How I Protect My Patients and Build My Business With Dark Adaptation Testing

No More Patients vs. Practice: How I utilize dark adaptation testing to prioritize both

When I brought dark adaptation testing into my practice with the AdaptDx^® tabletop device, it was with the goal of providing elite eye care to my at-risk patients. Since age-related macular degeneration (AMD) is the leading cause of blindness in patients over 55 and almost half of my patients at Seaside Eye Associates are between the ages of 60 and 90, this seemed like a good decision. With new discoveries for the treatment of neovascular AMD, I knew it was important to detect the disease as early as possible.

When we got our device, we were only testing patients with night vision complaints. However, after two years of this testing model, we wondered: were we missing AMD? If so, at what cost to our patients? At what cost to our practice?

Testing more patients: is it the right approach?

We decided to modify our protocol for dark adaptation testing to ensure that we were doing the right thing for our patients. Every patient over 50 was tested on the day of their exam. I told my staff, No, really. We’re testing everyone over 50, no matter what. Do not pass ‘Go.’ Do not collect $200. We needed to know: would we find more AMD? Would this help our practice?

After comparing data for July through August 2018, using our original testing model, to data from the same months in 2019 with our new everyone-over-50 testing protocol, it was clear we had made the right decision. The difference was staggering. Billable tests from dark adaptation increased from 17 to 63 per month, an increase of 265%. Billable testing from dark adaptation and ancillary imaging for our AMD patients was generating nearly $10,000 in monthly revenue.

These numbers validated our new approach: testing everyone over 50 was the right thing to do. We were finding early AMD, which was great for our patients, but we were also generating revenue. This completely changed the focus of our practice, and there was no turning back.

Getting staff buy-in for better implementation

Once we had this data, my staff bought into the value of testing dark adaptation speed for every patient over 50, even with our AdaptDx tabletop device. Because this was our standard protocol, implementation became more consistent and efficient. There was no more “forgetting” about dark adaptation testing on a busy day. Our staff prints daily schedules and tags patients over 50, allowing for review of the patient’s chart in advance. This helps the team maneuver to accommodate the rapid test within our pretest workflow.

“To ensure that we are doing the right thing for our patients, every patient over 50 is tested on the day of their exam.”

With the advent of the AdaptDx Pro^®, we were able to incorporate this crucial testing without adding a dark room into the mix. Now, patients can don the headset and kick back in our comfortable exam chair while they follow instructions from Theia.

As an optometrist, I can’t let my patients wake up with disrupted vision because they never knew they had subclinical AMD, never had the chance to implement lifestyle changes that may have slowed the progression of their disease. As a practice owner, I can’t ignore the incredible opportunities for generating revenue from billable testing and ancillary imaging for our AMD patients. Maximizing our dark adaptation testing allows me to prioritize my patients and my practice, because I’m able to do right by both.