Change your oil. Floss. Don't argue with your wife. Eat your vegetables. Lose 10 pounds. Stand on 17.

By now we can certainly add ask your patients about dry eye to the list of Things That Everyone Knows Make Perfect Sense. And yet, as we visit Las Vegas for this month's Academy meeting, it's guaranteed that someone is out there in the casino right now with a Jack up and a 7 in the hole and thinking … maybe.

Even if you only casually read the publications in ophthalmology, you can probably recite the mantra of the incidence of dry eye and the percentage of patients who still go untreated for the condition. In our case, Dr. Laurie Barber lays out the situation very nicely this month. There are lots of well-paid and hard-working marketing people who spend long days trying to understand why dry eye doesn't warrant more attention in ophthalmology practices. The average ophthalmologist, they'll admit in unguarded moments, simply pulls whatever he was detailed off the shelf in those rare instances when dry eye isn't a presenting complaint, but simply comes up in the course an exam.

After years of hearing the messages and editing the articles, I'm no closer than those poor marketers are to understanding why this is so. Your tires are probably underinflated to boot. I'm not going to harangue you about that either.

Surgeons do surgery; dry eye takes chair time; your priorities are your priorities. But is there another area of your practice where simply asking the right question of the right type of patient is as likely to lead to an undiagnosed ocular condition?  And though the pharmacy shelves are still full of me-too palliative drops, it's no longer true that that's all there is out there.

As it often does, Dr. Abelson's monthly column again offers a concise but comprehensive look at one aspect of dry eye, this time demulcents and how various formulations employ them.

Patients almost certainly don't know the differences in dry eye products. But consider the impact on a patient when you not only find an undiagnosed case of dry eye, but offer an educated recommendation for treatment. I'm guessing that's worth the investment of your time. Have fun in Las Vegas, but please, stand on 17.