Friday, December 21, 2012

Autologous Serum for Chronic Dry Eyes- Drawback and Benefits

Many of our dry eye patients are on autologous serum drops and still have severe chronic dry eye symptoms.  This is because treating dry eyes from the surface is insufficient for chronic dry eye relief because the tear secretion glands are under active after repeated inflammation which causes cellular functions to be suppressed

Read on, TheraLife can help- Revive your own natural tears now!

The use of autologous serum (AS) for treating ocular surface disorders dates back to at least the 1970s when it was used via a mobile ocular perfusion pump to treat ocular alkali burns.1  AS was described as a tear substitute in 1984 in the journal Arthritis and Rheumatism2 . The use of AS for the treatment of ocular surface disorders did not gain popularity until the late 1990s.3  The most common uses include the treatment of dry eyes4.   AS has also been suggested to  treat neurotrophic keratopathy- a recurrent corneal erosion6 and superior limbic keratoconjunctivitis (inflammation of the superior bulbar conjunctiva).

Aotologous Serum for Dry Eye

One of the aplications for AS is for severe dry eyes.  The reason being artificial tears lack essential tear components such as growth factors, vitamins, and immunoglobulins.8  Human serum contains substances such as epidermal growth factor, vitamin A, fibronectin and cytokines normally found in tears. These factors are important for maintaining a healthy corneal and conjunctival epithelium.10

Drawbacks of Serum Eye Drops Treatment

The drawbacks include:
1.  Infections - Since AS preparation is a body fluid, it is able to transmit infections.11  This includes viral infections such as hepatitis B and C , HIV (AIDS).

2.  Cost - Frequent blood extractions from the patient requiring prolonged treatment. Patients who need to use AS eye drops for an extended period of time will need to provide blood samples at least every three months.  AS eye drop therapy can be expensive. Daily cost could be 45-10 dollars.  Patients generally have to pay out-of-pocket for the AS eye drops because the majority of insurance carriers do not cover this treatment.  

3. Microbial Infections - AS contains no preservatives, which avoids the risk of preservative toxicity, however there is a potential risk of inducing infections because of microbial contamination of the dropper bottle.4


Autologous serum drops can be helpful.  However, when autologous serum, puntal plugs and prescription eye drops do not work.  Look to TheraLife for help.

Why TheraLife Eye?
Prolonged inflammation resulted from chronic dry eyes shut down normal cellular functions of tear secretion glands.  TheraLife revitalize the normal eye functions intracellularly to restore normal function.  It is not an eye drops, it is a capsule.


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This article is abstracted from Optometric Management Sept, 2012.

REFERENCES
1. Ralph RA, Doane MG, Dohlman CH. Clinical experience with a mobile ocular perfusion pump. Arch Ophthalmol 1975; 93 (10): 1039-1043.
2. Fox RI, Chan R, Michelson JB, et al. Beneficial effects of artificial tears made with autologous serum in patients with keratoconjunctivitis sicca. Arthritis Rheum 1984; 27 (4): 459-461.
3. Jeng BH. Use of autologous serum in the treatment of ocular surface disorders. Arch Ophthalmol 2011; 129 (12): 1610-1612.
4. Lee GA, Chen SX. Autologous serum in the management of recalcitrant dry eye syndrome. Clin Experiment Ophthalmol 2008; 36 (2): 119-122.
5. Matsuoto Y, Dogru M, Goto E, et al. Autologous serum application in the treatment of neurotrophic keratopathy. Ophthalmology 2004; 111 (6): 1115-1120.
6. delCastillo JMB, de las Casa JMM, Sardina RC, et al. Treatment of recurrent corneal erosions using autologous serum. Cornea 2007; 21 (8): 781-783.
7. Goto E, Shimmura S, Shimazaki J, et al. Treatment of superior limbic keratoconjunctivitis by application of autologous serum. Cornea 2001; 20 (8): 807-810.
8. Quinto GG, Campos M, Behrens A. Autologous serum for ocular surface diseases. Arq Bras Oftalmol 2008; 71 (6 Suppl): 47-54.
9. Lopez-Garcia JS, Garcia-Lozano I, Rivas L, et al. Use of autologous serum in ophthalmic practice. Arch Soc Esp Oftalmol 2007; 82 (1): 9-20.
10. Koffler BH. Autologous serum therapy of the ocular surface with novel delivery by platelet concentrate gel. Ocul Surf 2006; 4(4): 188-195.
11. Geerling G, Maclennan S, Hartwig D. Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol 2004 (88): 1467-1474.
12. Weisbach V, DietrichT, Kruse FE, et al. HIV and hepatitis B/C infections in patients donating blood for use as autologous serum eye drops. Br J Ophthalmol 2007; 91 (12): 1724-1725.
13. Eberle J, Habermann J, Gurtler IG. HIV-1 infection transmitted by serum droplets into the eye: a case report. AIDS 2000; 14: 206-207.

