Therapearl Cold Eye Mask

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Lacroix, Z., Leger, S. & Bitton, E. Ex vivo heat retention of different eyelid warming masks. Cont. Lens Anterior Eye 38(3), 152–156 (2015). Meibomian gland dysfunction (MGD) is the most common cause of dry eye disease (DED) and affects between 5 and 50% of the world’s population 1. MGD is defined as a chronic, diffuse abnormality of the sebaceous meibomian glands, which commonly is characterized by obstruction of the glandular duct and/or changes in the quality/quantity of glandular secretion 2. The condition, which is associated with age, sex, hormonal disturbances and environmental factors 3, leads to tear film alterations and ocular surface disease. Importantly, obstruction of the meibomian gland duct can lead to ductal dilation and subsequent loss of secretory cells in the gland 3. Consequently, the amount of secretion produced by the gland (meibum) is reduced. The obstruction is most likely also responsible for degeneration of the meibum. In MGD, the amount of branched chain fatty acids and cholesterol in the meibum is increased, which results in a more waxy and viscous secretion 3. Dysfunction of the meibomian glands could lead to increased evaporation of the tear film and evaporative DED 1. Department of Gastroenterology, Innlandet Hospital Trust, Kyrre Grepps gate 11, 2816, Gjøvik, Norway Belmonte C, Nichols JJ, Cox SM, et al. TFOS DEWS II pain and sensation report. Ocul Surf. 2017 Jul;15(3):404-37. FBUT is one of the most common tests used to diagnose and monitor DED and was chosen as the primary objective efficacy measure in this study. FBUT improved significantly for both groups from baseline, without any difference detected between the treatments. Additionally, our findings indicate that males generally experienced a greater increase in FBUT after 3 and 6 months of treatment (mean 1.33 s and 2.68 s respectively relative to females), suggesting that treatment may be more efficacious in males. FBUT has some limitations 49, 50, 51, 52, 53. Fluorescein itself reduces the stability of the tear film 54, 55 and the scoring of FBUT is not always exact. To this end, a standardized amount of fluorescein was instilled into each eye using a pipette, and the same observer performed measurements at each visit to eliminate the possibility of inter-observer bias. In addition, all measurements were repeated three times during each visit, with the mean value being recorded.

Oral supplements. For years we have prescribed omega-3 fatty acids (FA) for MGD and dry eye. Recently, the DREAM study has changed how we see this practice. 15 Basically, the study demonstrated that the particular FA supplements used in the well-designed trial did not help MGD any more than the sham pills that contained small amounts of olive oil determined to be easily met by most North American diets. With the heart community also finding little benefit to omega-3 supplements, many practitioners are discontinuing that recommendation. 16 Patients probably won’t complain, considering the high cost of these supplements.Blinking is free, as are several easy blinking exercise apps. Patients should adhere to the 20/20/20/20 rule: every 20 minutes take 20 seconds to look 20 feet away and blink 20 times. For those who struggle to incorporate regular blinking exercises, free apps, such as such as the Donald Korb Blink Training App (TearScience) and EyeLeo, encourage proper blinking with reminders and proper pacing. 17,18 Thomas J, Jacorb GP, Abraham L, Noushad B. The effect of smoking on the ocular surface and the precorneal tear film. Australas Med J. 2012;5(4):221-6. Sung S, Wang MTM, Lee SH, et al. Randomized double-masked trial of eyelid cleansing treatments for blepharitis. The Ocular Surface. 2018;16:77-83. Environment. Many environmental changes are inexpensive and particularly effective. Patients should use wraparound glasses and sunglasses when outside to prevent wind current from drying the eyes. In our office, we keep examples of Pantoptix glasses and other forms of protection such as Cocoon (Live Eyewear) that can be worn over regular glasses. Directions: Thera Pearl Eye Mask should be applied to skin or closed eyelids no more than the doctor recommended time of 20 minutes. Remove and wait at least 20 minutes. Reapply eye mask for no more than 20 minutes, if needed. Clean eye mask gently with mild soap between uses.

If your under-eye area is what’s dry, try these eye gel patches from Skyn Iceland. After leaving them on for 10 minutes, the transdermal eye patches will infuse the skin around your eyes with hydrating, soothing, and plumping ingredients like jojoba oil, olive fruit oil, and hydrolyzed extensin. Additionally, gingko biloba leaf extract brightens and de-puffs; coenzyme Q10 offers antioxidant protection; and the brand's own Icelandic complex, which comprises a blend of detoxifying and hydrating ingredients, like glacial water and arctic cloudberry, moisturizes even further. Store these in the fridge, and they'll feel even more amazing when placed beneath your dry, tired eyes. Jie Y, Xu L, Wu Y, Jonas J. Prevalence of dry eye among adult Chinese in the Bejing Eye Study. Eye (Lond). 2009;23:688-93. Nelson, J. D. et al. The international workshop on meibomian gland dysfunction: Report of the definition and classification subcommittee. Invest. Ophthalmol. Vis. Sci. 52(4), 1930–1937 (2011). Turner, A. W., Layton, C. J. & Bron, A. J. Survey of eye practitioners’ attitudes towards diagnostic tests and therapies for dry eye disease. Clin. Exp. Ophthalmol. 33(4), 351–355 (2005).

