Dry Eye

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.

Over the last few years, there have been several advancements in ocular surface disease diagnostic and treatment technology. Not sure which ones are right for your practice? Milton Hom, OD, FAAO, and Ben Gaddie, OD, FAAO, share their advice.

While there are a myriad of associated concerns due to ocular surface inflammation, a few eyelash-related complications of note are trichiasis, acquired distachiasis, local madarosis, and poliosis. Each of these is in some way connected to dry eye.

Check out our interview with Dr. Leslie O'Dell.

The lipid layer prevents evaporation of aqueous tears and prevents drying. Lipid deficiency due to meibomian gland dysfunction (MGD) is the most common cause of symptoms associated with dry eye disease.

Focusing on dry eye management is a great practice builder, but is not without challenges. These challenges lie in making the proper diagnosis, implementing new technology, properly training staff, developing an effective treatment plan and the time it takes to properly educate patients.

Warm compresses (WCs) are commonly recommended as supplementary therapy for MGD as well as a number of other conditions of the eyelid. While the core therapy for MGD is to remove obstruction, which requires an in-office procedure, the therapeutic goal of adjunctive WC use is to heat the eyelids to help soften and partially melt any remaining material obstructing the glands.

How often are you using punctal plugs in your practice? If your answer is similar to mine, it’s “not as often as I used to.” Classically, punctal plugs were a go-to treatment for dry eye patients. If artificial tears failed to yield relief, plugs were a logical next choice.

When it comes to optometry, innovation, and pushing for better care for your patients, where are you? We have met practitioners on all sides of the spectrum in many areas of optometry.

You diagnosed a patient and developed a treatment plan to improve the ocular surface. This is only the first (and often the easiest) step. The more challenging aspect is assuring that the patient follows through with the plan.

Liverpool, UK-The British Contact Lens Association meeting features several panel discussion on a theme. Topics included a look into the future for managing myopia and contact lens discomfort. In addition, improve the success of your multifocal contact lens fits with expert suggestions.

If patients are coming to us for a comprehensive examination, and vision begins at the tear film, why aren’t we routinely and objectively evaluating this critical layer?

Recently, I was stopped in my tracks when I overheard a colleague comment that she was unaware that topically administered cyclosporine (Restasis, Allergan) increases goblet cell density.

Months after being cleared, the Ebola virus was found in the ocular fluid of a survivor, according to a recent report from The New England Journal of Medicine.

I can assure you that as consumers, we are all looking for the first-class treatment. When it comes to recommendations for your patients, do you offer them best-in-class treatments, or do you hold back?

Researchers at the Cullen Eye Institute at Baylor College of Medicine have developed nanowafer technology to delivery ocular drugs, an alternative to inefficient eye drops.

What does it mean to have a premium practice? What does premium customer service deliver? These are common questions posed to medical practices and businesses as they seek out advice on how to thrive in today’s ever-competitive environment.

Our understanding of dry eye and ocular surface disease is expanding at exponential rates. This is allowing us to more accurately diagnose specific forms of dry eye and determine their root causes.

There are lots of parameters to choose from when looking for dry eye disease.

I get to spend a lot of time in OD practices talking about dry eye disease (DED). Many of these practices already do a lot for their dry eye patients, but many seem to fall into one camp or the other.

The mainstay of our therapy today consists of artificial tear preparations, surfactant lid cleansers, warm compresses for the eyelids, and the occasional antibiotic solution or ointment-this is the exact same therapy that was in vogue for treating OSD 25 years ago!

Midway through my education at University of California in San Diego, I was meeting with guidance counselors about what type of medical field I might like, and I hadn’t decided.

Since I read Dr. Robert Latkany’s study on nocturnal lagophthalmos in 2006,1 I am perpetually on the lookout for it, especially in the patients who present with dry eye symptoms. Sometimes it’s easy to spot lagophthalmos-sometimes, if you ask your patient about lid closure, they will report to you that they know about their incomplete lid closure, mostly when they sleep.

Are you providing the highest level of care for your dry eye patients? Testing with all the latest methods, osmolarity, MMP-9, TearScience’s LipiView, to name a few? Treating will a full armamentarium, specialized artificial tears, hot compresses, cyclosporine, steroids, punctual plugs, and more?

In my practice, we screen patients age 25 and over. This is a relatively arbitrary number, but I wanted to skew younger. We often think of dry eye disease as being an older person’s disease. There are a number of reasons why I decided to look at younger patients.

Before recommending laser vision correction for your patient, there are a number of factors you as an eyecare practitioner must consider.

In lieu of improving diagnostic tests, symptoms have been shown to be more repeatable than clinical findings.

It’s sort of funny-one of my childhood recollections is a discussion with my mother (the PhD in organic chemistry) regarding the virtues of Phisohex (hexaclorrphene, Septisol), a facial cleaner. “Phisohex is pH balanced,” she said, “so it is better for your skin.” At the time, the pH comment wasn’t important to me. What was important was that my mother said I should use it, and therefore the characteristic 1970s green bottle of Phisohex was standard at each sink in our home.