Wednesday, December 19, 2012

Winter Dry Eyes? Get Help from TheraLife


Winter, Snow, Dry Heat - My Eyes are So Dry, They Hurt!

For some people, this only happens in the winter when hot air furnaces and heaters are turned on. The heaters create hot, dry air movement that allows tears to evaporate quickly. Sometimes, increased water intake and the use of artificial tears do not seem to help. How annoying!
Low temperature during winter months also cause lower moisture in the air, further exacerbates dry eye symptoms.

For those who already have dry eyes, the dry eye condition seems to be worse as soon as the heat is on at home or at work.

What Can I Do to Relief Winter Dry Eyes?

1. Use a humidifier in the central heating system – this will require frequent cleaning to ensure bacteria and other organisms do not grow in the water reservoir.

2. Use a humidifier near your desk or inside an office

3. Drink at least 8 glasses of water.

4. Sit away from a hot air vent

5. Do not use artificial tears often, it will only make your eyes feel drier. Artificial tears tend to wash away the key tear thickening components -mucin and lipids and make your tear evaporate easier.

6.. Try TheraLife Eye Enhanced to help stimulate and produce tears naturally from your own eyes.

7. For those who already have dry eyes and are already taking TheraLife Eye Enhanced, increase dosage during winter months for relief! You can decrease the dosage again when spring comes in March when moisture content in the air increases.


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Tuesday, December 4, 2012

Severe Chronic Dry Eyes with Eye Ulcer- Complete Recovery with TheraLife Eye

It is known that chronic dry eyes left untreated can cause cornea damage, vision impairment and potentially blindness.  The following personal story only illustrate the fact that even for severe chronic dry eyes with eye ulcer, TheraLife Eye is able to restore tear glands to secrete balanced natural tears from your own body.

Severe dry eyes with eye ulcer. Relief by TheraLife Eye from Australia
"Over the last 21 months since we made our first purchase from TheraLife Inc, my wife has had amazing success with your “TheraLife Eye Enhanced”. No other product has come anywhere near to curing her dry eye. Before starting your recommended dosage of “TheraLife Eye Enhanced” and Omega-3 Fish Oil, her dry eye was so bad that she had a very painful ulcer in her eye. As recommended by you, she completely stopped using all other temporarily expedient, proscribed products. Although she understands that she must continue to take a maintenance dosage for the rest of her life, your “TheraLife Eye Enhanced” has completely removed all her eye discomfort and all she has to do if she detects a slight return of mild symptoms, is to temporarily increase dosage for a day or so."  R M, Australia,


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Friday, November 30, 2012

The Best Wraparound Sunglasses for Dry Eyes

Most people with chronic dry eye syndrome are affected by sun, wind and glare.

We get many questions regarding the best sunglasses to wear to help protect eyes from exposure to sensitive elements and potential damage due to long-term exposure to sunlight. Excessive exposure to UV radiation and blue light from the sun can cause cataracts, contribute to the onset of retinal diseases such as macular degeneration, and cause skin cancer in the sensitive tissue surrounding one's eyes. Radiation damage can even occur on cloudy days.

We recommend 100% UVA/UVB protecting wraparound glasses. The best lens color is amber, which also neutralizes blue light. Brown is the next best color.

