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Issue 7, August 2010

by Marlene Jacobs (Vision Optometrists)

Dry eye disease is one of the most common ocular conditions optometrists encounter on a daily basis. 3.5% to 33% of the population suffers from dry eyes.

The following factors pose a risk to the normal function of the eye’s surface:

  • Medications: Antihistamines, angiotensin-converting enzyme (ACE) inhibitors, decongestants, diuretics, anti-depressants, and even oral contraceptives.
  • Our climate plays a large role– Low humidity worsens existing symptoms. Air-conditioners, and upwardly facing air vents can compromise your tear film too.
  • Extensive visual tasking – Working for hours on a computer.
  • Aging – Hormonal changes challenges the tear film integrity in menopausal and postmenopausal women. Women on hormone replacement therapy are also at risk of developing dry eye syndrome.
  • Nutrition – Consuming much more omega 6 than omega 3 fatty acid in ratio greater than 15:1 can increase the risk of dry eyes. Balanced fatty acid intake will be less than 4:1
  • Contact Lenses, although smart new generation materials mitigate this concern to a degree.

When visiting your optometrists some of these diagnostic tests can be done to determine if you are at risk of dry eye syndrome:

  • Fluorescein staining: This dye diffuses into the tear film and assesses the integrity of the tear break up time (TBUT). The TBUT is the time from blink to the first appearance of dark areas. A normal TUBT is more than 10secs. Fluorescein also assesses the corneal integrity.
  • Lissamine green and rose Bengal staining: These dyes detect dead and devitalized cells on the cornea and the conjunctiva
  • Schirmer Testing: Assesses aqueous production within a 5 minute period. This involves a schirmer test strip placed underneath the lower eyelid.
  • Phenol red thread: Alternative to Schirmer and 15second test

Prevention and alleviation

The following management strategies can be followed to alleviate dry eye syndrome:


  • Pharmaceutical education – keep in mind that some medications cause ocular dryness
  • Environmental modifications – Position your computer screen below eye level to reduce ocular surface stress and reduce ocular exposure
  • 5-8 glasses of water daily
  • Redirect upward facing air vents
  • Room humidifiers
  • Contact Lenses – used as bandage contact lens to create moisture chamber and rehabilitating severely dry eyes.
  • Artificial tears – Generally the first line dry eye treatment. Compliance with recommended regimen and type of artificial tears determines success or failure. Sporadic dosing might alleviate symptoms temporarily but will not restore the tear film health, therefore artificial tears need to be administered according to the recommended regimen. If you opt for lower cost store brand, it might contain benzalkonium chloride (BAK), this preservative damage ocular surface when dosed in chronic fashion. Do not use vasoconstrictors as your tear volume and flow will reduce and rebound hyperemic (redness) response will occur.
  • Lacrimal inserts – Hydroxypropyl cellulose insert 5mm in length delivers lubrication to the ocular surface. We place the insert in the lower cul-de-sac, temporal of the cornea. It dissolves during 24-hour period. If you require someone to insert artificial tears and reside in assisted living, lacrimal inserts might be just the answer.
  • Nutrition and supplementation – Omega 3 fatty acid is a stable treatment for dry eyes. It decreases inflammation, stimulate tear production and thin meibomian gland secretions. 1000 to 2000mg of omega 3 per day is required.
  • Treatment of inflammation
  • Treatment of eyelids – Meibomian glands on the lid margins produce the lipid layer of the tear film. Anything affecting the function of these glands will reduce lipid flow and compromise tear film health. With meibomian gland dysfunction a warm compress can remove coagulated oils. If left untreated meibomitis can cause lid pouting, lid margin tylosis and complete gland impairment.
  • Punctal plugs are inserted in the tear drainage holes, to ensure the tears you have stay in place longer – very effective and non-invasive.
  • Autologous serum – Combination of your blood plasma and artificial tears administered 2-4 times daily.


Watery eyes


University Sport South Africa (USSA) will be represented by four women at the 2010 World University Championships in Szeged, Hungary in August 2010. The squad will be competing in the Women's Coxless Fours event, which is the women's showcase event at this regatta. Vision Optometrists are proud to be the eyecare and eyewear sponsor to this great team of woman. 

Seven students put themselves forward for selection into the Women's Coxless Four and after 4 intensive days of trials, the crew of Tara Bawden (University of Johannesburg), Naydene Smith (University of Johannesburg), Claudia Hazelwood (University of the Witwatersrand) and Kate Johnstone (University of Pretoria) were selected to represent University Sport South Africa at the 11th World University Rowing Championships.

The University of Johannesburg (UJ) held the majority of students in this crew and it was therefore also decided that UJ Coach, Alan Nooy be appointed as coach of the crew; another deciding factor for Alan's selection is that he has already shown his talent at preparing rowers for the international stage by coaching Peter Lambert for the 2009 World Championships held in Poland. Melissa Chaney, also of the University of Johannesburg, is the Team Manager.

The team departs on Saturday, 7 August 2010 and arrives in Szeged, on Sunday, 8 August 2010. The crew will spend Monday through Wednesday getting use to the rowing conditions and the surroundings. The regatta officially commences with heats on Friday, 13 August 2010 and the finals are rowed over Saturday, 14 August 2010 and Sunday, 15 August 2010.

Less 20% on Oakley eyewear. Ensure you protect your eyes against dryness by wearing a new pair of Oakley Rx or sunglass frames. Pop into our stores and spoil yourself with a new pair. This promotions runs from the 16th of August for a month and is applicable to all Oakley eyewear, whilst stocks last.


Useful articles this month
Dry Eye Syndrome
Dry eyes are a very common occurrence interfering with comfort and visual function and are more apparent in the winter season...
Optimum Nutrition for Your Eyes
Ocular nutrition and eye health is an important part of helping maintain our vision and eye health as we age...
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