Scleral Lenses for Dry Eye Syndrome

Those with dry eye syndrome (DES) suffer from eyes that feel dry, itchy, uncomfortable, irritated and at times very painful. Eye drops and artificial tears can deliver relief but are no more than a temporary solution. Eventually, patients with chronic dry eyes seek out more durable methods of treatment.

Scleral lenses are an excellent solution due to their large shape, unique features, and customized fitting for each patient. Though generally used to treat corneal irregularities and refractive errors, scleral lenses can also provide immense relief to dry eye patients.

Scleral lenses tackle three factors simultaneously: they provide vision correction, they protect the eye, and they serve a therapeutic purpose by lubricating the eye. Scleral lenses decrease pain, discomfort, eye redness, and itchiness while providing sharp, clear vision.

What Are Scleral Lenses?

Scleral lenses provide relief and visual rehabilitation to patients with dry eyes and corneal irregularities. These custom designed lenses vault over the cornea and rest on the sclera while avoiding the cornea. The liquid reservoir between the lens and the cornea provides a continuous moist environment that protects the cornea and provides relief for those with dry eyes.

Because these lenses are oxygen permeable, they provide the wearer with better comfort and a healthy cornea. In fact, their ability to transmit oxygen reduces eye problems, such as dry eyes, caused by diminished oxygen transmission to the cornea, which is common among most soft lens’ brands or hard (non-GP) lenses.

If you have Dry Eyes and are interested in scleral lenses, Dr. Coker can help. Experienced in fitting scleral lenses for dry eyes and other corneal conditions, Dry Eye Center at EyeCare About Vegas serves patients from all over Las Vegas, Henderson, Green Valleyand Seven Hills, in the state of Nevada.

Why Scleral Lenses Offer Relief to Those with Dry Eye Syndrome

Contact Lenses You Can Wear With Dry Eyes

Traditional soft contact lenses are not an option for those with dry eyes, as the lenses sit right on the cornea, which can be very irritating for dry eye patients. Moreover, they tend to act as sponges, soaking up the moisture from the surface of the eye. Wearing soft contact lenses can, therefore, prove to be virtually unbearable for the dry eye patient.

Scleral lenses, on the other hand, are comfortable since they vault over the cornea and rest on the sclera, thus avoiding the sensitive cornea.

Scleral Lenses Provide Continuous Eye Hydration

The zone between the surface of the cornea and the scleral lens is filled with a saline solution. This acts as a constant source of hydration for the eye and provides ongoing relief for the dry eye patient.

Scleral Lenses Soothe and Protect the Cornea

People with dry eyes tend to have sensitive corneas that are prone to injury. The simple act of blinking can irritate the eye or even injure the cornea due to the mechanical friction of the eyelids on the cornea. Scleral lenses prevent damage to the cornea by shielding the patient’s eyes from the friction caused by blinking and protecting it from any external irritants or dust.

If you struggle with dry eye syndrome and have been looking for a more effective treatment method beyond eyedrops and artificial tears, ask Dr. Coker about scleral lenses. We will patiently assess and explain your condition to you, and will perform a specialized, scleral lens custom-fitting to ensure that you receive the best fit for optimal visual clarity and comfort.

Call Dry Eye Center at EyeCare About Vegas today to schedule your consultation today.

Our practice serves patients from Las Vegas, Henderson, Green Valley, and Seven Hills, Nevada and surrounding communities.

TrueTear for Dry Eye Treatment

TrueTear®, by Allergan, is a drug-free, drop-free solution that temporarily increases tear production in adult patients. This technological device emits tiny pulsations of energy that prompt your eyes to produce their own tears, offering significant relief to those with severe dry eyes.

TrueTear is made for home use and can be purchased by prescription only. Speak with Dr. Coker to learn how this device can help alleviate dry, itchy and irritable eyes, and vastly improve the quality of your life.

How Does TrueTear Work?

