Seeing Eye To Eye

My Dry Eye Story

Written By: James Rieger | February 13, 2012

I am an Optometrist with Pepose Vision Institute and have had a dry eye condition for over a decade.  I have tried everything from over the counter drops and gels, prescription eye drops, warm towels and lid washes, to oral medications and supplements. All with limited success. At times my eyes are red, tired, teary, itch and this sometimes affects my vision. The worst times for me are in the Spring and Fall with allergies and in the winter with the cool dry weather. The newest testing and treatment equipment available in the United States is the Lipiview and Lipiflow system. In fact, we have one of the few systems in the US! The treatment was very simple, 12 minutes for each eye with an eye cup that is heated and massages the eyelid glands. Not uncomfortable at all. My eyes followed the reported study results with maximal effect in four weeks. I have noticed much more comfort, whiter eyes and I use drops much less then I normally would for this time of the year. The study suggests the treatment should be effective for 9 to 15 months and at that time it can be repeated.

I am a happy camper and know that many people with lipid layer deficiency, a type of dry eye, would also benefit with this new technology.  I am not completely drop-free but my eyes are clearer and more comfortable. Call our office to schedule your dry eye evaluation today to see if you would also be a good candidate for this treatment. Dr. Redfern recently posted a blog that explains the LipiFlow and LipiView systems. The video is available here: Breakthrough Treatment for Dry Eyes – LipiFlow

Breakthrough Treatment for Dry Eyes – LipiFlow

Written By: Jennifer Redfern | December 5, 2011

How Dry I Am!

Written By: Jay Pepose | September 2, 2011

Do you know of someone who has gritty, sandy, irritated eyes, with fluctuating vision that gets worse as the day goes on? If this sounds familiar, then you or a loved one may be suffering from dry eyes—one of the most prevalent ocular conditions.
Dry eyes are ten times more common in women than men, and are more common following the onset of menopause. It can be made worse by taking hormone replacement therapy, as it is the male rather than female hormones that support tear production by the lacrimal gland above the upper lid. Patients with both dry eye and dry mouth may have a very severe form called Sjögren’s syndrome. Dry eye can also also be exacerbated by common medications, such as diuretics, antihistamines and anti-depressants.
At Pepose Vision Institute, we are involved in clinical research to better diagnose dry eye syndromes and monitor treatment. This includes evaluating new devices that measure the lipid layer of the tears and the tear osmolarity. The first step towards relief is always the correct diagnosis, as dry eye can mimic some of the signs of allergy or other conditions and be easily missed.
If you suffer from dry eyes, what can be done? There are 3 steps to therapy. The first is the use of artificial tear supplements and night time gels. There are differences in artificial tears, regarding their thickness, viscosity and components, and so do not give up if you have tried one product. The second step is a prescription drop called Restasis that actually increases tear production. It also has an anti-inflammatory effect, which can be supplemented with short time use of other topical medications. Oral omega-3 supplements using fish oil and flaxseed also help.
However, one of the most immediate and effective treatment for dry eye is the one least utilized. Punctal plugs are microscopic (about the size of the tip of a ball point pen) and are molded to exactly fit into the tiny holes in the lids that drain away the tears. This is not where the tears come from, but rather how they drain away. The tears go down these 4 ducts, one in each lid, into the bony tissue and then to the back of our throat. We actually are drinking our tears all day long, which is why some people can taste their eye medicines! Punctal plugs can be painlessly placed in the office, not the operating room, with just the use of numbing drops. You do not feel the plugs and there is no maintenance required. They work instantly, just like putting a stopper in the drain when the faucet is dripping.
If you have chronically red, irritated eyes, with fluctuating vision and feel eye strain by the end of the day, please consider making an appointment with Pepose Vision Institute to have an evaluation for dry eyes and other conditions that could affect your sight. We are here to help you protect the most precious of our 5 senses.

I talked to 94.1 KPVR about Williams and Sjögren’s, click the play button below to hear the audio:

Treatments for Dry Eye Conditions

Written By: James Rieger | May 16, 2011

Pepose Vision Institute is not just a premier destination for LASIK vision correction and other types of refractive surgery. We also offer a full range of primary eye care services. These include annual eye health examinations, contact lenses (including specialty contact lens fittings), and treatment of ocular disease such as cataracts, glaucoma, macular degeneration, and dry eyes.

Whether you suffer from cataracts or dry eye syndrome or you simply desire to maintain your ocular health, our eye care clinics provide the most advanced care available. We continually invest in the most state-of-the-art diagnostic equipment to provide unsurpassed care for our patients.

Dry Eye Syndrome

Dry eye disease, also known as keratoconjunctivitis sicca, is a condition that results in the inflammation of the eye and the tear-producing glands. This inflammation decreases the eye’s ability to produce normal tears that protect the eye from irritation and keep it moisturized and lubricated. The tear film is composed of three intermingling layers:

• Oily layer – outermost layer prevents evaporation
• Watery layer – middle layer moisturizes the eye
• Mucous layer – inner layer allows adherence between the eye and the watery layer

A disruption of the function of any one or more of these layers can cause dry eye symptoms.