Cheaper glasses may have a coating to block out UV light that can rub off overtime. Many people think it is the tint that helps protect one's eyes, but it is actually the UV filter on, or in, the lens. So, if the filtering coating wears off, a dark lens actually increases pupil dilation, allowing more light to enter the eyes.

Relief Your Dry Eyes with TheraLife Eye
TheraLife Eye is a capsule.  It is not an eye drops.  TheraLife Eye revitalize your dry eyes intra-cellularly to secrete your own balanced tears.  Clinically proven to work in 80% first time users.  Get relief today.


To learn more how TheraLife Eye works.
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Call and talk to a doctor toll free 1-877-917-1989 US and Canada. International (650) 949-6080
email inquiries to: info@theralife.com
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Thursday, November 29, 2012

Punctal Plugs and Dry Eyes- Pros and Cons

In patients who do not find symptomatic relief despite medical therapy and maximal lubrication, punctal occlusion is often indicated. Rather than applying an artificial tear, punctual occlusion helps to preserve any remaining natural tear fluid, which has by far the best wetting and nutrient capacity for the ocular surface. Preserving the patient’s own natural tears by blocking the lacrimal drainage system, thereby increasing tear volume and decreasing tear osmolarity, can successfully maintain the integrity of the ocular surface, corneal transparency and visual acuity. In patients with moderate or severe dry eye, it is capable of improving quality of life and preventing vision loss.

Punctal Occlusion for Dry Eye Syndrome

The idea behind punctal occlusion is straightforward: increase the aqueous component of the tear film by blocking tear outflow..Punctal occlusion helps to retain the patient's own tears on the ocular surface. This intervention is highly effective and usually used after environmental control, drop therapy, omega-3 fatty acid supplementation and topical prescription eye drop prove inadequate. Preferably performed after surface inflammation is brought under control, occlusion methods include punctal plugs as well as thermocautery, electrocautery, laser ablation or direct surgical closure.
Before performing a procedure to occlude a punctum permanently, many authors suggest a trial of temporary punctal occlusion using various plugs. While this is prudent, one must keep in mind some of the intrinsic limitations of these devices. More specifically, failure of collagen plugs to predict epiphora after permanent punctal occlusion. One systematic review7 showed a relative scarcity of controlled clinical trials assessing the efficacy of punctal occlusion therapy in dry eye. Although the evidence is very limited, the data suggest that silicone plugs can provide symptomatic relief in severe dry eye. Moreover, temporary collagen plugs appear similarly effective to silicone plugs on a short-term basis.

The reported results of punctal plugs vary. It seems to work for patients with dry eye of mostly mild to moderate severity. The magnitude of the treatment effect was more striking following implantation of non-dissolvable silicone plugs, but occlusion with temporary collagen plugs also had an apparent beneficial influence on the clinical course of dry eye, as indicated by significantly lower scores for several study parameters in comparison with the control group.

Punctal Plugs and Inflammation

One area of interest is the relationship of pharmacologic therapies with punctal occlusion. Punctal occlusion has been shown to improve objective and subjective measures of dry eye but may exacerbate ocular surface inflammation in subjects with overt clinical inflammation. Because of this issue, an international panel of experts developing comprehensive treatment guidelines for ocular surface disorders recommended that the inflammatory condition be treated before punctal occlusion.


Punctal Plugs and Increased Ocular Bacterial Infections

Because puntal plugs back up tears – which does not allow debri and bacteria from draining. Some patients will experience ocular bacterial infections, which require anti-biotic eye drops for treatment.

Complications

Although punctal occlusion is an effective therapy for KCS, there are complications related to punctal plug insertions.Recognized complications of conventional silicone plugs include
  • epiphora - over flow of tears onto the face
  • punctal ring rupture,
  • abrasion of the corneal and conjunctival surface,
  • suppurative canaliculitis - infection of lacrimal gland causing surface abnormalities that sometime require surgical interventions.
The retention rates for the different kind of silicone plugs have been reported to be about 50% after one year,extrusion of silicone plugs is common, occurring within three months in up to 50% of cases.

