Treating Dry Eyes: Exploring Options Beyond Artificial Tears

Treating Dry Eyes: Exploring Options Beyond Artificial Tears

Dear Dr. Roach: I developed chronic dry eyes after undergoing cataract surgery on both eyes. Seeking relief, I consulted a specialized ophthalmologist who prescribed Restasis, followed by Xiidra when the first medication didn’t yield improvement. Despite using the recommended treatments for months, my condition persisted. When I inquired about alternative options such as Miebo or the LipiFlow procedure, the specialist seemed dismissive. Do her actions indicate incompetence?

It is unlikely that a dry eye specialist would be unaware of new treatments within their field of expertise. Therefore, there may have been miscommunication or other factors leading to the specialist’s response. General ophthalmologists like myself possess broad knowledge across various conditions, whereas specialists focus on in-depth understanding of a few conditions. Rest assured, there are alternative approaches worth exploring.

Artificial tears are typically the initial recommendation, and they offer relief for many individuals. However, some patients continue to experience discomfort despite frequent use. One possible explanation for persistent dry eyes is blockages in the meibomian glands, which secrete an oily substance that prevents eye fluid from drying and prompts the lacrimal glands to produce additional tears. To address this, some generalists suggest attempting to unblock these glands using baby shampoo and warm water.

When these conservative measures fail, consulting an ophthalmologist becomes essential. They can conduct an examination to assess the condition of the meibomian glands and explore further treatment options. The medications you tried, such as cyclosporine (Restasis) and lifitegrast (Xiidra), are commonly prescribed. However, it’s important to note that they may not be effective for everyone.

In cases where blockages persist, ophthalmologists may consider more potent interventions. LipiFlow, a heat-based treatment, has shown promising results in unblocking meibomian glands. While this procedure often proves successful, it may require repeated sessions, typically every six months or longer, depending on the individual. Additionally, plugs can be inserted to reduce tear drainage and enhance moisture retention.

It is crucial to consult with an ophthalmologist to determine the underlying cause of your dry eyes. They can guide you through the available treatment options and create a personalized plan to alleviate your symptoms effectively.

Ensuring Optimal Hand Hygiene: Killing Bacteria and Viruses

Dear Dr. Roach: We’ve been advised to wash our hands with soap and water for 20 seconds to eliminate the COVID-19 virus. However, I’m curious about the recommended duration for killing bacteria and other viruses. How long should we wash our hands to effectively eliminate these pathogens?

The recommended duration of 20 seconds for handwashing applies to both bacteria and viruses. Alternatively, an alcohol-based hand sanitizer can also be used as a rapid and effective means of hand hygiene. It is essential to wash your hands before and after meals, as well as after using the restroom. While bacterial spores are resistant to regular handwashing, they can be effectively removed with soap and water. However, in cases where bacterial spores pose a concern, such as with Clostridioides difficile, handwashing is necessary, as alcohol-based sanitizers are not effective against these spores.

Maintaining proper hand hygiene is crucial for preventing the transmission of bacteria and viruses. By following these guidelines, you can help protect yourself and others from infectious diseases.

Readers can submit questions to [email protected].

Frequently Asked Questions:

1. Why did the specialist seem dismissive when alternative options were mentioned?
– It is unlikely that a dry eye specialist would be unaware of new treatments within their field of expertise. Miscommunication or other factors may have led to the specialist’s response.

2. What are the initial treatments for dry eyes?
– Artificial tears are typically the initial recommendation and offer relief for many individuals. However, some patients may continue to experience discomfort despite frequent use.

3. What could be the cause of persistent dry eyes?
– Persistent dry eyes may be caused by blockages in the meibomian glands, which secrete an oily substance that prevents eye fluid from drying and prompts the lacrimal glands to produce additional tears.

4. What can be done to address blocked meibomian glands?
– Some generalists suggest attempting to unblock the glands using baby shampoo and warm water. If these conservative measures fail, consulting an ophthalmologist becomes essential for further assessment and treatment options.

5. What medications are commonly prescribed for dry eyes?
– Medications such as cyclosporine (Restasis) and lifitegrast (Xiidra) are commonly prescribed. However, it’s important to note that they may not be effective for everyone.

6. What more potent interventions can be considered for persistent blockages?
– Ophthalmologists may consider the LipiFlow procedure, a heat-based treatment that has shown promising results in unblocking meibomian glands. Additionally, plugs can be inserted to reduce tear drainage and enhance moisture retention.

7. How long should hands be washed to effectively eliminate bacteria and viruses?
– The recommended duration for handwashing to eliminate bacteria and viruses, including COVID-19, is 20 seconds. Alternatively, an alcohol-based hand sanitizer can also be used for rapid and effective hand hygiene.

Definitions:

– Cataract surgery: A surgical procedure to remove a cloudy lens from the eye and replace it with an artificial lens.

– Ophthalmologist: A medical doctor who specializes in the diagnosis and treatment of eye diseases and disorders.

– Dry eyes: A condition in which the eyes do not produce enough tears or the tears evaporate too quickly, leading to discomfort and vision problems.

– Meibomian glands: Small glands located in the eyelids that secrete an oily substance called meibum, which helps keep the eyes lubricated and prevents tears from evaporating.

– Restasis: A medication containing cyclosporine that is commonly prescribed for dry eyes to reduce inflammation and increase tear production.

– Xiidra: A medication containing lifitegrast that is commonly prescribed for dry eyes to reduce inflammation and improve eye comfort.

Suggested Related Links:
Weill Cornell Medicine
American Academy of Ophthalmology

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