Montreal TFOS ambassador Prof Etty Bitton with Quebec optometrist Roy Jean-Yves

After many years of preparation, a dedicated dry eye clinic at the Montreal School of Optometry was inaugurated in 2012, a first within a North American Optometry school. Beginning with only half a day a week, the referrals quickly increased. The clinic has been adjusted accordingly, is now running three full days a week and continues to evolve.

The impact of the dry eye clinic on education has been immeasurable, as optometry students and residents are able to witness firsthand the impact on the quality of life of dry eye disease (DED) patients, while simultaneously obtaining exposure to the latest diagnostic and therapeutic options. This dedicated dry eye clinic allows knowledge building and experience in more advanced DED cases that have been referred by colleagues and other healthcare professionals. The students and residents can then transfer this knowledge to their own clinical practices as practitioners. A number have even gone on to open their own dedicated DED clinics within their practices, equipped with the latest instrumentation to help their patients.

The School’s dry eye clinic has not only influenced students in their future practice but has attracted some back from practice to participate in clinical research on dry eye and undertake graduate studies. This rising interest in clinical research has paralleled the success of the clinic, as contemporary instrumentation and challenging DED cases have highlighted clinical topics worthy of research.

Having had a keen interest in DED for many years, I was honoured to be approached by the Tear Film and Ocular Surface Society (TFOS) to become a Canadian ambassador. In 2015, when TFOS launched a global perspective on DED with its second Dry Eye Workshop, I was invited to participate in the TFOS DEWS II communications sub-committee. Selection as one of 150 global members, and one of seven from Canada, was a validation of the work that was being done at the Montreal dry eye clinic.

The TFOS DEWS II effort allowed me to collaborate with other world leaders who shared a similar passion.

The clinical expertise that has developed with the progression of the School’s dry eye clinic has also permitted me to strengthen local and international collaborations via research projects and enhance inter-institutional relationships. This included hosting a pharmacy student who explored the challenges of dry eye patients within that profession. This interprofessional collaboration offered us both a better understanding of the challenges of each programme and how we can address certain issues related to DED. As a result of this collaboration, I was invited to speak at the annual meeting of pharmacists on dry eye to discuss how we can better address this complex issue.

More recently, A/Prof Jennifer Craig from the University of Auckland completed part of her sabbatical at the Montreal School of Optometry. The opportunity to collaborate on a clinical research project with a known world leader in dry eye was a welcomed opportunity. Not only did the research allow us to explore and advance clinical research on dry eye, but the exchange of knowledge and discussions on future inter-institutional collaborations were promising. We already have plans for another clinical research collaboration opportunity.

In summary, creating and developing a dry eye clinic at the Montreal School of Optometry has allowed us to offer patients a unique focus on DED, prepare our future eyecare professionals to better serve their patients suffering with DED and promote collaborations for further clinical research.

Optometrist Etty Bitton is professor at the Ecole d'Optometrie (School of Optometry), Université de Montréal, director of the school’s dry eye clinic and a TFOS ambassador.