The Curse of Dry Eyes

http://www.npr.org/blogs/health/2014/09/04/345518998/dry-scratchy-eyes-staring-at-screens-is-driving-this-trend

More and more Ophthalmic healthcare professionals are treating dry,scratchy eyes every day.We love our PDA's and tablets so much that we all cannot stop staring at them,often decreasing our blink rate to an alarming level. Combined with the increased evaporation of our tear film due to poor production from our meibomian glands- a recipe  for red,painful,scratchy eyes that feel as if they have been sand blasted.

Hope is on the way with a variety of tools and supplements to treat meibomian gland disease, blepharitis and other common causes of dry gritty eyes.

The increased intake of omega 3 oils certainly helps, but the plugged glands themselves often need warming and expressing to clear the debris.Expensive methods such as the lipiflow have not shown benefit over meibomian gland expression with specialised gland compression forceps (Malosa UK) and at a much more reasonable cost.

Crusts on the lashes that develop with blepharitis can now be removed with a device from the USA called Blephex.This device removes the build up of debris on the lid margin common with blepharitis.

A staggering array of dry eye drops are now available,and choosing between them is often subjective.Preservative free and hypotonic drops give greater comfort .

Once the surface of the eye is uninflamed, a punctal plug maybe used to improve the retention of tears on the surface of the eye and therefore the comfort.These are simple to insert by a trained Eye doctor,you cannot feel them, or easily see them as they are less than a millimeter in diameter.

Some hope for all those sufferers.

 

Advances in glaucoma

Glaucoma is a common progressive condition, causing blindness in both the elderly and the young alike.For many years the treatments consisted of eye drops to lower the pressure inside the eye,which was the main risk factor for progression.

These drops are often difficult to administer, toxic to the surface of the eye, and often forgotten until its time for another appointment with the eye doctor.

Although surgery has been available for Glaucoma, trabeculectomy creates a channel through the white of the eye (sclera) hidden under a flap,this procedure was invented in the 1970's,and carries some significant risks, and often requires repeat visits to get it "just right".

This has provided an opportunity for the innovators to find better ways of treating Glaucoma,including Glaucoma Drainage devices,trabecular stents,suprachoridal stents and intraocular lasers.

The future is looking brighter for Glaucoma sufferers!

 

Learning from scrolls

The philosophy in Cornea transplants is now to direct treatment to the diseased cells only.The latest treatment available for Corneal endothelial diseases is DMEK,or Descemets Membrane Endothelial Keratoplasty. This treatment requires a Corneal donor, a Surgeon with the skills to remove the endothelium without tearing,and precision instruments.

In all new treatments, a period of collaborative learning with those interested in innovating and providing the latest techniques, meeting and sharing ideas.

 The early morning Eurostar from Ebbsfleet.

The early morning Eurostar from Ebbsfleet.

The Eurostar from Ebbsfleet arrives at Gare du Nord by 0915 and another 15 minute taxi ride to The Rothschild Opthalmological Institute in Paris to visit Dr Alain Saad and spend the day practicing DMEK ( and visiting the Grand Palais for dinner!) kindly sponsored by Geuder who produce excellent instruments for DMEK

 Dr Alain Saad and Damian Lake

Dr Alain Saad and Damian Lake

You can see how the Descemets scrolls up and is aspirated into a glass cylinder on my video above, ready for transplantation.This thin piece of tissue enables the Cornea to stay clear and returns sight to the blind,which is why its so important to share the knowledge.Thank you to Alain and his team for such a great day and enjoy the video.