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    Uncover patient lifestyle habits that lead to OSD

    The iPhone screeches at 5:30 am.

    She reaches over to squint at her inbox before dragging herself to the kitchen to brew some coffee. Breakfast is a handful of Claritin, Ortho Tri-Cyclen, Synthroid, and a few multivitamins, chased by over-sugared espresso and a cigarette.

    She takes a quick shower, then moves into her daily beauty routine of a hair-sprayed knot or ponytail, accessorized only by heavy black eye makeup, an age-defying beauty trick learned years ago during her study abroad in Paris. Waterproof eye liner, waterproof mascara, and a dusting of a nude sparkly eye shadow will get her through the high-impact 14-hour work day, flawless and chic, without creases or smudges.

    She makes a note in her iPhone calendar to schedule the next Botox injection so her clients cannot see those emerging crow’s feet. She makes an additional note to schedule a new contact lens prescription because blurry vision seems to be regularly impacting the afternoons and evenings.

    This is not an article in a fashion magazine; rather, it’s a real-life scenario to be considered for your practice. Following a patient through her day will help you to help her.

    This patient is in your chair every day

    Let's address a few situations in the above scenario as we enter the eye exam with this 30-something female for her annual eye health and contact lens evaluation.

    Her chief complaint reads: “Needs a new supply of contact lenses and is beginning to notice visual fluctuations and midday contact lens awareness.” Initially, both she and the eyecare provider (ECP) believe the problem to be with the refraction or the contact lens fitting.

    But let’s wind the clock backward and see what ocular surface disease-exacerbating insults occurred in the immediate past. What external stressors are contributing to your patient’s intermittent blurred vision?

    We’ll provide answers along with clinical pearls to help you better treat these patients who visit your practice every day.

    Going backward in time

    Last night, this patient went out with her girlfriends and enjoyed a glass or two of wine. She has been dehydrated since the wine began affecting her lacrimal gland output.1 She got home a bit late and did not get her required amount of sleep.2 Because she was a bit tipsy, the lids that are normally not quite completely sealed were perhaps slightly more open on this particular evening, causing her to wake up with eye irritation due to the evaporation effects of the incomplete closure.3

    Related: First-class dry eye treatment

    Leslie E O’Dell, OD, FAAO
    Leslie E. O’Dell, OD, FAAO, is the director of the Dry Eye Treatment Center at May Eye Care Center in Hanover, PA. Dr. O’Dell lectures ...
    Amy Gallant Sullivan
    Amy Gallant Sullivan, is cofounder and executive director of TFOS (www.tearfilm.org), a world leader in eye health education that’s ...

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