Dry Eye

Dr. Scott Schachter offers advice on how to better manage non-symptomatic dry eye patients and encourage them to comply with your treatment plan

Adding this technology can improve your diagnosis and better educate your patients

Contact lens wearers are dropping out for comfort and vision reasons. Contact lenses can be considered a significant cause of these symptoms if they contribute to an unstable tear film or trigger inflammatory reactions.

In order to properly care for our contact lens patients, we have to take responsibility for the changes that are occurring in the tear film under the lens.

Sjögren’s syndrome is underdiagnosed and seriously impacts the ocular surface and quality of life and places the patient at risk for multisystem involvement. Optometry’s role in identification, diagnosis and collaborative long-term management is an important one. Earlier attention to symptoms leading to diagnosis and collaboration with other health professionals will ensure better quality of life for our patients.

The recent announcement that 1-800 Contacts has partnered with online eye exam provider Opternative to offer consumers eye exams online has rocked the optometry community. What can we learn from this announcement, and what should we do?

The Tear Film and Ocular Surface Society’s Meibomian Gland Workshop was tasked to sort through the literature to determine proper terminology of conditions affecting the lid margin. Review the terminology, gland anatomy, gland expression classifications, and treatment strategies.

Did you ever consider that those tools in your dry eye arsenal are also good for acutely sick eyes? I recently had a patient who drove this point home…even to my ophthalmology partner.

Shire plc obtained U.S. Food and Drug Administration (FDA) approval for Xiidra (lifitegrast ophthalmic solution) 5%, a twice-daily eye drop indicated for the treatment of the signs and symptoms of dry eye disease in adult patients.

Blepharitis is an inflammatory condition of the eyelids leading to red, irritated, itchy, and dandruff-like scales that form on the eyelashes.

Ron Melton, OD, FAAO, and Randall Thomas, OD, MPH, FAAO, discussed common practices for treating dry eye, meibomian gland dysfunction (MGD), and blepharitis at the American Optometric Association (AOA) annual meeting. Here are a few medical management pearls from their discussion.

Certainly, one would assume that nothing could be safer than a product designed for use with children. Television commercials with smiling, happy babies covered in frothy bubbles imply the product is harmless. Ubiquitous marketing alone creates a subconscious sense of safety for both doctor and patient.

I was once characterized as an “information parasite” by a colleague. I must admit that I do troll the Internet, particularly Pub Med, for new, intriguing information especially when its related to one of my two favorite ocular phenomenon that are pseudoexfoliation syndrome and the lid margin.

Point-of-care (POC) diagnostic laboratory testing is not common in eye care. This is not due to any lack of clinical need-it is rather the result of a lack of specific tests known to demonstrate diagnostic and/or treatment relevance to the optometrist and a general resistance to adopting new diagnostic technologies.

It’s been a busy week for ophthalmology research and news after both the Association for Research in Vision and Ophthalmology (ARVO) annual meeting in Seattle and the American Society of Cataract and Refractive Surgery (ASCRS) annual meeting in New Orleans.

Dry eye represents a major opportunity with more than 25 million people suffering from the condition in the U.S.,1 and meibomian gland dysfunction (MGD) is thought to be the most common cause of dry eye.2 During a session at SECO, Walt Whitley, OD, MBA, FAAO, shared his tips for making the most of this opportunity in your practice.

Mass media and medical publications have been warning for years that the incidence of diabetes is rising rapidly and predicting a “health catastrophe” in which more than 10 percent of the U.S. population would be living with this disease.

While many eyecare practitioners (ECPs) are just now learning about Demodex infestation of the eyelids and adnexa, the fact is that this condition has been around for as long as mankind. The entomologists Johannsen and Riley from Cornell University first described the species in detail anatomically as early as 1915, but it wasn’t until the 1960s that clinical reports of demodex-related blepharitis began to emerge in the literature.

First acquired during birth from the mother and rapidly thereafter from the surrounding environment, bacteria colonize our conjunctiva and lacrimal systems. It is estimated that more than 200 species of bacteria commonly inhabit the human conjunctival mucosa.

Clark Chang, OD, MSA, MSc, FAAO, recently shared what he considers to be the top-five innovations in eye care during a session at SECO 2016.

Anyone who treats ocular surface disease (OSD) recognizes the important role oral antibiotics play in therapy, especially in patients with meibomian gland dysfunction (MGD). Yet the existing evidence is insufficient to conclude the effectiveness of oral antibiotic therapy, according to a report published in Ophthalmology.

Dr. Scott Schachter discusses using dry eye testing in your practice to identify dry eye patients.

Dry eye disease (DED) has long been thought to be a progressive condition, but a study published in Ophthalmology found that most of its participants who were diagnosed with DED reported no change or some level of improvement.

Nowadays, you are unlikely to read a journal or go to a meeting without hearing the importance of dry eye disease in our practices and for our surgical patients. This was not always the case. I want to introduce you to the Tear Film and Ocular Surface Society (TFOS) and the brains behind it: David Sullivan, PhD, and his family- Rose, Ben, and Amy-who dedicate their lives to help us better understand dry eye disease.

my fellow shared with me that after I left the room, the patient complained about me being a “salesman.” Awestruck, I came away realizing that my best intents and clinical knowledge had been taken the wrong way and that the cost of the best treatment for this patient were overshadowed by the fact that she was going to have an out-of-pocket cost.

A common barrier to many practitioners is the concern that their practice does not have the patient foundation to make investment in the services economically profitable. I assure you that OSD management will profit the patient in many ways that includes clearer, more comfortable vision, enhancing their productivity and overall wellbeing.

Scott Schachter, OD, says there have been a lot of advancements in technology that helps diagnose and treat dry eye, but he says there's still more optometrists can do.

Several weeks ago, I learned of a more recent, somewhat concerning trend. Since the Allergan and Actavis merger, sales reps are now promoting Restasis to primary care doctors, internist and allergists.

I think that most of us would agree that new technologies generally mean better patient outcomes. But those outcomes always come with an added cost.

Leaders in their respective specialties came together at the American Academy of Optometry 2015 meeting in New Orleans to share their latest research in dry eye and glaucoma.