Conclusion

Careful patient selection is critical for successful punctal occlusion. It should be performed only when appropriate, and when the likelihood of benefit far outweighs the risk and cost. A variety of techniques are available to choose from on the basis of the duration of desired effect and the severity of aqueous tear deficiency and associated ocular surface disease. Punctal occlusion can dramatically improve the quality of life in many patients with moderate cases of dry eyes and can prevent visual loss in patients with severe cases of dry eyes
-----------------------------------------------------------------------------------------------------------------.
How TheraLife Eye can help!
TheraLife Eye is clinically proven to be 80% effective in dry eye relief for first time users.  TheraLife Eye is effective when puntal plugs, prescription eye drop, eye drops failed. The reason is because TheraLife Eye work on restoring normal cell functions to tear secretion glands,  intracellularly.


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REFERENCES
1. American Academy of Ophthalmology. Punctal occlusion for the dry eye. Ophthalmology 1997; 104: 1521.
2. Freeman JM. The punctum plug: Evaluation of the new treatment for the dry eye. Trans Am Acad Ophthalmol Otolaryngol 1975; 79: 874–87.
3. Dohlman CH. Punctal occlusion in keratoconjunctivitis sicca. Trans Am Acad Ophthalmol Otolaryngol 1978; 85: 1277-1281.
4. Cohen EJ. Punctal occlusion. Arch Ophthalmol 1999; 117: 389–90.
5. Glatt HJ. Failure of collagen plugs to predict epiphora after permanent punctal occlusion. Ophthalmic Surg 1992; 23: 292–3.
6. Redmond JW. Correspondence: Punctal occlusion with collagen implants. Ophthalmic Surg 1992; 23: 642.
7. Ervin AM, Wojciechowski R, Schein O. Punctal occlusion for dry eye syndrome. Cochrane Database Syst Rev 2010 Sep 8;(9):CD006775.
8. Geldis JR, Nichols JJ. The impact of punctal occlusion on soft contact lens wearing comfort and the tear film. Eye Contact Lens 2008 Sep; 34(5): 261-5.
9. Nava-Castaneda A, Tovilla JL, Rodriguez L, et al. Effects of lacrimal occlusion with collagen and silicone plugs in patients with conjunctivitis associated dry eye. Cornea2003; 22: 10-14.
10. Yazdani C, McLaughlin T, Smeeding JE, et al. Prevalence of treated dry eye disease in a managed care population. Clin Ther 2001;23:1672–1682.
11. American Academy of Ophthalmology Preferred Practice Patterns. Dry Eye Syndrome. 2003. Available at: http://www.aao.org/aao/education/library/ppp/upload/Dry-Eye-Syndrome.pdf.
12. Dursun D, Ertan A, Bilezikci B, et al. Ocular surface changes in keratoconjunctivitis sicca with silicone punctum plug occlusion. Curr Eye Res 2003; 26: 263–269.
13. Pflugfelder SC. Anti-inflammatory therapy for dry eye. Am J Ophthalmol 2004; 137: 337–342.
14. Behrens A, Doyle JJ, Stern L, et al. The Dysfunctional Tear Syndrome Study Group. Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea 2006; 25: 900–907.
15. Yang H, Fujishima H, Toda I, et al. Lacrimal punctal occlusion for the treatment of superior limbic keratoconjunctivitis. Am J Ophthalmol 1997; 124:80–7.
16. Sugita J, Yokoi N, Fullwood NJ, et al. The detection of bacterial biofilms in punctal plug holes. Cornea 2001; 20: 362–365.
17. Murube J, Murube E. Treatment of dry eye by blocking the lacrimal canaliculi. Surv Ophthalmol 1996; 40: 463-480.
18. Kojima K, Yokoi N, Nakamura Y, et al. Outcome of punctal plug occlusion therapy for severe dry eye syndrome. Nippon Ganka Gakkai Zasshi 2002; 106: 360–364.
19. Balaram M, Schaumberg DA, Dana MR. Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome. Am J Ophthalmol 2001; 131: 30-36.

