This week in KeratoScoop: Thyroid eye disease drug coming. Recent study on IPL. Surveys and more surveys. Free shipping annual subscription option that helps us raise preservative awareness! Special discounts on subscriptions. Nanotears are here. And lots more.

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March 4, 2019   Newsletter  -    Volume 11 - Issue 5

In this issue...


  • Drug news
  • IPL study
  • Various abstracts
  • Upcoming events
  • The NuLids question
  • Another survey! Omega 3s? Skin care?
  • And yet another survey (3rd party this time, about laser surgery)


  • DryEyeShop PF free shipping subscriptions!
  • SPECIAL! Subscribe & save 20% on lid hygiene
  • Did you know? About baby shampoo...
  • Onion goggles (& optical) return
  • Video redux
  • NanoTears are here
  • Preservatives in the shop's drops: going, going, GONE.
The Dry Eye Zone
Dry Eye Stories
Dry Eye Talk Forums

Drug news

Horizon Pharma reported positive Phase 3 trials of their orphan drug teprotumumab for thyroid eye disease. Most participants experienced a 2mm reduction in proptosis. They have fast-track status as an orphan drug and plan to move ahead with it this year. More here. 

This is not about a dry eye drug per se, so it isn't on my drug pipeline page, but those who suffer from dry eye as a result of thyroid eye disease will want to know!

Study highlight: IPL

Thought this one was particularly worth caling attention to - I get questions about IPL pretty frequently these days - so I blogged about it a bit:

IPL for stubborn MGD

Various interesting abstracts

Autologous serum for neuropathic cornea pain

Grading scales for ocular surface staining

Surgical treatment for exposure-related severe dry eye

Sjogrens and dry eye

A couple of abstracts specific to Mexico:

Converting a dry eye questionnaire for Mexican users

Risk factors for OS damage in Mexican dry eye patients

And for further reading "Dry Eye Research - Still regressing?" (Seitzman et al, Ophthalmology 2/19). Raises important questions.


Houston (March 23, 8am-2pm) - Keratoconus

NKCF is holding another Keratoconus Family Symposium. It's going to be great! Wonderful lineup of speakers as always, addressing a range of topics, both medical and practical. It's a great opportunity to connect with other individual and families affected by keratoconus. I will be there and would love to meet you! Click here for details or to register.

LA Area (April 8, 1pm-3pm) - Dry Eye

Orange County Dry Eye Support Group is hosting a meeting next month. They are always very well organized and informative, and this meeting will feature Dr Dan Carver (speaking on IPL and NuLids. Click here for information and to RSVP. 

Know of an event that should be listed here? Please send details!

The NuLids question!

Last week, I reached out for feedback on the possibility of our stocking NuLids at the DryEyeShop. Thought you might like to see the results!

NuLids Survey Results

In a nutshell:

  • 70% of people had never heard of it
  • 87% are or might be interested in it
  • 43% thought the price was reasonable, and
  • 79% thought it was appropriate for the DryEyeShop to stock it. 

But... the real highlight was all the comments. I'm so grateful to all of you who take the time to complete these surveys and provide such thoughtful feedback. It's more than just gathering information. In this case, there's something particularly precious to me about the collaborative, community approach to considering something for the shop... it meant a great deal to me. 

The bottom line to me right now is that I'm going to continue looking into, and testing NuLids, and I'm keenly interested in feedback from anyone using it. I'm not going to stock it in the public part of our store but I am considering stocking it on behalf of doctors who are training patients on it. That might make it a convenience for them (if for example they could get their tip replacements from us) and it would still put is in the middle of the information stream, which I'm keen on. I would really like to get a better sense of what the particular 'niches' will end up being for this product. As I've mentioned, I feel rather strongly about people having good home care tools for MGD, not exclusively a lot of expensive in-office procedures though I recognize those have their place.

Should we or shouldn't we: Omega 3s? Dry eye friendly skin care?


To keep the Dry Eye Shop strong, we really have a need to diversify a little and expand into some new areas. I do NOT have any intention of straying away from our core competencies... I only ever want to sell things here to the extent doing so is a service. 

