Page 49 - Demo

their eyes regular breaks from long-term wear of contacts and wear eyeglasses for periods of time to prevent CL induced papillary conjunctivitis. Since CL over wear is a primary contributor to developing GPC, consider switching the patient to a more frequent replacement schedule. (A 4.5 to 36 percent decreased incidence of GPC was seen with more frequent replacement.)
Blepharitis: Another eyelid condition that will affect CL wear is blepharitis, an in ammation infection of the lids. Symptoms can be caused by the following conditions: bacterial eyelid infection, Meibomian Gland Dysfunction (MGD), dry eyes, fungal eyelid infection and Demodex, a parasitic eyelash mite. Blepharitis is often concurrent with dry eyes and result in a condition called dry eye blepharitis syndrome (DEBS). Dry eye may be a late expression of blepharitis, making it important to treat blepharitis to reduce the chance of dry eye. Bacterial overgrowth on the eyelid margins and at the base of the eyelashes can multiply and form a toxic bio lm similar to the plaque that forms on teeth. The bio lm is a food source for a type of parasitic mite on the eyelashes called Demodex. These mites can grow in numbers and contribute to blepharitis and dry eye symptoms. Another lid complication that can lead to meibomian gland dysfunction is the production of exotoxins, a type of bacteria that cause meibomian gland in ammation. Skin conditions often associated with blepharitis are ocular rosacea, dandruff, psoriasis and eczema. Common symptoms can be intermittent or chronic and consists of burning, stinging, crusting at the eyelash base, sensation of a foreign body, itchy, irritated and watery eyes. A loss of eyelashes is another possible symptom.
Blepharitis makes contact lenses very uncomfortable as it leaves the eye unlubricated and dry. This can cause problems for contact lens wearers. Contact lens wear should be stopped until the condition is cleared up.
Conjunctivitis (also called pink eye) occurs when the conjunctiva lining on the inside of the eyelids (and also is the top layer of the cornea) becomes in amed. It can cause itching, burning, tearing or a feeling that something is in your eye. Conjunctivitis can be due to allergies or a bacterial or viral infection. Infectious pink eye is highly contagious and can easily spread from one eye to the other
and to other people. Advise the patient to remove their lenses until it clears up. Advise them that they should either see their doctor for further evaluation and treatment immediately, and no later than a few days if conditions don’t improve.
Dry eye syndrome: Dry eyes are caused by a lack of tears. Tears are necessary for the normal lubrication of our eyes and to wash away particles and foreign bodies. Most patients who experience dry eyes may describe a burning, scratching or stinging sensation. They may also have strained or tired eyes after reading, even for short periods of time. Reading reduces the blink rate by more than half. If these patients wear contact lenses full time, they will likely feel uncomfortable, especially later in the day. Having dry eyes can lead to tiny abrasions on the surface of their eyes, which will show during uorescein staining.
Common causes of dry eyes include: aging, dry environment or workplace (wind, air conditioning), excessive time on the computer, sun exposure, smoking or secondhand smoke exposure, cold or allergy medicines, an eye injury or problem with the eyes or eyelids (drooping eyelid or bulging eyes, exophthalmos), Sjogren’s syndrome (includes dry eyes, mouth and mucus membranes, and often rheumatoid arthritis or other joint disorder) and previous eye surgery such as Lasik.
The following steps may help:
• Arti cial tears, available as either drops or ointments. Ointments last longer, but are thicker and can cause blurry vision especially with contact lenses.
• Reduce or eliminate smoking. Avoid secondhand smoke, direct wind and air conditioning.
• Use of a humidi er, especially in the winter. • Blink more often.
• Periodically rest the eyes, looking away at more distant objects, especially while reading, watching television or using the computer.
Meibomian Gland Dysfunction (MGD): The Meibomian glands (or tarsal glands) are a special kind of sebaceous glands at the rim of the eyelids inside the tarsal plate. They are responsible for the supply of meibum, an oily substance that prevents evaporation of the eye’s tear lm; prevent tear spillage onto the cheek, make the closed lids air-
49 EYEZONE Issue 91-92 May / August 2020