This week in KeratoScoop: Enough BAK already! Did-you-knows from TFOS DEWS II. Try a handy blinker! Ziena glasses are on sale. Allergan's still screwing around on Refresh PM. And we lost a giant, Perry Rosenthal MD. 

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March 13, 2018   Newsletter  -    Volume 10 - Issue 6


Another glaucoma drop study, but:

Really? How many more solid, compelling studies like this one, showing the damaging, drying effects of BAK-preserved glaucoma drops, will it take before industry and medical professionals stop plying this stuff and go completely preservative free? 

All you have to do to gather the facts is a little PubMed searching on benzalkonium chloride and dry eye (it's been very well documented for years) and then start reading the labels of drops people are using daily on a long-term basis. It does not take a conspiracy theorist to conclude that same ophthalmic pharmaceutical companies that are treating dry eye are also causing it with their BAK-preserved ocular drugs, and ophthalmology and optometry are not yet doing enough to prevent it.

Consumers, beware. If your over-the-counter (e.g. allergy, redness reliever or "combo") or Rx (eg glaucoma) drop contains benzalkonium chloride, and you're using it daily for a prolonged period, there are well known risks you deserve to know and you deserve lower risk alternatives.

Did you know?

If you score 13 or more on OSDI, you should be getting a proper dry eye diagnostic workup. (Source: TFOS DEWS II Diagnostic Methodology Report, section 8, clinical protocol.) Oh and by the way, get the smartphone OSDI app and score yourself before every doctor visit!

The objective of the TFOS DEWS II Pain and Sensation subcommittee was to “highlight the neurobiological mechanisms that underpin DISCOMFORT accompanying dry eye disease”. (My emphasis.) 34 pages and 543 references of… all about pain.

There are 170 different systemic drugs known or suspected to cause, contribute to or aggravate dry eye, according to table 3 of TFOS DEWS II Iatrogenic Dry Eye report, which also tells us that dry eye caused or worsened by lid surgery (e.g. blepharoplasty) is common and underdiagnosed,

Follow DryEyeZone on Twitter for daily TFOS DEWS II quick facts. 

DryEyeZone Blink Reminder

Upcoming events

March 19 - Orange County Dry Eye Support Group (Laguna Hills, CA). Guest speaker: Dr Dan Carver. Click here for details and to RSVP.

April 13-14 - SSF National Patient Conference: Exploring Sjogrens (Denver, CO). Click here for brochure and registration form.

June/July - Keratoconus patients, NKCF is working on an event in North Carolina in June and Illinois in July!

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


Product news

Refresh PM NITEYE bubble bandages
Yes, of course it's still on backorder. No, I don't know when. If you call or email Allergan you may receive any number of stories or dates (judging from what's been told and forwarded to us, none of which agrees with what they're telling us). Me, I won't believe anything till I see it at this point. NITEYE fans: I'm sorry, but we finally had to pass on the steep price hike we had from the manufacturer recently. Ouch! If you had an existing subscription, your price will not change, but all new orders and subscriptions are at the new price (ugh...$42.58... IKR???)

Purilens fans....

  • You're going to get your wish: they're working on a 2oz bottle! No guarantees about timing, but it's going to happen! I'm really looking forward to that. There are a lot of people who can't use all of a 4oz bottle within the time their doctor recommends continuing to use an open one.
  • Reminder to scleral lens users in Canada, Purilens is available now at There's a twist, though.

Use discount code ZIENA10 for 10% off Ziena Dry Eye Glasses

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For those who don't know our history, has always had a dual purpose: First, to provide a unique service, by wrapping information, support and advice around a lot of obscure products for patients whose needs are not well known or understood. Second, to financially support our own efforts in dry eye education and advocacy projects.

The Dry Eye Shop is in one of its rougher patches right now and we sure could use your help! If we have been helpful to you in some way - through the DryEyeZone or DryEyeShop sites, groups, newsletters, etc - and if you would like a way to show support, here are some suggestions:

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Thank you so much, everyone!!

Note from Rebecca

If you missed my tribute to Perry Rosenthal, it's on the blog now.

I've been so moved by all the emails and Facebook posts about what he has meant to others. We were so privileged to know him. 

Be well everyone!


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