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Making Sense of Lid Margin Disease Course Description This course will address lid margin disease and related ocular surface disease disorders. It will cover the basic etiology and presentation of lid margin disease in its various forms. We will also discuss a systematic approach to diagnosing and treating often-overlooked forms of lid margin disease. Course Length 2 Hrs Scot Morris, O.D. e: [email protected] COPE # 23476-AS Audience: General Speaker Disclosure In the last 24 months I have received compensation in some fashion from the following entities for the stated reasons. CONSULTANT/ADVISORY BOARD: Allergan, Bausch & Lomb, Essilor, Eyefinity/Officemate, ECR Vault, EyeMaginations, EyeStar TV, GPN, MARCO, Odyssey Medical, Opti-align SPEAKER/EDUCATOR: Alcon, Allergan, CIBA, Essilor, EyeMaginations, MARCO, Vistakon GRANT RECIPIENT: Biosciences, Alcon, Allergan, ELOA, Review of Optometry AUTHOR/EDITOR: Optometric Management, Optometric Office, Optometry Times, Review of Optometry COMPANY OWNERSHIP: Ocular Technology Solutions, Morris Education & Consulting Associates, LLC, Eye Consultants of Colorado, LLC OTHER: Ocular Surface Society of Optometry (Treasurer) Course Objectives 1. 2. 3. 4. 5. 6. 7. 8. Discuss the financial implications of going electronic Compare and contrast the electronic office to the paper office Describe workflow analysis List the real vs. perceived practice needs as they relate to EHR List hardware and software requirements Describe product analysis options Describe integration options and points of concern Describe data conversion considerations Morris Education & Consulting Associates, LLC 303.250.0376 www.mecaconsulting.com [email protected] Scot Morris, O.D. e: [email protected] Abridged Course Notes I. What is Lid Margin Disease A. Symptoms B. Presentation "Take-Home" Notes 1. Blepharitis a) Anterior (1) Infectious (a) Common Pathogens b) Posterior (1) Seborrheic Bleph (2) Seborrheic Bleph with Meibomian Seborrhea (3) Seborrheic Bleph with Meibomitis (4) Primary Meibomitis (5) MGD (6) MG Seborrhea 2. Meibomian Gland Dysfunction a) Morphological Changes (1) Duct (2) Orifice (3) Gland (4) Expression (a) Volume (b) Quality (c) Associated Conditions 3. Lid Distribution Issues a) b) c) II. Who Gets Lid Margin Apposition Closure Distribution Disease 1. Lipid Issues 2. Allergies 3. Chronic Topical Meds 4. Dry Eyes 5. Mechanical Issues "To Do List" Morris Education & Consulting Associates, LLC 303.250.0376 www.mecaconsulting.com [email protected] Scot Morris, O.D. e: [email protected] Abridged Course Notes "Take-Home" III. Why Is It There IV. How do we look for lid margin Disease A. Diagnostic Protocol Notes 1. History 2. Lids/Lid Margin 3. Palpebral Conjunctiva 4. Tear Film 5. Ocular Surface 6. Tear Production 7. Tear Stability 8. Drainage System 9. Meibomian Gland Evaluation V. How Do We Treat It A. Traditional Therapy 1. Antibiotics/Combo’s 2. Hot Compresses 3. Lid Expression 4. Lid Hygiene 5. Oral Medications 6. Other Topical Medications B. New Thoughts on Disease Management 1. Protect Patients health and vision 2. Provide Comfort 3. Arrest Disease Progression 4. Decrease negative inflammation 5. Control secondary cellular changes 6. Restore normal anatomy & Physiology C. New Thoughts on Lid Margin Disease Therapy "To-Do List" 1. Dealing with Infection a) Pathogen Eradication 2. Dealing with Inflammation a) Who are the inflammatory players on the lid margin b) Direct Immunomodulation c) Indirect Immunomodulation 3. Topical Therapeutic Options and Alternatives Morris Education & Consulting Associates, LLC 303.250.0376 www.mecaconsulting.com [email protected] Abridged Course Notes Scot Morris, O.D. e: [email protected] VI. Why do We Treat It A. What if we don’t 1. Financial a) Optical Remakes b) Lost medical revenue c) Lost patients "Take-Home" Notes 2. Medical Ethics & Clinical Practice a) LMD Progression b) Severe Dry Eye B. The Practice Management Protocol 1. Proceed a) Game Plan (1) Plan (2) Train (3) Market b) Practice Buy-In c) Tools 2. Practice a) Approach (1) Medical Mindset (2) Schedule Alterations 3. Profit a) Coding Problems and Pitfalls b) Show me the Money c) Get out of your own way "To Do List" Morris Education & Consulting Associates, LLC 303.250.0376 www.mecaconsulting.com [email protected]