They say variety is the spice of life. That’s certainly the case for Stephanie Lai, who reflects here on more than 10 years working in optometry and an increasing passion for dry eye management.
To date, I’ve been a graduate in a corporate flagship practice, spent time as a locum around regional Australia, been a clinical supervisor in Singapore, completed a Public Health course, and worked as a project officer with the Brien Holden Foundation. My love of travel has also led me to a three-year break where I taught business English in Spain and Germany, putting optometry on the backburner.
These days, I’m much more settled as I split my time between a corporate practice and a dry eye clinic.
As someone who suffers from two inflammatory disorders, the literature linking inflammation to dry eyes fascinates me. So when I noticed an advertisement for a new dry eye clinic opening, I jumped at the chance to get involved. It’s been a huge learning experience; our understanding is evolving as more research is done.
Practising between the two clinics can sometimes be like comparing chalk and cheese.
At my regular clinic, patients often come because they want a new pair of glasses. Some admit to having dry eye symptoms if I specifically probe them, almost as an afterthought. I enjoy the challenge of doing a full refraction, health check, contact lenses and retinal imaging. I find it rewarding to be able to improve their vision and, solve their eye health problems, and have them leave the practice happy with their new frames or contact lenses.
The dry eye clinic, on the other hand, involves more focussed time with each patient, chatting about what they’ve experienced, and what has and hasn’t worked for them. Many patients have had symptoms for years. They seek the services of a specialised dry eye clinic as a last resort, and I am sometimes surprised at how little they’ve engaged with their regular optometrist, despite wearing glasses.
These patients come in for a minimum of five appointments. These are spaced out over several weeks allowing time to build a strong relationship. Our discussions touch on diet, stress levels, and sleep – all of which are known to have an impact on inflammation, making it so important to look at a person holistically.
COMPLEMENTARY SKILLS
Working in these two practices is incredibly stimulating for someone who relishes change as much as I do. Despite the differences, I find that my two roles are complementary and my skills transferable between the two. I’m so used to looking at the glands and expressing to check meibum quality at one clinic, that I often do it at the other without thinking. If, at a routine check-up, the patient has either mentioned symptoms or signs of dry eye, I will ask them to return for a follow-up, where I can have a better look at their tear meniscus height, tear break-up time, and have them do an ocular surface disease index questionnaire.
Far from being annoyed at returning, they’re often grateful for the extra care and education.
FINDING CRACKS
As optometrists, we are uniquely placed to reach our community. While dry eye symptoms may not directly lead to vision loss, quality of life can really be impacted.
We screen for glaucoma and other conditions but often not for dry eyes – yet this causes more discomfort and can be so debilitating.
It’s clear that some patients suffering from chronic dry eyes are falling through the cracks – whether they’re not volunteering information, or they don’t view their symptoms as relevant to an eye exam. Asking the right questions and taking a few extra minutes on the slit lamp to check for signs can make a huge difference for those who might be suffering in silence.
Stephanie Lai graduated in optometry from the University of Auckland in 2009 and completed her Graduate Certificate in Public Health and Leadership at the Australian College of Optometry in 2022. She splits her time working as an optometrist at Dry Eye Solution and Bailey Nelson in Sydney.
