Dry Eye Clinic

upper left of a woman's face, featuring her eye

The Dry Eye Clinic – which opened at the Vision Institute in November 2023 – is unique because of its coordinated care. It has grown tremendously in the short time it has been open, according to Sabrina Mukhtar, MD, Assistant Professor of Ophthalmology and Director of the Dry Eye Clinic.

“There is a significant need for a more in-depth approach to dry eye disease, especially for the complex patients we see at the UPMC Vision Institute,” she said.

Among the features that make the clinic stand out is the machine learning program, CSI Dry Eye, which was created by one of the previous UPMC Cornea Fellows, Dr. Ahmed Al-Ghoul. The program helps document and track dry eye metrics to provide objective data for diagnosis and monitoring prognosis. The clinic has a multi-disciplinary approach to dry eye disease; working with all members of the team at the UPMC Vision Institute to provide exceptional care. It is also considered a “one-stop shop,” where available products are suggested to patients, and serum tears are drawn and delivered to the patient during the appointment. Providers are able to spend time with the patients, due to longer patient blocks built into the schedule. This allows them to “really dig deep into the underlying mechanism of dry eye disease specific to the patient so that we can provide holistic and targeted treatment,” said Dr. Mukhtar.

Having this clinic is important because dry eye disease is a significant cause of ocular morbidity with several studies showing how it impacts quality of life. It is a complex disease process anchored in inflammation with several risk factors – some of which are modifiable. “It is important for us to delve deeper, be more objective with our testing to monitor disease severity and prognosis with our treatment plans,” Dr. Mukhtar said. “For our severe cases, we offer procedures to help break the inflammatory cycle and to help rejuvenate the meibomian glands that are often the main reason people suffer from evaporative disease.”

Dr. Mukhtar reported that the clinic is going great, with several patients mentioning they are thrilled to have a dedicated clinic. She cited the staff as the reason for its success, saying everyone is completely committed to patient care and go above and beyond what is required.

Appointments start well before the scheduled clinic day when the front desk staff calls patients to schedule. Lengthy questionnaires are sent that require patients to share lifestyle factors, medications, diet, sleep, hydration, and other factors that may affect dry eye disease. Upon check in, technicians review the questionnaires and provide targeted imaging/testing based on the reason for referral, and then Dr. Mukhtar sees the patient and helps come up with a targeted treatment plan. A coordinator helps schedule procedures and provide patient education. At the end of the appointment, a file is available for patients to review their testing and next steps in the plan. On follow ups, dry eye questionnaires are administered so patients can monitor their prognosis.

The clinic is actually so popular, they are working to hire more providers. Unfortunately, because dry eye disease diagnostics and treatments are not covered by health insurance, there is an access to care issue as most procedures are an out-of-pocket cost. “Resolving this is something important to the Department as we want to continue to improve access to care and provide the best care to patients regardless of financial status,” Dr. Mukhtar said. “We are working on innovative methods to achieve this.”

The next goal is to integrate advanced levels of imaging, including confocal imaging to image corneal nerves and inflammatory cells into diagnostics. They are working to also provide personalized biomarker diagnostics so that they can help patients navigate the myriad of medications available in the market. Lastly, the clinic is collaborating with scientists to help advance care in dry eye disease.

The Dry Eye Clinic is located on the third floor of the Vision Institute, in the Refractive and Ocular Surface Suite. Clinic is typically on Fridays from 8 am to 5 pm, but procedures are performed on certain Wednesday afternoons of the month as well, specific to dry eye treatment.