The tiny pulsations of energy emitted by TrueTear induce neurostimulation — a natural response that leads your eyes to produce their own tears. The device stimulates a nerve in the nasal cavity and sends out signals to the brain, which, in turn, send nerve signals to the tear glands to temporarily increase tear production.

For it to work, the TrueTear tip needs to contact the nerves located under the bridge of the nose. Just insert the tip all the way to the top part of the nose, or as far as is comfortable. You will know you’re stimulating the correct spot once you feel a tingling sensation in your nose and your eyes begin to emit tears. In certain people, tearing happens almost immediately, though it really depends on one’s individual anatomy and tear deficiency.

The TrueTear is user-friendly, as it is made up of just a few parts and only two buttons. Moreover, it offers a free app that can be seamlessly paired with your smartphone to better monitor the usage of the device.

How Does TrueTear Feel?

People typically report a tingling or tickling sensation, though it really depends on the level of strength of the energy pulsations. It is generally not uncomfortable or painful.

How Often and For How Long Do I Need to Use TrueTear?

The amount of time you use the device can vary. The TrueTear device has a built-in timer allowing for a maximum of a single 1-minute use for each cycle. To further prolong its use, simply start another cycle and use it until you feel tears coat the surface of your eye, though not beyond 3 consecutive minutes. After that, wait 1 hour before re-inserting the device into the nose.

TrueTear can be used for a total of 30 minutes per day. For most patients, we recommend they use TrueTear at least twice a week.

How Long Can I Use One Tip and How Do I Clean It?

The tip must be replaced every 48 hours, as it contains a hydrogel that dries out after two days of use. Moreover, make sure to use the tip before the expiration date printed on the packaging.

To clean the device, use an alcohol pad to gently wipe the disposable tip, but be careful to steer clear of the hydrogel areas.

All About the TrueTear App

The free app, which can be easily paired with your smartphone, helps you track your device usage and battery level, as well as learn new ways of using TrueTear. The app also allows you to get assistance in the event that you encounter any problems with the device. Moreover, environmental conditions that can affect your eyes are displayed in the app, which includes humidity, temperature, pollen count, and pollution index.

Ask us about how TrueTear can alleviate your dry eye condition and enhance your quality of life. Dr. Coker and the caring and knowledgeable staff at Dry Eye Center at EyeCare About Vegas are always here to help patients experience the best vision care and treatment possible.

Our practice serves patients from Las Vegas, Henderson, Green Valley, and Seven Hills, Nevada and surrounding communities.

Punctal Plugs

If you suffer from dry, burning, irritated or itchy eyes, you may have dry eye syndrome. Dry eye syndrome is a condition where your eyes either don’t produce enough tears or produce low-quality tears that can’t keep your eyes adequately hydrated. Sometimes the meibomian glands, which produce the oily layer of your tears, found inside your eyelid don’t function properly or are blocked, causing your tears to dry out.

If your tear ducts are blocked, your eye doctor may suggest punctal plugs.

What Are Punctal Plugs?

Punctal plugs are small devices that are inserted into the tear ducts — the puncta — of the eyelids. Another type of plug is inserted into the tear duct, the canaliculus, at a deeper level.

Puncta are small openings in your eyes that drain tears. The plug, which is about the size of a grain of rice, prevents fluid from flowing from the eyes. This ensures that the maximum amount of tears remain on the eyes at all times, resulting in less itching, burning, and redness.

Two Types of Punctal Plugs

Temporary/dissolving plugs

Temporary/dissolving plugs are made of a material, such as collagen, that the body absorbs over time. These plugs can last anywhere from a few days to several months in the eye. After refractive surgery, such as LASIK, temporary plugs are frequently used to keep the eye moist. They can also be used to test out punctal plugs to see if they provide dry eye relief.

Semi-permanent plugs

Semi-permanent plugs are composed of medical plastic, such as silicone or acrylic, that lasts longer. These plugs are made to stay in the eye for years. Your eye doctor can remove them, if necessary.

Another sort of semi-permanent punctal plug is inserted in the canaliculus, which is a deeper section of the tear duct. Once in the eye, these plugs are completely invisible.

