Wednesday, June 19, 2013

Abstract: Blink Intensive vs. Optive

They both did something, but Blink did it better & faster.

To analyze tear osmolarity over time after instillation of two commercially available eyedrops.
This prospective, nonrandomized, simultaneous, comparative, open-label, unmasked study included 40 eyes of 20 consecutive subjects (mean age, 34.8 ± 11.8 years) with a diagnosis of moderate dry eye. Subjects were instructed to administer contralaterally controlled lubricants to the right ([RE] Blink Intensive Tears, Abbott Medical Optics, Santa Ana, CA) and left ([LE] Optive Eye Drops, Allergan Inc., Irvine, CA) eyes three times daily for 21 days. The impact of hypoosmotic (RE) and osmoprotective (LE) drops on tear osmolarity (TearLab Osmolarity System, TearLab Corporation, San Diego, CA) was measured before and 30, 60, 90, 120, and 180 minutes after instillation of the first set of drops. Follow-up measurements were performed 22 days later, 1 day after the subjects stopped using the drops.
In RE, compared with baseline, tear osmolarity values were significantly reduced at all time points after instillation, including at 180 minutes (p < 0.01). In LE, osmolarity was significantly reduced from baseline at all time points through 120 minutes (p < 0.01) but returned toward baseline at 180 minutes (p < 0.11). The minimal value reached at 90 minutes after instillation or the average reduction from baseline osmolarity was 27.6 ± 9.5 mOsm/L for RE as compared with 22.1 ± 12.3 mOsm/L for LE. Both groups showed significantly lower tear osmolarity at 21 days compared with that at baseline (hypoosmotic, 307.8 ± 11.9 mOsm/L vs. 329.4 ± 8.4 mOsm/L, p < 0.001; osmoprotective, 316.1 ± 12.5 mOsm/L vs. 327.6 ± 8.4 mOsm/L, p < 0.002).
Our results showed that both eyedrops reduced tear osmolarity within a short time frame after drop instillation (i.e., up to 120 minutes) and after a longer time frame (i.e., 21 days of application). However, hypoosmotic drops with sodium hyaluronate reduce tear osmolarity at a greater and more sustained rate than glycerin and carboxymethylcellulose-based osmoprotectants.

Optom Vis Sci. 2013 Apr;90(4):372-7. doi: 10.1097/OPX.0b013e318288bdbe.
Montani G.
Course of Optics and Optometry, University of Salento, Salento, Italy.

Tuesday, June 18, 2013

7Eye AirShield and Ziena Oasis glasses available with CLEAR lenses now

All 7Eye AirShield frames are available with clear lenses now, I'm pleased to say... Prior to this, to get clear lenses for primarily indoor use you had to either get the much more expensive 24:7 lenses or incur the additional cost of getting a local optician to put in clear lenses.

$99 all frames.

Oh yes, and the Ziena Oasis is now available with clear lenses too, which should be helpful for those wanting them for the workplace.

Don't forget, the 15% pre-summer eyewear coupon is still good through end of the day Friday!

Abstract: More dry eye in psoriasis patients

Dry eye and tear film functions in patients with psoriasis.

To evaluate dry eye symptoms, tear film function and ocular surface changes in patients with psoriasis.
The Dry Eye Questionnaire and ophthalmic examination including the Schirmer test, tear break-up time, corneal fluorescein test, meibomian gland obstruction and conjunctival impression cytology were assessed in patients with chronic plaque psoriasis. Results were compared between 30 patients and 30 healthy controls.
The rate of positive responses in the Dry Eye Questionnaire and staining of corneal fluorescein test were significantly higher in the patients (P = 0.030) than in the controls (P = 0.012). The tear break-up time in patients was significantly lower than in the controls (P < 0.001). However, there were no differences in the Schirmer test and meibomian gland function between the patients and controls. In the impression cytology analysis, more cell alteration and decreased goblet cell density were observed in the patients (P < 0.001) compared with those obtained from controls (P = 0.003).
The dry eye symptom was more common in patients with psoriasis. In addition, the patients showed a higher tear film instability and significant degeneration on the ocular surface when compared with the normal controls.

Jpn J Ophthalmol. 2013 Mar 23. [Epub ahead of print]
Her Y, Lim JW, Han SH.
Department of Dermatology, Hallym University Chuncheon Sacred Heart Hospital, Chunchon, Republic of Korea.

Abstract: Don't (ab)use saline as an artificial tear?

To determine and compare the effects of single and frequent topical applications of saline solution on tear protein concentration in clinically normal subjects.... 
Even a single application of saline solution resulted in significant changes in major tear protein and sialic acid concentration in the tears of normal subjects. Differences in the recovery of tear protein concentration may be related to the process of protein production and secretion. A balance between normal tear function and the therapeutic effects of ophthalmic solutions should be considered when deciding the frequency of application, particularly in patients with dry eye.

The first thing I thought of reading this was... wish I could see the exact same study using, say, Refresh Plus PF or some other typical non viscous CMC drop. Obviously, saline is NOT a lubricant and should not be thought of or used as such... yet... I've known so many people who overused artificial tears (say every 10 minutes or so) and never had any doctor suggest it might not be good for them, though one would think the 'washout' effect described here ought presumably to apply to those too I would think?

I confess I am a proponent of occasional use of saline drops by dry eye patients – but for specific reasons and ONLY within reasonable limits.

1) As an alternative eyewash. Better to use saline (0.9% sodium chloride) than a BAK-preserved commercial eyewash product (as they virtually all are).
2) As an occasional drop for the soothing effect. There are a lot of dry eye patients who report that all polymer artificial tears make their eyes feel worse… temporarily wet, for sure, but less comfortable. Some of them have developed sensitivities to certain ingredients. Many of those who can afford it are on serum tears instead. Most pursue alternatives to keeping comfortable such as moisture chamber glasses, cold compresses or what have you. But now and then they just need some way to feel nice and wet without introducing irritating stuff. There's nothing more soothing when your eyes feeling like they're burning holes in your head than a stream of chilled saline. But not as a habit, please!!!!
3) As a buffer for more irritating drops. A handy trick for rendering a highly irritating Rx drop (Restasis a commonly cited one…) is to put in a teeny drop of saline 10-15 minutes earlier.

Curr Eye Res. 2013 Jul;38(7):722-8. doi: 10.3109/02713683.2013.777967. Epub 2013 Mar 22.
Shigeyasu C, Hirano S, Akune Y, Mochizuki H, Yamada M.
National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center , Meguro-ku, Tokyo , Japan.