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There has been a powerful increase in the prevalence of dry eye disease in the last several decades. This has been paralleled by substantial alterations in environmental and social settings. These include the use of air conditioning and forced air heat in homes, cars, and office buildings, as well as significantly increased time spent working on computers. More individuals than ever before are wearing contact lenses. Population demographics, disease patterns and prevalence, and the rise in the number of the elderly have also changed. All of these factors have significant effects on the ocular surface resulting in dry, irritated eyes. Several decades ago, only saline eye drops were accessible, now there are many products accessible in the pharmacy.
The suffering linked with this condition is substantial and gets worse if left untreated. However, early and proper intervention can slow, halt, or even reverse disease progression. Tons of patients have dry eyes and can no longer endure contact lens wear. “These patients then usually seek LASIK surgery“, explains Dr Ashraf of the Atlanta Vision Institute. He adds that, “here at Atlanta Vision, we pay particular attention to the ocular surface and try to identify these patients. Approximately 50% of our patients have some form of ocular surface disease. These patients are then started on treatment prior to and after surgery.” He adds that, “this has
significantly improved patient comfort and visual results of the surgery.” Yet, despite these statistics, lots of eye care providers continue to underestimate the impact of this eye disease on patients’ eye-related health, vision, and quality of life.
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Many technologies from telecommunication, imaging, lithography, computer circuits to missile defense, have been revolutionized through the the invention of the laser. The first medical application of the laser was in the field of ophthalmology approximately 50 years ago. It was initially used for retinal photocoagulation and since then has been used for numerous diagnostic and therapeutic devices in the field.
In 1983, an ophthalmologist and a team of scientists at the IBM research laboratory applied the newly developed excimer laser onto corneal tissue. Unlike other lasers, this laser produced incredibly precise cuts without any heat nor any damage to the surrounding tissue. During the following 15 years, advances in biomedical research and technology evolved into the modern form of LASIK surgery. This technology has helped millions of people worldwide improve their vision and quality of life.
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Based on a report in the November issue of Optometry and Vision Science, 2% of the people that wear contact lenses adhere to the appropriate cleaning procedures; 80% of contact lens wearers think they follow the proper procedures, when in actuality only 2% were following all recommended guidelines for proper contact lens care. Here are some crucial contact lens cleaning procedures:
The authors reported that just 50% of the contact lens wearers followed through with the recommended guidelines. Dr Ashraf, LASIK surgeon at the Atlanta Vision Institute, states that while the risk of Keratitis, which is due to contact lenses, is very rare, the potential exists for severe complications. These complications could be infectious Keratitis of which could result in permanent vision damage.
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Keratoconus can be a progressive condition, in which the cornea produces very irregular astigmatism, becomes thin, and may create scarring. If Keratoconus patients cannot bear gas permeable contact lenses, then the answer is a corneal transplant. Keratoconus also is a complete contraindication to any laser refractive surgery. However, reports from numerous international centers claim outstanding results of stabilizing the disease through corneal collagen cross-linking. In this procedure, Riboflavin is allowed to penetrate the cornea and utilizing UV light directed at the cornea the collagen bonds fortify, resulting in a more steady cornea.
Multiple surgeons outside the U.S. utilize corneal cross-linking as their routine treatment for Keratoconus and some are performing laser refractive surgery in conjunction with corneal cross-linking on these patients. Despite the success of this procedure, the FDA has not approved this process in the U.S. Dr. Ashraf, medical director of the Atlanta Vision Institute, has been utilizing this technology for the past two years at his Dubai office. He states: “We’ve had excellent results with this procedure with minimal side effects and it is unfortunate that this procedure is not available for our United States patients.” He also adds that several of his United States patients have flown to Dubai to seek treatment.
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