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Dry Eyes with CPAP use?

If you use a CPAP machine then you likely have experienced 'CPAP dry eye'.  The common symptomology is patients with scratchy, irritated eyes on waking if mask fit is not perfect or a nighttime shift occurs.

CPAP is not a real 'diagnosis'... but certainly a common clinical observation.

Beyond ensuring that mask fit is optimal, for CPAP dry eye I recommend that patients use either:
Ocunox night-time gel with Vitamin A or I-Defence

Both are non-preserved and when used just before bed, prevent much of the overnight evaporation that causes the morning discomfort.

Both gel caused some blurred vision so only evening use is recommended.

Learn more about these products on mEYEspa

OCUNOX       I-DEFENCE

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Reasons for Digital Eye Strain: Blue Light?

This is the domain of an Optometrist. Please speak your Optometrist for all your options however…

 

There are definite camps and opinions on the blue light question.  It is less universally accepted than all of the other posted reasons for digital eye strain. 

 

In theory, higher-energy, shorter-wavelength blue light emitted from screens is thought to adversely effect the visual system by overloading it with extra energy - like headphones turned up too loud.

The controversy arises because you get far more blue light by being outdoors on a sunny day that you could ever get from a digital device.  So why some folks respond well to blue-blocking lenses at the computer but never previously had issues with sunlight is a part of the confusion.

Lens marketing folks have also twisted the blue-light issue by claiming damage to the inner eye that simply is not true - You are not going to get eye cancer from your screen!

Another confusing lens issue is that most "blue blocking" lenses only actually block ~15% of blue light!   So is 15% reduction actually enough to have an effect? - unknown.   Some blue-blocking lenses block up to 80% but these lenses are typically a yellow hue and cosmetically not acceptable for most people.

 

It is true that high energy blue light can disrupt your sleep.  So using low blue screens or blue-blocking lenses may be useful for folks that use a screen right up to the moment they go to bed.

 

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Confusing Omega 3 - What to take for your Eyes - Advice, Information & Successful Clinic-Tested Eye Products

How much Omega 3 should I take for dry eye?

Simple question but the answer is a bit complex.  Omega 3 supplements vary widely in their potency.

The following information is what I recommend in clinic.

It is not applicable to everyone and talk to your eye care provider for more individualized information.

omega3-eyes

Look at the label of your Omega 3 supplement.  Look for these numbers:

Serving Size:  e.g. 1,2,4 capsules

Capsule Size: e.g. 500mg to 1200mg

EPA content and DHA content.

Ignore the serving size initially.
Look at the EPA + DHA total

For dry eye, this total needs to be at least 1000mg per dayThen figure out how many servings that you need
to get ~1000mg/day of EPA + DHA

I often recommended up to 2000mg/day (EPA+DHA)

Also look for the form (triglyceride preferred)

See example below

 

On the above Krill Omega 3 label...  one capsule (serving) has 75mg (EPA) + 45mg (DHA) = 120mg.   For dry eye therapy I recommend 1000mg/day so... you would need 1000/120 = 8.33 ~ 8 capsules a day.  (That's alot!)

On this PRN De Omega 3 label to the right... one serving is 4 capsules which delivers 920 mg (EPA) + 920 mg (DHA) = 1840mg.

I would recommend just 2 capsules of the PRN high potency product.

You can buy PRN product here from meyeSPA.

 

Liquid Omega 3's generally have high potency and usually 1/2 a teaspoon will achieve the ~1000mg guideline but check the label.

Most important TIP...  Take with food!  Without food, even the best Omega 3 will not absorb properly and not deliver the desired relief!

Dr. Jason

 

prn-omega3-reading-label

 

 

 

 

 

 

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Recommendations for Aqueous Deficiency Dry Eye

Thealoz

Recommendations based on an Aqueous Deficiency Dry Eye

  The goal of treating aqueous deficiency dry eye is to dilute the tears so that they are less salty and irritating to the ocular tissue.

   LEVEL ONE: Use non-preserved rewetting drops designed for Aqueous Deficiency.  Recommended 2-6 times per day.
     Option 1 - Thealoz® available through mEYE Spa – filtered bottle
     Option 2 – non-preserved Theratears or non-preserved HypoTears – available through any pharmacy - individual use

  LEVEL TWO: All level ONE recommendations but to an enhanced vigilance also add a non-preserved eye gel at bedtime -
                      Recommended: Ocunox available at mEYE Spa or select pharmacies

  LEVEL THREE: Burst of prescription topical steroid and/or Restasis® would be discussed by an Optometrist for inflammatory dry eye disease

 

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Recommendations for Lipid Deficiency Dry Eye

Hyabak

meyespa iris  Recommendations based on a Lipid Deficiency Dry Eye (MOST common form)

  The goal of treating lipid deficiency dry eye is to reduce the evaporation of tears from the ocular surface as low moisture causes irritation and damage to the ocular tissue.

