Making Dry Eye Work For Your Independent Optometry Practice

Mr. Harry Notaras and Dianne Pyliots – principal optometrists at Eyewear Youwear, a practice in Sydney’s upscale Surry Hills suburb – embody the philosophy that differentiation and the ability to market special interests will ultimately lead to prosperity in the world. independent optometry.

Harry Notaras.

A passionate investor in new technologies, Notaras established the firm in 1995 and has continually sought ways to make its service stand out to a population largely made up of office professionals in industries such as architecture, law, art and design.

Dry eye was an unknown phenomenon when Eyewear Youwear began operations 27 years ago, but as research in the field evolved, the practice’s interest in expanding its reach to accommodate its patient base s is also increased.

“As dry eye became more and more studied and studies such as DEWS (Tear Film & Ocular Surface Society’s Dry Eye Workshop) came out, this piqued our interest as we had patients who were still complaining of problems of vision saying they could see clearly one moment and blurry the next, and they have to keep blinking to fix it,” Notaras explains.

“As the research grew and told us more about the importance of dry eye treatment for visual function, it got us more interested. And when the first instruments emerged, we have adopted and manufacturers now have a multitude of opportunities to diagnose and treat dry eye disease.

The IRDA dry eye diagnostic tool.

Indeed, Eyewear Youwear has started to develop its dry eye range. Over the years, he has added an Intense Pulsed Light (IPL) machine from Lumenis, a heated eyelid goggle device incorporating heating capability for Meibomian Gland Dysfunction (MGD) called Blephasteam, and imaging of meimbography on his slit lamp. Pyliotis, the practice’s optometrist, can also prescribe prescription eye drops like ciclosporin and lifitegrast, often working in tandem with Notaras during the dry eye patient’s journey.

More recently, through BOC Ophthalmic Instruments, Eyewear Youwear has sought to elevate its dry eye diagnosis and treatment offering, acquiring instruments produced by SBM Sistemi, a northwestern Italian company that exceeds its weight in terms of ophthalmic innovation.

This took the form of IDRA, a diagnostic device launched in 2019 which is SBM’s most advanced ocular surface analyzer. And earlier this year, the practice introduced Activa, SBM’s first treatment instrument for MGD, featuring an eye mask with heating and massage technology.

The devices have been welcome additions to Notaras’ practice, whose dry eye patients typically fall into two groups. Those with more manageable dry eyes caused by environmental factors and those with anatomical issues such as rosacea, blepharitis, and MGD, among other conditions.

“When it comes to dry eye, we see a great mix of people. We tend to assess everyone who walks in the door, because while most people won’t tell you they have dry eyes, especially contact lens wearers, it’s one of those things that creeps in and they think it’s normal until you show them otherwise,” he says.

Since acquiring the SBM instruments, Notaras has been impressed with the broad functionality of the IDRA device which has a small footprint and mounts to its existing slit lamp.

“It’s ideal for a practice of my size based in Surry Hills. It provides information on many aspects such as tear meniscus height, non-invasive tear break-up time, automatic 3D meibography,” he explains, noting additional functions such as auto-interferometry test , blepharitis examination, break-up time staining test, white-to-white. measurement and pupillometry.

“It also has blink rate detection, which can be recorded to assess whether patients are blinking correctly. IDRA allowed us to go much deeper with an instrument, instead of jumping from one to another.

In Notaras’ practice, Activa acts more like a second-line therapy, with IPL the last line. Although not as comfortable as expected for patients, Notaras has been impressed with the results in his practice.

The Activa is a goggle-like device for MGD.

“It’s one of the few instruments I know of that does both massage and heating. The other one I know of can be more invasive and very expensive for a consultation, when it’s a much less expensive treatment option,” he says.

“The Activa is a goggle-like device, but it’s stiffer, and you have to be a bit more careful with how you use it on the patient and manage their

make sure you don’t let dry eye patients go who end up seeking treatment elsewhere.

If practices haven’t incorporated some level of dry eye management, Notaras says now is a good time to start. There is an abundance of technologies and therapies out there, and although they may require some initial investment, there are plenty of aids to improve skills in this area.

“If you want to stand out, I think it’s time to adopt this type of service. There are CPD courses, articles, and events offered all the time on dry eye and don’t require a huge investment of your time. »

Partnership with a dry eye innovator

While BOC Instrument’s relationship with SBM is one of its most recent, dating back to 2017, the company now offers a suite of seven instruments from the manufacturer. SBM itself only entered the dry eye field in 2015.

SBM’s entrepreneurial spirit was the catalyst that prompted BOC’s Managing Director, Mr. Tony Cosentino, to sign a distribution agreement for Australia.

In addition to flagships like the IRDA and Activa, the company’s latest releases include two new imaging modules: the DSLC200 which adds digital capabilities to slit lamps; and the Dry Eye Module (DEM 100), a software interface that attaches to the slit lamp and DSLC200 and offers a comprehensive set of dry eye diagnostics.

Soon, BOC hopes to start importing SBM’s new topographer called OS 1000, described as a dedicated dry eye platform with topography, including film analysis and 3D meibography. For this device, SBM has yet to obtain registration certifications for Australia, which it hopes to obtain in early 2023.

“This is a company that innovates through research – not by copying other existing technologies – which is why we brought them into the portfolio,” says Cosentino.

More information on SBM Sistemi devices available through BOC Instruments can be found here.

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Teaming up with an SBM Sistemi – an innovator for dry eye