How Are Punctal Plugs Inserted?

Your eye doctor will first inspect your eye to determine the optimum type and size of plug for your eyes.

Anesthesia may be used to numb your tear ducts. However, in some cases, you may not need to have your eyes numbed. As the punctal plug is inserted into your eyelid, you may feel some pressure.

After the plugs are inserted, you should be able to resume your normal activities at once.

When and How are Punctal Plugs Removed?

How to remove the plugs and when will depend on which plugs are inserted.

To remove silicon plugs from the tear ducts, your eye doctor will use forceps to gently pull the plugs out. Another option for removing these plugs is to use a saltwater solution to flush them out. The plugs are forced out of the tear ducts and into the nose or throat during this procedure.

Surgery is usually required to remove plugs that are deeper in the tear duct (in the canaliculus).

For most people, punctal plugs don’t cause any problems. However, if you have any eye pain, itchiness, or fear you have an infection, contact your eye doctor right away. The eye doctor will examine your eyes and remove the plugs if necessary.

Are Punctal Plugs for You?

Consult your eye doctor if artificial tears or other eye drops have failed to relieve your dry eye symptoms. If blocked tear glands are the culprit, your doctor might advise you to try punctal plugs. For more information regarding punctal plugs contact Dry Eye Center at EyeCare About Vegas today!

Our practice serves patients from Las Vegas, Henderson, Green Valley, and Seven Hills, Nevada and surrounding communities.

Autologous Serum Eye Drops for Severe Dry Eye Syndrome

Dry eye syndrome is a chronic lack of moisture in the eye caused by insufficient tears or poor tear quality. It can lead to irritation and, left untreated, can damage your corneas. While artificial tears and lubricating drops help the majority of patients, others continue to search for relief, especially if their dry eye syndrome is severe. Autologous serum eye drops (ASED) are a possible treatment for intransigent cases of dry eye.

What are Autologous Serum Eye Drops?

Autologous means that the donor and the recipient are the same person. In this case, Autologous Serum Eye Drops (ASED) are made from a patient’s own blood. These drops are found to be highly effective and well-tolerated. They consist of ingredients that artificial tears can’t replicate. They promote healthy growth and healing of the ocular surface ( the cornea) and contain antibodies, albumin, Vitamin A, and special growth factors important for healthy eyes known as epidermal growth factors.

ASEDs are not tear substitutes and are often used alongside other dry eye treatments such as artificial tears, lubricating eye drops and in-office treatments provided by some optometrists for dry eye.

How are Autologous Serum Eye Drops Made?

Autologous serum eye drops are created by drawing a very small amount of your blood into a sterile tube and allowing the blood to clot for at least 10 hours.

The blood is then spun for 15 minutes so the serum is separated. The blood serum is collected, combined with sterile saline and divided into several small dropper bottles. The serum to saline ratio varies according to your doctor’s assessment of the severity of your dry eye. The serum is not red; it is clear, like other eye drops.

This process takes up to three hours. You usually receive several months’ supply of drops, depending on your dosing frequency.

The prepared eye drops are placed in the freezer to maintain optimal freshness and remove the risk of harmful microorganisms growing for up to 6 months.

The serum drops create a lubricating fluid rich in certain nutrients and growth factors that may be missing in very dry eyes.

What Do Autologous Serum Eye Drops Cost?

ASED are not FDA approved because they are a blood product and not a pharmaceutical; most health insurance policies do not cover the treatment. Medications that have attained FDA approval receive government and health insurance funding to lower their cost to patients. For this reason, ASED are priced higher than traditional eye drops, but are considered life-changing for many patients.

How Long Does it Take to Notice Improvement?

Most patients experience a noticeable reduction of their dry eye symptoms within 2 weeks of starting ASED therapy.

If you suffer from dry eye syndrome, and have been frustrated trying to find relief for dry eye, we recommend you consider ASED. Contact Dry Eye Center at EyeCare About Vegas to learn more about ASED and how they can change the way you see.

