of dry eye therapy before moving forward with an advanced procedure. Making each patient aware of the complications of dry eye and ocular surface problems before surgery can help them to have more realistic expectation of possible dry eyes in the future.

Regardless of the method— whether it be artificial tears, punctual plugs, Restasis, Xiidra, etc. — any treatment of dry eye seems to provide a better potential outcome post cataract and corneal refractive surgery compared to eyes that have not been pre-treated before the procedure. 

What you want to avoid is quickly referring to a surgeon without addressing these important issues. Failing to adequately treat dry eyes can lead to a misrepresentation of your ability to diagnose and treat ocular disease in general within your professional community. Luckily for optometrists, the recent changes in public awareness has brought the attention of dry eye to the forefront. It is our job to be the first to identify these issues and to educate patients on how the chances of a successful outcome post-surgery is dependent on successfully treating this subtle problem pre-surgery.