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Myopia- Management

Melissa Barnett, OD, FAAO, FSLS, FBCLA, offers quick tips for ODs to ensure an optimal ocular surface for their patients wearing scleral contact lenses.

Click here to read the associated transcript

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® Editorial Advisory Board member. They inform decisions on observation or treatment. Find out more!

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Tips for optimal management of glaucoma suspects

 Hi, everybody. I am Gretchyn Bailey with 

®. And I have the pleasure of speaking now with Dr. Jake Lang from Minneapolis. Jake is talking to us about a lecture he is delivering at this year’s Twin Cities Ocular Surface Disease Symposium. Boy, that is a mouthful. And that meeting is all virtual this year. It is also combining with Dry Eye Boot Camp at the same time. Jake, first, thanks very much for talking with me. I really appreciate you taking the time.

 My pleasure. Thanks for having me here. And thanks to Everything Dry Eye, Dry Eye Boot Camp and Twin Cities OSD symposium for allowing me to speak to people about advanced technology, intraocular lenses (IOLs), and ocular surface disease.

We spoke a lot about advanced technology IOLs, where IOLS have come from, where they are going, new technology that is on the horizon, ways of correcting refractive error, ways of correcting presbyopia, and maybe ways of integrating technology into our IOLs in the future. We talked a lot about that and then how the ocular surface plays such a huge role in making these advanced technology lenses work. Without a healthy ocular surface, we just can’t get out of that technology what we want. I kind of did it a little analogy to having this great cell phone and having horrible service. You just can’t get out of your phone what you want. If you don’t have that, if you don’t have good WiFi, your Zoom meetings just don’t work that way.

Related: MGD: Identification and treatment

 And we have all experienced that lately, haven’t we?

 We have, there has been a learning curve. We talked a lot about ocular surface, how it plays a role, things to look out for, things to do about ocular surface disease so that your patients are set up for success. We talked about different conditions that cause irregularities in the surface and ways to fix those, make those lenses work at their maximum. That was really the focus of the lecture today.

 I have a quick question for you about these advanced technology IOLs that many people are referring to as premium IOLs, many patients are paying more out of pocket for them. Are you finding that patients who do have some ocular surface disease challenges prior to having a premium IOL implanted, are they experiencing more problems afterward? Do you think, because they have higher expectations due to a premium IOL? Or would you say it is on par with a non-premium implant?

Related: Dry Eye Boot Camp morphs into Everything Dry Eye

 No, I think the patients really expect success. Now more than ever, just because of our world of our generational changes, but also the technology that they are paying for, they want to work. If you buy a new computer or a new phone, you expect it to work and without that ocular surface disease being treated, it is not going to work. And so yeah, they are expecting: “You told me this is going to work. I paid for it. Why isn't it working?” And I do find these patients are more willing to do the treatments too, like, “Yes, this is what I want.”. So you know, they see the end and the goal in sight. They are more willing to adhere to your recommendations do what you want, because they have skin in the game too, right? They want this lens to work. They want this technology; they want this freedom from glasses. So, they are willing to jump in and do whatever it takes, and sometimes they are disappointed if that wasn’t brought up to them, beforehand. Why didn't you tell me this? I would have done this. I would have waited; I would have taken care of whatever I needed to take care of beforehand.

 You said that these patients are willing to put in the time and the effort prior to cataract surgery. Would you say that they are more compliant or more interested in achieving ocular surface success than say patients who are not opting for a premium IOL?

 I think that varies with the patient to some degree because some patients are more concerned about their ocular health than others. I find the patients that want that extra level of vision is realizing that there are a lot of moving pieces and they will adhere and do whatever they need to do to get to that higher level of vision, especially in the preoperative period. I mean, they come in for X amount of measurements and all these extra appointments and have a lot of questions about the lens. They are engaged in setting themselves up for success.

Related: Twin Cities OSD Symposium + Dry Eye Boot Camp = Dry Eye Everything

 If you had 2 or 3 pearls to offer to your fellow ODs, about preparing the ocular surface for premium IOL patients, what would those be?

 Yeah, treat early, treat often. Look, lift, pull, and push. That is an American Society of Cataract and Refractive Surgery (ASCRS) recommendation. Take that extra minute to look around a little bit more, recognize what you are seeing, explain it to the patient, take those extra minutes to explain and educate the patient about what is going on. And then on the back end, don’t necessarily mess it up with post-operative treatments either. These post-operative treatments need to be ocular surface friendly as well.

