Eyeworld

Reference 1. Liew M, Zhang M, Kim E, et al. Prevalence and predictors of Sjögren's syndrome in a prospective cohort of patients with aque- ous-deficient dry eye. Br J Ophthalmol. 2012;96:1498–1503. Editors' note: Dr. Solomon is the surgical and refractive director at Solomon Eye Associates Physicians and Surgeons, and principal investigator at Bowie Vision Institute (Bowie, Md). He has financial interests with Rapid Pathogen Screening. Contact information Solomon: jdsolomon@hotmail.com evaluation. In addition to a general- ized decline in visual function, she was experiencing intermittent ocular surface irritation and intermittent worsening of vision when working on the computer. While sitting in the exam chair she was noted to be chewing gum, which is sometimes evidence of self-management of xerostomia. Her Ocular Surface Disease Index (OSDI) score was 34. She demonstrated clin- ical symptoms that are suggestive of Sjögren's syndrome. We conducted dry eye diagnostic testing, which re- vealed a homeostatic lack of stability between both eyes when tested with the TearLab Osmolarity Test (TearLab, San Diego), and subse- quent InflammaDry confirmed elevated MMP-9. We also conduct- ed the Sjö test, which indicated that this patient was likely to have Sjögren's syndrome. These results allowed us to tar- get therapy with topical steroids and institute topical cyclosporine along with nutritional supplements. We then coordinated with the patient's primary care physician and followed with a referral to a rheumatologist, all prior to surgical management of the cataract. Benefit of testing Efficiency in a practice is only as good as what we can offer patients. Understanding how diagnostic testing works and how to apply the technology is where its value lies. I recommend that physicians looking to implement diagnostic technol- ogies in their practices conduct research themselves. Take the time to educate staff so they understand the value of these tools and have a vested interest in the process. Also, I recommend that you utilize the representatives of each of the companies and allow this team- work philosophy to take its course, offering patients a clear understand- ing of the added value of each test. We pride ourselves in providing the best possible management and making our practice a center for in- novation by delivering ophthalmic diagnostic technology that broadens our ability to diagnose efficiently and allows for specific, targeted care for our patients. EW 31 EW CORNEA January 2015

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