Optometric Office

MAR 2016

Products and their applications for optometry.

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PATIENT CARE * WHERE TO FIND IT: Allergan 800.347.4500 | allergan.com Bruder Healthcare Company 888.827.8337, Ext 203 | www.bruderophthalmic.com tanice.hinton@bruder.com Oasis Medical 844.820.8940 | oasismedical.com customerservice@oasismedical.com ZeaVision 866.833.2899 | zeavision.com 18 M a r c h 2 0 1 6 | o p t o m e t r i c o f f i c e . c o m to the severity of the dry eye condition. I love the Dry Eye OSDI Questionnaire app. It calculates the Ocular Surface Disease Index score for a quantitative level of the patient's symptoms. Level I It is important to address symptoms early to avoid problems. For patients with mild symptoms, conservative treat- ments include warm compresses to stim- ulate meibomian oil gland production and limit excess evaporation. The Bruder mask (see page 17) offers ease of use and sustained heat. Also, many patients do well with a few artificial tear drops, such as Oasis Tears (top right), as needed daily. This glycerin-based product con- tains the non-active ingredient sodium hyaluronate, a long-lasting visco-elastic which adheres to the ocular surface with- out causing blurred vision. Oasis Plus is slightly more viscous. Supplements to fight the inflammatory process are important as well. We have seen improvements in patients who take EyePromise EZ Tears from ZeaVision, LLC. Level II For long-term resolution of symptoms, Allergan's Restasis is extremely beneficial for these patients. The topical immuno- modulator increases tear production in patients with ocular inflammation due to keratoconjunctivitis sicca. Many ODs are implementing this topical therapy sooner rather than later as they see patients feel- ing better and achieving more comfort at the end of the day. I recommend Restasis twice daily before lens insertion (waiting at least 15 minutes before inserting lenses) and at bedtime (after removing lenses). Level III Although patients with significant ocular surface disease may find better results with spectacle correction, some patients, such as those with keratoconus and ex- tremely severe refractive errors simply don't have that option. For these patients we must be creative. Many corneal specialists actually treat severe corneal diseases using semi-scleral lenses combined with preservative-free solutions and artificial tears to literally bathe the cornea in an ideal solution. Additionally, even though the use of oral pilocarpine (Salagen) is rarely dis- cussed, ophthalmologist Jeffery Hinson, MD, from Macon, GA, is having success. "My patients are very happy using 5 mg tablets once or twice per day for dry eye symptoms. They don't experience the side effects of those using the recommended dose of three to four per day." Unfortu- nately, I have found the drug to be rather expensive and rarely covered by insurance due to lack of prescribing. Finally, my favorite treatment for se- vere DES is autologous serum eye drops made from the patient's own blood by a compounding pharmacy. Serum contains many components found in healthy tears and mimics the tears' pH and salinity. Pa- tients love how they feel. We may not always be excited to see a 48-year-old female contact lens patient with hyperopia, astigmatism and dry eye syndrome who is also a computer pro- grammer. We choose to smile and let them know that we love a good challenge. But we can reap the rewards both person- ally and professionally if we put forth the effort to prevent these patients from drop- ping out of contact lenses. A happy patient for life makes it all worth it. OO Matt Dixon, OD, is in private practice in Perry, GA. Oasis TEARS lubricant drops can be used throughout the day to help reduce dry eye symptoms. Annual exam fee Contact lens professional fitting fee Annual supply daily disposable multifocal lenses Plano polarized sunglasses Back-up spectacles Medical office visits DES (2) Revenue for fitting presbyopes in your practice $100 $125 $550 $175 $600 $130 Amounts above are for illustration purposes only and not suggested charges

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