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OD Brings in Technology to Help Patients Get off the Hamster Wheel of Dry Eye Treatments

Dr. Denton uses Lumenis technology for in-office treatments
Dr. Denton uses Lumenis’ technology for in-office treatments. Photos courtesy of Dr. Denton

In 2016, when Melanie Denton Dombrowski, OD, MBA, FAAO, opened Salisbury Eyecare and Eyewear in Salisbury, North Carolina, her to-do list included building a practice that focused heavily on dry eye and aesthetics. “In the first few years of having a practice, however, my focus was on keeping the lights on and seeing as many patients as I could,” she recalls.

Then came COVID-19. “I was four years into practice, and that was the moment when I decided to reassess what I wanted this practice to be. I knew I could not be fully fledged until I brought in more equipment. It was time to up the game,” she says.

In July 2020, Dr. Denton went all in, acquiring Lumenis’ intense pulsed light (IPL) equipment, approved by the U.S. Food and Drug Administration. Finally, she felt she could make significant headway with her patients. The Optimal Pulse Technology(™) and triple pulse technology ensure targeted, precise and controlled treatments.

In November 2023, Dr. Denton again expanded her practice by adding OptiPLUS to her offerings. The dual frequency RF technology expanded treatment options into the aesthetic realm and served as a complementary device to OptiLIGHT for dry eyes.

“Before having these technologies, I felt like a hamster on a wheel with patients whose signs of dry eye kept returning. We’d try something, implement a routine, and it would work for a while. But the minute the patient stopped the treatment, dry eye disease would return. With these technologies, I finally had a way to improve meibomian gland functionality and meibum quality,”1 she says. “I wasn’t just covering up the condition anymore.”

HER NEW STANDARD

Dr. Denton pointing to an image of a patient's meibomian glands, teaching two staff members about dry eye
Dr. Denton can use images as an education tool for patients and staff alike to show the impressive results.

Since adopting Lumenis’ technologies, Dr. Denton says she has achieved excellent outcomes. “This has completely changed my view on dry eye disease. I used to think that if the glands were gone, they were gone,” she says. As a result of these successes with Lumenis technologies, her dry eye practice and reputation has grown.

“I was initially hesitant to add RF technology to my practice,” says Dr. Denton—or Dr. D as she’s known to her patients. But OptiPLUS’ dual frequency RF technology reaches different skin layers to target the meibomian glands and enhance blood circulation and collagen production, and Dr. Denton found that incorporating the device as a complementary treatment increased interest in IPL treatments within those first few months.

Patients appreciate that there’s “no downtime.” They worry that they’re going to need transportation home and a few days away from work. But even Dr. Denton’s most sensitive patients are good to go minutes after their treatments. “Many patients tell me they feel great when they leave here,” she says.

LUMENIS UNPARALLELED SUPPORT

Optilight and optiplus technology units from lumenis for dry eye
The combination of OptiLIGHT and OptiPLUS from Lumenis is a powerful tool for optometrists who want to offer in-house eye care treatments.

Initially, Dr. Denton was performing all treatments herself. But she noticed that her dry eye practice was “growing at the expense of everything else.” Last summer, she decided to implement some changes. OptiPLUS’ delegable nature made it simple for Dr. Denton to have licensed practitioners take over much of the treatment. “Today, I joke that I don’t know how to do the RF. I do, but I’m not the primary person,” she says.

Lumenis conducted in-depth training, and a field trainer came in. It was a thorough and effective experience for Dr. Denton’s staff. She shares that since training her licensed practitioners, her presence is no longer necessary in the room during dry eye treatments.

Combined with Dr. Denton’s adjusted schedule and improved method of conducting dry eye assessments, this shift has allowed all the components of her practice to start growing steadily again.

Dr. Denton says that the support from the company was one of the reasons she chose Lumenis. The other is that “this was the company that all the big names in dry eye disease were using: Laura Periman, MD; the late Art Epstein, OD, and more. I wanted to use the technology that is being used by the people and company doing the research and publishing the papers.”

PROGRESSIVE OPTIONS

Dr. Denton in her office where she treats dry eye
There’s an element of counseling involved in working with dry eye patients, says Dr. Denton.

Patients can be anxious about dry eye treatments, “so it’s vital for us to ensure proper education. At my clinic we’ve put together folders, filled with treatment information,” Dr. Denton explains. “Every patient receives a folder during their first dry eye assessment, plus I share my YouTube channel with them where they can learn more on their own time.”

Dr. Denton describes three treatment approaches to managing aspects of dry eye disease. “The first is what I call the DIY approach: lid scrubs, drops and compresses. Many patients have already dabbled there,” trying these strategies at home or at the advice of an eye care professional. The second is therapeutics prescribed by an eye care professional, and the third is a selection of in-office treatments.

Dr. Denton sees two primary groups of patients. The first is people in her current patient base who have signs of dry eye. The second is those who come from hundreds of miles away because of her specialty area. It is not uncommon for newly diagnosed patients—depending on the severity of their symptoms—to start with the first approach and move into the others. The patients who travel to her are ready to go with the in-office treatments because they have already tried everything else. “They found me because this is what I offer. They are looking for the dry eye and aesthetic treatments I can offer with Lumenis’ IPL technology and OptiPLUS.”

OUTSTANDING RESULTS

These patient stories are oftentimes also the most dramatic. “You have to have intentionality when setting up a dry eye clinic. These patients are so frustrated and have suffered so much; they’re often desperate for someone to see and hear them.”

Indeed, the transformations that follow are often stunning. “Symptoms such as depression and anxiety are often associated with dry eye disease.4 Patients with severe dry eyes may seem needy and high-maintenance, but with proper care, we have seen major behavioral changes in these patients as they start to get back the pieces of their lives. For the first time in a while, they are able to do things, such as reading for pleasure or driving,” Dr. Denton says. “My patients have told me they’ve felt like different people since getting their hope back.”

References:

  1. Chelnis et (2023), Clin Ophthalmol. 17:3089–3102.
  2. Javate RM, Cruz RT Jr, Khan J, Trakos N, Gordon Nonablative 4-MHz dual radiofrequency wand rejuvenation treatment for periorbital rhytides and midface laxity. Ophthalmic Plast Reconstr Surg. 2011 May-Jun;27(3):180-5. doi: 10.1097/IOP.0b013e3181fe8e5a. PMID: 21283035.
  3. Rabkin JM, Hunt Local heat increases blood flow and oxygen tension in wounds. Arch Surg. 1987 Feb;122(2):221-5. doi: 10.1001/archsurg.1987.01400140103014. PMID: 3813871.
  4. He Q, Chen Z, Xie C, Liu L, Wei R. The Association Between Dry Eye Disease With Depression, Anxiety and Sleep Disturbance During COVID-19. Front 2022 Jan 5;12:802302. doi: 10.3389/fpsyt.2021.802302. PMID: 35069294; PMCID: PMC8766963.

Read other stories from Lumenis here.

 

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