This week in KeratoScoop: DREAM fish oil study results. Sjogrens conference. TFOS DEWS II Did-you-knows. Events. Lacripep trial recruitment. Free shipping. Rx dry eye glasses and other product highlights. 

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KeratoScoop

April 16, 2018   Newsletter  -    Volume 10 - Issue 11

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The DREAM study

Last Friday saw the much awaited publication of the results of the DREAM study of essential fatty acid dietary supplements in the treatment of dry eye.

This was to be the study to trump all studies. Hundreds of patients on a high dose of triglyceride form fish oil - or placebo specially designed to be indistinguishable from it - for an entire year. (Most other studies - and all meta-analyses of studies - have had much shorter treatment periods.) It was NIH-funded, and very, very carefully designed and executed. Everyone's been waiting to hear the results. 

And?

As far as dry eye went, the fish oil had no more effect than placebo. 

On the face of it, the results seem not just stark and disappointing, but almost unintelligible, given the history of research in this area. The results, of course, are all over the mainstream press, who, true to form, make it all sound very simple. 

It's not simple, of course, and the story's not over. Omega 3 supplements in one form or another have been a mainstay of dry eye treatment for so long that the recommendations won't change overnight, and this study will unquestionably be discussed and debated for a long time to come.

But the supplement industry has had a rude awakening, in the context of much broader trend of commentary on the role of vitamins and dietary supplements. As a minimum, we're in for some much-needed discussion of how to effectively, reliably evaluate the benefits of Omega 3s in dry eye. There is a role for simplistic questions (e.g. "Does it work?") - but it's a limited role. With dry eye, what we most often really need to be asking is, "For whom does it work?" and "How often does it work?" so we can get closer to the core questions of how and why it works (if it does).

If you're wanting to dig into the details, here's the study itselfhere's some contextual Omega 3 and dry eye information and references from TFOS DEWS II Management and Therapy Report, and here's my off-the-cuff in-the-moment blog response to the news last Friday: The DREAM Study Disappointment

Sjogrens patient conference in Denver

What a terrific time, and what a wonderfully organized event. This was my first time at the Sjogrens Syndrome Foundation's annual patient conference, and it was impressive. There were about 450 patients attending, most of whom traveled in from out of state! In case you're interested, here are some blog posts from Friday. I particularly enjoyed SSF Chair Steve Cohen's dry eye talk - he goes straight for the practical stuff everyone really wants to hear.

Friday afternoon on arrival

Dr. Johr's introduction to Sjogrens

Dr. Cohen's talk on dry eye

Did you know?

...TFOS DEWS II snippets from my daily tweets

The common preservative benzalkonium chloride (BAK) is damaging to everything from the mucous and lipid layers of the tear film to our trigerminal nerve endings. WHY is the industry still using this chemical in so many of our commonest OTC and Rx eye drops? More about this, from TFOS DEWS II Iatrogenic report, 4.3.2.1.

Dry eye after blepharoplasty is underdiagnosed. "A thorough knowledge of the eyelids' complex anatomical structure and function is mandatory to prevent inadvertent injury and to ensure effective tear film function," says TFOS DEWS II Iatrogenic report. This means - among other things - don't go, and don't let your friends go, to a plastic surgeon, no matter how well reputed - go to an oculoplastic surgeon.

Blink rate is not just affected by computer work, reading and other tasks requiring concentration, but... other factors including dopamine levels and cognitive state. More about this, from TFOS DEWS II Pain and Sensation report.

"New instruments and procedures designed to quantify eye sensations and pain need to be developed" to help people with dry eye. Industry, please set up and listen: dry eye is a symptom disease. More about this from TFOS DEWS II Pain and Sensation report.

 "Neuropathic pain should not be diagnosed as DED... but management, when it manifests as dry eye symptoms, needs further research." More about this from TFOS DEWS II Pain and Sensation report.

Upcoming events

April 28 - National Patient Conference, Sjogrens Society of Canada (Mississauga, ON). Click here for details and registration.

Nov 9-11 Dry Eye Retreat, Not a Dry Eye Foundation (Williston, FL). Click here for details and registration.

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

Dry eye clinical trials

Lacripep: If you have been diagnosed with primary Sjogrens Syndrome, you may be eligible to participate in Lacripep clinical trials. Recruiting at 28 locations. Click here for details. 

More dry eye clinical trials

Want to connect with other dry eye patients or scleral lens users? Join a group!

Dry Eye Talk (Forum)
DryEyeTalk (Facebook)
My Big Fat Scleral Lens (Facebook)
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DryEyeShop
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Blink and you'll miss the free shipping?!

Apparently.

I put a free shipping coupon in my last newsletter, and concluded it must have been invisible. Everything wants free shipping, just... not last week? Was it the waning crescent moon? 

Here's your second chance, and in fact a better deal. The button's nice and BIG and WIDE this time. If this doesn't get noticed, I'll have to resort to some kind of cheesy twirling animation.

Coupon code is KeratoScoop1011. Domestic US shipping addresses only. Expires Friday, April 20.

Free Shipping Over $50
Dry Eye Glasses

Rx Ready

Did you know? Ziena and 7Eye dry eye glasses take prescription lenses. Two ways to get prescription Zienas:

  1. Purchase the frames online, then take them to your optician for your Rx. Or:
  2. Once you're sure you know the frame fits and meets your needs, have us arrange to get your Rx done by the manufacturer's expert lab. 

To get a quote on prescription Ziena or 7Eye glasses, just email us your prescription, indicate whether you need single vision or bifocals, and give details of tints or any special coatings. Turnaround time is about two weeks.

TIP: For best results and least likelihood of needing a re-do, get your progressives done locally where the optician can get the most accurate seg height measurement.

