Eyeworld

21 EW NEWS & OPINION May 2018 better patient education about aller- gies can also involve ophthalmolo- gists. Here's how ophthalmologists can arm patients to better manage the growing intensity and frequency of ocular allergy. Pearls for ophthalmologists 1. Adjust your seasonal scheduling with seasonal allergic conjuncti- vitis (SAC) patients. As allergy sea- sons become longer in many areas, ophthalmologists may want to up- date when they typically see patients before the peak season hits. "On average, depending on where you live, pollen season can be 28 days longer than it was 10 years ago," Dr. Demain said. If you typically see SAC patients in late February before spring pollen season but the season is now tracking earlier, you may advise patients to come to your prac- tice in mid-February instead. 2. Refer to allergists as necessary. As more allergy patients present to the office, ophthalmologists should consider all symptoms affecting a patient and work closely with allergists for patient care as needed. "I think they need to see a more holistic approach for the patient," Dr. Bielory said. "Will the ophthal- mologist treat the nose as well? If they are, that's fine. If not and the patient still has a runny nose and other problems, what have we done to help?" he said. "We can evaluate and send back to the ophthalmologist or optom- etrist," Dr. Demain said. "Consider allergists as good collaborators in the overall management of a patient." Allergists can provide systemic treatments for rhinoconjunctivitis and provide any state-of-the-art allergy treatments, including subcu- taneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Sublingual immunotherapy involves the placement of an allergen under the tongue. Studies of SLIT have found it can be effective, although it is monotherapy for one specific allergen versus treating multiple allergens at once, Dr. Bielory said. "It's chronic use, and you have to start before the season. It's a dai- ly dose," he said. Adverse effects include itching around the mouth, but it's convenient for patients who cannot come to the allergist's office regularly, Dr. Bielory said. Some allergists add SLIT treatment for patients receiving shots, but insur- ance companies are hesitant about coverage because of the extra cost, he explained. Ophthalmologists and allergists can also encourage patients to take more at-home steps to track or avoid offending allergens. Dr. Bielory recently launched a free app called the Accupollen Allergy Tracker that can indicate where the highest pollen counts are in a specific area near the user's phone, to help those affected stay informed. The app uses information from allergists as well as from the National Allergy Bureau. 3. Help patients to stay informed about their allergic triggers. "Peo- ple with environmental allergies should be familiar with what they are allergic to," Dr. Demain said. "If they are familiar with their aller- gies, they can follow allergy cycles." With the use of specific websites or apps that track typical allergic triggers or air quality, patients can make informed decisions about their day. "If there's a high birch cycle in the morning, a patient may think, 'I shouldn't ride my bike in the morning because that's when the pollen will be at the highest. Maybe I should do an indoor activity in the morning and go bike riding in the afternoon,'" Dr. Demain said. 4. Prepare to treat dry eye syn- drome that appears in allergic conjunctivitis patients. The two often present together, Dr. Bielory said. EW Editors' note: The physicians have no financial interests related to their comments. Contact information Bielory: drlbielory@gmail.com Demain: jdemain@allergyalaska.com Rosario: nelson.rosario@ufpr.br Stephens Instruments | 2500 Sandersville Rd | Lexington KY 40511 USA Toll Free ( USA ) 800.354.7848 | info@stephensinst.com | stephensinst.com © 2018 Stephens Instruments. All rights reserved. I N S T R U M E N T S | S I N G L E U S E | D R Y E Y E | B I O L O G I C S Take a closer look Stephens is more than instruments. Our range of products includes reusable and single-use instruments, dry eye treatments and sterile tissue allografts. Our loyal customer base is a testament to the high quality and superior service you will experience from Stephens. Stephens — more than instruments. DRY EYE A full line of punctal occlusion and diagnostic products from Lacrivera® INSTRUMENTS Over 1,500 high-grade surgical stainless steel and titanium instruments BIOLOGICS Halo sterile tissues for glaucoma and corneal surgery SINGLE USE Fresh, precise and sterile SafeSite™ instruments for each procedure

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