Ophthalmology & Optometry/Dry Eyes

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QUESTION: Hi John,

I was wondering if you could please help me?

I have had 'blepharitis' for a number of years.  Sometimes it will also disappear for years!  I do know it is a chronic condition that there is currently no cure for, to date!!  I am female, aged 34.

What I wanted to know is can you recommend any good preservative free eye drops?

I currently use Blephasol as an eye makeup remover.  And then Thealoz as an eye drop, only when I really need it though, but it is quite pricey and it only lasts for 2 months once opened.

Do you know of any other preservative free eye drop that is cheaper/better/lasts longer?

Also is the Blephasol and preservative eye drops enough to control the condition?

Thanks,

Lisa.

ANSWER: Lisa,

I have found that lid hygiene and lubrication be the main-stays of good control.  I suggest an eye scrub (be gentle!) like ocusoft or sterilid.  Diluting organic tea tree shampoo works VERY well for this as well.  (something like JASON tea tree shampoo)

Lid hygiene normalizes and controls the bacterial and microbe growth around the eyelid margin--this is a large component of the symptoms.

Artificial tears are important to normalize the ocular surface, and I would suggest Theratears, Systane, or Refresh as my top three brands.

Treating with just artificial tears only helps the symptoms, but does little fix the real problem - which is inflammation/irritation of the eyelid margin, glands, etc.  

Good Luck!
Dr.D

---------- FOLLOW-UP ----------

QUESTION: Hi Dr.D,

That's great.  Thanks for replying.

Do you think I should stop the Blephasol and use a normal eye makeup remover instead?

Then use either ocusoft or sterilid twice a day?  Would I still use this if I have no symptoms?

Also, lastly, just use the artificial tears as a last resort?  Can eyes get too used to artificial tears so that they become reliant on them?

Sorry, there are a lot of questions.

Thank you.

Lisa.

Answer
I am unfamiliar with Blephasol, but at a quick glance (reading on Amazon.com) I would suggest using Ocusoft pads instead.

For the first week or two, try twice daily, then move to just in the evenings when you're removing makeup.

I would use artificial tears twice daily for the first few weeks to help heal and recondition the ocular surface. Use them as needed for flare ups and irritation.

Good Luck!
Dr.D

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John M. Dovie, OD, FAAO

Expertise

As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.

Experience

Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

Organizations
American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

Publications
Seminars/Presentations:
“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
Publications:
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Education/Credentials
Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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