- Topography. When topography devices were first introduced, they cost $65,000 and had few speciality options. Today, however, you can obtain
a topographer that offers five times as many features as the original models and costs less than six
figures (e.g., the Topcon CA-200). Topography allows you to observe corneal staining patterns that
are associated with dry eye. There are even topographers that measure tear film break-up time and
tear meniscus height (e.g., the Oculus Keratograph).
- Opt-Align. This new system from Stereo Optical measures ocular alignment in about
30 to 60 seconds. It yields a variety of information, such as the existence of phorias and vertical imbalances,
and even helps differentiate asthenopia symptoms from those caused by dry eye. Opt-Align has saved me hours
and, more importantly, helped me to diagnose and manage individuals once thought to have dry eye, who instead
presented with proprioceptive disparity and ocular alignment issues.
- Specular microscopy. There are numerous instances when patients have presented with
symptoms of contact lens intolerance, for example, that we initially believed were associated with dry eye.
Later on, we determined that the underlying problem was related to endothelial issues, ranging from
decompensation to simple stress on the endothelial cells. The Konan CellChek is a
great specular microscope that
captures signs of early endothelial stress and readily displays below-average numbers.
- Office management professionals. With all these instruments in place, you'll need a
system or staff to help you manage the medical/practice component, including credentials, coding, billing,
accounts receivable, insurance verification, tracking, proper protocol-driven testing, etc. There are
several companies that you can outsource these activities to, such as Optometric Medical Solutions. With
those headaches out of the way, it's a lot easier to focus on the medical/clinical component of your
dry eye practice.
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