there’s a target on your chest
“Dry eye” is a lucrative, fast-growing industry.
This means we are marketing targets for a wide variety of products and services, from drugs and devices subject to regulatory oversight to quack remedies, from sophisticated “dry eye clinics” to charlatans claiming they can cure us. And everything in between.
Separating sheep from goats isn’t always easy.
Sometimes good ideas come with poor packaging. Sometimes poor ideas come with impressive packaging. Some marketing seems benign, sometimes it falls into a grey area, sometimes it’s blatantly unethical. This last category is the one I’m concerned with today.
Most people can spot shady marketing practices - on a good day.
But when you’re in pain, when you’re struggling, when it’s gone on, and on, and on, and nothing’s working, you get beaten down. At some point, almost anything that promises HOPE of relief may start to look attractive, and you find it easier to rationalize the “outer wrappings”. This is especially true if whoever is doing the marketing successfully portrays themselves as kind and compassionate - things we are hungry for in the world of dry eye and eye pain.
Today’s post is my way of encouraging everyone to try not to let their pain fool them into abandoning their native good sense.
I’m not saying “don’t try things”. I’m saying “think and seek advice from others” before you become yet another nail for yet another hammer.
five little red flags
Red flag #1: Over-promising
Over-promising in the dry eye world is foolishness. No one can consistently deliver on promises of relief.
There is no straight line to be drawn between dry eye disease(s) and dry eye symptoms. That fact is well established in the medical literature.
We hurt, because we hurt. The science of eye pain and discomfort is in its infancy. No one can tell you with certainty whether you hurt because of “dry eye” or because of MGD or because of lagophthalmos or because of ocular allergy or because of conjunctivochalasis or because of any specific combination of these things nor, if you have these things, can they tell you with certainty that your pain is some form of neuropathy or neuralgia. Therefore, they cannot tell us with confidence that treating one or more of those things with whatever particular treatment(s) they happen to favor will make us FEEL better. Relief is discovered in practice.
Trust the doctors who tell you the truth: That they may feel confident of what can improve disease, but that they DO NOT KNOW for sure whether it will make your eyes feel better. Humility matters.
Cruising websites? “Satisfaction guaranteed” - “100% satisfaction” - wording like this is a red flag.
Relief comes in all shapes and forms - some of them surprising. And not all of them are complicated, expensive, or hard to come by. For some it’s drugs, for some it’s devices, for some it’s procedures, for some it’s dietary change, for some it’s moisture chamber glasses, for some it’s scleral lenses or PROSE, for some it’s all about less screen use and other lifestyle modifications, for many it’s a unique combination of things that they work out over time. Magic bullets are few and far between.
Red flag #2: Over-scaring
Scare-mongering about the future of your eye condition is a flagrant violation of the hippocratic oath to first do no harm. Run, don’t walk, when you encounter this.
Responsible, competent physicians are straightforward, honest and realistic with you about any disease or condition you have that could threaten your sight, even if they fail to help your issues with pain and discomfort.
Physicians who attempt to frighten you about the future of your eye pain or similar issues, as a means of marketing their products or services, are violating the most basic ethical standard of their profession.
Companies that use fear marketing directed at pain patients (because, let’s face it, that’s what we are)… we should avoid them, rather than rewarding them for such abusive manipulation.
If you think I’m over-dramatizing, that means there’s a lot out there on the market right now that you haven’t seen. That’s a good thing.
Red flag #3: Over-pricing
People with dry eye have become notorious in the industry for their willingness to pay anything for relief.
That makes us targets.
We can’t judge everything based on price. There’s so much we don’t know about the reasons for pricing structures, for example.
But we should not hesitate to try to apply some kind of a reasonableness standard to what is being offered us. If it seems unreasonably expensive compared to reasonably comparable services or products, that’s a red flag.
Note: A red flag doesn’t have to mean “don’t do it”. A red flag can mean, “I think I should have a conversation about this with someone totally unconnected to it and get their opinion.”
I saw a marketing email the other day that had - among many other red flags - a list of suggestions for how to finance a service offered in relation to dry eye. This service, to the best of my understanding, did not include any actual medical treatment - it was perhaps more akin to self-help seminars and/or personal coaching. The list of financing suggestions included getting a new credit card, selling excess household goods, and taking out a loan on your home. A steep discount was offered if you purchased within 7 days. If you do not see a Really Big Red Flag here without my pointing it out, please know that you are vulnerable to dry eye scams and fraud.
Red flag #4: Over-dissing
Is someone enticing you to their products or services on the basis that they know other common approaches to dry eye “don’t work”?
Is someone pitching “natural” products, treatments or strategies by dissing drugs and devices? Part of the red flag here is generalizing in any way about dry eye: that’s just bad practice. Different things work for different people. Honest doctors and honest businesses acknowledge that fact. Personally, I avoid drugs like the plague - so what? I know many other people for whom topical or systemic medications are a vital and effective part of their treatment. This is reality. Anything from a gluten-free diet to a high dose of cyclosporine may work great for one person and be useless for another. This is reality. Our mileage varies. It’s the nature of the beast as best we know it today.
Red flag #5: Over-glamouring
Just. Don’t. Fall. For. It.
Think about it. The specialists who can do you the most good are probably not going to be the most visible social media darlings or the ones with the slickest trappings.
They’re more likely to be the scientifically-minded physicians that aren’t really all that interested in business. Many of them are simple and unassuming and lacking in name recognition.
Don’t let yourself be hypnotized into thinking that your solution must necessarily lie in the hands of one of the most visible or most famous names in the dry eye community.
Good work is often done in surprisingly unpretentious places.