The rise of standalone dry eye clinics is no longer a fringe movement. Insight speaks to the people behind Australian practices leading the charge, each offering a blueprint for how innovation, patient-centred care and business savvy can co-exist.
The moment South Australian optometrist Ms Jennifer Rayner lifted the shutters on her new dedicated dry eye clinic nine years ago, she opened a portal into what felt like a solitary professional existence.
For the first two-and-a-half years, it was a grind. She ran the clinic entirely on her own, including full clinical responsibility, while also burdened by the self-doubt that came with being a pioneer in this space.
Rayner’s path to establishing Alleve Eye Clinic in Adelaide, thought to be Australia’s first stand-alone dry eye clinic, was shaped by decades of experience in ophthalmology and optometry. Beginning her career as an ophthalmic nurse in hospital and private settings, she developed a familiarity with ocular surface disease.
”I saw the impact dry eye was having on patients – and at the time there was little care or understanding of the disease, so patients were told to use hot flannels, baby shampoo, lots of drops and learn to live with it,” she recalls.
Rayner later qualified as an optometrist in 2003 and briefly ran an independent practice. That didn’t work out, but with the emergence of new research and treatment options in dry eye in 2016, she launched Alleve and began quietly carving out a niche that others would soon follow, including another local business that’s about to take its dry eye care model global.
“Hardly anyone was doing dry eye at the time, the awareness from patients and practitioners that we could treat this wasn’t there, and neither was the referral base,” she says. “One of our leading corneal specialists actually rang me and wished me luck as I was facing a tough road. I certainly saw a unique space for myself, for my own passion to be able to help patients.”
The clinic’s model – to only focus on clinical dry eye care – was a deliberate choice: by avoiding refractions or retail eyewear, Rayner could position herself as a trusted referral partner rather than a competitor.
Dedicated dry eye clinics like Alleve have emerged in Australia as both a response to rising prevalence and an acknowledgment that managing chronic ocular surface disease requires time, expertise, specialised equipment, and, increasingly, collaborative care with fields like dietetics, psychology and pain management.
For the early adopters in this space, including Mr Jason Holland’s Oculuxe Clinic by The Eye Health Centre in Brisbane and, more recently, Ms Liz Barrett’s sprawling Dry Eye Solution, it’s a story that mirrors the evolution of dry eye management itself: from a misunderstood and often dismissed condition to a recognised clinical area that demands intensive care.
From those early one- to two-day weeks, Alleve Eye Clinic has grown into a thriving practice operating five days a week, with one evening session.
“Last year we were booked out nearly three months ahead for new patients,” Rayner says.
“People underestimate the impact dry eye has on patient’s mental and emotional health. It is an inflammatory, progressive disease which left untreated, can lead to social isolation, poor work productivity and depression often associated with chronic diseases. Patients are so grateful to finally have someone acknowledge their pain, and now be able to do something about it.”
Expansion is now on the horizon, with plans for more treatment rooms and additional practitioners.
While Rayner may consider her clinic more of a slow burn in those early days, the story contrasts with that of Barrett’s who, in just three years, has scaled her Dry Eye Solution concept into seven clinics across New South Wales and one in Melbourne.
In 2026, clinics are opening in Brisbane, Canberra, as well as internationally in Dublin and London. That’s 12 clinics in total by the end of next year.
When she opened her first Dry Eye Solution clinic in 2022, the industry thought Barrett was “mad”, but now her vision looks less like a gamble and more like a blueprint.
The model works because the demand, the prevalence, is already there. Patients often arrive after years of frustration, misdiagnosis, or dismissal. One woman visited 20 optometrists before finding her.
“She cried on the phone when I first spoke to her, and then cried again when she came in. It was the relief – at being understood and heard,” Barrett recalls. “She’d been told there was nothing wrong, but within minutes on the slit lamp we discovered Demodex infestation, ocular rosacea and several other issues.
“This happens a lot, she’s not the only one.”
It’s a story all too familiar to Holland too. He’s been working at the forefront of dry eye for 23 years now. His clinic, established in 2006 as a spin-off from The Eye Health Centre, was designed as a medical eye clinic, managing chronic conditions rather than selling glasses.
Today, about 60% of his caseload is dry eye, with the remainder focused on glaucoma and long-term eye disease management.
This is alongside his role as president of the Dry Eye Society, founded by a group of Queensland optometrists who have a focus not only on the clinical element of dry eye, but the business side too.
Early on, he says dry eye was poorly recognised: ophthalmologists often avoided it, and most optometrists were left recommending lubricants. The release of the TFOS DEWS II report in 2017 shifted perceptions, validating dry eye as a significant condition with measurable quality-of-life impacts.
“I didn’t have a clear business model when I started,” he says. “I just knew there was a group of patients that had nowhere to go to be treated, so that’s why I founded the clinic.”
Building viable businesses
Striking out and hinging a business on one aspect of eyecare is a bold move. Rayner, Barrett and Holland all stress that building a viable funding model is critical.
