Notes on what I can offer toward diagnosis, treatment & management of the following

DRY EYE/BLEPHARITIS/INSTILLING EYEDROPS

Dry eye researchers have developed the TFOS DEWS II flow charts to help manage dry eye

View these at https://www.sciencedirect.com/science/article/pii/S1542012417302148

and the executive summary can be found at TFOS DEWS II Report Executive Summary - PubMed 

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Points that I would add for selecting eyedrops:-

Aqueous deficit: Polytears (R) adds aqueous but flows through quickly.

Inflammatory  irritable eyes: especially where the oil layer of the tears is poor or the meibomian oil glands are in poor condition. Sodium hyloronate products work well to reduce lid- eye surface rubbing and a good environment for replacement cells to be stable and  reduce persistent inflammation.

Mucus membrane defects and epithelial cell lesions: Systane(R) provides a hand holding network across the non-wetting surface.

Sore inflamed eyes, including chronic dry eye: Novatears(R) can give  instantaneous relief but should be limited to one installation a day to reduce excess drops ( the dropper is poor and flows freely). It is very quick at soothing soreness. Novatears improves each tear component's performance ( aqueous, oil and mucus).. Where is its not useful is if the eye lack a tear component. It is especially good at dissolving oil caps in meibomian glands and this improves the oil flow to the tear film.

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Blepharitis: sterilid is a good foam to wipe through the lashes to reduce bacteria numbers and still be gentle on the skin. Sodium hyloronate  eye drop products rubbed through the lashes reduce bacteria numbers and improve cell moisture and can reduce the itchy sore feeling common in blepharitis. This is a skin friendly option.

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A home remedy used by chronic blepharitis suffers is 1/4 teaspoon of baking soda dissolved in 1Cup of boiled and cooled water. This is used over the eyelids, lashes and as an eye wash.

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I do not like shampoo being used on the lash area because it is harsh in comparison to other specifically prepared products.

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For children and eyedrop sensitive adults I frequently recommend the drops to be dropped onto the eye lashes at the nasal area, then ask the child or adult to blink several times. This is a lot less trauma for the individual who struggles to have their eyes open and waiting for the splash of the eyedrop. I have not seen any increase in bacterial eye infections from this method.

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There is an attachment for medicated eyedrops to assist people to get the drop in the open eye, and also an attachment with large flanges that compress the bottle for people with low finger strength ( such as in arthritis).

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ANTIFOG FOR APPOINTMENTS AND FLIGHTS WHERE MASKS ARE REQUIRED.

There are three products: single wet-wipe sachets which are quick, no mess and last 24 hours; No fog spray and wipe; No fog gel and wipe.

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Driver's vision: 10% of people with excellent sight and good binocularity fail the screening test when licencing with the Titmus screener. 20% fail because one eye has no sight, limited sight or uncorrected sight in one eye. Seldom do people pass with an uncorrected sight impediment. Optometrists separate the distance visual acuity from the stereo-vision component  and can pass those with excellent sight. We can advise people with poor sight  and ensure that the peripheral vision range is a pass for driving.

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Coming soon...

Red eye

Foreign body

Children's vision

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