THESE ARE THE FEW OF MY FAVORITE ...... TEARS!!!

When it comes to choosing the right artificial tear product one is facing a plethora of products in the eye care aisle at any local pharmacy.  The patient has to make an important decision about their daily eye care mostly based on the product information on the box, heavy TV advertising or hopefully his or her eye doctor’s recommendation.

Here are a few pearls of wisdom that should help when you select the artificial tear product that is right for you.  These are listed in the order of my preference with the first few being preferred and the last ones are a definite no.

1.       GO PRESERVATIVE FREE!  My favorites in this category are Preservative Free Refresh Plus and Preservative Free Optive for Sensitive Eyes, Preservative free Genteal and Preservative Free Systane.

2.       Benzalkonium chloride (aka BAK) is an extremely irritating additive that is found on most bottled eye drops except for the few that have an alternative to BAK.   Purite is a safer alternative to BAK and is converted to water once it reaches the eye surface.    Other BAK free  tears are Hypotears, Natural tears, Systane, Systane Ultra and Systane Balance (preserved with polyquad), Genteal, Blink tears.

3.       AVOID BAK (Benzalkonium chloride) preserved tears and over the counter drops such as

Clear Eyes, CVS and other pharmacy store brand multi action drops promising to take away the red.  SAY NO TO VISINE – a bottle full of BAK that will further more irritate the eye surface.

SAY NOT TO Bausch and Lomb Advanced Eye Relived Rejuvenation which has plenty of BAK.

4.        AVOID ROTHO artificial tears.  They feel like mint in your eye.  I am not sure if it is the fact that there is menthol in it’s inactive ingredients that leaves the eye feeling burning or other inactive ingredients but I had to wash out Rotho tears with my favorite Preservative Free Refresh Plus to get rid of the burning. 

Once you have selected a drop that works for your eye, get a small sample from your doctor’s office or your local pharmacy to try it out.  Occasionally certain individuals may be sensitive to other inactive ingredients of the product and still feel irritated despite tear use.  If the product you chose works great for you, I would commit to using it twice a day before you brush your teeth in the morning and night.  You can even set a bottle next to your computer if you are a frequent computer user.  Carry another bottle/pack in your handbag or keep in your car out of sun’s reach to use when you are travelling and are exposed to sunshine and wind, the common culprits of dry eye condition.  Once you incorporate use of artificial tears into your daily routine, it will become a good habit and your eyes will thank you! 

February - SAVE YOUR VISION Month

By: Ophthalmology Times Staff Reports

San Francisco—February is “Save Your Vision Month,” and the American Academy of Ophthalmology (AAO) is encouraging Americans over the age of 40 to make an appointment for an eye examination.
According to AAO, by 2020 43 million Americans will be at risk for significant vision loss or blindness from such age-related eye diseases as cataract, diabetic retinopathy, glaucoma, and age-related macular degeneration—an increase of more than 50% over the current number of Americans with these diseases.
“Eye diseases become more common as we age, but eye problems can occur at any age. Getting a comprehensive eye exam, and following through with the recommendations of [an ophthalmologist] can be the difference in saving your vision or preventing further vision loss later in life,” said Aaron Weingeist, MD, an ophthalmologist in Seattle and a clinical correspondent for AAO. “Many patients will have no recognizable symptoms of vision loss, but it is important to identify, monitor, and treat early.”

Along with a baseline eye exam at the age of 40, the Academy recommends the following regular eye exam schedule for adults with no risk factors:
• 65 years of age or older, every 1 to 2 years
• 55 to 64 years of age, every 1 to 3 years
• 40 to 54 years of age, every 2 to 4 years
• Under 40 years of age, every 5 to 10 years.
AAO noted that education and awareness are also part of the eye health equation. In order to provide the public with the most accurate eye health information available, AAO, has launched a comprehensive new web site, GetEyeSmart.org, to help bring reliable eye health information to the public.

Dry eyes make your vision blurry, give your eyes a break!

How many of us wake up in the morning with a sensation of grit in your eyes or eyelids stuck together by mucous discharge?  How many feel like their eyes start watering the minute they sit down in front of their computer or read a book?  How many feel like their eyes burn and are fatigued at the end of the day causing blurry vision?  If you are not experiencing any of the symptoms above, you probably know someone who does!  The common thread here is DRY EYES.

Now, you may ask me "Doctor, why would I have dry eyes if my eyes water all the time?"  Well, the tears are not just a turn on the faucet type mechanism.  In order for our eyes to feel moist they need a balanced lake of elements that covers the exposed surface.  Imagine a nice shear butter lotion covering your hands on a cold windy winter day.  A healthy tear film would provide such a barrier against the elements like air conditionining, heat vents, air blowing in your car, and sunny and windy weather.

A healthy tear film is like a tiered red velvet cake.  The foundation layer is a layer of sugar coating the eye surface cells to make tears stick to the surface.  The middle layer is the liquid aqueous layer that is actually made by your tear gland in the outer corner of the eye and the surface layer is that shear butter layer that provides a moisture trap and prevents evaporative loss of tears.  Many tiny glands inside the lower and upper eyelids called meibomian glands make this top oily layer.  Their production is highly regulated by sex hormones such as estrogen and progesterone, surrounding inflammation due to chronic allergies or other eye diseases and diet. 

This sounds like a simple enough cocktail but as we get older the cells that make the "ingredients" become compromised due to chronic allergies, exposure to the outdoor elements and simple cell aging.  As our eyes sense the lack of protective cover, a signal is sent to the brain to stimulate only one type of tear layer - the aqueous.  The other two layers are not made "on demand" therefore the evaporative loss will lead to lack of tears despite a well functioning tear gland and watering eyes!

So we face the challenge of finding the perfect tear "magic potion”.  So many choices of artificial tears are available to us over the counter!  In the next post, I will review my winners and losers of the over the counter products that are within arm's reach at your local pharmacy's eye care aisle.  Meanwhile you can see your eye doctor to eliminate presence of chronic allergies and meibomian gland dysfunction. Stay tuned!

Your Eyes Deserve To See Better

Have you ever wondered what it is that makes your vision blurry after sitting in front of a computer for a long time?  What makes your eyes red every summer season?  Can you ever get rid of those glasses that you have been wearing since you were five?  Now you can find the answers you are looking for here in a two-way street of communication through my professional blog for people just like you!  In a world of overhwelming deluge of information online and offline, I set out to deliver a clear and information message to all of my patients or patients-to-be about their most precious resource - their eyes.   By no means I want to substitute a visit to the doctor with this blog, but rather I aim to educate our patients about common eye conditions, problems, most advanced procedures we offer and answer most frequently asked questions.   There are many studies that confirm that one needs to hear a new peice of information several times before it is stored as a  long-term memory.  I want this blog to be a resource for my patients to go back to and look up the things we had discussed during our visit.  This blog is intended to be as much as a tool for patient education as it is a forum for everyone who has questions about his or her vision and eye health.  So feel free to join in and comment!