Rayner likens it to the approach of ophthalmologists and other specialists. Patients at Alleve pay private fees, which have steadily increased to reflect her expertise, with some minor Medicare rebates.
“But there is no Medicare or health fund remuneration for things like diagnostic imaging, meibography, IPL and red or blue light therapy. Patients understand this and are prepared to pay out-of-pocket for relief of their symptoms,” she says.
Holland stresses it’s a “chair-heavy” condition, with multiple-session therapies such as intense pulsed light (IPL), Rexon-Eye, and low-level light therapy (LLLT) demanding significant practitioner time.
“If you’re going to do this work, you need a business model that charges appropriately –otherwise you’ll quickly fall into a hole,” he says.
“To do it well, you also must allow sufficient time for diagnostics too, because dry eye is a complex condition. You can’t take a broad-brush approach. I’ve been asked many times to write treatment protocols, but I’ve never done it, because it’s such a challenging condition. Every patient requires a slightly different plan.”
Holland urges clinics to offer “tiered” treatment options, noting that while the ideal treatment might not always be affordable, offering alternatives allows patients to trial other options and, in their own minds, justify the sometimes “sizable” costs for more advanced treatments.
Appropriate billing has been part of Barrett’s success too, but she’s introduced a social element.
At Dry Eye Solution, patients are charged a consultation fee which is for diagnostics and creating a tailored treatment plan. Each treatment is charged separately, which includes holistic care and guidance.
Barrett has also built in a community care program, realising advanced dry eye care is not accessible to all right now.
“If someone can’t afford treatment, they go on a waitlist, so that if there’s a cancellation or spare chair time, we call them in and treat them for free. It’s important to us that all patients are given a chance,” she says.
Finding patients, building trust
Practices can pay all the money in the world for sophisticated social media marketing and SEO optimisation, but letting the outcomes speak for themselves, patient-by-patient, has been the sharpest marketing strategy – whether it’s intentional or not.
For Rayner, this word-of-mouth marketing has also built a strong and trustful referral network. About half of her patients self-refer, with the remainder funnelled via optometrists, ophthalmologists, and other health specialists.
“One of the key marketing tools we have is letters back to GPs. They’re busy, so we make sure they’re kept in the loop. It builds trust and relationships,” she says.
Barrett says at first only 8-12% of patients came via referral. Now it’s closer to 40%.
“Ophthalmologists were the most cautious, but once they saw the results things really started to snowball. Still, that means sadly about 60% of our patients self-refer. Ideally, it should be 10%, with the rest coming through the eyecare system.”
She feels there’s still a long way to go for the industry to adequately care for dry eye sufferers. Patients often arrive at her clinics after years of frustration, misdiagnosis, or dismissal.
“Some people look at IPL and think, ‘we could make more money from this,’ but dry eye disease demands holistic care, advanced diagnostics, and highly specialised training.
“Without this depth of expertise, patient outcomes will fall short. We have built the dedicated infrastructure that dry eye care truly requires – ensuring patients who are referred to us receive the best possible specialised care.
“Our KPI is simply optometrist and patient happiness. I want our clinics to be seen as an extension of the referring optometrist or specialist. We don’t sell glasses or contact lenses – we just treat dry eye. That way, others can refer to us with confidence, knowing we’ll send their patients back with an improved ocular surface and quality of life.”
Barriers remain for general optometrists considering advanced dry eye care. Appointment time allocation can strain resources, plus there can be significant equipment outlay and the constant need to learn and upskill.
Yet Rayner believes opportunities exist for practices to begin offering care without major investments. Many practices across the country have established a dry eye clinic within their existing practice, and she’s impressed with the quality of referrals coming across her desk nowadays.
“Things like IPL units are big investments and you have to do the maths around how many people you’ll see to get an ROI, but the trouble is you won’t see a return until you actually start seeing people.
“Not everyone needs an IPL – it’s just one tool in the box. If you have meibomian gland imaging, you can still offer other treatments like cyclosporin, steroids and doxycycline and refer when necessary.”
Treatment: Tools and philosophy
Across the clinics interviewed for this article, there’s a shared philosophy of the need for time, tailored interventions, and holistic care, but treatment mixes reflect different influences and ways of thinking.
At Alleve, Rayner offers pharmacological therapies, IPL, red and blue LLLT, punctal plugs, oral tetracycline and azithromycin. She is also a strong advocate for manuka honey drops, although everyone might not agree.
“They’re a mainstay of our practice. Utilising manuka honey is key to managing the inflammatory response from expressing meibum in our clinic. We can go from some very hardened oil and within two or three sessions, we’ve got fabulous oil function. Without oil, your tears are going to evaporate, and then all those other treatments – IPL – may not be as effective.”
Lifestyle factors – especially diet, gut health, stress and sleep – are also central.