 Absolutely. I like don’t mess it up after. (Laughter) That is good advice.

Related: OSD patients and contact lens wear

 Well, the surgeons always tell me, “Don't mess up my work.”.

 This was some great information. Jake, thank you very much for talking with me today and I will talk to you soon.

Articles

Twin Cities Ocular Surface Disease Symposium

How OSD affects advanced technology IOLs 

During the Dry Eye Everything meeting, Whitney Hauser, OD, suggests knowing patient objectives and outlining a treatment plan and timeline for patients so they understand what is going on.

Related: Challenges and opportunities with OSD in 2020

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Damon Dierker, OD, FAAO, explains how his Dry Eye Boot Camp meeting joined with Ahamd Fahmy’s Twin Cities Ocular Surface Disease Symposium to form Everything Dry Eye Virtual Symposium.

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Dry Eye Boot Camp morphs into Everything Dry Eye

Damon Dierker, OD, FAAO, highlights what’s new in dry eye, such as neurostimulation, nasal spray, biologics, and more from his panel at Dry Eye Everything Virtual Symposium.

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New developments in dry eye treatments

Whitney Hauser, OD, suggests ODs take the opportunity of the COVID-19 pandemic to redirect their practices and identify new goals during the Dry EyeEverything meeting.

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Challenges and opportunities with OSD in 2020

Ahmad Fahmy, OD, FAAO, discusses his Twin Cities Ocular Surface Disease Symposium joining with Damon Dierker’s Dry Eye Boot Camp to create Dry Eye Everything Virtual Symposium.

Twin Cities OSD Symposium + Dry Eye Boot Camp = Dry Eye Everything

Ahmad Fahmy, OD, FAAO, explains that the line in the sand for the ocular surface is the corneal epithelium. He outlines his talk at Dry Eye Everything Virtual Symposium which looks at how corneal nerve sensation intersects with the health of the ocular surface.

Neurotrophic keratopathy and ocular surface disease

Ahmad Fahmy, OD, FAAO, shares insights from his talk at Dry Eye Everything Virtual Symposium, including the importance of carefully looking at the lid margin.

How to start treating dry eye

Melissa Barnett, OD, FAAO, FSLS, FBCLA, discusses what ODs need to keep in mind for OSD patients and contact lens wear, including comments on contact lenses amid COVID-19.

Related: How OSD affects advanced technology IOLs

Video: OSD patients and contact lens wear

Jake Lang, OD, FAAO, offers suggestions to set patients up for success with cataract surgery.

Video: How OSD affects advanced technology IOLs

The virtual symposium arose from combining two in-person meetings which were cancelled due to the 

Related: Highlights from Twin Cities Ocular Disease Symposium 2019

Below are highlights from Dr Korb and Dr Nau’s talk.

Check out coverage from the virtual symposium 

Highlights from the Everything Dry Eye Virtual Symposium

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Related: Ahmad Fahmy checks in at the Twin Cities Ocular Surface Disease Symposium 2019

Check out highlights of the meeting below.

From beginner to advanced dry eye management, this combined meeting has something for everyone

Ahmad Fahmy, OD, FAAO, DIPL, ABO, shares the excitement at the second annual Twin Cities Ocular Surface Disease Symposium in Minneapolis.

Ahmad Fahmy checks in at the Twin Cities Ocular Surface Disease Symposium 2019

Scott Hauswirth, OD, FAAO, discusses collaborate approaches ODs and MDs can take when treating Ocular Surface Disease at the Twin Cities Ocular Surface Disease Symposium 2019.

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Comanage dry eye for best results

Ahmad Fahmy, OD, FAAO, DIPL, ABBO, highlights intense pulsed light (IPL) therapy for the treatment of ocular surface disease at the second annual Twin Cities Ocular Surface Disease Symposium in Minneapolis.

IPL and dry eye

Ahmad Fahmy, OD, FAAO, DIPL, ABBO, kicks off the second annual Twin Cities Ocular Surface Disease Symposium with an introduction to the 2019 conference.

Related: Highlights from Twin Cities Ocular Disease Symposium  2019

Ahmad Fahmy kicks off the second annual Twin Cities Ocular Surface Disease Symposium

Whitney Hauser, OD, and Jacob Lang, OD, FAAO, discuss highlights of the Twin Cities Ocular Surface Disease Symposium in Minneapolis, MN.

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