Our practice serves patients from Las Vegas, Henderson, Green Valley, and Seven Hills, Nevada and surrounding communities.

REFERENCES:

• https://www.reviewofoptometry.com/article/rethink-autologous-serum
• https://www.aaojournal.org/article/S0161-6420(19)31946-3/fulltext

Eye Drops for Dry Eyes: Why You Should See Your Eye Doctor

Effectively managing a health condition like dry eye syndrome (DES) requires a thorough diagnostic and treatment process. So why do so many people find themselves pacing up and down the eye drop aisle at their local drug store, searching for yet another eye drop to ease their symptoms?

Knowing exactly what’s causing your symptoms and how to treat the condition at its source is the only way to attain long-lasting relief. At Dry Eye Center at EyeCare About Vegas, we do more than just treat the symptoms — we determine the underlying cause of your DES and get to the root of the issue.

Do You Have Dry Eye Syndrome?

DES is a progressive eye condition that affects over 20 million North Americans annually. It is caused by either poor tear quality or insufficient tears.

The most common cause of poor tear quality is a condition called Meibomian gland dysfunction (MGD), a blockage of the meibomian glands — the tiny glands at the edge of the eyelids that secrete an oily film into your tears.

Some medical conditions that can cause decreased tear production include Sjogren’s syndrome, rheumatoid arthritis, lupus, scleroderma, thyroid conditions, and lupus. Aging and a vitamin A deficiency can also lower tear production.

Symptoms of DES range from mildly uncomfortable to debilitating, and can include:

• Red eyes
• Dry eyes
• Painful or irritated eyes
• Watery eyes
• Light sensitivity
• Itchy eyes
• Fatigued eyes
• Burning eyes
• Blurred vision

DES can make it difficult for the eye to flush out foreign bodies, so sand, grit and allergens sometimes get stuck in the eye.

Why Do People Use Over-the-Counter (OTC) Eye Drops?

Given how uncomfortable dry eye symptoms can be, it’s no surprise that dry eye sufferers seek relief using over-the-counter drops. People with DES may not realize that they should visit their eye doctor rather than seek solutions on their own.

Some eye doctors recommend using OTC eye drops to temporarily treat mild symptoms until the condition naturally heals. For example, after an eye injury or surgery, many find that lubricating eye drops soothe the eyes and provide moisture.

But not all eye drops are created equal. People with mild to moderate cases of DES who seek relief from OTC solutions may be choosing the wrong types of drops or dosage for their eyes.

The three main categories of non-prescription eye drops are:

• Lubricating eye drops/artificial tears
• Antihistamine eye drops
• Redness-reducing eye drops

Masking a mild case of DES by using redness-reducing eye drops (also called decongestant eye drops) won’t address the underlying source of the redness. In fact, decongestant eye drops have been shown to exacerbate DES symptoms in the long run.

What’s more, your eyes can eventually become [desensitized] to the effects of OTC eye drops after repeated use. This eventually leads people back to the drugstore in search of even stronger eye drops, perpetuating the never-ending “eye drop cycle.”

End the Vicious Eye Drop Cycle

Experiencing continual eye irritation indicates the need for professional eye care. An optometrist will isolate the cause of your DES and use their expertise to find the most effective treatment for lasting relief.

Even if you have a mild case of dry eye syndrome, now is the perfect time to start treatment, before symptoms worsen. If you’ve sought help in the past but were told nothing else could be done to treat your eye condition, speak with Dr. Coker regarding the latest and most effective dry eye treatments.

If you’re ready to end the cycle of getting over-the-counter eye drops without lasting relief, contact Dr. Coker for a dry eye evaluation.

Our practice serves patients from Las Vegas, Henderson, Green Valley, and Seven Hills, Nevada and surrounding communities.

REFERENCES

• https://www.allaboutvision.com/buysmart/eye-drops.htm
• https://www.allaboutvision.com/conditions/dryeye-syndrome.htm