In June 2012, eyeLABS center for Ocular Surface Disease became the first optometry clinic in Canada to offer LipiFlow Thermal pulsation treatment - the only FDA approved treatment for evaporative dry eye. eyeLABS is a unique facility because we don't sell glasses - we manage the ocular surface of patients far and wide and we do so with an array of options that allows for a customized approach to managing a very complex disease - Dry Eye Disease.
eyeLABS year 1 clinical results:
Looking just over 100 eyes treated using a combination of LipiFlow, lid management techniques, and medicine we have achieved a 90% rate of significant improvement in clinical signs and patient symptoms, 8% with mild to moderate improvement and 2% minimal to no change. This was defined in our clinical study by validated patient symptom scores, gland scores, corneal staining, tear film break up time and visual acuity. As a result we continue to educate as many physicians and patients as possible about the shift in approach of managing dry eye from exclusively cornea to the eyelids and glands.
Prevalence of DED vs. Diabetes
According to NDEP (National Diabetes Education Program) there are 25.8 million Americans living with diabetes. According to a Marketscope 2011 Comprehensive Report on the Global Dry Eye Products, there are 23 million patients living with Dry Eye Disease. Of course the comparison in the impact of two diseases on the body isn't fair, but the impact on quality of life (QoL) is eerily similar. A 2012 study examining 87 dry eye patients and 71 healthy volunteers found that vision-related QoL in dry eye patients was impaired and was correlated with anxiety and depression( Li, M Invest Ophthalmol Vis Sci. 2012 Aug 17). Countless studies examining QoL within the diabetic subset show strong correlations to anxiety and depression due to the daily burden of medicine, monitoring and management.
Dry eye is too often dismissed by physicians as insignificant and 'not as important' as other ocular ailments like cataracts or glaucoma and patients have become embarrassed to mention it. In fact, when eyeLABS Dry Eye Clinic patients were surveyed, the most common reason for not talking about dry eye with other doctor was embarrassment. Embarrassment that their doctor wouldn't think it was important. Interestingly all patients reported social anxiety about the cosmetic appearance of their red eyes to colleagues, family, friends etc. and had sought out medical attention to treat the anxiety as a result.
The social impact of these two diseases are far-reaching. Given that the prevalence of the disease is near equivalent why is it that dry eye is swept under the rug? It is possible that medical options of dry eye have been limited and expert agreement on the cause is divided has resulted in doctor's complacency towards this growing epidemic.
Being in the position that I'm in seeing dry eye and ocular surface day in day out I can say that this condition does deserve attention and undivided attention at that. My patients are physicians, teachers, celebrities, pilots, mothers, fathers and and they have all opened up about the anxiety that dry eye has caused them. One might assume that those listed above are 'professionals' and would never leave the disease to take over their lives but many patients have even considered suicide prior to having treatment because of how limited their lives had become. For the first time they have had relief and I feel grateful for the opportunity to change their lives.
When one considers the impact of a disease on mental health, the mental health should be then considered a co-morbidity. Diabetes, Dry Eye Disease and many other ailments all have the common denominator on reduction in quality of life and an increase in depressive and anxious tendencies. Almost 50 million Americans share this common denominator between diabetes and dry eye, but those with dry eye don't have nearly as many resources for dealing with their condition. Considering the success I've had with my patients in this last year, I submit that we can do a better.
In good health,
Dr. Richard Maharaj OD, FAAO