Managing Dry Eye for the Long Haul

When we think of conditions that require long-term management, diabetes, hypertension and glaucoma often come to mind. Like these chronic conditions, dry eye disease (DED) also requires both ongoing management for lasting positive outcomes and an awareness that success lies in the long-term collaboration of the practitioner and patient. Ultimately, successful DED management necessitates a shift in perspective of the doctor and patient from short-term treatment goals that result in temporary relief to a comprehensive chronic care plan for a more permanent resolution. Armed with the right strategies and approaches, clinicians can give their dry eye patients a lifetime of relief.

Proceed With Caution: Low Vision and Driving

ODs have a duty to properly assess and counsel patients with congenital or acquired visual impairments who would like to acquire driving privileges or who will become non-drivers because of their vision loss.

Here, we discuss the complexities of the current vision and licensure standards, how they affect patients with vision loss and what ODs can do to properly evaluate and counsel patients who are visually impaired and want to drive.

Fresnel Prism to the Rescue

Perhaps the most common complaint we encounter is double vision. This occurs for a multitude of reasons, including muscle and nerve injury, and can be quite severe. In these situations, the extent may vary depending on the gaze and head position. In the short term, we often use occlusion—either binasal or spot—to eliminate the double vision and evaluate the visual system weeks later as the visual, and cognitive and control systems come back online. For comitant diplopia, we often investigate the use of prism to attempt to restore single vision. The two cases presented here demonstrate how the use of temporary Frensel prism can get your patients on the road to recovery quickly and effectively.

One Size Won’t Fit All: Treating Ocular Infection

Due to their complexity and temperament, ocular infections can be a pain to treat. Finding the right antibiotic requires a thorough understanding of the most likely causative organisms, resistance patterns, patient-specific data and pharmacologic information that may impact the patient’s response to the drug. And we have to do it all while the clock is ticking—the earlier treatment begins, the better the prognosis. However, sometimes, less is more. Exercising discretion in situations where the infection is most likely to be caused by a virus, such as in non-purulent infectious conjunctivitis, has been proven to decrease the spread of resistant organisms.