Optometrists see the opportunity in building a dry eye clinic but often get stuck on how to get started. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down once again with Dr. Trevor Miranda to explore the business of building a successful dry eye clinic, from creating treatment protocols and developing your team to improving patient conversion and generating a meaningful new revenue stream.

Dr. Miranda shares how dry eye has grown to the point where his practices now generate more revenue from dry eye products and services than from contact lenses. He breaks down his LION approach — Lids, Inflammation, Obstruction and Nutrition — and explains why having a structured clinical philosophy makes it easier to develop treatment plans, train staff and create consistency across a practice. Just as importantly, Trevor explains why doctors should not be doing everything themselves. By developing highly trained ocular hygienists, his clinics are able to run dry eye treatments alongside primary eye care, creating greater efficiency while giving patients more education and support.

The conversation also dives into the systems behind a thriving dry eye business: creating a dedicated dry eye assessment pathway, clearly recommending the optimal treatment rather than simply the cheapest option, training team members to confidently discuss treatment, establishing a dry eye champion, setting revenue targets and tracking KPIs. Trevor explains why implementation — not simply acquiring knowledge — is what separates practices that dabble in dry eye from those that truly build a successful specialty service.

Finally, Harbir and Trevor discuss the Dry Eye Summit, which brings together doctors, staff, industry partners and dry eye leaders for focused education, hands-on exposure to new technology and practical business strategies. The Summit also offers dedicated training for ocular hygienists and an advanced procedures lab, making it an opportunity to elevate not only the doctor’s knowledge but the capabilities of the entire dry eye team. And because the Dry Eye Summit is now held only once every two years, this year's meeting represents a valuable opportunity for practices looking to take their dry eye services to the next level.

• Build systems, not just a collection of technology. Successful dry eye clinics need structured treatment protocols, patient pathways and clearly defined roles for the doctor and team.
• Empower an ocular hygienist or dry eye champion. Properly trained team members can educate patients, coordinate treatment, perform delegated services and help the dry eye clinic operate alongside primary eye care.
• Treat dry eye like a real business unit. Set revenue goals, track referrals and KPIs, hold regular team meetings and continue investing in education and training.
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Dr. Trevor Miranda is the owner of Cowichan Eyecare in British Columbia, operating five clinics with a team of 12 doctors. He has built two dedicated dry eye centres and a team of ocular hygienists, and is one of the founders of the Dry Eye Summit alongside Dr. Richard Maharaj and Dr. Jeff Goodhew.

The Dry Eye Summit takes place November 21–22, 2026, with an Advanced Procedures Lab on November 20. The ocular hygienist course takes place November 21.

Learn more at mydryeye.ca.

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