“Treating dry eye takes time – and an individual approach. I’m a public awareness committee member for the TFOS Lifestyle Report – the workshops really brought home the need for an holistic approach – the role that good gut health, stress, anxiety and depression management, good sleep patterns, awareness of screen use and even cosmetics play in diagnosing and managing dry eye disease,” Rayner says.
“You can’t just use one tool and clinical approach for everyone and expect it to work, when there are so many factors that contribute to the ocular surface and tear film health.”
Holland believes successful dry eye clinics will need to embrace multidisciplinary links with nutritionists, GPs, pain specialists, and even mental health practitioners as dry eye often overlaps with systemic disease, and wellbeing.
“In 2017, neurosensory abnormalities was added to the DEWS II definition of dry eye. We now know there are patients whose eyes look clinically healthy, yet they continue to experience dryness symptoms even after the dry eye itself has been addressed. There are now several drugs in development aimed at this neuropathic pain pathway, exploring whether we can modify or interrupt the signals coming from the eye.”
Similarly, a central part of Dry Eye Solution’s approach is recognising that dry eye isn’t just about the eyes. Diet, stress and mental health all play a role, which means working closely with psychologists.
The clinics now have an in-house GP, making prescriptions such as Ivermectin Plus cream for Demodex – developed by US ophthalmologist Dr Rolando Toyos – easier to access.
“An optometrist can’t prescribe it, but our GP can – often via telehealth. We’re the only clinic in Australia with access to that cream, and it’s incredibly effective,” Barrett says.
Arguably the most crucial ingredient in Dry Eye Solution’s success is a partnership with Dr Toyos who pioneered IPL for dry eye. He jumps on a video conference call with Barrett’s head optometry team to discuss cases and new evidence each Tuesday.
“We incorporate Dr Toyos’ recommendations, including equipment, into our model – combining his expertise with our own to set the benchmark for dry eye treatment,” she says.
That includes the OCULUS Keratograph K5 for diagnostics, offering consistency across locations. IPL with the Lumenis OptiLight remains a cornerstone treatment, but Barrett is quick to note not all devices or techniques are equal.
She’s particularly excited by innovations on the horizon, including microneedling, CO2 laser and platelet-rich plasma (PRP) drops, though she notes these still await TGA approval.
Holland is excited about a “massive pipeline” of biologics, devices, and dietary interventions on the horizon.
In the new TFOS DEWS III report, he notes the final section discusses future therapies comprehensively.
“There are a lot of things in the pipeline – particularly biologics with four different blood-based drop options, all developed differently,” he says.
New device-based therapies are emerging, such as Tixel i in the US, which delivers precise pulses of heat via tiny, pyramid-shaped titanium pins to the eyelid margins, and radiofrequency treatment, which is now in Australia with the EnVision device and Lumenis also launching a device.
The future of dedicated clinics
There’s agreement that dry eye care is maturing into a recognised subspecialty that requires more than just looking at the patient’s eyes.
Often their ocular surface is the manifestation of something bigger.
Looking ahead, Holland sees potential in several areas, including a ‘day-spa’ like experience and peri-orbital aesthetic therapies – an area he’s already dabbling in with the Lumenis OptiLight.
“When designing Oculuxe, The Eye Health Centre deliberately went for a day-spa look,” he says.
“With IPL, while the primary goal is to improve eye health, these treatments often deliver aesthetic benefits too, which helps some patients justify the cost. But you need to be clear on your intent: doing IPL for cosmetic benefits is not the same as doing IPL for dry eye.”
Rayner anticipates the proliferation of dedicated dry eye clinics in Australia, alongside more specialised optometry practices in myopia, glaucoma, and other clinical areas.
“Optometrists are well placed to deliver exceptional dry eye care. We have the knowledge and therapeutic endorsement to diagnose and treat ocular surface disease,” she says.
“Optometry is naturally evolving … people are drifting towards a more clinical practice versus a refraction practice model as opposed to the hybrid we know.”
Barrett has a similar take, along with a reimagined patient experience.
“It’ll be holistic. Like our Double Bay site, designed like a medi-spa. A GP, ophthalmologist, optometrist and even access to psychologists. Treatments that range from IPL to massage to ice baths. A space where patients feel cared for in every aspect.”
“Our Melbourne clinic already offers all of this. The facility where this is located also enables access to a dietitian, pain management specialist, hyperbaric chamber, infra-red sauna, gym and personal trainers, IV infusions, women’s health clinic, holistic café, and a cryo chamber – as well as a large room for meetings, training and presentations for patients and ECPs.”
For these clinicians, the future of dry eye treatment is not only about expanding clinics but shifting the mindset of eyecare itself.
“It’s about recognising this is a subspecialty of both optometry and ophthalmology,” Barrett stresses.
“Patients deserve time, expertise, and compassion. If we can keep building that, we’ll change lives.”
More reading
Rohto Dry Aid ‘redefining symptom relief in the digital age’
Optometrists going back to the future on dry eye disease
The Save Sight Institute Dry Eye Registry: Building the ‘big’ picture of dry eye