Image of Ziena Nereus

Ziena Nereus

$160.00

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Image of Ziena Verona

Ziena Verona

$160.00

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Image of Ziena Oasis

Ziena Oasis

$160.00

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PROSE & Scleral lens supplies

ScleralFil preservative free saline

Did you know? ScleralFil, by Bausch & Lomb, is a buffered preservative free saline with the same ingredients as Purilens Plus and the long-since-discontinued Unisol 4.

It is sold in boxes of 30 10mL vials. These vials are twice the size of LacriPure and Addipak, and they are "flat-bottomed" so they will stand on end easily, which helps ensure the tip stays clean when you set them down.

ScleralFil is my personal favorite saline for travel. At least, until Purilens comes out with their much anticipated 2oz bottle! Meantime, I've grown quite attached to these 10mL vials.

For more tips on preservative free salines, see our PF saline guide.

One other quickie: Inexpensive scleral-friendly soap: Leader Optical Soap. If you want a more budget-friendly alternative to Ocusoft's excellent soap for contact lens users, try this one. Whatever you use, remember to always use soap free of moisturizers before handling your sclerals.

Image of ScleralFil 10mL Preservative Free Saline Solution

ScleralFil 10mL Preservative Free Saline Solution

$17.50

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Image of Leader Optical Soap

Leader Optical Soap

$2.50

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Night dry eye protection

Tip for the very, awfully, painfully dry at night

On those really rough nights, when you're just not sure how you'll make it through the night without getting up repeatedly to put in more "goop" (again), consider taping down your worst eye for the most effective relief. Pick a tape suited to your budget and skin sensitivity, from standard medical tape to the Cadillac style.

Image of Mepitac Soft Silicone Tape

Mepitac Soft Silicone Tape

$17.50

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Image of 3M Kind Removal Silicone Tape

3M Kind Removal Silicone Tape

$7.95

Buy Now
Image of 3M Micropore hypoallergenic paper tape

3M Micropore hypoallergenic paper tape

$3.10

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Drops, gels and ointments

What's in my drops?

Look it up on our handy ingredient reference list, rather than having to jump from product to product digging for details.

Find out all the nerdy dry eye patient's favorite trivia, like:

  • Which other drops have the same active ingredient(s) as your favorite?
  • Which drops contain lipids?
  • What preservatives, if any, are in gels and ointments?
  • Which drops have the BIG NO-NO, benzalkonium chloride?

If you are searching for ingredient information on a drop not on my list, please let me know so I can add it!

The luxury version of a cold or warm compress

When you feel like splurging and just want something really luxurious on your eyes... it doesn't get any better than the Tranquileyes XL kits. They come with beads (heated in warm water) or instants (the snap kind, that you boil afterwards) or BOTH. All of these kits were recently upgraded so they have LOTS more of the inserts included, so if you get the snap kind, you can go for a few days then just boil them all together to reset them. If you get the bead-only kit, you'll have enough to keep one pair frozen for those painful, inflamed, red lid days and one pair ready to heat for your MGD treatment.

Image of Tranquileyes XL with Beads

Tranquileyes XL with Beads

$59.00

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Image of Tranquileyes XL with Instants

Tranquileyes XL with Instants

$59.00

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Image of Tranquileyes XL with Beads & Instants

Tranquileyes XL with Beads & Instants

$79.00

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If you'd like to be supportive...

Small things are really, really helpful to us as a small business trying to do a little good in our little corner of the world! If you can do any of the following for us, we'd be so grateful! And thank you so much to those who have!

  • Like DryEyeShop and DryEyeZone on Facebook
  • Follow DryEyeShop and DryEyeZone on Twitter
  • Purchase something once in awhile at dryeyeshop.com that you might have gotten somewhere else a little cheaper.
  • Show your doctor a product you're using that you got from us. Share your doctor's name with us so that we can ask them if they would like some literature for their office.

Notes from Rebecca

DEZ library

On my way to Denver this past week, I finally started work on the new Dry Eye Library on the DryEyeZone site. (No, don't bother looking, it's not there yet.) It's SO FUN. All the writing I've been longing to do for the past five years - but even better than it would have been earlier, because now we have TFOS DEWS II as the handiest medical reference.

I know I sound like a broken record, but I just can't get enough of TFOS DEWS II. It's a really big deal to me to be able to go to a single source on so many topics, and get not only a terrific summary of "What We Know" - as in, accumulated medical evidence and thought over the past decade and beyond - but a complete list of references for ALL of the really reputable studies on each topic. It saves so much work along with the worrying and wondering what I'm missing even after hours of trawling through PubMed.

Anyway, the library is coming along, and I'll let you know when I get close.

Denver trip for SSF meeting

What a great trip! (Other than the actual travel part, which kind of stank, but I'm almost over it.) In between sessions I hung out quite a bit at the 7Eye/Ziena table. It was an eye-opener to see how many people with Sjogrens dry eye don't yet know about the concept of dry eye glasses! Amazing the things one takes for granted in my hyper-specialized little world. - I met so many amazing people, and learned a lot about Sjogrens that I did not know.

And the SBA emerging leaders class goes on...

It looks like I'm going to be using my newsletter for a little therapeutic writing outlet about the progression of the class. We haven't had any sessions since my last issue, but I spent much of today on my homework for tomorrow's class. Setting apart the actual business side of it, this process is teaching me so much about myself that I needed to know. Like exploring why on earth I have such an intense and seemingly irrational aversion to certain common things like planning and goals. It's definitely getting more interesting every day.

Have a great week everyone!

Rebecca

About KeratoScoop

KeratoScoop is Rebecca Petris's weekly newseletter on dry eye and scleral lens topics.

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