Tuesday, November 27, 2012

Coping with Depression Caused by Chronic Dry Eyes

It has been well documented that chronic dry eyes cause depression- see another TheraLife blog here.   Maybe your dry eyes hurt so much that all you can think of all day and all night is how much pain you are feeling.  Do you get up in the middle of the night to put eye drops in your eyes?
Does sadness overwhelm you at times, leaving you unable to enjoy the people and activities in your life?

When your emotions cloud your outlook, interfere with your relationships or affect the way you sleep at night and function during the day, you may be suffering from depression or an anxiety disorder.
You're not the only one who feels sad or worried when you have chronic dry eyes.  at times. It's normal.  Chronic dry eyes affect a person’s quality of life.  It's perfectly natural for you to respond to the ups and downs we all experience with elation or fear.

It's common, and occasionally even helpful, for you to react to life's stresses, challenges and dangers with anxiety.
  • What's NOT perfectly natural is when those feelings persist long after the event or condition that triggered them.
  • What's NOT normal and expected is when those feelings seem to come at you from nowhere, appearing even in the absence of obvious external triggers.
  • What's certainly NOT helpful is feeling the weight of your emotions so heavily that they interfere with sleep, prevent you from performing daily activities or arouse concern in the people who care about you.
In its milder forms, depression or anxiety can make it difficult to even get yourself out of bed each morning and to go through the motions of your daily activities. Fatigue, inertia, feelings of sadness and recurring fears can hover like a rain cloud over your life.

In its more severe forms, a depression or an anxiety disorder can immobilize you, sabotage your relationships, trigger feelings of helplessness and self-destructive behavior, and perhaps even turn your thoughts to suicide.
You DON'T have to suffer this way
The most important thing for you is to permanently resolve this issue of chronic dry eyes so your life can get back to normal.   


TheraLife Can Help
In a clinical trial, TheraLife Eye relieved dry eye symptoms in 80% of the dry eye sufferers.  TheraLife Eye is a capsules that treats dry eyes from inside out, unlike most of the other dry eye relief today that is based on drops, treating the surface of the eye ball.  It has been shown that frequent use of eye drops make eyes drier.  Take a different approach now.


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Tuesday, November 20, 2012

Meibomian Gland Dysfunction- How TheraLife Can Help

The primary function of meibomian glands is to secret lipids, the thickening agent for tears.  In chronic dry eye syndrome, meibomian glands play an important part of  dry eye relief.  the inability to thicken tears lead to evaporative dry eyes.  Blepharitis (eye lid abnormalities and infections), Rosacea often concur with Meibomian Gland Dysfunction (MGD) making it one of the most difficult dry eye conditions to treat.  Assessment and treatment of meibomian gland disease is often a necessary step in successful dry eye treatment.

How to look for  Meibomian Gland Dysfunction

Normal meibum is thin with clear liquid which is expressed very easily.  With various stages of MGD, the meibum becomes thicker, (see photo above) and the expressed liquid becomes thicker, granular and some time in clumps and the liquid become opague.  The expressing meibum can be very difficult.

Often MGD is accompanied by lots of inflammation - on the eye lid, in the eye.  In most cases, MGD is accompanied also by tear volume in-sufficiencies (Lacrimal Gland). Thus setting up a situation where dry eyes cause inflammation and the inflammation causes the tear secretion glands to shut down.

Certain drugs can cause MGD, especially drugs to dry up acne - such as Accutane, antihistamines used in allergy treatments.


Treatment of Meibomian Gland Dysfunction

Typical treatments for MGD includes:
1. Wet hot compresses - twice a day, each time 10 minutes to unclog the meibomian glands
2. Eye lids cleaning daily to minimize eye infections
3. Oral Antibiotcis - Doxycycline or Azithromycin daily
4. Steroid eye drops - such as Lotamax or PredForte to calm down inflammation during a flare. Steroid eye drops are limited to one month since long term use may result in kidney and liver damages.

How can TheraLife help?

TheraLife Eye is formulated to revitalize all the tear secretion glands, including meibomian glands, lacrimal glands to get sustainable long lasting relief.  TheraLife Eye is used along with the procedures described above for speedy recovery and long term maintenance.


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photo curtesy of Gary N. Foulks MD, FACS.