We asked several glaucoma specialists what one thing they’ve done in the last year that has improved their practice efficiency. Read their responses below.

First and foremost, excellence in patient care comes before efficiency. For both patient care and efficiency reasons, I have tried to switch as many glaucoma patients as possible to compounded glaucoma medications. For example, if patients are taking timolol in the morning and latanaprost at night, I switch to compounded Tim+Lat once a day. If they’re on 2 or 3 different drops, I switch to a morning/night combination formulation. This works well for the patient because it doesn’t require refrigeration and it improves compliance. This also streamlines our practice by saving the time that staff would need to spend to obtain prior authorizations and communicating with pharmacies.

Steven R. Sarkisian, Jr., MD
Cataract and glaucoma surgeon
Oklahoma Eye Surgeons
Oklahoma City, OK

The biggest efficiency tip for me has been utilizing selective laser trabeculoplasty (SLT) as an initial treatment for glaucoma, and even growing this part of my practice. I feel empowered by the 6-year LiGHT trial data and patients find the facts to be convincing and desirable: that SLT arm eyes were less likely to progress, less likely to need incisional glaucoma surgery, and less likely to have cataract surgery at 6 years. The efficiency of SLT comes from the reduction in patient phone calls and administrative burden related to eye drop side effects, refills, prior authorizations, and related issues.

Sarah H. Van Tassel, MD
Assistant professor of ophthalmology
Weill Cornell Medical Center
New York, NY
Editor’s note: Dr. Van Tassel reports consultancy to Belkin Vision.

Scheduling planned 4-to-6-month testing (eg, visual field or optical coherence tomography) separate from the planned return office visit has improved clinic efficiency. This way, with technician shortages, we can divert testing to days we may be less clinically busy. Overall, the goal is to run on time to improve the patient experience.

Arsham Sheybani, MD
Associate professor of ophthalmology and visual sciences
Washington University
School of Medicine
St. Louis, MO

One thing we have done in the past couple of years is adopt the SITA Faster 24-2C algorithm for our routine visual field testing. This strategy allows for quicker testing so that patients are more alert and able to focus on the task at hand. The strategy also allows for testing 10 additional central points compared to the standard 24-2, which provides additional data and a deeper understanding of the disease process. Our entire glaucoma service now uses this approach, which provides clear benefits for efficiency.

Malik Y. Kahook, MD
The Slater Family Endowed
Chair in Ophthalmology
University of Colorado
School of Medicine
Aurora, CO

One big thing was to incorporate the Olleyes virtual visual field platform (VisuALL). That not only increased our efficiency for certain patients, it dramatically expanded our visual field templates and increased our capacity to perform visual fields in our patients. This is disruptive technology.

Davinder S. Grover, MD, MPH
Cataract and glaucoma surgeon
Glaucoma Associates of Texas
Dallas, TX

As we returned to pre-COVID volume, I noted that our lobby was unnecessarily filled with patients. With proper scheduling, only a few patients should be seated in the lobby at any given time. I re-evaluated our scheduling patterns, looked at the number of technicians we have to work up patients, and calculated the number of patients we could accommodate every hour. I further divided that into how long it took each tech to work up each patient. We never wanted our techs to rush, nor to have patients feel rushed, so we modified our schedule to correlate with our techs’ abilities.

Since we modified our schedule, we are still seeing the same number of patients per day with limited wait times. Patients are happier. The clinic feels less chaotic. Staff members are happier as well!

Mark J. Gallardo, MD
Cataract and glaucoma surgeon
El Paso Eye Surgeons
El Paso, Texas

We did a review of all the surgeons’ preferences to see how ingrained those preferences were. We were able to consolidate several approaches, which makes things easier for the staff, simplifies supply management, and improves set-up and surgical times.

John Berdahl, MD
Cataract and glaucoma surgeon
Vance Thompson Vision
Sioux Falls, SD

The assignment of a “lead technician” in the office is essential in making sure the clinic is flowing, the doctor is going into the right rooms, the patients are being seated in a timely manner, and all the other technicians are moving along efficiently. The lead tech is the glue that binds the clinic together to make things flow and can be a huge asset to the practice.

Sahar Bedrood, MD, PhD
Cataract and glaucoma surgeon
Advanced Vision Care
Los Angeles, CA