Friday, November 2, 2007

Study: Usefulness of OSDI

We keep saying it... we keep saying it... I hope more doctors will start employing it! This is a great, EASY, quick little tool for assessing dry eye symptoms. That the results don't correlate with Schirmer should not be thought of as a drawback - since there has always been lack of correlation between symptoms and schirmer scores no matter how you measure them.

Ocular surface disease index for the diagnosis of dry eye syndrome

Ozkura F et al, Ocular Immunology and Inflammation, 2007 Sep-Oct;15(5):389-93.

Purpose: Evaluation of ocular surface disease index (OSDI) questionnaire for the diagnosis of dry eye syndrome. Methods: Sixty-eight patients admitted to the Ophthalmology Polyclinic of the Dumlupinar University between December 2005 and April 2006 were randomly studied. The OSDI questionnaire was performed before, and the Schirmer and tear film breakup time (TBUT) tests were performed after the routine ophthalmologic examination. Results: There was a significant inverse correlation between the OSDI and TBUT test scores, but no correlation between the Schirmer test scores and OSDI (r = -.296, p = .014, r = -.182, p = .138, respectively). Although there was a significant difference between the low and high OSDI having cases according to the TBUT test scores (p = .043), there was not according to the Schirmer test scores. Conclusions: The OSDI is a standardized instrument to evaluate symptoms, and can easily be performed and used to support the diagnosis of dry eye syndrome.

And by the way, in case you don't have a copy handy, here's a link to a downloadable copy of OSDI.

Newsblurb: Thank you to a Beverly Hills "opthamalagist"

What a great state of things compared to a year ago: There is now getting to be so much mainstream press coverage of dry eye that I no longer feel obliged to post blurbs about every half-witted press report about dry eyes out of exquisite gratitude to any journalist willing to give such a dull sounding topic the time of day.

But this one caught my eye and the obsessive English major in me (ok, so I did drop out... what's your point?) could not help herself.

No cure for dry eyes, but there are many effective new treatments

She went to see Beverly Hills opthamalagist Dr. Kerry Assil because she wanted Lasik eye surgery. But he told her it would make her dry eye condition even worse.

I thought that on Dry Eye talk I had already seen every possible way to butcher the spelling of this word but...


However, my indignation over their orthography quickly gave way to pleasure at reading that someone was actually told not to get LASIK because of dry eye. Thank you, thank you, thank you.

(By the way, I wouldn't exactly describe artificial tears, Restasis, plugs and steroids as "new" treatments, but never mind.)

Update on my BSLs

Just a quick update on my Boston Sclerals for those who are interested.

I've been wearing the BSLs since June 2006, and went back for an "update" recently.

Two reasons for new lenses -
1) Poor vision in my left eye. Entirely my fault, because I had to leave the clinic earlier than scheduled when I was being fitted back in 06, so we never got a chance to either review the fit of the left lens or optimize the vision. After that I just never managed to scrape together enough time to go back to BFS and do something about it. I'm right eye dominant and was so thrilled with the vision in that eye that I just didn't make it a priority.

2) Dr. Rosenthal came out with a new lens design (the T6) that I wanted to try.

I almost hesitate to tell you how efficiently Dr. Rosenthal nailed the new lenses for me - I don't want to set expectations for anyone else, because in most cases it takes several iterations and patients need to be there for 1-2 weeks. But... I can't help gloating over what a genius he is. In both cases, he nailed it in the very first lens he made.

The T6 is awesome. Incredibly comfortable. It was good before and better now. As for the vision, well, I suppose part of my response is due to having been walking around substantially undercorrected in my left eye for more than a year but I was blown away by how well I am seeing now. I flew home Tuesday night and after a long day followed by 7 hours of WESTbound travel, I was able to DRIVE myself and my daughter home (1.5 hours away from the airport) in the middle of the night. No chance of getting sleepy at the wheel, I was drinking in how clear everything looked and enjoying not being blinded by headlights. Granted - that was with freshly re-inserted lenses so I don't by any means expect it to be that way most evenings, but at least I known it CAN be if I refill them.

Another new thing for me: I tend to get some debris under the lenses, particularly the left. Dr. Rosenthal showed me a trick to reduce this which I am going to continue experimenting with: He told me to fill the lens partway with Celluvisc and top it off with Unisol. The idea is that the added viscosity will slow down fluid exchange so gunk can't work its way under the lens so quickly. It really worked very well the day I tried it at the clinic - most intriguing. However, I hate methylcellulose and couldn't bring myself to go buy some celluvisc, so I decided to try this with Dwelle. Did it yesterday successfully. Today I was short on time and stuck with just plain Unisol so I'll see how the performance compares. I will continue experimenting with this in both eyes and see how it goes.

BFS is such an amazing place. It's always inspiring to be there, seeing people who have been in pain and/or unable to see well for years suddenly have a whole new world opened to them when they get fitted. The combination of scientific brilliance, total focus on patient experience, and compassion make that a truly unique facility.

Other BFS updates - satellite offices opening in Houston (Baylor) and LA (Doheeny) in due time. Satellite newly opened in Tokyo.

I'm working on stocking all consumables for BSL users in The Dry Eye Shop, with the exception of cheap locally available items (hydrogen peroxide and Unisol). We currently have plungers - both for insertion and removal - and Lobob cleaner, and expect soon to have Miraflow, hydrogen peroxide neutralizing tablets, new contact lens cases specifically for sclerals, and some specialized plungers outfitted with lights for people who have difficulty inserting the lenses.

Will post on update when I've had a month or two in these new T6 lenses.