DRY EYE INFORMATION AND TREATMENTS

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1 DRY EYE INFORMATION AND TREATMENTS

If you cannot come to your appointment, please call us at least 24 hours before at 450.419.6345. Failure to notify us will result in a $50 fee being charged.

com DRY EYE INFORMATION AND TREATMENTS DÉFINITION Dry eye is a multifactorial disease of the tears and the ocular surface that results in discomfort, visual disturbance and tear film instability.

This abnormal condition might appear simple at first glance, but it can have a significant effect on a patient s visual comfort and quality of life.

2 If you cannot come to your appointment, please call us at least 24 hours before at Failure to notify us will result in a $50 fee being charged. Institut de l œil des Laurentides 4800, rue Ambroise-Lafortune Boisbriand, Québec J7H 1S6 Telephone: ŒIL (6345) or ŒIL (6345) Fax: YEUX (9389) institutdeloeil.com DRY EYE INFORMATION AND TREATMENTS DÉFINITION Dry eye is a multifactorial disease of the tears and the ocular surface that results in discomfort, visual disturbance and tear film instability. It is accompanied by increased osmolarity and inflammation of the ocular surface. Dry eye is a very common and widespread syndrome. This abnormal condition might appear simple at first glance, but it can have a significant effect on a patient s visual comfort and quality of life. If not properly treated, dry eye can also damage the surface of the eye. The Institut de l œil des Laurentides is a Specialized Medical Centre accredited for a second consecutive time with the highest distinction from Accreditation Canada: Accredited with Exemplary Standing. The accreditation process serves to evaluate and improve the quality and safety of the health care delivered and to standardize policies and procedures.

DRY EYE HAS MANY CAUSES Here are a few: Aging. Systemic disease. Topical or systemic medications. History of eye surgery. Environmental factors (poor ventilation, poor air quality).

3 DRY EYE HAS MANY CAUSES Here are a few: Aging. Systemic disease. Topical or systemic medications. History of eye surgery. Environmental factors (poor ventilation, poor air quality). Reduced blink rate (computer work, reading). Allergies. Reduced tear production. Poor-quality tears. HERE ARE SOME SYMPTOMS OF DRY EYE: Blurred vision/reduced vision. Burning sensation/irritation/redness. Feeling of a foreign body in the eye. Watery eyes. Sensitivity to light. Pressure around or behind the eye. Eye fatigue.

$TYPES OF DRY EYE Dryness caused by aqueous tear deficiency (decreased tear production) Decreased tear production can be caused by aging, hormonal changes, medication, refractive surgery (LASIK) and$ chronic inflammatory diseases (e.g. Sjögren s syndrome, rheumatoid arthritis, etc.).

chronic inflammatory diseases (e.g. Sjögren s syndrome, rheumatoid arthritis, etc.).

4 Dry eye is divided into two major categories that require different therapeutic approaches. Note that most cases of dry eye are a combination of both! TYPES OF DRY EYE Dryness caused by aqueous tear deficiency (decreased tear production) Decreased tear production can be caused by aging, hormonal changes, medication, refractive surgery (LASIK) and chronic inflammatory diseases (e.g. Sjögren s syndrome, rheumatoid arthritis, etc.). In these cases, the treatment for dry eye consists of increasing the quantity of tears on the surface of the eye, using artificial teardrops, lubricating ointments or topical medications. Dryness caused by excessive tear evaporation (poor tear quality) In the presence of blepharitis (eyelid inflammation), poor-quality tears derive most often from a dysfunction of the meibomian glands. The opening of these glands is located on the edge of the eyelids. The glands secrete meibum, an oil that protects tears from evaporating. If the secretion of meibum is altered, the constitution of the tears is compromised. This results in very rapid tear evaporation.

TREATMENT GOALS Inflammation Débris Blépharite Normal Blepharitis causes redness, irritation, itching and the formation of flake-like scales on the eyelids.