Anyway, I was so encouraged by the outpouring of feedback about NuLids that I decided to start asking more questions about what we should do! So, up next:

  • Should we stock Omega 3 fatty acid supplements? We used to... like 10 years ago. I stopped when the market got flooded with a ton of proprietaries, and there were a ton of poorly executed, suspiciously funded studies. The data were confusing and uninformative and the marketing was... depressingly rah rah rah. But I'm wondering if it's time to re-enter this area, learn about it again and see what I can do to help create some context for the options.
  • Should we stock skin care products that are believed to be dry eye friendly? This is an area I feel painfully ignorant of and we get asked more, and more, and more. I'm talking about good quality skin products to help eyelids that are sore and dry eye from dry eye treatments, or possibly even some makeup items that may be reasonably compatible with mild to moderate dry eye (or special occasions for those of us who rarely venture into eye makeup anymore). I put a feeler out on the Facebook group and the response was overwhelmingly positive. This is definitely an underserved area, and I'm definitely going to start collecting information. Remains to be seen whether we start stocking products!
  • Is there some other product or type of product you feel we should stock?

Thanks in advance!

Did you have complications from laser eye surgery?

As you probably know, I am not a fan of elective laser surgeries because, while many have good experiences and outcomes, there are a lot of others who have had dry eye, eye pain, or vision complications (or even all of the above, like myself incidentally) - even those whose surgery was impeccably performed by one of the most highly qualified surgeons. Depending on the type and degree of issues, these problems can have profound life impact that is poorly understood, from forms of dry eye that do not respond to treatment, to life-altering chronic eye pain patterns, to PTSD and severe or persistent depression. I consider myself very fortunate not to have experienced any of the extremes. I do, however, have chronic eye pain and quite a bit of vision loss - both acuity and quality; at my last appointment, my BCVA was 20/80 and I have extremely low contrast sensitivity and other issues which thus far have not all been solvable even with scleral lenses. 

Most of you who have followed me for awhile also know that I do not get involved in "anti lasik" campaigning. It's not my thing, and I want to avoid - if possible - contributing to or hosting discussions that could be unhealthy or even unsafe for people who are struggling. 

But... I believe it's a travesty that industry leaders refuse to address these matters, neatly side-stepping the issues at stake and instead pointing to high "satisfaction rates" and low rates of, say, intra-operative complications. So I want to be supportive of any efforts to gather data on our issues that could be useful in some way. As you know I love surveys and data!

The following link is not a DryEyeZone or DryEyeShop survey, it is being run on behalf of the site (some of you are familiar with them or the Facebook group). So any of you who have had complications after an elective vision correction surgery such as RK, PRK, LASIK, SMILE, please consider adding your information:

Patient Experiences After Refractive Surgery Gone Wrong: Make Your Voice Heard


Annual Free Shipping Program

Want free shipping?

If you are a frequent purchaser, we have an annual membership program with free shipping that helps you save, and helps us do more to raise awareness about dry eye risks! Check it out:

PF = Postage Free!

PF = Preservative Free!


DryEyeShop PF is our way of offering you a better deal on shipping.

For $99 annual fee, you can have unlimited free shipping in the shop for a year! 

For an even better deal, pair this with a subscription to save more on things you need regularly!

Part of the proceeds of these annual fees goes to our 2019 eyedrop preservative awareness campaign. Be part of making a difference!

Read all about DryEyeShop PF!

Speaking of shipping

We've upgraded our shipping calculator software and... I've never, ever managed to do that in the past without a few hiccups here and there. If YOU are experiencing any problems, please let us know and we'll fix them ASAP!

Eyelid care

Subscribe & SAVE... on lid hygiene!

20% off

... your first shipment, then 5% off all recurring orders! Swap products at any time to try others!

Browse all eyelid hygiene products.

Did you know?

Lid scrubs are not just better, but also safer than diluted baby shampoo: Baby shampoo can reduce goblet cell density! See section 3.1.1 of TFOS DEWS II Management and Therapy Report (a/k/a The Dry Eye Bible).

