In these uncertain times, many patients are continuing to experience the symptoms of dry eyes but hesitate to seek an in-office consultation with their eye care physicians. Telemedicine has provided a platform for patients to seek quick and efficient guidance for their treatment, although it does have certain limitations. This article is intended to discuss the role telemedicine plays in the treatment of dry eye disease.
Symptoms of dry eye disease typically include irritation, grittiness, foreign body sensation, scratchiness, burning, stinging, excess tearing, blurred vision, eye fatigue, and light sensitivity. It’s difficult to diagnose dry eye disease based upon symptoms alone because many of these symptoms can also occur with various other ocular diseases. When any of these symptoms are severe, and in-office consultation is preferred.
To diagnose dry eye disease, physicians will look for reduced tear break up time, reduced tear meniscus, increased tear meniscus, corneal keratitis, conjunctival irritation, blepharitis, poor meibomian gland expression, telangiectasia of the eyelids, debris and/or collerettes on the eyelashes, conjunctival injection, and poor blink dynamics, among other signs.
Physicians need to evaluate ocular signs in order to formally diagnose and begin treating dry eye disease. From there, a physician will observe the patient for improvements, or pivot to an alternate treatment method.
Telemedicine consists of either a video chat or phone call with a patient. These types of communication facilitate the discussion of symptoms and allow the doctor to correlate them to disease processes, such as dry eye disease.
In telemedicine, a video chat will allow your doctor to grossly examine external ocular tissues and/or function, as well as gauge your severity. However, the best way to observe these signs is by in-office slit-lamp biomicroscopy. Slit-lamp biomicroscopy provides the doctor with the proper magnification to see the signs of dry eye disease.
Another limitation of telemedicine in the treatment of dry eye disease is the inability to check eye pressure. Topical corticosteroid therapy may be indicated as a treatment for dry eye disease. Although effective, there is the possibility of ocular side effects associated with topical corticosteroid therapy, such as elevated eye pressure, steroid-induced glaucoma, and cataract formation. It is typically suggested that a patient’s eye pressure be monitored when using topical corticosteroids.
Although there are limitations in eye care, telemedicine has provided patients a quick way to seek care from the safety and comfort of their homes. In these uncertain times, our patients’ safety is our number one concern and we have made it a priority to ensure patients can be seen virtually online via a telemedicine appointment or in our offices by providing a safe and secure environment.
We have implemented new safety protocols that include temperature checks, social distancing, a virtual check-in, air purifiers in all exam rooms, and pre-surgery testing for COVID-19 to ensure all risks are minimized. If you are interested in booking a virtual or in-person appointment, please contact us at 678-381-2020.