  LEVEL ONE: Use non-preserved rewetting drops designed for Lipid Deficiency.  Recommended 2-6 times per day.

     Option 1 - Hyabak® available through mEYE Spa (filtered bottle)
     Option 2 – non-preserved Optive Fusion or Optive Advanced - available through any pharmacy – individual use


  LEVEL TWO: All level ONE recommendations but to an enhanced vigilance also add

          [1] 5-10min of Bruder Mask at bedtime
          [2] Omega 3’s (more info here) 1000mg/day to 2000mg/day (note that Omega 3 is not to be used with Coumadin or other Rx blood thinners)


  LEVEL TWO+: (overnight irritation) All level ONE recommendations but to an enhanced vigilance also add a non-preserved eye gel at bedtime -
                        Recommended: Ocunox or I-Defence available at mEYE Spa or some pharmacies


  LEVEL THREE: Pulse of prescription topical steroid and/or oral medications would be discussed by Optometrist for inflammatory dry eye disease

See mEYEspa 50+ Dry Eye Clinic Pack or mEYEspa under 50 Dry Eye Clinic Pack for bundled product savings

 

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The Basics - Dry Eye - mEYEspa at Studio Eye Care Featured

eye drop meyespa

The condition name 'DRY EYE' is inherently confusing as many people with 'Dry Eyes' excessively tear.  They may have symptoms that do not necessarily feel dry.  'Dry Eye' refers more to an imbalance in your tear chemistry.  The thin film of fluid on the surface of your eyes is quite a complex recipe and if that is not produced by your body properly, unstable vision and discomfort and sometimes permanent damage to the ocular tissue can ensue.

For the purposes of mapping a treatment plan and communicating status, I break down DRY EYE into two main forms [1] suspected lipid deficiency [2] suspected aqueous deficiency
Note that these can occur concurrently and are listed as ‘suspected’ as they are sometimes hard to distinguish clinically but are treated differently.

Management options for progressing severity for both forms of dry eye will be highlighted below. If not treated, eyes that are chronically dry progress to having DRY EYE DISEASE. This is an inflammatory condition that generally requires prescription drops or oral medications to manage. Advancing Dry Eye Disease is not only uncomfortable but can cause unstable vision and irreparable damage to ocular tissue.

Concurrent with any treatment, I recommend four easy changes that you can make to help both forms of Dry Eye
meyespa iris  Hydration – drink lots of water!
meyespa iris  Humidity – consider a humidifier in house or work environment for winter or dry environments
meyespa iris  Screen use use – try to limit and take breaks of 5 minutes minimum each hour
meyespa iris  Make-Up – consider hypoallergenic make-up and be sure not to line eye lid margins (tissue between lashes and eyeball)

 

How do I know what form of Dry Eye that I have?

The BEST way to determine what form of dry eye that you have is an eye exam by an Optometrist!  Special dyes and tests are used to identify your type of dry eye (AQUEOUS vs. LIPID Deficiency) and the best treatment course.   If this this is not possible, start with recommendations on LIPID deficiency based dry eye as it is much more common.

More information - See mEYEspa Clinic Packs for common treatment protocols

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Digital Dilemma Excerpt - The Vision Council 2016

digital strain meyespa

Except from "Eyes Over Exposed: The Digital Device Dilemma" (The Vision Council 2016)

We awake to the glow of a phone acting as an alarm clock. We work for hours on our computer screens, perhaps stopping to look at something on another screen—a television, a tablet, a smartphone. The pattern is repeated again and again as our days are filled with electronic images of news reports, online shopping, video games, movies, emails and texts….

This constant exposure to technology is a shock to our eyes. For centuries, we have evolved our sight by viewing a wide variety of objects outside from varying distances. A combination of factors including the proximity at which we view digital screens, the frequency and length of time of this use, physical responses to screen habits, and exposure to high-energy visible (HEV) or blue light, have conspired to cause visual discomfort in 65 percent of Americans. 1 This stress and strain, combined with other physical discomforts, is called digital eye strain.    READ MORE

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Reasons for Digital Eye Strain: Dryness & Ocular Surface Issues

One of the most impactful things that you can do to stabilize vision and reduce digital eye dryness issues is use non-preserved rewetting eye drops formulated for evaporative issues (such as I-DROP MDG or Thealoz DUO®).  To be effective these drops should be used at least twice a day i.e. proactively!.

This is especially true for contact lens wearers as the ocular surface dries more quickly!

A great way to get a quick refresh throughout the day is Hypochlorous spray.

Warm compresses, prescription medications and Omega 3 supplements are also used to combat dryness – digital or not!  See the Dry Eye BLOG posts

Bundle and save on Digital Eyestrain clinic packs from mEYEspa

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