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    Uncover patient lifestyle habits that lead to OSD


    • The all-in-one solutions used by contact lens wearers have important anti-bacterial detergent properties, but they are also likely to contribute to epithelial distress, goblet cell distress, and tear film instability.7,13 Simply changing DED patients to daily wear contact lenses or to a hydrogen peroxide-based cleansing system can improve symptoms of DED.18

    • Visual fluctuations are a common symptom of DED. Keep this in mind when your refraction and vision exam don’t match, i.e., the 20/20 patient with complaints of blurred vision.19

    • Talk to your patient about digital device use, the number of devices and screens they view during their day, and the number of hours spent on devices. Digital device use is increasing, as are symptoms of eye discomfort, fatigue, and blurred vision.20 Infrequent and partial blinks are common when using digital devices, adding to evaporative stress to the ocular surface and tear film instability.21

    Related: Diagnosing and treating dry eye with technology

    Cosmetics and your patients

    This hypothetical patient highlights the multifactorial nature of DED. In holistic evaluation, many lifestyle and environmental stressors are uncovered as active contributors to her ocular irritation, blurred vision, and contact lens intolerance. The multifactorial nature is revealed: device use, rest, environment, lifestyle, hydration, medications, hygiene, cosmetics, hormone manipulation,22 to name a few.

    Of dry eye sufferers, approximately 70 percent are women.23 Millions more have dry eye symptoms of varying severity, which are episodic due to adverse contributing factors such as low humidity or contact lens use, cosmetics, and systemic medications.5

    Cosmetics aren’t being blamed enough for OSD. Additionally, our best interventions are handcuffed in the face of continued multifactorial insults that remain uncorrected. Overlooking the beauty counter can be detrimental, often at your patient’s expense. As cosmetics are a known exacerbator of dry eye and meibomian gland dysfunction, and an impressively growing market, with over $60 billion in revenues in the U.S. alone,24 it is paramount for ECPs to know the habits of our patients. We must educate ourselves, and our patients about proper ocular health, and cosmetic uses.

    As a profession, we have spent many years diagnosing and treating eye disease, yet the fact that our patients’ lifestyles and aesthetic routines can seriously compromise their ocular health remains underappreciated.

    Think of a noninsulin-dependent diabetes mellitus patient. Prescribing an oral anti-glycemic agent is not enough if the patient’s dietary habits remain poor.

    Working to improve our patients’ ocular surfaces won’t get us very far if our patients continue to use products that compromise the ocular surface.

    Managing tear film health is part of our daily routine… Managing our patients’ vision is our responsibility. Furthermore, a dysfunctional tear film may pose a health risk and/or negatively impact contact lens wear or surgical outcomes such as LASIK or cataract surgery. Know and learn your patients’ daily routines when determining their management and treatments. It is a rewarding way to enhance your patient’s quality of care.

    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