As a doctor talks to a patient, speech bubbles show important aspects of care from instructions to medication to coupons.

Community Spotlight: Black EyeCare Perspective (Part 2)

Black EyeCare Perspective, an organization created by Black optometrists, helps facilitate better dialogue between eye care professionals and the Black community. We talked to Doctors Essence Johnson and Jacobi Cleaver about their work with the group, overcoming barriers to treatment, and making sure patients feel informed. Read Part 1.

Educating the patient

Some patients have used over-the-counter relief drops, like Visine, because they are affordable and familiar. Identifying less familiar treatments that can work for chronic dry eye, not just occasional dryness, is important.

"We have to reverse those cycles of what they’re used to getting," Johnson says.

As someone who has chronic dry eye, Johnson can speak from personal experience. Telling patients she has used products herself or on her family helps build trust. She also lets the patients know she is not making any money off her recommendations. Johnson also provides off-label hacks that can extend the shelf-life of treatments. For example, she may share that a treatment may only need to be used 2 times a day, even though the box says 4 times a day.

By educating patients on strategic ways they can extend the lifespan, she makes it more likely they will purchase high-quality eye medicine, even if they are facing financial challenges.

"Visine is $2 a bottle," Johnson said. "The stuff we really need is $5, $15, $20 a bottle."

In addition, Johnson provides a written or physical copy of what she is recommending. This way, patients do not forget what they were supposed to buy when they get to the pharmacy.

Talking about comorbidities

Dry eye can be related to other conditions. Many people may experience it while undergoing chemotherapy, for example. But often no one tells them that, Johnson said.

"A lot of my dry eye treatment is educating the mess out of it," she says.

Symptoms and diagnosis can improve with understanding and passionate care by doctors, she says. It just comes down to how much time doctors are willing to spend educating and listening to patients.

Barriers to eye care treatment

Geographic barriers

A common barrier to eye care treatment is access. Many doctors go into private practice, but most of those practices are not in low-income areas, Johnson says. That dictates who is being served.

That is one of the reasons Johnson and Cleaver have gone into community health. They work in clinics associated with hospitals in low-income communities and communities of color. The work allows them to improve access in those areas and treat conditions such as dry eye.

"It is an invisible disease," Johnson says. "It is something that's very widespread."

Limited treatments

Doctors are also limited in what treatments they can offer for conditions like chronic dry eye. When you prescribe something, you are only picking from a handful of things, Cleaver said. What is cost-effective for the patient also plays a role.

"It's not like we're pulling from an arsenal," Johnson said.

Financial barriers

Costs alone can be a significant barrier.

Some patients have insurance but are considered underinsured, while others have no insurance at all. That can make getting patients the proper treatments more challenging.

"You have to jump through hurdles," Cleaver says. Some insurance companies will sometimes reject requests for certain treatments.

To help patients afford costs, doctors sometimes have to turn to other options. Johnson has provided patients with pharmacy coupons, for example. It is a small gesture, but one that could mean the difference between a patient getting a treatment and not.

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