Dry Eyes And Contact Lenses-A Good Article

A good article from Medicine.Net

Dry Eyes and Contact Lenses

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A properly fit contact lens should ride or float on the eye on a thin film of fluid (tear film). With each blink, this film of fluid between the contact lens and the eye is replaced with fresh fluid, allowing debris to be washed away and fresh oxygen that is dissolved in the fluid to reach the cornea. If this film is compromised in quantity or quality, the contact lens may become uncomfortable or even unhealthy to wear.

At each examination, the eye doctor will evaluate the fit of the contact lens and look for signs of early damage to the cornea that may be a result of a compromised tear film. If the contact lens itself is the problem, changing the lens curvature, diameter, or material may correct the problem. Sometimes the chemicals in multipurpose storage solutions for contact lenses can cause changes to the eye’s surface that mimic chronic dry eye, and this can be eliminated by switching to a hydrogen-peroxide based cleansing system. Other causes of compromise include exposure to chronic wind and dust, and incomplete or infrequent blinking, such as when staring at a computer for long periods without resting the eyes.

If the doctor suspects that a patient may be suffering from dry eyes, the next step is to determine the cause so treatment can be tailored appropriately. The eye’s tear film is actually composed of three separate layers, and a deficiency in any one of the three layers will result in an inadequate tear film.

  1. The mucin layer. This layer lies closest to the eye and is produced by the cells on the eye’s surface. These cells can be damaged by exposure to certain chemicals and medications, heat, or autoimmune disorders. The doctor will ask the patient detailed questions and will place dyes on the eye to assess the level and location of the damaged cells. Treatment may involve eliminating exposure to certain chemicals or prescribing anti-inflammatory eye drops such as Restasis or steroids.
  2. The aqueous (watery) layer. This layer is produced by the lacrimal glands. Function of the lacrimal glands can diminish with age or certain diseases. Again, the doctor will ask several questions and evaluate the severity of the dryness by placing dyes on the eye. Additional tests such as the Schirmer’s test (in which small strips of paper are placed in the corners of the eyes to measure the amount of tears that are being produced) or measurement of the concentrations of substances within the tears may be performed. An inadequate watery layer can be supplemented with artificial tear drops. The watery layer can be made to stay on the eye longer by placing tiny plugs in the eyelid’s punctae, the small openings on the eyelids through which tears from the eye drain into the nasolacrimal duct and then into the nose.
  3. The lipid (oily) layer. The eyelids have a special row of oil glands called meibomian glands that open onto the surface of the eye. With each blink, the oils secreted from these glands coat the surface of the watery layer, preventing the watery layer from evaporating too quickly between blinks. The doctor will examine the openings of these glands and assess whether the oils are flowing freely or are backed up in the glands. Also the tear break-up time (the amount of time it takes for the tears to evaporate from the eye’s surface) will be assessed. Thickened or blocked oil can be corrected with warm compresses, gentle massaging of the lids, and daily cleansing of the eyelid margins and eyelashes with mild soaps or baby shampoo. Thickened oils also can be thinned with dietary changes such as consuming more omega-3 fatty acids (found in fatty fish) and medications such as low doses of tetracyclines. Tetracyclines are particularly effective in people who also suffer from rosacea; however, they may not be used in women who are or might become pregnant.

Once the dry eye problem is treated and the quality of the tear film is improved, wearing contact lenses becomes both safer and more comfortable.

Dr. Warren

New Patient Intake Interview

We’ve been granting our patients access to their personal health record (PHR for short) for months now.  We just recently rolled out new features which now allow our patients to perform their Intake Interview even before coming into the office.  Patients of ours who have been receiving our eNewsletters have received some information about logging into their PHR.

This requires a couple of steps to insure proper handling of sensitive health care information.  Patients who want to access their PHR and/or complete their intake interview can go to revolutionphr.com   In order to log in, you will need your user name and password.  Just call the office at (262) 752-2020 or email us at office@warreneyecarecenter.com to request your credentials.  Include the phone number that you want us to call you at with the credentials in your email.

You will be given your log in name as well as a temporary password so that you can log into your PHR.  After that it will take you just a couple of minutes to complete your intake interview and you can always review your information.  If you aren’t able to complete your intake interview before coming to the office, you will be able to do so once you arrive, either on one of our office iPads or a computer in the office.  Emily will help you logging in for the first time while you’re in the office.

It will take a few weeks for this to all become “second nature” for our staff and patients, but having had patients log in upon arrival at the office for several years in the past, I know that patients will appreciate this new level of service.

Dr. Warren


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Wow! Our New Retinal Camera Is Here….

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Yesterday, we took delivery of our new retinal camera that I mentioned awhile ago.  I got it set up and working today and was able to take some test images and used the technology with one patient today.  All I can say is WOW!

The quality of the images is stunning and its incredibly easy to operate and the imaging process is so fast and easy that patients love it too.  This device will allow me to provide even more comprehensive and efficient care to you, my patients.   The two images above were taken with our new AFC 330 Camera, one is of the front portion of my eye (you can even see my RK scars, which are typically invisible) and the other is the very first photo that I took with the camera, its of my 14 year old son’s eye, without dilating the pupils!

Dr. Warren


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Today Was A Big Day, 68 Years Ago

No matter how you feel about the outcome of the recall elections yesterday, please take a few minutes today to reflect on the sacrifices and heroics of so many on D-Day.  It saddens me to see how little attention the local and national media spend remembering those sacrifices and educating our youth of the importance of this date.

If you have the good fortune of knowing or coming into contact with with a WW II vet today, please take a moment to thank them.   So many gave so much for us to have the right to hold free elections, it would be a shame on today of all days to not thank them for their heroics and sacrifices.

Dr. Warren