Optometry Practice Growth Through Ocular Surface Care, With Amniotic Membranes

Demographic and industry trends are widening the eye care gap and creating a practice growth opportunity for optometrists. As Americans age, demand rises for ocular surface disease (OSD) and other age-associated conditions — in 2025, the Dry Eye Syndrome treatment market hit $6.7 billion and is projected to grow to $11.1 billion by 2033. Additionally, the ophthalmology workforce is projected to decrease. This positions independent eye care professionals to expand medically necessary ocular surface services that improve clinical outcomes and support sustainable practice growth.

PECAA is working with industry partners to help optometrists expand medical optometry services, including in-office amniotic membrane therapy. The PECAA K-DISK dehydrated amniotic membrane is a convenient and easy to handle OSD and corneal healing treatment option that can be placed under a Collagen Shield or Bandage Contact Lens, providing a shelf-stable solution alongside BioTissue’s longstanding cryopreserved Prokera.

Anterior Segment Healing With Amniotic Membrane Therapy

Clinical Indications (OSD/Dry Eye/PED) and Product Selection (Dehydrated vs. Cryopreserved)

Amniotic membranes support corneal epithelial healing for persistent epithelial defects (PEDs) and ocular surface inflammation, including moderate-to-severe dry eye disease. Many practices keep both dehydrated and cryopreserved options available; dehydrated membranes can be a cost-conscious entry point with straightforward in-office handling.

Clinically, both membrane types deliver rapid symptom relief for ocular surface pain and refractory dry eye signs that do not improve with first-line therapy (e.g., persistent corneal staining or SPK). Product selection is often based on severity, inventory and workflow preference.

Underused Dry Eye Treatments In Optometry

Only a small percentage of independent optometrists perform in-office amniotic membrane placement, which leaves many practices without a high-value tool for medical optometry and medically necessary revenue. Many clinicians start with dehydrated membranes because handling and workflow feel simpler, then add a cryopreserved membrane for more advanced ocular surface disease.

Billing, Documentation And Medical Necessity

Membranes may help beyond 'severe’ cases, including moderate dry eye disease, when other treatments fall short. The service is billable under CPT 65778 (amniotic membrane placement without sutures). Because the code has a zero-day global period, repeat treatment may be covered when medically necessary and clearly documented (diagnosis, findings, and prior treatment response). Discuss expected out-of-pocket cost up front.

Clinical Outcomes: Dry Eye Relief And Faster Ocular Surface Healing

Stepwise Dry Eye Disease Protocol: Screening, Escalation And When To Place A Membrane

A dehydrated membrane complements a cryopreserved membrane as an in-office option to speed corneal epithelial healing for dry eye disease and Superficial Punctate Keratitis (SPK). A practical stepwise protocol:  

• Screen at comprehensive exams
• Recommend tears and follow-up when TBUT (Tear Break-Up Time) is low
• Escalate to topical steroids when corneal staining or symptoms persist
• Then consider amniotic membrane therapy when response remains inadequate (confirm coverage and cost first)

Use dehydrated membranes for grade 1–2 SPK (12 mm or 16 mm) and reserve cryopreserved for more advanced OSD.

Expanding The Candidate Pool 

Patients with dry eye report that they experience restrictions in activities and social life, resulting in up to 34% impairment in daily activities — consider expanding membrane treatment beyond only the most severe dry eye presentations to reach this segment. In moderate Dry Eye Disease (DED) with persistent corneal staining/SPK — especially in ocular rosacea, MGD, or when corneal sensitivity suggests early neurotrophic risk — amniotic membrane therapy can support re-epithelialization, reduce ocular surface inflammation and help stabilize tear-film homeostasis.

Clinical Workflow For In-Office Amniotic Membrane Placement 

If prior authorization is needed for other components of the plan, some practices place amniotic membranes to start relief while coverage is confirmed. Cryopreserved amniotic membrane manufacturers may provide an under-desk freezer to support storage and a smoother workflow. Before placement, confirm benefits and estimate out-of-pocket cost, obtain consent, then rinse/soak in saline per protocol and set expectations for the 3–5 days the membrane is in place.

Demand for ocular surface disease care is rising, creating an opportunity for optometrists to expand medically necessary dry eye disease services. Amniotic membranes — dehydrated options for straightforward adoption and cryopreserved for more advanced OSD — can fit into a stepwise protocol when signs persist despite first-line therapy. Strong documentation and appropriate CPT 65778 use, plus upfront cost counseling, help practices implement in-office amniotic membrane placement with confidence. For implementation support, clinical resources and peer best practices, consider attending 90 Days To Dry Eye, Presented By PECAA or connect with PECAA to help your team build a consistent ocular surface workflow.