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Cover Story

                                                                                          DR Y E YE











                                                                           “  likely produce new ways
                                                                                Ongoing research will


                                                                                     to treat symptoms
                                                                                          and prevent
                                                                               meibomian glands from
                                                                                                           “
                                                                                       being blocked.















             dry eye can also create a great deal of  Thanks to improved technology and  iTEAR100 (Olympic Ophthalmics) is
             emotional distress for the sufferer.  fitting guidelines, scleral contact   an external nasal nerve stimulator that
                                               lenses are making a comeback as a  was recently approved by the FDA.
             Fortunately, dry eye symptoms can   treatment for DED, says Dr. Ngo.   A varenicline nasal spray (Oyster Point
             often be successfully treated. For MGD,  “These hard contact lenses sit over the   Pharmaceuticals)  is  also  expected
             lipid-based artificial tears prevent   entire cornea, like a bowl filled with   soon.
             evaporation and warm compresses   saline that holds a cushion of water
             help glands secrete oil. “Avoid   over the eyes.”                   As  to the future,  “we’ll  see  more
             facecloths which don’t retain heat,”                                innovations for warming and massaging
             says Dr. Ngo. “Medicated, warming   Recent technological advances include    eyelids on the device side,” says Dr.
             facemasks can  be  microwaved,  and   intense pulsed light (IPL) and    Ngo. “And ongoing research will likely
             eyedrops increase tear volume on the   radio-frequency, which warm the   produce new ways to treat symptoms
             ocular surface.”                  meibomian glands and allows them
                                               to release tears. Such treatments are   and prevent meibomian glands from
             Artificial tears have improved greatly    usually done in a doctor’s office and  being blocked.”
             over the years, he adds. Earlier    their effects last several months.
                                                                                 Amniotic eye drops could eventually
             versions contained preservatives,   Nasolacrimal stimulation, another   help with severe ocular surface
             which damage the ocular surface, but   recent  treatment, operates on a
             most are now preservative-free. Many   different mechanism for treating    disease, he adds. Researchers are
             eye  drops  contain  hyaluronic  acid,   dry eye than most therapies. “Most   also  tackling  the  fundamental
             which promotes healing of the ocular   first-line therapies supplement the   mechanism underlying DED: drops
             surface and helps retain water.   tear film, warming the meibomian   being  developed  in  Japan  will  allow
                                               glands, or reducing inflammation   people to secrete more tears. And
             The underlying cause of DED may   to maintain hydration at the ocular   research is underway to reduce
             be  inflammation,  in  which  case,  an    surface,” says Dr. Ngo. “Nasolacrimal   oxidative stress on the eye, which
             anti-inflammatory for the ocular    stimulation works by stimulating the   damages the ocular surface and plays
             surface may be prescribed. The proper   nasal nerve and could complement  an important role in DED.
             treatment, especially for the elderly, is   those therapies well.”
             often a mix of medication to improve                                The millennia-long marathon to treat
             tear output, plus an anti-inflammatory.  Not yet available in Canada, the   dry eye disease effectively continues.


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