Dry Eye Information

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Dry Eye Dr Morris

Dry Eye


To live our practice’s mission and create a complete, informative and a distinct eye care experience for you, when applicable our exams include a personalized DRY EYE assessment form to deliver better awareness of your own DRY EYE status as well as create clarity around the best course of individualized treatment for your condition.

The information on our forms is based on current studies, knowledge and practice. It is a personalized plan for you to have the best treatment, timely referrals and follow-up care. This DRY EYE assessment form has been modified to deliver some general information online.

Digital Eye Strain is common cause of dry eye.  Read more information on > Digital Eye Strain

Dry Eye Information

The condition name 'DRY EYE' is inherently confusing as many people with 'Dry Eyes' excessively tear.  I like to say that Dry Eye refers more to an imbalance in the tear chemistry. That thin film over your eyes is quite a complex recipe and if that is not produced by your body properly, unstable vision and discomfort and sometimes permanent damage to the ocular tissue can ensue.

For the purposes of mapping a treatment plan and communicating status, I break down DRY EYE into two main forms [1] suspected lipid deficiency [2] suspected aqueous deficiency Note that these can occur concurrently and are listed as ‘suspected’ as they are sometimes hard to distinguish clinically but are treated differently.

Management options for progressing severity for both forms of dry eye will be highlighted below. If not treated, eyes that are chronically dry progress to having DRY EYE DISEASE. This is an inflammatory condition that generally requires prescription drops or oral medications to manage. Advancing Dry Eye Disease is not only uncomfortable but can cause unstable vision and irreparable damage to ocular tissue.

Four recommendations for both forms of Dry Eye [1] Hydration – drink lots of water! [2] Humidity – consider a humidifier in house or work environment for winter [2] VDT use – try to take breaks of 5 min each hour and instill rewetting drops [3] Make-Up – consider hypoallergenic make-up and be sure not to line eye lid margins

How do I know what form of Dry Eye that I have?

The BEST way is an eye exam!  Special dyes and tests are used to identify your type of dry eye (AQUEOUS vs. LIPID Deficiency) and the best treatment course.   If this this is not possible, start with recommendations on LIPID deficiency based dry eye as it is much more common.

Recommendations based on a Lipid Deficiency Dry Eye (MOST common)

The goal of treating lipid deficiency dry eye is to reduce the evaporation of tears from the ocular surface as low moisture causes irritation and damage to the ocular tissue.

Recommendations based on current accepted care protocol.

LEVEL ONE: Use non-preserved rewetting drops designed for Lipid Deficiency Recommended 2-6 times per day
     Option 1 - Hyabak® available through our office and online (filtered bottle)
     Option 2 – non-preserved Optive Fusion or Optive Advanced - available through any pharmacy – individual use

LEVEL TWO: All level ONE recommendations but to an enhanced vigilance also add [1] 5-10min of Bruder Mask (or warm compress) at bedtime, [2] Omega 3’s (ideally of Trigyceride form) 1000mg/day to 2000mg/day (note that Omega 3 is not to be used with Coumadin or other Rx blood thinners)

LEVEL THREE: Prescription topical steroid and/or oral medications will be discussed for inflammatory dry eye disease

Recommendations based on an Aqueous Deficiency Dry Eye

The goal of treating aqueous deficiency dry eye is to dilute the tears so that they are less salty and irritating to the ocular tissue.

Recommendations based on current accepted care protocol.

LEVEL ONE: Use non-preserved rewetting drops designed for Aqueous Deficiency Recommended
     Option 1 - Thealoz® available through our office – filtered bottle
     Option 2 – non-preserved Theratears or non-preserved HypoTears – available through any pharmacy - individual use

LEVEL TWO: All level ONE recommendations but to an enhanced vigilance also add a non-preserved eye gel at bedtime -
Recommended: Ocunox available at our office or select pharmacies

LEVEL THREE: Prescription topical steroid treatment will be discussed for inflammatory dry eye disease

Dr Morris' Vision Blog

  • Eye Make-Up Trend and Stys
    Aug 2017 | There is a make-up trend that giving me business... in a bad way.  The popular look to paint lid margins is giving young women sore, irritated eyes and eye lids.  In the image below you can see the trend to paint lid margin (the strip of lid tissue between the lashes and the eye ball).  The problem is that there are openings to small glands (meibomian) on this strip that become clogged with makeup causing lid inflammation (sore), stys (infections) and irritated eyes (dry eye).  I know that an old Optometrist is not going to change teenagers' make-up styles!... but just be aware to [1] not use if you can [2] try to make sure that this area is cleaned properly after use [3] see an Optometrist if you have any of the symptoms listed above asap!      Dr.j   Studioeyecare.com


  • Blinding Eye Tattoos
    July 2017 |  Re-posted information > credit to author below   Dr.j   StudioEyeCare.com

    Getting an Eye Tattoo Can Blind You

    You may have heard about a new frontier in tattooing: eyeball tattoos. A quick internet search will turn up dozens of photos (some real, some fake) of people with black, blue or multi-colored eyes. But just because some people have gotten away with it, don’t assume it’s safe—or a good idea. Your ophthalmologist says the risks aren’t worth it.