It’s estimated that 20 percent of Americans, women more often than men, suffer from dry eyes, which can cause a range of uncomfortable symptoms. Dry eyes are characterized by a scratchy, gritty, or burning feeling, redness, stringy mucus, and increased sensitivity to light. Wind, dry air, and other environmental factors are but a few of the causes.

Surprisingly, dry eye syndrome can also cause excessive watering eyes due to the tears lacking the proper balance of mucous, water, and oil to coat the eyes properly. Chronic dry eyes can lead to damage of the eye’s surface, an increased risk of eye infections, and eventually, the inability to produce tears. Left untreated, severe forms of dry eyes can even damage your vision. At our St. Louis, Missouri centers, we can help patients determine potential causes of their dry eye syndrome and identify appropriate dry eyes treatments.

Causes of Dry Eyes

Some common causes of dry eyes include:

• Aging
• Hormonal changes, such as pregnancy or menopause
• Autoimmune diseases such as lupus, rheumatoid arthritis, and Sjogren’s Syndrome
• Smoking
• Environmental factors (such as smoke, dry or windy weather, heaters, air conditioners, dust, contact lens wear, prolonged computer use)
• Allergies
• Contact lens wear
• Certain medications (such as decongestants, antihistamines, oral contraceptives, tranquilizers, diuretics)
• Vitamin A deficiency
• Inflammation of the eye’s tear-producing gland

LASIK or another type of refractive surgery can worsen or bring on dry eyes. Similarly, those with extreme dry eyes may be disqualified from undergoing LASIK surgery.

Treatments for Dry Eyes

Common treatment of dry eye syndrome includes the use of artificial tears or ointments. However, excessive or prolonged use of artificial tears can disrupt the natural production of tears, leading to further aggravation of the condition instead of providing desired relief.

Though there is no cure, those who suffer from dry eyes can come to our St. Louis, Missouri practice and learn about ways to manage the condition. We generally suggest a combination of the following dry eyes treatment options:

• Lubricating tears and ointments
• Punctal plugs, temporary or permanent
• Special eyewear while sleeping such as goggles or moisture chambers
• Omega-3 and Omega-6 Fatty Acid supplements such as HydroEye®
• Restasis® therapy

HydroEye® SoftGels: HydroEye® SoftGels are recommended by many doctors and can give patients continuing relief from dry eyes, whatever the cause of the condition. The SoftGels contain a proprietary blend of nutrients that fight inflammation and help your eyes maintain a healthier tear film. These supplements were developed by ophthalmologists and nutritional scientists, manufactured according to the premier quality standards, and made from the finest ingredients. With continued use, HydroEye® SoftGels may give you uninterrupted relief from dry eyes. The treatment contains omega-3 and omega-6 fatty acids, vitamins, minerals, and other ingredients that help you maintain healthy tear production.

Restasis®: Often, the root cause of dry eye syndrome is inflammation of the eyes’ tear-producing gland; this inflammation can be triggered or made worse by allergies, smoking, prolonged computer use, and other factors mentioned above. Unlike artificial tears, which only temporarily relieve dry eyes, Restasis® Ophthalmic Emulsion actually stimulates your eyes to produce more tears, addressing the root cause of discomfort. Restasis® is a prescription eye drop that, when used twice daily, causes a noticeable increase in natural tear production that will continue to improve with time. Restasis® can be used in conjunction with artificial tears, though non-prescription eye drops will become less necessary as healthy tear production is restored. Restasis® has been well-tolerated by patients and is currently the only dry eyes treatment to actually increase tear production.

For more information on Dry Eye treatments please check on line at www.PeposeVision.com or call us at 636-728-0111

Can’t Get the Red Out?

Written By: Jay Pepose | April 21, 2008

This time of year, we see lots of people coming in with red eyes. The weather is changing and pollen counts are record high. It is important to realize that not all red eyes are from the same cause. An office visit can help to clarify the correct diagnosis and treatment.

For example, a red, burning eye with discharge could be infected, while a burning, red eye with a scratchy, foreign body feeling could represent dryness. If the prominent symptom is itching in both eyes, along with redness and a teary discharge, that is most often allergy. Unfortunately, sometimes over the counter allergy medications like Zyrtec, can exacerbate dry eye, compounding the list of problems. Contact lenses can both absorb pollens and act like sponges, worsening dry eye and allergy symptoms. An acute attack of angle closure glaucoma can also cause a red eye, and could represent an ocular emergency requiring urgent treatment.

Significant allergic conjunctivitis can often be accompanied by nasal symptoms and may require a team approach with the ophthalmologist working closely with an allergist. This can help to pinpoint the conditions that the patient is allergic to, allowing them to try and minimize exposure and/or undergo desensitization treatments. Appropriate use of oral and ophthalmic medications may alleviate both systemic and ocular symptoms.

If you have dry eye, allergies or chronic redness, the doctors at Pepose Vision Institute are here to help. Proper treatment begins with accurate diagnosis. Our doctors specialize in diseases of the ocular surface and cornea, and offer the latest treatments. If you have chronic red eyes, a thorough, complete eye examination is your next step!