Required Reading

[Eli]

Hey all,
If you are looking for some of the latest medical information regarding DES, you should browse the articles on this site. It is a summary of information discussed at the DEWS 2007. You will find it informative.
http://www.tearfilm.org/dewsreport/

[Rebecca Petris]

Now there is a treasure trove. Didn't realize this was in the public domain already. Thanks Eli.

[William53]

did they shut down link?

Hi,

When I try to open that page, I get kicked over to one of those OpenDNS Guide pages. The tearfilm.org site is the first one listed, but following that link just brings me back to OpenDNA Guide.

[Rebecca Petris]

Probably a browser problem. It's in a really nasty frame layout.

[charmee]

Cool

The link worked for me. Thanks Eli!

Charmee

[charmee]

Dwelle got a mention

Rebecca, Dwelle and Dry Eye Company were mentioned favorably in the report.

Here's the quote from the above mentioned site, in the DEWS Management and Therapy section, under Tear Lubricants, Osmolarity:

"...Following the
addition of a fluid with a high colloidal osmolality to the
damaged cell surface, deturgescence occurs, leading to a
return of normal cell physiology. Theoretically, an artificial
tear formulation with a high colloidal osmolality may be of
value. Holly and Esquivel evaluated many different artificial
tear formulations and showed that Hypotears® (Novartis
Ophthalmics, East Hanover, NJ) had the highest colloidal
osmolality of all of the formulations tested. Formulations
with higher colloidal osmolality have since been marketed
(Dwelle® [Dry Eye Company, Silverdale, WA]..."

Charmee

[Eli]

Possibilities for the Dry Eye Directory

Rebecca,
I believe that a good portion of the doctors who contributed their time to the DEWS Report are clinicians as well as researchers. For instance, Steve Pflugfelder and Reza Dana. Perhaps you might consider them as you continue your invitations to join the directory? Also, it was cool to see Dwelle mentioned in the report. Way to go!

[Rebecca Petris]

Re Dwelle... wow, that was unexpected! I know several dry eye specialists who are very fond of Dwelle... apparently there's at least one on the workshop.

I believe that a good portion of the doctors who contributed their time to the DEWS Report are clinicians as well as researchers. For instance, Steve Pflugfelder and Reza Dana. Perhaps you might consider them as you continue your invitations to join the directory?

Drs. Pflugfelder and Dana have already been invited (along with many other TFOS members) and I hope they join the listing. Thanks for the suggestion!

[EllMitcho]

There is a lot of info there however the section on drops is facinating yet depressing - here is the sumarry;

"Although many topical lubricants, with various viscosity
agents, may improve symptoms and objective ndings,
there is no evidence that any agent is superior to another.
Most clinical trials involving topical lubricant preparations
will document some improvement (but not resolution) of
subjective symptoms and improvement in some objective
parameters.4 However, the improvements noted are not
necessarily any better than those seen with the vehicle or
other nonpreserved articial lubricants. The elimination
of preservatives and the development of newer, less toxic
preservatives have made ocular lubricants better tolerated
by dry eye patients. However, ocular lubricants, which
have been shown to provide some protection of the ocular
surface epithelium and some improvement in patient symptoms
and objective ndings, have not been demonstrated
in controlled clinical trials to be sufcient to resolve the
ocular surface disorder and inammation seen in most dry
eye sufferers."

Great.

EllMitcho

[Rebecca Petris]

Wait... this should not be depressing, but important information to read.

"Although many topical lubricants, with various viscosity
agents, may improve symptoms and objective ndings,
there is no evidence that any agent is superior to another.
Most clinical trials involving topical lubricant preparations
will document some improvement (but not resolution) of
subjective symptoms and improvement in some objective
parameters.4 However, the improvements noted are not
necessarily any better than those seen with the vehicle or
other nonpreserved articial lubricants. The elimination
of preservatives and the development of newer, less toxic
preservatives have made ocular lubricants better tolerated
by dry eye patients. However, ocular lubricants, which
have been shown to provide some protection of the ocular
surface epithelium and some improvement in patient symptoms
and objective ndings, have not been demonstrated
in controlled clinical trials to be sufcient to resolve the
ocular surface disorder and inammation seen in most dry
eye sufferers."

Actually I don't think this is giving a depressing prognosis. I think what they are saying boils down to:

1) Artificial tears are all more or less alike

2) Artificial tears in and of themselves do not treat the underlying problem.

Aren't these just things we all already know? Although personally I would dispute #1 because I think that there are demonstrable differences in surface wetting efficacy amongst drops (though not always differences in the level of relief patients experience). But to me the bottom line is that we need to be treating ocular surface disease at the source, to the extent possible. We need lubricants to keep our surfaces comfortable and protected.

[EllMitcho]

yea I guess your right - I am still hoping for the magic gloop I guess!

EllMitcho

[brd888]

Research

It's just nice to see there is work being done in the world to further understanding and treatment of dry eye problems. Not all researchers are looking at curing heart disease and cancer.

Shine and McCulley from University of Texas seem to be working on tear film science at the moment.