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    Uncover patient lifestyle habits that lead to OSD


    She conveniently leaves her false eyelashes on for a week (altering the wind-deflecting capacity of the eyelashes)11 as client dinners do not permit much remaining time in the evening for her beauty maintenance. She’s thinking about getting eyelid tattoos instead, but this is associated with worse MGD.12 (Figure 3)

    In addition, the daily lid margin oil reservoir overstripping caused by her product usage triggers the meibomian glands to up regulate meibum production in an attempt to keep up with the desiccating stress and meibum replacement demand. The lipid/protein composition is altered, and a poor quality meibum results.13

    During the day, the patient experiences reflex tearing but blames this on “allergies,” so she takes an oral antihistamine. Remember, she already has her morning cocktail of including oral antihistamines.

    Related: Creating a dry eye protocol


    Common medications known to contribute to DED include antihistamines, and anti-anxiety, anti-depressant, and anti-hypertension medications.14,15 The complete list of over-the-counter (OTC) medications is important to clarify in the patient history. There is a common misperception that OTCs, vitamins, supplements, and “natural products” are universally “safe.”

    In any given week, four out of every five U.S. adults will use prescription medicines, dietary supplements, or OTC drugs, and approximately one-third of adults will take five or more different medications during the same time period.16

    • Contact lens use combined with cosmetic use should be addressed, and it is recommended that contact lenses be inserted before makeup application to prevent trapping cosmetics under the lens and to prevent products from coating the contact lens.17

    Leslie E O’Dell, OD, FAAO
    Leslie E. O’Dell, OD, FAAO, is the director of Dry Eye Center of PA and Wheatlyn Eye Care in Manchester, 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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    Optometry Times A/V