Over-the-Counter Eye Care + Supplements

Department of Optometry, Radiography and Lighting, National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of Southeast Norway, P.O. Box 235, 3603, Kongsberg, Norway FBUT is one of the most common tests used to diagnose and monitor DED and was chosen as the primary objective efficacy measure in this study. FBUT improved significantly for both groups from baseline, without any difference detected between the treatments. Additionally, our findings indicate that males generally experienced a greater increase in FBUT after 3 and 6 months of treatment (mean 1.33s and 2.68s respectively relative to females), suggesting that treatment may be more efficacious in males. FBUT has some limitations 49– 53. Fluorescein itself reduces the stability of the tear film 54, 55 and the scoring of FBUT is not always exact. To this end, a standardized amount of fluorescein was instilled into each eye using a pipette, and the same observer performed measurements at each visit to eliminate the possibility of inter-observer bias. In addition, all measurements were repeated three times during each visit, with the mean value being recorded. Lubricants. In almost every form of DED, a lubricant is needed. However, the sheer number of ocular lubricants on drug store shelves is overwhelming. Patients need guidance in choosing the correct product for their specific form of dry eye, especially regarding generic brands, in which the preservatives often differ from branded products. For example, patients with predominantly MGD-induced evaporative dry eye will likely do better with a lipid-based drop, at least until those glands are functioning normally. For effective treatment of MGD, temperatures of warm compresses need to exceed 40°C 26– 28, setting the basis for treatment with heating devices. Several studies have shown that Blephasteam (Spectrum Thea Pharmaceuticals LTD, Macclesfield, UK), a steam-based system, is effective at delivering heat to the eyelids and treating MGD 19, 29– 31. Only one other trial has compared Blephasteam to another device 32. Wolffsohn JS, Arita R, Chalmers R, et al. TFOS DEWS II diagnostic methodology report. Ocul Surf. 2017;15(3):539-74.

Jaeschke, R., Singer, J. & Guyatt, G. H. Measurement of health status: Ascertaining the minimal clinically important difference. Control Clin. Trials 10(4), 407–415 (1989). For those who do not need the extra lipid or those who do not do well on a lipid-based drop, the biggest decision is whether to recommend preserved or non-preserved drops. Clearly, benzalkonium chloride (BAK) should be avoided if possible, but the effects of other preservatives have yet to be studied on a clinical level. The rising trend is to use non-preserved drops, a clinical wisdom without clear clinical scientific evidence. In theory, preservative free formulations eliminate one possible irritant; in practice, many of the new preservatives seem to work well for patients and the formulations are often less expensive. Treat any underlying skin conditions — conditions like rosacea can have a big effect on dry eyes. Oftentimes, skin or overall health conditions can correlate to dry eyes so treating any underlying conditions can subsequently have a positive impact on dry eyes.”

Product Summary

Terada, O., Chiba, K., Senoo, T. & Obara, Y. Ocular surface temperature of meibomia gland dysfunction patients and the melting point of meibomian gland secretions. Nippon Ganka Gakkai Zasshi 108(11), 690–693 (2004). Patients should always keep airflow away from their eyes to avoid exacerbating dry eye. Counsel them to avoid long-term exposure to ceiling and box fans (especially at night) and to keep the heat and air conditioning in the car at their feet, not in their face. Dry eye therapy is often incredibly daunting to patients. Most people are familiar with diseases treated with a course of medication, surgery or a few weeks of palliative measures as their body fights off the untreatable virus. Unfortunately, dry eye tends to be chronic and patients must understand that they are in for a lifetime of care. I liken this new eye care approach to that of their dental care. Without thinking, most of us floss, brush and see our dentist regularly. Similarly, all patients, and dry eye patients in particular, need to care for and maintain a healthy ocular surface over their lifetime.

Suitable cold or hot, you can choose the type of treatment you’re after with Thera-Pearl Eye-ssential Mask. Designed with Pearl Technology, the small pearls can retain heat or remain cool for long periods of time. This versatile product is suited to those with even the most sensitive eyes.Wolffsohn, J. S. et al. TFOS DEWS II diagnostic methodology report. Ocul. Surf. 15(3), 539–574 (2017).