Welcome to Optometry Simplified.

Every week, I curate clinical evidence, practical ideas, and enduring principles that can help us care for patients thoughtfully and lead our practices wisely. Here's what I'm learning and applying this week.

Resources to Remember

Read your way to an MBA.

Author and bookstore owner Ryan Holiday reads a lot. Watch as he shares his list of the best books on leadership, business strategy, and mindset, which he claims are better than an MBA education. Ryan Holiday​

If you aren't recommending SLT as first line yet, read this.

Justin Schweitzer, OD, and Nathan Lighthizer, OD, talk all things SLT. They even discuss the ongoing research comparing DSLT vs. SLT. You'll want to hear how they stack up. EyesOnEycare​

Keratoconus is more common than most of us were taught. Learn how to act on new prevalence data and get the latest updates on keratoconus from international experts on Saturday, Dec 12, 2026, in Dallas, TX. Use the code: ODSIMPLIFIED for 25% off! Register Now

Articles to Apply

Does your retina display your birthdate?

Oculomics is a hot topic right now. This open access review reframes oculomics around health span, using AI to estimate biological age from fundus photos, OCT, and even lens images. Asia-Pacific Journal of Ophthalmology​

Quotes to Consider

"To be all in for your employees is to recognize and nurture their potential, to set the stage for your team to tap into their biggest desires and empower them to express their real selves. I believe my role is to help everyone on my team become more of who they are, who they feel called to be." - Mike Michalowicz, All in ​

My Observations

The DEWS III report has been out for over a year now.

It’s a huge document. It is, by far, the best and most practical summary of information on dry eye. I’ve attempted to unpack certain aspects of it [here] and [here].

But even after reading the full published report and my summaries, there is still wiggle room for uncertainty when applying that information to your day-to-day practice.

So here’s my best attempt at creating a simple, memorable, stepwise approach to managing dry eye.

The five steps come from years of seeing these patients and a summer of teaching DEWS III. Claude.ai helped me land on the acronym. I’m calling it the TEARS framework.

T: Trigger. Something has to start the process, and “the patient complained” isn’t enough. Good triggers include a positive SPEED or OSDI, fluctuating vision you can’t explain, contact lens dropout, a glaucoma patient on multiple drops, an upcoming cataract or refractive consult, or just MGD findings on an asymptomatic routine care patient.

E: Early treatment. This means lid hygiene, warm compresses done correctly, a preservative-free tear, and an honest conversation about screens, sleep, and environment. It isn’t the treatment plan. It’s the floor, and it gives the patient relief while they wait for the visit that actually matters.

A: Assess. The OSD evaluation is a dedicated medical visit, separate from the annual exam. It covers three areas: the tear film, the ocular surface, and the eyelids, checking all for any abnormalities or "etiological drivers," as DEWS III puts it.

R: Record and rule out. This is the step most of us shortchange. Document every abnormality you find, not just the ones that point to dry eye. Each finding goes into one of two buckets. Either it fits dry eye, or it’s a masquerader or comorbidity. I've said this before here: the extent to which you sort and treat masqueraders and comorbidities is the extent of your success managing these patients.

S: Stack. Each documented abnormality gets a treatment, and the treatments run concurrently, not in sequence. That’s the “stack, don’t stage” principle from before. Pick two or three treatments across the at-home, in-office, and pharmaceutical buckets based on what you found, not on what you usually prescribe.

There you have it: TEARS. I will hold for your applause.

Can you do me a favor? If you found any of these resources helpful, share this newsletter with one of our colleagues!

KYLE KLUTE, OD, FAAO Curating optometric wisdom

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