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How Dry Eye Disease Changed Optometry

The secondary consequences of embracing optometry’s expertise.

Optometrists continue to become more aware of the myriad underlying etiologies of dry eye disease (DED), and industry continues to pour resources into clinical research that provides treatment options for patients. As optometry faces more patients with DED, it is easy to lose sight of how the field’s understanding of this condition has led to an uptick in practice scope and profitability. Let’s take a minute to slow down and think about how optometry’s embrace of DED treatment has changed practices across the country.


Optometrists who have become DED specialists have diversified their practice offerings. These clinicians have used DED treatment as a foundation upon which to build a more nuanced understanding of providing primary eye care, which leads to improved patient satisfaction and bolsters bottom lines.

Take, for example, a patient with chronic ocular allergy symptoms. Such a patient might benefit from an examination by a DED specialist and, if underlying DED is present, could find his or her allergy symptoms and dry eye symptoms mitigated by appropriate treatment. An optometrist who becomes educated on the various presentations of and treatments for DED and other ocular surface diseases is best equipped to identify this component of the patient’s ocular surface disease, which might otherwise go undetected and untreated.

This patient—now a happy patient—presents two growth opportunities for the practice’s bottom line: more treatment volume and more referrals. The patient, previously treated only for ocular allergy, is now treated for DED and ocular allergy. And this satisfied patient may refer friends and family to the practice that successfully treated his or her frustrating eye condition, leading to higher patient volume and more opportunities for the practice to encounter patients who require treatment for any number of conditions.


Optometrists often defer to their surgical colleagues on major surgical questions and procedures. This is appropriate, as it aligns with their training and expertise. Likewise, optometrists, as primary eye care doctors, should take the opportunity to practice their training to its fullest potential. This means expanding our scope of practice and not just practicing primary eye care, but being more medically orientated and treating many disease states such (as glaucoma) and other common medical problems (such as DED). Optometry will continue to gain the respect of other medical professionals when it has demonstrated its ability to properly manage complex eye conditions, the most common of which is DED.

We are fortunate that optometry has a lot of growth potential when it comes to upping our game. Optometrists seeking to expand the scope of their practice may find that DED is a useful gateway for deepening and diversifying their practice.


The number of optometrists practicing in the United States is nearly double the number of US ophthalmologists.1,2 As the patient population continues to age—the number of patients older than 65 is expected to increase by nearly 13 million from 2012 to 20203—optometrists will encounter more and more patients in their role as primary eye care providers. Optometrists will be able to improve the spectrum of services they offer these patients by educating themselves on DED, giving them an opportunity to expand their practices and improve their bottom lines.

Josh Johnston, OD, FAAO
  • Clinical Director and Residency Director, Georgia Eye Partners, Atlanta, Georgia
  • drj@gaeyepartners.com
  • Financial disclosure: Consultant (Akron, Allergan, Alcon, BioTissue, Sun, Johnson & Johnson Vision, Shire, Oculus Consulting Partners)
  1. United States Department of Labor Bureau of Labor Statistics. Occupational Employment Statistics: 29-1041 Optometrists. May 2016. Washington, DC: United States Dept of Labor Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes291041.htm. Accessed January 9, 2018.
  2. American Academy of Ophthalmology. Eye Health Statistics. San Francisco: American Academy of Ophthalmology. https://www.aao.org/newsroom/eye-health-statistics#_edn25. Accessed January 9, 2018.
  3. Ortman JM, Velkoff, VA, Hogan H. An aging nation: the older population in the United States: population estimates and projections. Washington, DC: US Census Bureau; May 2014. https://www.census.gov/prod/2014pubs/p25-1140.pdf. Accessed January 9, 2018.
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