Dry eye disease: the patient journey

Dry eye disease: the patient journey

Although some patients may experience some symptoms of dry eye only occasionally, dry eye disease is a chronic condition, so it is important for patients to understand the implications.
It may take a few attempts with different products for patients to achieve relief from their symptoms. This may be because the treatment is ineffective or, alternatively, because of a phenomenon known as ‘tight shoes’ (i.e. where the patient feels only the worst symptom and, once this is treated, the symptom for the next worse condition surfaces in the patient’s awareness)[1].
• Advise patients that they may be able to only detect the most painful or irritating symptom. This means that it not uncommon to see a new symptom surface after one symptom has been treated because, once one symptom has improved, the patient may be able to detect another for the first time. This can be frustrating for patients, because it may feel like their symptoms will never be relieved fully;
• If patients are anxious or frustrated, reassure them that there are other treatment options available. For example, there are some types of specialised eyewear, called moisture chamber spectacles, which wrap around the eyes to protect them from irritants and help them to retain moisture. Always refer patients with persistent symptoms to an eyecare specialist.
If symptoms persist or worsen, patients should be referred to an eyecare specialist. This could be a sign of a more serious underlying condition, or suggest that their dry eye disease is severe and they require more targeted or potent treatment.
The following diagram, showing the dry eye patient’s journey in community pharmacy, can help to decide what is the best course of action at each stage. It is important to follow up with patients and encourage them to return after at least two weeks to find out whether their treatment was effective or whether their symptoms are persistent or have worsened.



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