    Paul Freund, MD, and Mark Greve, MD, from the University of Alberta in Canada recently reported on a tragic case. A 24-year-old man underwent an eyeball tattoo procedure and experienced a sudden, painful loss of vision while the tattoo artist was injecting ink into the first eye.

    For eye tattoos, the tattooist injects ink just under the surface of the conjunctiva, so it colors the sclera – the white part of the eye. In this case, the ink had been injected too deep, into the vitreous humor in the middle of the eye.

    The patient sought treatment three days after the tattoo procedure. Drs. Freund and Greve removed the vitreous and the lens of the eye. The lens had been damaged by the needle during the tattoo procedure. The doctors discovered that the mixture of vitreous and tattoo ink was contaminated with bacteria. Two surgeries and multiple procedures to deliver antibiotics were done to try to control the infection and complications from the tattoo procedure.

    Eventually, the entire eye had to be removed because the young man was in so much pain. After the eye was removed, the retina and inside of the eye were found to be stained with ink. There was also cell loss on the corneal epithelium—which keeps the cornea healthy. Even if the eye had been saved, the patient would have had serious vision problems.

    Eyeball tattoos have serious risks and have not been medically or scientifically studied. Because they are not a traditional part of tattooing, artists who are doing eyeball tattoos may not be properly trained. Risks of eyeball tattoos include:

    Decreased vision or complete blindness
    Infection from the injection or ink
    Potential loss of the eye
    Sensitivity to light
    Feeling like something is in your eye


    Written by: Dan Gudgel
    Reviewed by: Paul R Freund, MD
  • First Sunglasses from Canada?
    July 2017 | My daughter had a recent visit to the Ontario Science Centre in Toronto and found this interesting trivia for me...  The first sunglasses / snow goggles to protect eyes from damaging UV rays from the sun came from Canadian Inuit...  https://en.wikipedia.org/wiki/Snow_goggles    Happy 150 Canada   Dr.j   Studioeyecare.com

  • U2's Bono and Glaucoma
    July 2017 | In honor of U2 playing in Dublin this weekend I am pasting great 2015 information from the American Academy of Ophthalmology...  (Although in Canada Optometrists treat glaucoma too!)

    4 Things You can Learn About Glaucoma from Bono
    Written by: Linda Apeles
     
     Jan. 09, 2015
    One of the biggest glaucoma-related news stories of 2014 was Bono's revelation that he has the condition. While his comments about it have been brief, there are important tips the public can learn about glaucoma following the rockstar's announcement.

    1. Having glaucoma doesn't mean you have to go blind.

    When Bono announced he had glaucoma, he revealed that he has had the condition for many years. He serves as a great example of how many people with glaucoma can keep their sight and still lead very active lives if treated early enough. In fact, the probability of blindness due to glaucoma has decreased by nearly half since 1980. Researchers believe that advances in diagnosis and therapy are likely causes for the decrease.

    2. Glaucoma treatments work!

    It's no wonder the public never suspected that Bono had an eye disease – that's how effective glaucoma treatments, such as medicated eye drops and minimally invasive surgery, can be. "I have good treatments and I am going to be fine," Bono said at the time of the announcement.

    3. The earlier you get diagnosed, the better.

    The key to preventing vision loss from glaucoma is early diagnosis. While the details of his treatment have not been shared with the public, 54 year-old Bono said he has had the disease for over 20 years, so it's likely he was diagnosed at an early stage. Blindness from glaucoma can often be prevented with early treatment.

    4. Glaucoma may have no obvious symptoms in its early stages.

    As you get older, it is especially important to have regular medical eye exams. The only sure way to diagnose glaucoma is with a complete eye exam. A screening that only checks eye pressure is not enough to find glaucoma. The American Academy of Ophthalmology recommends that all adults (even if they have no signs of symptoms of eye problems) get a baseline eye examination at least by age 40, the time when early signs of disease or changes in vision may occur. A baseline exam can help identify signs of eye disease at an early stage when many treatments can have the greatest impact on preserving vision. Of course, if you have any problems with your vision or eye comfort before age 40, don't wait; make an appointment with an ophthalmologist right away.