Dry Eye Glasses

Onion Goggles are back!

ONION GOGGLES are back! And with them, I'll be bringing back some of our low-cost dry eye glasses and goggles. While I had plenty of reasons to stop selling this category last fall, the fact is, I'm always referring people places for them, and will always be a big believer in the practical relief they can bring, and we get so many people asking about them that it's just more practical to continue selling them. So you'll see them gradually being added back to the shop over the next few months. Next up will be the Guard Dogs products.

Onion Goggles

Video reruns

I know, I need to do some new ones! I'll get there soon! But in the meantime, there's lots of subscribers who have never seen the existing ones....

Practical solutions for the non-closing eyelid

Comparing the various moisture goggles for night use

PROSE & Scleral lens supplies

Subscribe & save... SALINE!

20% off

... your first shipment, then 5% off all recurring orders! Swap products at any time to try others!

For a truly great deal, sign up for our free shipping annual subscription (DryEyeShop PF) as well!

Browse all saline products.

Back: Dalsey Adaptives See Green products

Not new, just returning from vacation (a/k/a technical glitch in the shop). This product line is comprised of special aids for scleral lens users who are unable to successfully use conventional scleral lens insertion tools and techniques.

Dalsey Adaptives
Drops, gels and ointments

NanoTears are here!

Image of NanoTears MXP FORTE Preservative Free

NanoTears MXP FORTE Preservative Free


Buy Now
Image of NanoTears TF Preservative Free

NanoTears TF Preservative Free


Buy Now

Going going GONE! Preservatives

In the interests of raising awareness about preservative risks, we are taking the lubricants at the Dry Eye Shop completely preservative-free. 

What does this mean for you? You will no longer be able to find the following types of products at the Dry Eye Shop:

  • Any drops with preservatives. (The only ones we ever had were Systane Balance, which we stopped carrying, and FreshKote, which recently became preservative free.)
  • Any gels. (Because all gels have preservatives. Except, of course, gel drops, e.g. Celluvisc, but that's a drop, not a gel. We haven't had gels in stock in a long time anyway, though, because Alcon have had them on backorder for so long. Genteal Gel in particular is very popular in the dry eye world, so I wanted to give everyone a heads up that we will not continue stocking it. I have a lot of respect for that product, but... we want to be preservative-free across the board.
  • Any contact lens wetting drops. Because, so far as I know, all drops labeled as lens wetting drops contain preservatives. If any PF versions come on the market, we are very likely to stock them (that is, if they're any good) for the benefit of scleral lens users. 

Just so you know, our preservatives 'ban' applies only to drops for use in the eye. Our biggest concern with preservatives is potential damage to the tear system and ocular surfaces resulting from long term exposure. We will still be stocking lens cleaning and disinfection solutions that have preservatives (because there are no sufficiently good PF options on the market for most of them) as well as lid hygiene products and such, though even with the lid care products you'll see us leaning more and more to the most ingredient-friendly options we can find.

If you...

...received one of our customer satisfaction survey eyes and completed it, THANK YOU! The positive responses are SO heartening. The ones with questions and suggestions are SO educational and helpful for us. I really, really appreciate everyone taking the time to complete these!

Are you connected?

Join a group!

Dry Eye Talk (Facebook)
My Big Fat Scleral Lens (Facebook)

DryEyeTalk (Forum)

Random last-minute notes

Not to whine, but 10:30pm on a Sunday, squinting at my laptop, is just never my ideal time to be blogging or writing a newsletter.j I have been dousing my sclerals with scleralfil every so often for the past hour (and no, that's really not a good idea either). 

Please consider kicking in $5 per month to my Patreon account so I can do this a little more comfortably. The better I can see, the better I can do my job :) 

Begging duty dutifully completed (ugh).

Have a terrific week, everyone!


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The Dry Eye Shop | 20720 State Hwy 305 NE Ste 2A Poulsbo, WA 98370 | 1-877-693-7939