5 TREATMENT GOALS Inflammation Débris Blépharite Normal Blepharitis causes redness, irritation, itching and the formation of flake-like scales on the eyelids. Blepharitis is often bacterial in nature or caused by a skin condition, such as dandruff or rosacea. It affects people of all ages. Blepharitis is not contagious and does not normally cause permanent eye damage. This condition is called chronic blepharitis because it rarely disappears completely. The treatment depends on the type of blepharitis. The key to treating most types of blepharitis is to keep the eyelids clean and free from crust formulation. Treatments can include applying warm compresses to the eyelids and cleansing the lids with wipes. Some cases of blepharitis may require more complex treatment plans. Treating dry eye can vary depending on the cause. Here are the main therapeutic approaches. Increasing the quantity of tears Treating dry eye usually starts by instilling artificial teardrops four times a day or applying a lubricating ointment at bedtime. Increasing tear production If the symptoms are not resolved by increasing the quantity of tears, medicated eye drops (anti-inflammatories, immunosuppressants, etc.) may be prescribed to improve the production of tears. Conserving existing tears In some cases, punctal plugs may be used to block tears from draining naturally, thus increasing the time that the tears remain in contact with the eyes.

6 You may need to purchase tears, drops, ointments. For your convenience, you can choose to purchase them at the pharmacy located on the main floor of the Institut de l oeil des Laurentides. Treating skin conditions and concomitant inflammations Treating blepharitis is essential for managing dry eye. Warm compresses are applied on the eyelids to soften the oil that has accumulated in the glands and to dislodge debris. Cleansing the eyelids with over-the-counter lid wipes may also be recommended. In the case of a bacterial infection, a topical antibiotic may also be prescribed. Limiting or avoiding the use of eye makeup is often recommended when treating blepharitis. In the case of blepharitis accompanied by skin problems, oral antibiotics are occasionally recommended to control certain conditions, such as rosacea. MEDICATIONS AND TREATMENT OF DRY EYES EYELID CLEANSING Cleanse the free edge of your upper and lower eyelids once or twice a day with a lid wipe, then thoroughly rinse the eyelids with warm water or as recommended by your healthcare MOIST WARM COMPRESSES Place a clean moist warm compress over the eyelids for minutes twice a day or as prescribed by your healthcare ARTIFICIAL TEARDROPS Instill 1 drop times a day in each eye or as prescribed by your healthcare OPHTHALMIC GEL/OINTMENT Apply 1 cm to the back of each lower eyelid at bedtime or as prescribed by your healthcare

OMEGA-3 SUPPLEMENT Take 2000 to 3000 mg a day with food or as prescribed by your healthcare Note : If you are taking an anticoagulant, such as warfarin (Coumadin) or heparin, consult your doctor

7 OMEGA-3 SUPPLEMENT Take 2000 to 3000 mg a day with food or as prescribed by your healthcare Note : If you are taking an anticoagulant, such as warfarin (Coumadin) or heparin, consult your doctor before taking this supplement. ANTIBIOTIC OPTHALMIC OINTMENT Put 1 cm of ointment on your index finger or on a cotton-tipped swab and apply the antibiotic ointment along the base of the lashes of the lower and upper eyelids or as prescribed by your healthcare RESTASIS 0.05 % OPHTALMIQUE EMULSION Instill 1 drop twice a day in each eye (at approximately 12-hour intervals) or as prescribed by your healthcare It is normal for Restasis to burn following instillation. TETRACYCLINE Take as prescribed by your healthcare Note : Do not use if you are pregnant. Avoid sun exposure during treatment. If you experience any problems, such as diarrhea, discontinue the medication immediately. ANTI-INFLAMMATORY DROPS Instill 1 drop times a day in each eye for weeks, then reduce to a day in each eye for weeks or as prescribed by your healthcare

TO REACH US Weekdays (Monday to Friday) Ch. de la Côte N At the Institut de l œil des Laurentides at 450.419.6345 or 1.888.419.6345 Ambroise Lafortune Ch.

8 TO REACH US Weekdays (Monday to Friday) Ch. de la Côte N At the Institut de l œil des Laurentides at or Ambroise Lafortune Ch. de la Côte S Grande-Allée Sortie 19 Sortie Evenings/weekends/ statutory holidays Go to your hospital s emergency department.tell the emergency physician that you recently had eye surgery. The physician will contact the on-call ophthalmologist, if necessary. 640 Institut de l œil des Laurentides 4800, rue Ambroise-Lafortune Boisbriand, QC, J7H 1S6 The INSTITUT DE L OEIL DES LAURENTIDES offers the Accord D financing plan (12 equal payments, no service charge or interest). * All prices are subject to change without notice. Version août 2016

RETINAL LASER SURGERY OR ARGON PHOTOCOAGULATION

RETINAL LASER SURGERY OR ARGON PHOTOCOAGULATION If you cannot come to your appointment, please call us at least 24 hours before at 450.419.6345. Failure to notify us will result in a $50 fee being charged.