Optometric Office

MAR 2016

Products and their applications for optometry.

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o p t o m e t r i c o f f i c e . c o m | M a r c h 2 0 1 6 29 A special test called the "Schirmir Test" measures the amount of tears being pro- duced by the eye. This test is performed by placing a strip of porous paper in the lower cul-de-sac after first placing topi- cal anesthetic into the patient's eyes. The anesthetic will numb the eye so it will not tear reflexively due to irritation from the test strip. After insertion of the test strip, the patient is then instructed to keep their eyes closed for five minutes. The test strip is then removed, and the amount of wet- ting is measured. Wetting of the test strip of less than 10mm may indicate the pres- ence of dry eyes. Tear quality can be measured by using the TearLab Osmolarity Test and/or the InflammaDry Test. The TearLab Osmo- larity Test requires only nanoliters of fluid to analyze the osmolarity of the tear film, a key indicator of dry eye disease. Tears with high osmolarity can determine the severity of the dry eye. As hyperosmolar- ity leads to visual fluctuations and tear film instability, it is key to identify and manage early before damage to the cor- nea can occur. The test is fast and easy to perform; all technicians are trained by TearLab representatives, and from collec- tion to results the test takes only seconds. Ocular surface inflammation can be detected using the InflammaDry test. This single-use, disposable test is able to detect an elevated inflammatory protein (matrix metalloproteinase 9 or MMP- 9) in the tear film, which is a marker for dry eyes. The technician collects the tears with the InflammaDry sample collector, then activates the test using the provided buffer solution and waits 10 minutes. El- evated levels of the inflammatory protein are indicated by the appearance of a red result line. Treating DES There are several treatments for dry eyes depending on the severity of the case. Lid hygiene. The first course of action is advising the use of lid hygiene, which involves applying warm compresses to open the meibomian glands and scrupu- lous cleaning of the lids and lashes with baby shampoo. The paraoptometric can help the doctor by explaining the process of lid hygiene. Artificial tears. The dry-eye patient is often advised to use artificial tear supplements. These drops or ointments, such as Refresh Optive Gel Drops from Allergan, are available over the counter, and the pa- tient can be advised to purchase either preserved or non- preserved drops, or WHERE TO FIND IT: Allergan 800.416.8780 | Refreshbrand.com Eagle Vision Inc. 800.222.7584 | dryeye.org Lacrivera 855.857.0518 | lacrivera.com Nordic Naturals 800.662.2544 | nordicnaturals.com Odyssey Medical Inc.,/Beaver-Visitec 888.905.7770 | beaver-visitec.com RPS Diagnostics 877.921.0080 | RPSdetectors.com info@inflammadry.com TearLab 855.TEARLAB | TearLab.com marketing@TearLab.com how often the drops should be used. The assistant can review proper technique for drop insertion. Supplements. Patients may also be in- structed to start taking vitamin supple- ments, such as ProDHA Eye from Nordic Naturals, that include omega-3 fatty acids, which have been shown to provide some DES relief. Punctal plugs. For those patients with more severe dry eyes, the doctor may rec- ommend the use of punctal plugs made from either silicone or collagen, which keep more tears in the eyes by blocking the punctum, allowing tears to drain from the eye. Companies such as Lacrivera, Beaver-Visitec and Eagle are just a few that offer plugs. Topical steroids. For patients with se- vere symptoms, prescription steroids may be prescribed to reduce inflammation. Janet Hunter, COMT, president of Eye Source, LLC, specializes in ophthalmic tech nician training. The TearLab Osmolarity Test requires only nano- liters of fluid to analyze the osmolarity of the tear film.

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